Resource Library

Health Financing in Ghana: Willingness to Pay for Normal Delivery Benefits in a Community-Based Health Insurance Plan

Births attended by skilled birth attendants and/or those at medical facilities are significantly associated with better birth outcomes, including reduced maternal mortality. Nkoranza is a rural district in Ghana with a population estimated at 128,000 in 2000. The Catholic Diocese of Sunyani launched the Nkoranza Community Health Plan (NCHP) in 1992. The plan was a response to the inability of district residents to pay for their health care, especially hospitalization, following the introduction of the cash-and-carry system into Ghana's health sector in the late 1980s. For some time, women in Nkoranza have sought to have normal deliveries covered by the plan. The Sunyani Diocese health system and hospital administrators were interested in expanding the plan's benefits package to include this service. They were unsure, however, of the impact of such a benefit on premiums and enrollment and were concerned about creating demand for inpatient deliveries that could not be met in the present facility. The Commercial Market Strategies project provided technical assistance to NCHP to assess the cost of introducing a normal birth delivery benefit and the willingness of consumers to pay for the increased premium to cover the expanded benefits package. Ninety-six percent of currently enrolled women surveyed in Ghana's Nkoranza district were willing to pay higher insurance premiums for expanded birth-delivery benefits.