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.
Evaluation of the delivery fee exemption policy in Ghana: Population estimates of changes in delivery service utilization in two regions.