Ameyaw Edward Kwabena, Kofinti Raymond Elikplim, Appiah Francis
Department of Population and Health, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Economics, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Ghana.
Health Econ Rev. 2017 Dec;7(1):16. doi: 10.1186/s13561-017-0152-8. Epub 2017 Apr 26.
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.
To examine the relationship between National Health Insurance and maternal healthcare utilisation across three main wealth quintiles (Poor, Middle and Rich).
The study employed data from the 2014 Ghana Demographic and Health Survey. Both descriptive analysis and binary logistic regression were conducted.
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.
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.
本研究的背景是，尽管加纳的孕产妇死亡率下降了49%，但情况仍然严峻，2011年至2015年期间平均每10万例活产中有319例孕产妇死亡。
研究国家健康保险与三个主要财富五分位数（贫困、中等和富裕）的孕产妇医疗保健利用之间的关系。
该研究采用了2014年加纳人口与健康调查的数据。进行了描述性分析和二元逻辑回归分析。
从描述性分析来看，富裕女性的产前检查率和在医疗机构分娩的比例较高，分别为96.5%和95.6%。然而，二元逻辑回归结果显示，拥有国家健康保险的贫困女性进行至少四次产前检查的可能性比中等财富五分位数的女性（5%，置信区间=2.12-4.76）和富裕女性（2%，置信区间=1.14-4.14）高7%（置信区间=1.76-2.87）。同样，拥有国家健康保险的贫困女性在医疗机构分娩的可能性比中等和富裕财富五分位数的女性高14%（置信区间=1.42-2.13）。
该研究证实了国家健康保险计划在加纳有利于穷人的说法。由于贫困在加纳主要是农村现象，卫生部应将农村地区的妇女作为目标，让她们加入国家健康保险，以提高孕产妇医疗保健的利用率。
