Ghana's national health insurance scheme in the context of the health MDGs : an empirical evaluation using propensity score matching

In 2003 the Government of Ghana established a National Health Insurance Scheme (NHIS) to improve health care access for Ghanaians and eventually replace the cash-and-carry system. This study evaluates the NHIS to determine whether it is fulfilling its purpose in the context of the Millennium Development Goals #4 and #5 which deal with the health of women and children. We use Propensity Score Matching techniques to balance the relevant background characteristics in our survey data and compare health outcomes of recent mothers who are enrolled in the NHIS with those who are not. Our findings suggest that NHIS women are more likely to receive prenatal care, deliver at a hospital, have their deliveries attended by trained health professionals, and experience less birth complications. We conclude that NHIS is an effective tool for increasing health care access, and improving health outcomes. -- Health insurance ; prenatal care ; Millennium Development Goals ; Propensity Score Matching