Health Insurance Coverage, Socioeconomic Status of Women, and Antenatal Care Utilization in Ghana

Abstract

Promoting antenatal care (ANC) utilization is one of the key drivers of the Safe Motherhood Initiative aimed at improving maternal health in low-income countries. The study sought to examine the effects of health insurance coverage and socioeconomic status of women on antenatal care utilization in Ghana. The study used cross-sectional data from the 2014 Ghana Demographic and Health Survey (GDHS). Negative binomial and binary logistic regression models were applied. The results showed that women covered with national health insurance were more likely to have more antenatal care visits and adequate and timely antenatal care. The results showed that having an advanced age, attaining secondary or higher-level education, being employed, being in the richest wealth quintile, and having an active national health insurance subscription during pregnancy significantly predicted ANC utilization. The study suggests that if interventions aimed at reducing the burden of prenatal care are not implemented, coupled with women’s economic empowerment to cater to the cost of prenatal care, the benefits of the ANC associated with early and adequate ANC services may not optimally be achieved. That aside, ANC services in Ghana are technically ‘free’ through the user-fee exemption policy under the NHIS. However, socioeconomic factors still largely determine women’s decisions to utilize maternal health services.