National health insurance scheme enrolment and antenatal care among women in Ghana: is there any relationship?
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
The NHIS should be strengthened and resourced as it may act as an important tool for increasing antenatal care attendance among women in Ghana.
Department of Geography, University of Western Ontario, London, ON, Canada.
Jenna
J
Dixon
Eric Y
EY
Tenkorang
Isaac N
IN
Luginaah
Vincent Z
VZ
Kuuire
Godfred O
GO
Boateng
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics / Q000706:statistics & numerical data*; D057216:Propensity Score; D012423:Rural Health; D012959:Socioeconomic Factors; D014186:Transportation / Q000191:economics; D014504:Urban Health; D055815:Young Adult
Ghana; antenatal care; health insurance; maternal; women