Hubert Amu

Health insurance subscription among women in reproductive age in Ghana: do socio-demographics matter?

BackgroundPremised that health insurance schemes in Africa have only been introduced recently and continue evolving, various concerns have been raised regarding their effectiveness in improving utilisation of orthodox health care and the reduction of out-of-pocket expenditures for their population, particularly women.ObjectiveTo examine the effects of socio-demographics on health insurance subscription among women in Ghana.MethodsThe study draws on the 2014 Ghana Demographic and Health Survey. Bivariate descriptive analysis and binary logistic regression were used to analyse the data.ResultsWealth status, age, religion, birth parity, marriage and ecological zone were found to have significantly predicted health insurance subscription among women in reproductive age in Ghana. Urban dwellers, women who are nulliparous, those with no or low levels of education, African traditionalists and the poor were those who largely did not subscribe to the scheme.ConclusionThe findings underscore the need for the National Health Insurance Authority to carry out more education in association with the National Commission for Civic Education and the Information Services Department to recruit more urban dwellers, nulliparous women, those with no or low levels of education, African traditionalists and the poor unto the scheme.

Barriers and motivations for health insurance subscription in Cape Coast, Ghana: a qualitative study

BackgroundOne of the main objectives of the Ghana National Health Insurance Scheme, at its establishment in 2003, was to ease financial burden of the full cost recovery policy, particularly on the poor. However, currently, majority of the scheme’s subscribers are individuals in the upper wealth quintile, as the poor in society rather have not subscribed. We explored the motivational factors as well as the barriers to health insurance subscription in the Cape Coast Metropolis of Ghana.MethodsThis study collected qualitative data from 30 purposively selected subscribers and non-subscribers to the National Health Insurance Scheme using an in-depth interview guide.ResultsMajor motivational factors identified were; affordable health insurance premium, access to free drugs, and social security against unforeseen health challenges. Encouragement by friends, family members, and colleagues, was also found to motivate subscription to the health insurance. The major barriers to health insurance subscription included; long queues and waiting time, perceived poor quality of drugs, and negative attitude of service providers both at the healthcare facilities and the health insurance office. The study underscores the need for the National Health Insurance Authority to conduct intensive education to change the negative perception people have regarding the quality of health insurance drugs. Efforts should also be made to reduce the waiting time in accessing healthcare with the National Health Insurance Scheme card. This would motivate more people to subscribe or renew their membership.ConclusionsThe implication of barriers found is that people may not subscribe to the scheme in subsequent years. This would, therefore, consequently defeat the objective of achieving universal healthcare coverage with the scheme.

Preparedness of health care professionals in preventing maternal mortality at a public health facility in Ghana: a qualitative study

BackgroundPreparedness of health care professionals for emergency situations is quite indispensable in quality health care; yet, information barely exists on the preparedness of health care professionals for emergency cases in health facilities in Ghana. This study sought to assess the preparedness of health professionals in preventing maternal mortality cases at a public health facility in Ghana.MethodsThis is a qualitative study that used purposive and convenient sampling techniques to recruit 12 health care professionals for in-depth interviews. The interviews were tape-recorded, transcribed and the results presented in themes verbatim.ResultsThe results show that health care professionals at the hospital were ill-equipped to effectively handle maternal mortality cases in the municipality. As such, inadequate staff size and dearth of essential logistics militate against the preparedness of health care professionals in curbing maternal mortality.ConclusionsMore health care professionals and essential logistics should, therefore, be provided by the Ghana Health Service to augment the existing ones.

What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

Background. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partners education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women. Conclusions. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partners education, parity, and distance in their planning regarding delivery care in rural Ghana.

Trends in contraceptive practices among women in reproductive age at a health facility in Ghana: 2011–2013

BackgroundThere is dearth of information on contraceptive use among women in reproductive age in Ghana over time. This study sought to examine the trends in contraceptive practices among women in reproductive age in a health facility in Ghana in terms of acceptor rates, age at first reporting and couple-years of protection.MethodsThe contraceptive data of women were extracted from the registry of a health facility for a three-year period from 2011 to 2013. Graphs and tables were used to present the trends in the use of various contraceptive methods for the study period.ResultsDepot Medroxyprogesterone Acetate (Depo-Provera) was the most accepted contraceptive method as well as the most protective method against unwanted pregnancies for the three-year period. However, male condom, estradiol valerate/norethindrone enanthate (Norigynon) and pills were the lowest among all the contraceptives used by women for the study period in terms of acceptance, while intra-uterine device had the lowest couple-years of protection.ConclusionsSome contraceptive methods have been consistently under-utilised by women in the catchment area and needed to be promoted to improve upon the contraceptive use rate.

Determinants of Skilled Birth Attendance in the Northern Parts of Ghana

Background. An integral part of the Sustainable Development Goal three is to ensure universal access to sexual and reproductive healthcare services which include skilled delivery by the year 2030. We examined the determinants of skilled delivery among women in the Northern part of Ghana. Methods. The paper made use of data from the Demographic and Health Survey. Women from the Northern part of Ghana were included in the analysis. Bivariate descriptive analyses coupled with binary logistic regression estimation technique were used to analyse the data. Results. Region of residence, age, household wealth, education, distance to a health facility, religion, parity, partner’s education, and getting money for treatment were identified as the determinants of skilled delivery. While the probability of having a skilled delivery was higher in the Upper East Region, it was lower in the Northern and Upper West Regions compared to the Brong Ahafo Region. Conclusion. Our findings call for more attention from the Ghana Health Service and the Ministry of Health in addressing the skilled delivery gaps among women particularly in the Northern and Upper West Regions in ensuring attainment of the Sustainable Development Goal target related to reproductive health care accessibility for all by the year 2030.