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A geospatial analysis of the impacts of maternity care fee payment policies on the uptake of skilled birth care in Ghana

A geospatial analysis of the impacts of maternity care fee payment policies on the uptake of skilled birth care in Ghana
A geospatial analysis of the impacts of maternity care fee payment policies on the uptake of skilled birth care in Ghana
Background: Many low and middle income countries have initiated maternity fee exemption and removal policies to promote use of skilled maternity care. After two and a half decades of these policies, uptake of skilled birth care remains low and inequalities continue to exist in many low and middle income countries. This study uses 2 decades of birth histories data to examine four maternity fee paying policies enacted in Ghana over the past 3 decades and their geospatial impacts on uptake of skilled delivery care.

Methods: Bayesian Geoadditive Semiparametric regression techniques were applied on four conservative rounds of Demographic and Health Surveys in Ghana to examine the extent of geospatial dependence in skilled birth care use at the district level and their associative relationships with maternity fee paying policies focusing on the temporal trends when the policies were functional.

Results: The results show that at the country-level, the policies had a positive influence on use of skilled delivery care; however their impacts on reducing between-district inequalities were trivial.

Conclusions: The findings suggest that targeted interventions at the district level are essential to strengthen maternal health programmes in Ghana.
maternal health, geospatial dependence in skilled delivery care, bayesian geoadditive models, demographic and health survey, ghana
1471-2393
1-13
Amoako Johnson, F.
e348fd15-9fe2-472f-a701-2980b8cec4d5
Amoako Johnson, F.
e348fd15-9fe2-472f-a701-2980b8cec4d5

Amoako Johnson, F. (2016) A geospatial analysis of the impacts of maternity care fee payment policies on the uptake of skilled birth care in Ghana. BMC Pregnancy and Childbirth, 16 (41), 1-13. (doi:10.1186/s12884-016-0833-z).

Record type: Article

Abstract

Background: Many low and middle income countries have initiated maternity fee exemption and removal policies to promote use of skilled maternity care. After two and a half decades of these policies, uptake of skilled birth care remains low and inequalities continue to exist in many low and middle income countries. This study uses 2 decades of birth histories data to examine four maternity fee paying policies enacted in Ghana over the past 3 decades and their geospatial impacts on uptake of skilled delivery care.

Methods: Bayesian Geoadditive Semiparametric regression techniques were applied on four conservative rounds of Demographic and Health Surveys in Ghana to examine the extent of geospatial dependence in skilled birth care use at the district level and their associative relationships with maternity fee paying policies focusing on the temporal trends when the policies were functional.

Results: The results show that at the country-level, the policies had a positive influence on use of skilled delivery care; however their impacts on reducing between-district inequalities were trivial.

Conclusions: The findings suggest that targeted interventions at the district level are essential to strengthen maternal health programmes in Ghana.

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Accepted/In Press date: 24 February 2016
Published date: 29 February 2016
Keywords: maternal health, geospatial dependence in skilled delivery care, bayesian geoadditive models, demographic and health survey, ghana
Organisations: Social Statistics & Demography

Identifiers

Local EPrints ID: 390422
URI: http://eprints.soton.ac.uk/id/eprint/390422
ISSN: 1471-2393
PURE UUID: 870bc810-5921-48a4-9287-751fbd9edbf4

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Date deposited: 01 Apr 2016 13:38
Last modified: 02 Dec 2019 20:19

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Author: F. Amoako Johnson

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