Socio-economic differences in cost of pregnancy-related health services in the peri-urban Accra, Ghana

J Public Health (Oxf). 2015 Sep;37(3):540-6. doi: 10.1093/pubmed/fdu072. Epub 2014 Oct 3.

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.

Keywords: economics; health services; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Ghana / epidemiology
  • Health Care Costs / statistics & numerical data*
  • Humans
  • Maternal Health Services / economics*
  • Maternal Health Services / statistics & numerical data
  • National Health Programs / economics
  • National Health Programs / statistics & numerical data
  • Pregnancy
  • Socioeconomic Factors
  • Urban Population / statistics & numerical data
  • Young Adult