Serchim Clement Kwame, Opoku Daniel, Bonney Richard Abeiku, Safo Kwame Sarkodie, Amegble Samuel Kwabla, Kodi Nathaniel Nii Korley, Mensah Kofi Akohene
School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Nursing and Midwifery Training College, Fomena-Adansi, Ghana.
BMC Health Serv Res. 2025 May 13;25(1):685. doi: 10.1186/s12913-025-12861-z.
In 2008, the Government of Ghana implemented a free maternal healthcare policy through the National Health Insurance Scheme to increase financial access to maternity care services and reduce perinatal and maternal mortality rates. As an area with less evidence, this study sought to explore healthcare providers' perceptions of the free maternal healthcare policy for quality healthcare delivery in Kwadaso Municipality, Ghana.
This study adopted a qualitative approach using an exploratory study design. Fifteen participants were purposefully included. Key informant interviews (KIIs) were conducted among administrators, doctors, physician assistants or nurses in charge, nurse managers, and midwives in charge of maternity units of the selected health facilities. The qualitative data were analyzed thematically.
The study identified four key themes in the implementation of the free maternal healthcare policy: (1) Service coverage, characterized by broad inclusivity but marred by persistent co-payments for some services; (2) Human and financial resources, marked by adequate staffing alongside financial constraints affecting service delivery; (3) Facilities and equipment, highlighting spatial limitations and equipment shortages; and (4) Process of care and safety, demonstrating protocol adherence despite challenges in postnatal care follow-up. Overall, the policy was associated with notable reductions in maternal and neonatal morbidity and mortality.
The free maternal healthcare policy improves access and outcomes but faces challenges in funding, infrastructure, and postnatal care. Addressing these gaps is vital for sustainable maternal healthcare improvements in Ghana.
2008年，加纳政府通过国家医疗保险计划实施了免费孕产妇医疗保健政策，以增加获得孕产妇护理服务的经济机会，并降低围产期和孕产妇死亡率。作为一个证据较少的领域，本研究旨在探讨医疗服务提供者对加纳夸达索市免费孕产妇医疗保健政策的看法，以实现高质量的医疗服务提供。
本研究采用定性方法，采用探索性研究设计。有目的地纳入了15名参与者。在选定卫生设施的管理人员、医生、负责的医师助理或护士、护士长以及负责产科病房的助产士中进行了关键信息访谈（KIIs）。对定性数据进行了主题分析。
该研究确定了免费孕产妇医疗保健政策实施中的四个关键主题：（1）服务覆盖范围，其特点是包容性广泛，但一些服务仍存在持续的自付费用问题；（2）人力和财力资源，其特点是人员配备充足，但财政限制影响了服务提供；（3）设施和设备，突出了空间限制和设备短缺问题；（4）护理和安全流程，尽管产后护理随访存在挑战，但仍表明遵守了规程。总体而言，该政策与孕产妇和新生儿发病率及死亡率的显著降低相关。
免费孕产妇医疗保健政策改善了可及性和结果，但在资金、基础设施和产后护理方面面临挑战。解决这些差距对于加纳可持续改善孕产妇医疗保健至关重要。
