Adawudu Emefa Awo, Aidam Kizito, Oduro Elisha, Miezah Dennis, Vorderstrasse Allison
Elaine Marieb College of Nursing, University of Massachusetts, Amherst, MA, USA.
Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Health Serv Insights. 2024 Sep 3;17:11786329241274481. doi: 10.1177/11786329241274481. eCollection 2024.
Ghana was the first sub-Saharan country to implement a National Health Insurance Scheme (NHIS). In furtherance of the nation's Universal Health Coverage (UHC) goals, in 2008, Ghana actualized plans for a Free Maternal Healthcare Policy (FMHCP) under the NHIS. The FMHCP was aimed at removing financial barriers to accessing maternal and neonatal health services. This scoping review was conducted to map out the literature on the effects of the FMHCP under the NHIS on the utilization of maternal and infant health care in Ghana. Six databases including CINAHL, PubMed, Sage Journals, Academic Search Premier, Science Direct, and Medline were searched in conducting this review with key terms. A total of 175 studies were retrieved after the search and finally, 23 articles were included in the study after various stages of elimination. The review followed the reporting guidelines stated in the Preferred Reporting Items for Systematic and Meta-analyses Extensions for Scoping Reviews (PRISMA-ScR). The results showed an overall increase in the utilization of antenatal care, facility-based delivery, and postnatal care services. However, certain systemic issues persist regarding access to maternal and infant healthcare. Socio-demographic inequalities such as maternal level of education, place of residence, and economic status likewise barriers such as the existence of out-of-pocket payments, long distance to health facilities, and poor distribution of resources in rural areas hindered the utilization of maternal and infant healthcare. The country faces significant work to eliminate existing barriers and inequalities to ensure that it achieves its UHC goals.
加纳是撒哈拉以南第一个实施国家健康保险计划（NHIS）的国家。为推动国家的全民健康覆盖（UHC）目标，2008年，加纳在国家健康保险计划下实现了免费孕产妇保健政策（FMHCP）的计划。免费孕产妇保健政策旨在消除获得孕产妇和新生儿保健服务的经济障碍。本次范围综述旨在梳理关于国家健康保险计划下的免费孕产妇保健政策对加纳孕产妇和婴儿保健利用情况影响的文献。在进行本次综述时，使用关键词搜索了包括护理学与健康领域数据库（CINAHL）、医学期刊数据库（PubMed）、Sage期刊、学术搜索大全、科学Direct和医学在线数据库（Medline）在内的六个数据库。搜索后共检索到175项研究，最终，经过各个筛选阶段，23篇文章被纳入本研究。该综述遵循了系统评价和Meta分析扩展的范围综述首选报告项目（PRISMA-ScR）中规定的报告指南。结果显示，产前保健、机构分娩和产后保健服务的利用率总体有所提高。然而，但在获得孕产妇和婴儿保健方面，某些系统性问题仍然存在。社会人口不平等现象，如孕产妇教育水平、居住地点和经济状况，以及自付费用的存在、到医疗机构的距离较远和农村地区资源分配不均等障碍，阻碍了孕产妇和婴儿保健的利用。该国在消除现有障碍和不平等现象方面面临着重大工作，以确保实现其全民健康覆盖目标。
