Impact of Free Delivery Care on Health Facility Delivery and Insurance Coverage in Ghana's Brong Ahafo Region
Impact of Free Delivery Care on Health Facility Delivery and Insurance Coverage in Ghana's Brong Ahafo Region
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DOI：
10.1371/journal.pone.0049430
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发表时间：
2012-11-16
期刊：
影响因子：
3.7
通讯作者：
Kirkwood, Betty R.
中科院分区：
文献类型：
--
作者：
Dzakpasu, Susie;Soremekun, Seyi;Kirkwood, Betty R.
背景：包括加纳在内的许多撒哈拉以南国家都出台了向孕妇提供免费医疗的政策。这些政策的影响，特别是对穷人获得保健服务的影响，尚未采用严格的方法进行评估，因此，为这些政策辩护的经验基础薄弱。在加纳，最近的一份报告也对目前提供免费保健的机制----国家健康保险计划----提出了质疑。纵向监测数据从两个随机对照试验中进行的布朗阿哈福地区提供了一个独特的机会，以评估加纳的policy.Methods的影响：我们使用时间序列方法来评估加纳的2005年政策的影响免费分娩护理和2008年的政策免费国民健康保险孕妇。我们估计其对设施交付和保险覆盖面的影响，以及在控制时间趋势和季节性后，这些outcomes.Results的社会经济差异：设施交付一直在显着增加。2005年和2008年的政策与2.3%（p = 0.015）和7.5%（p = 0.015）的覆盖率显著跃升相关。
Background: Many sub-Saharan countries, including Ghana, have introduced policies to provide free medical care to pregnant women. The impact of these policies, particularly on access to health services among the poor, has not been evaluated using rigorous methods, and so the empirical basis for defending these policies is weak. In Ghana, a recent report also cast doubt on the current mechanism of delivering free care - the National Health Insurance Scheme. Longitudinal surveillance data from two randomized controlled trials conducted in the Brong Ahafo Region provided a unique opportunity to assess the impact of Ghana's policies.Methods: We used time-series methods to assess the impact of Ghana's 2005 policy on free delivery care and its 2008 policy on free national health insurance for pregnant women. We estimated their impacts on facility delivery and insurance coverage, and on socioeconomic differentials in these outcomes after controlling for temporal trends and seasonality.Results: Facility delivery has been increasing significantly over time. The 2005 and 2008 policies were associated with significant jumps in coverage of 2.3% (p = 0.015) and 7.5% (p