Department of Geography, University of Western Ontario, London, ON, Canada.
Trop Med Int Health. 2014 Jan;19(1):98-106. doi: 10.1111/tmi.12223. Epub 2013 Nov 13.
The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana.
Data were drawn from the Ghana Demographic and Health Survey, a nationally representative survey collected in 2008. The study used a cross-sectional design to examine the independent effects of NHIS enrolment on two dependent variables (frequency and timing of antenatal visits) among 1610 Ghanaian women. Negative binomial and logit models were fitted given that count and categorical variables were employed as outcome measures, respectively.
Regardless of socio-economic and demographic factors, women enrolled in the NHIS make more antenatal visits compared with those not enrolled; however, there was no statistical association with the timing of the crucial first visit. Women who are educated, living in urban areas and are wealthy were more likely to attend antenatal care than those living in rural areas, uneducated and from poorer households.
The NHIS should be strengthened and resourced as it may act as an important tool for increasing antenatal care attendance among women in Ghana.
本研究旨在探讨加纳的全国健康保险计划(NHIS)参保是否会影响女性利用产前护理的可能性和时间。
数据来自 2008 年进行的具有全国代表性的加纳人口与健康调查。该研究采用横断面设计,考察了 NHIS 参保对 1610 名加纳女性的两个因变量(产前检查的频率和时间)的独立影响。由于计数和分类变量分别作为因变量,因此拟合了负二项和对数模型。
无论社会经济和人口因素如何,参加 NHIS 的女性进行的产前检查次数多于未参加的女性;然而,这与第一次关键检查的时间没有统计学关联。受过教育、居住在城市地区和富裕的女性比居住在农村地区、未受过教育和来自贫困家庭的女性更有可能接受产前护理。
应加强和提供 NHIS,因为它可能是增加加纳女性产前护理就诊率的重要工具。