Objectives: To determine changes in the proportion of deliveries at health facilities and the proportion attended by health professionals after delivery fee exemption implementation.
Design: Pre and post intervention implementation cluster-sampled household survey. Setting: Central and Volta regions of Ghana. Participants: Women who had delivered in these regions during the fee exemption policy and an equivalent period of time prior to it.
Main outcome measures: Place of delivery and person attending.
Results: After fee exemption implementation the likelihood of delivering in a health facility increased significantly in Central (OR 1.83, p
Conclusions: After the implementation of fee exemption the proportion of deliveries in health facilities increased in both regions. Although changes cannot be directly attributed to delivery fee exemption, results demonstrating that the greatest increases in facility-based deliveries occurred among the poorest and least educated women are consistent with the expectation that the policy would particularly benefit women with the greatest financial barrier to health care and at the greatest risk of maternal mortality.
Penfold, S.; Harrison, E.; Bell, J.; Fitzmaurice, A. Evaluation of the delivery fee exemption policy in Ghana: Population estimates of changes in delivery service utilization in two regions. Ghana medical journal (2007) 41 (3) 100-109.