Ghana's National Health Insurance Scheme in the context of the health MDGs: an empirical evaluation using propensity score matching

Health Econ. 2010 Sep;19 Suppl:95-106. doi: 10.1002/hec.1633.


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 an important aspect of its promise 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 indicators 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 improving health outcomes among those who are covered, which should encourage the Ghanaian government to promote further enrollment, in particular among the poor.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Delivery, Obstetric / statistics & numerical data
  • Female
  • Ghana
  • Health Services Accessibility
  • Humans
  • Insurance, Health / economics*
  • Maternal Health Services / economics
  • Maternal Health Services / standards*
  • Middle Aged
  • National Health Programs / economics*
  • Pregnancy
  • Pregnancy Complications / prevention & control
  • Propensity Score
  • Socioeconomic Factors
  • Time Factors
  • Young Adult