Assessing the impact of Ghana‟s free maternal health care policy on maternal mortality: a retrospective study in St. Francis Xavier hospital

Abstract

Access to quality maternal health care services before, during and after childbirth remains critical in the efforts by world leaders towards reducing maternal mortality. Whilst an estimated 90 percent of all births in most developed countries benefit from the services of trained healthcare professionals, less than half of births in developing countries (which accounts for 99 percent of the world‟s maternal deaths), benefit from trained maternal care service providers. Ghana, a middle-lower income country among other efforts targeted at reducing maternal mortality, implemented the free maternal health care policy initiative in July 2008 eliminating the barrier of financial access to quality maternal health care services. Twenty years on after the successful implementation of this policy initiative, this study seeks to examine the impact of the free maternal health care policy on maternal mortality in St. Francis Xavier Hospital in the Assin Foso Municipality. The study was a descriptive study which made use of secondary quantitative data collected from the biostatistics unit and maternal records from the maternity unit from 1997 – 2018. The free maternal care policy among other interventions, contributed to a reduction in maternal mortality ratio (pre and post policy MMR mean = 1332.68 /100000LB and 311/ 100000LB respectively). ANC coverage and distribution of midwives and registered nurses had a statistically significant impact on maternal mortality ratio (p = 0.001, 0.036 and 0.048). PNC coverage and institutional deliveries however had a statistically insignificant impact on maternal mortality ratio (p = 0.883, 0.872). The free maternal care policy over the years, has played a role in the decline of Ghana‟s national maternal mortality ratio and should be maintained and strengthened with the equipping of health facilities with trained health staff and logistics.