title: Health insurance determines antenatal, delivery and postnatal care utilisation: evidence from the Ghana Demographic and Health Surveillance data.
abstract: OBJECTIVE
  This study aims to evaluate the effect of maternal health insurance status on the utilisation of antenatal, skilled delivery and postnatal care.
  
  
  METHODS
  A population-based cross-sectional study.
  
  
  METHODS
  We utilised the 2008 Demographic and Health Survey data of Ghana, which included 2987 women who provided information on maternal health insurance status.
  
  
  METHODS
  Utilisation of antenatal, skilled delivery and postnatal care.
  
  
  METHODS
  Multivariable logistic regression was applied to determine the independent association between maternal health insurance and utilisation of antenatal, skilled delivery and postnatal care.
  
  
  RESULTS
  After adjusting for socioeconomic, demographic and obstetric factors, we observed that among insured women the likelihood of having antenatal care increased by 96% (OR 1.96; 95% CI 1.52 to 2.52; p value<0.001) and of skilled delivery by 129% (OR 2.29; 95% CI 1.92 to 2.74; p value<0.001), while postnatal care among insured women increased by 61% (OR 1.61; 95% CI 1.17 to 2.21; p value<0.01).
  
  
  CONCLUSIONS
  This study demonstrated that maternal health insurance status plays a significant role in the uptake of the maternal, neonatal and child health continuum of care service.
authors.affiliation: Julius Global Health, Julius Centrum for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Joyce L
authors.initials: JL
authors.lastname: Browne
authors.affiliation: Julius Global Health, Julius Centrum for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gbenga A
authors.initials: GA
authors.lastname: Kayode
authors.affiliation: Noguchi Memorial Institute of Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Daniel
authors.initials: D
authors.lastname: Arhinful
authors.affiliation: Julius Global Health, Julius Centrum for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Samuel A J
authors.initials: SA
authors.lastname: Fidder
authors.affiliation: Julius Global Health, Julius Centrum for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Diederick E
authors.initials: DE
authors.lastname: Grobbee
authors.affiliation: Julius Global Health, Julius Centrum for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Klipstein-Grobusch
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000191:economics*; D003710:Demography; D005260:Female; D005869:Ghana; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011181:Postnatal Care / Q000191:economics*; D011247:Pregnancy; D011295:Prenatal Care / Q000191:economics*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: antenatal care; health insurance; postnatal care; skilled delivery