Main Article Content
Abstract
Access to maternal healthcare services is crucial in reducing maternal mortality rates, particularly in rural areas of developing countries like Ghana. The National Health Insurance Scheme (NHIS) in Ghana offers free maternal healthcare services to registered pregnant women, yet uptake remains low in rural districts. Understanding the socio-demographic factors influencing NHIS registration among pregnant women is essential for targeted interventions to improve maternal health outcomes. A cross-sectional study was conducted in a rural district in Ghana, involving pregnant women accessing antenatal care services. A structured questionnaire was administered to collect socio-demographic data and information on NHIS registration status. Data were analyzed using descriptive statistics and logistic regression to determine factors associated with NHIS registration. The prevalence of National Health Insurance Scheme (NHIS) registration among the interviewed pregnant women was exceptionally high, reaching 98%, with approximately 87% maintaining active NHIS membership. NHIS registration exhibited statistically significant associations with marital status (χ2=7.20; p=0.01). Moreover, the maintenance of active NHIS membership was significantly associated with various demographic factors, including age (χ2=5.00; p=0.03), educational level (χ2=8.77; p=0.00), marital status (χ2=5.38; p=0.02), and gestational age of pregnancy (χ2=5.84; p=0.02). Married respondents demonstrated a twofold likelihood of NHIS registration compared to their unmarried counterparts (AOR=2.05, [95%CI (1.53-39.69)], p=0.013). Conversely, respondents aged over 19 years were 0.5 times less likely to maintain active NHIS membership compared to teenage respondents (AOR=0.95, [95%CI (1.00-6.667)], p=0.050). Notably, respondents in their 35th week of pregnancy exhibited twice the likelihood of maintaining active NHIS membership compared to those with pregnancies below 35 weeks (AOR=2.08, [95%CI (1.03-61.80)], p=0.047). Socio-demographic factors such as age, education level, marital status, and gestational age of pregnancy significantly influence active membership of National Health Insurance for free maternal healthcare among pregnant women in rural Ghana. These findings underscore the importance of targeted interventions to address socio-demographic disparities and enhance NHIS registration among pregnant women, ultimately improving maternal and child health outcomes in rural Ghana.
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References
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- Manyeh, A. K., Amu, A., Williams, J., & Gyapong, M. (2020). Factors associated with the timing of antenatal clinic attendance among first- time mothers in rural southern Ghana. BMC Pregnancy and Childbirth, 1–7.
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- Salari, P., Akweongo, P., Aikins, M., & Tediosi, F. (2019). Determinants of health insurance enrolment in Ghana : evidence from three national household surveys. Health Policy and Planning, 00(August), 582–594. https://doi.org/10.1093/heapol/czz079
- Thi-thuy-dung, N., Ha-duc, N., Quang-dinh, T., The-dung, N., Goyens, P., & Robert, A. (2017). Late Entry into Antenatal Care in a Southern Rural Area of Vietnam and Related Factors. Journal of Pregnancy and Child Health, 4(3), 1–9. https://doi.org/10.4172/2376-127X.1000334
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- Warri, D., & George, A. (2020). Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study. BMC Pregnancy and Childbirth, 20(1), 1–12. https://doi.org/10.1186/s12884-020-2746-0
References
Abdulai, I. A., Adams, A., & Studies, I. D. (2019). We are IntechOpen , the world’s leading publisher of Open Access books Built by scientists , for scientists. In Health-Care Access (pp. 1–19). https://doi.org/10.5772/intechopen.88982
Ali, S. A., Dero, A. A., Ali, S. A., & Ali, G. B. (2018). Factors affecting the utilization of antenatal care among pregnant women : A literature review. J Preg Neonatal Med, 2(2), 41–45.
Ameyaw, E. K., Ahinkorah, B. O., & Baatiema, L. (2021). Is the National Health Insurance Scheme helping pregnant women in accessing health services ? Analysis of the 2014 Ghana demographic and Health survey. BMC Pregnancy and Childbirth, 6, 1–8. https://doi.org/https://doi.org/10.1186/s12884-021-03651-6 (2021)
Banda, I., Michelo, C., & Hazemba, A. (2012). Factors Associated with late Antenatal Care Attendance in Selected Rural and Urban Communities of the Copperbelt Province of Zambia. Medical Journal of Zambia, 39(3), 29–36.
Bonfrer, I., Breebaart, L., & Poel, E. Van De. (2016). The Effects of Ghana’s National Health Insurance Scheme on Maternal and Infant Health Care Utilization. PLoS ONE, 11(11), 1–13. https://doi.org/10.1371/journal.pone.0165623
Dalinjong, P. A., Wang, A. Y., & Homer, C. S. E. (2017). The operations of the free maternal care policy and out-of-pocket payments during childbirth in rural Northern Ghana. Health Economics Review, 1–9. https://doi.org/10.1186/s13561-017-0180-4
Gebrekidan, K., & Worku, A. (2017). Factors associated with late ANC initiation among pregnant women in select public health centers of Addis Ababa, Ethiopia : unmatched case-control study design. Pragmatic and Observational Research, 223–230. https://www.dovepress.com/terms. php
Ghana Statistical Service, & Ghana Health Service. (2018). Ghana Demographic and Health Survey.
Gudayu, T. W. (2015). Proportion and Factors Associated with Late Antenatal Care Booking among Pregnant Mothers in Gondar Town , North West Ethiopia. African Journal of Reproductive Health, 19(2), 94–100.
Kotoh, A. M., & Boah, M. (2019). “No visible signs of pregnancy, no sickness, no antenatal care”: Initiation of antenatal care in a rural district in Northern Ghana. BMC Public Health, 19(1), 1–13. https://doi.org/10.1186/s12889-019-7400-2
Manyeh, A. K., Amu, A., Williams, J., & Gyapong, M. (2020). Factors associated with the timing of antenatal clinic attendance among first- time mothers in rural southern Ghana. BMC Pregnancy and Childbirth, 1–7.
Pell, C., Were, F., Afrah, N. A., Chatio, S., Manda-, L., Men, A., Hamel, M. J., Hodgson, A., Tagbor, H., Kalilani, L., Ouma, P., & Pool, R. (2013). Factors Affecting Antenatal Care Attendance : Results from Qualitative Studies in Ghana , Kenya and Malawi. 8(1). https://doi.org/10.1371/journal.pone.0053747
Salari, P., Akweongo, P., Aikins, M., & Tediosi, F. (2019). Determinants of health insurance enrolment in Ghana : evidence from three national household surveys. Health Policy and Planning, 00(August), 582–594. https://doi.org/10.1093/heapol/czz079
Thi-thuy-dung, N., Ha-duc, N., Quang-dinh, T., The-dung, N., Goyens, P., & Robert, A. (2017). Late Entry into Antenatal Care in a Southern Rural Area of Vietnam and Related Factors. Journal of Pregnancy and Child Health, 4(3), 1–9. https://doi.org/10.4172/2376-127X.1000334
Twum, P., Qi, J., Aurelie, K. K., Xu, L., & Kk, A. (2018). Effectiveness of a free maternal healthcare programme under the National Health Insurance Scheme on skilled care : evidence from a cross- sectional study in two districts in Ghana. BMJ Open, 1–8. https://doi.org/10.1136/bmjopen-2018-022614
Warri, D., & George, A. (2020). Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study. BMC Pregnancy and Childbirth, 20(1), 1–12. https://doi.org/10.1186/s12884-020-2746-0