National health insurance subscription and maternal healthcare utilisation across mothers’ wealth status in Ghana

Introduction: This study is against the backdrop that despite the forty-nine percent decline in Maternal Mortality Rate in Ghana, the situation still remains high averaging 319 per 100,000 live births between 2011 and 2015. Objective: To examine the relationship between National Health Insurance and maternal healthcare utilisation across three main wealth quintiles (Poor, Middle and Rich). 

Methods: The study employed data from the 2014 Ghana Demographic and Health Survey. Both descriptive analysis and binary logistic regression were conducted. 

Results: Descriptively, rich women had high antenatal attendance and health facility deliveries represented by 96.5% and 95.6% respectively. However, the binary logistic regression results revealed that poor women owning NHIS are 7% (CI = 1.76–2.87) more likely to make at least four antenatal care visits compared to women in the middle wealth quintile (5%, CI = 2.12–4.76) and rich women (2%, CI = 1.14–4.14). Similarly, poor women who owned the NHIS are 14% (CI = 1.42–2.13) likely to deliver in health facility than women in the middle and rich wealth quintile. 

Conclusion: The study has vindicated the claim that NHIS Scheme is pro-poor in Ghana. The Ministry of Health should target women in the rural area to be enrolled on the NHIS to improve maternal healthcare utilisation since poverty is principally a rural phenomenon in Ghana.