The study used two rounds of repeated cross-sectional surveys of the Ghana DHS 2008 and 2014 extracted from the website of Measure DHS upon completion of an online application process. The DHS data sets were considered appropriate as they offered baseline and end-line data on the FMCHP’s implementation and allowed for comparison. Variables m14 and m15 from the original data sets were used to construct two outcomes of interest: ante-natal care uptake and facility-level delivery utilization, respectively.
In practice, pregnant women have access to the FMHCP through free registration with the NHIS. Hence, women registered under the scheme were used as proxy variables and classified as having subscribed to the FMHCP and a binary variable of ‘1’ and ‘0’ constructed to represent benefiting from the ‘free’ policy or otherwise, respectively.
Multiple dependent variables were considered; antenatal care uptake, facility-level delivery utilization, stillbirth and perinatal death. All dependent variables are analyzed and reported individually.
Drawing on Mosley and Chen’s conceptual framework for studying child survival rates and other literature, maternal age, area of residence, parity, abortion history, employment status, education, wealth index, and region were adjusted for as independent covariates for precision. All models were built using a stepwise approach to determine relevant independent covariates based on their statistical significance.
Author(s) Details:
John Azaare
Department of Health Service, Policy Planning, Management and Economics, School of Public Health, University for Development Studies, Tamale, Ghana.
Kasim Abdulai
Department of Clinical Nutrition and Dietetics, Translational Nutrition Research Group, University of Cape Coast, Cape Coast, Ghana.
Robert Bagngmen Bio
College of Health and Well-Being, Kintampo, Ghana.
Recent Global Research Developments on the Impact of Maternal Health Policies on Perinatal Mortality
Federal Public Policy and Legislative Solutions:
The American Hospital Association (AHA) emphasizes maternal health as a top priority.
Legislative initiatives in the United States aim to address maternal mortality and reduce disparities.
The American Rescue Plan Act of 2021 allows states to extend Medicaid and CHIP eligibility for pregnant individuals to 12 months postpartum (instead of the previous 60 days).
The Black Maternal Health Momnibus Act seeks to prevent maternal mortality and severe morbidity, focusing on COVID-19 impact, behavioral health, workforce gaps, and social determinants of health [1] .
State-Level Solutions:
State policies play a crucial role in preventing infant and maternal mortality.
Factors contributing to maternal death include lack of consistent access to comprehensive care and persistent racial disparities.
State-level solutions include improving access, addressing social determinants of health, and promoting equity [2] .
Global Efforts and WHO Policies:
The World Health Organization (WHO) emphasizes maternal and perinatal death surveillance and response.
Policies include notification and review of maternal and neonatal deaths, aiming to improve care and reduce mortality [3] .
References
- American Hospital Association. (2021). Federal Public Policy and Legislative Solutions for Improving Maternal Health. Health. Issues Brief.
- Preventing Infant and Maternal Mortality: State Policy Options
https://www.ncsl.org/health/preventing-infant-and-maternal-mortality-state-policy-options - Maternal and Perinatal Death Surveillance and Response
https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/maternal-and-perinatal-death-surveillance-and-response
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