title: Socio-economic differences in cost of pregnancy-related health services in the peri-urban Accra, Ghana.
abstract: BACKGROUND
  Financial and physical barriers are known to limit access to maternal health services in developing countries. These limitations are often compounded by the low socio-economic status of women. This study examined socio-economic differences in health services cost incurred by pregnant women.
  
  
  METHODS
  A cross-sectional cost survey of 300 women who had delivered a live birth in the last 12 months was undertaken.
  
  
  RESULTS
  Majority of the women were aged between 20 and 39 years. About 63% of the women claimed they were registrants of the National Health Insurance Scheme (NHIS). However, only 64% of them provided valid NHIS identification cards. There were relatively more insured women in the rich quintiles (44%) compared with insured women in the poor quintiles (33%). Generally, women who were in the rich quintile incurred the highest average medical and non-medical costs, spent the highest time prior to service provision and lost the highest average incomes.
  
  
  CONCLUSIONS
  Women socio-economic differences play a critical role in access to health services. We recommend that awareness campaigns on the NHIS must be intensified. The Ghana Health Services through its Community-based Health Planning Service should carefully structure its home visits to cover education on pregnancy-related health services.
authors.affiliation: School of Public Health, College of Health Sciences, University of Ghana, PO Box LG13, Legon, Accra, Ghana.
authors.forename: M
authors.initials: M
authors.lastname: Aikins
authors.affiliation: School of Public Health, College of Health Sciences, University of Ghana, PO Box LG13, Legon, Accra, Ghana.
authors.forename: R
authors.initials: R
authors.lastname: Aryeetey
authors.affiliation: School of Public Health, College of Health Sciences, University of Ghana, PO Box LG13, Legon, Accra, Ghana.
authors.forename: P
authors.initials: P
authors.lastname: Dako-Gyeke
authors.affiliation: School of Public Health, College of Health Sciences, University of Ghana, PO Box LG13, Legon, Accra, Ghana.
authors.forename: P B
authors.initials: PB
authors.lastname: Adongo
authors.affiliation: School of Public Health, College of Health Sciences, University of Ghana, PO Box LG13, Legon, Accra, Ghana.
authors.forename: L
authors.initials: L
authors.lastname: McGough
mesh_terms: D000328:Adult; D005260:Female; D005869:Ghana / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008427:Maternal Health Services / Q000191:economics* / Q000706:statistics & numerical data; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data; D011247:Pregnancy; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: economics; health services; public health