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Levels and Determinants of Low Birth Weight in Infants Delivered Under the National Health Insurance Scheme in Northern Ghana

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Abstract

This research determined the levels and odds ratios for low birth weight (LBW) infants delivered under the National Health Insurance Scheme (NHIS) compared to LBW infants delivered under the previous “Cash and Carry” system in Northern Ghana. Birth records of infants delivered before and after implementation of the NHIS in Northern Ghana were examined. Records of each day’s births during the identified periods were abstracted. Days with fewer or no births were accommodated by oversampling from days before or after. Chi squared tests of independence were used to examine the bivariate association between categorical independent variables and LBW. Multiple logistic regression models were used to examine the relationships among selected variables for mothers and infants and the odds ratios for LBW. Infants delivered under NHIS had lower rates of LBW (16.8 %) compared to infants born under Cash and Carry (23.3 %). Mothers who delivered under NHIS were significantly less likely to have infants at LBW (unadjusted OR 0.65; 95 % CI 0.49, 0.86). The rate of LBW among infants delivered under NHIS is significantly lower than among infants delivered under Cash and Carry. The rate of LBW under Cash and Carry in 2000 fell by 27 % in relation to the NHIS in 2010. These findings confirm that the NHIS, which gives pregnant women in Northern Ghana four antenatal visits and access to skilled health professionals for delivery at no cost to the mother, significantly improved birth weight outcomes.

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References

  1. Chang, S. C., O’Brien, K. O., Nathanson, M. S., Mancini, J., & Whitter, F. R. (2003). Characteristics and risk factors for adverse birth outcomes in pregnant black adolescents. The Journal of Pediatrics., 143, 250–257.

    Article  PubMed  Google Scholar 

  2. World Health Organization (2008). Low birthweight: Newborns. WHO-Statistical Information System (WHOSIS). Retrieved from http://www.who.int/whosis/indicators/compendium/2008/2bwn/en/index.html (18 Oct 2011).

  3. United Nations Children’s Fund and World Health Organization. (2004). Low birthweight: Country, regional and global estimates. New York: UNICEF.

    Google Scholar 

  4. Kramer, M. S. (1987). Determinants of low birth weight: Methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65(5), 663–737.

    PubMed Central  CAS  PubMed  Google Scholar 

  5. Kramer, M. S., Sequin, L., Lydon, J., & Goulet, L. (2000). Socio-economic disparities in pregnancy outcome: Why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14(3), 194–210.

    Article  CAS  PubMed  Google Scholar 

  6. Nepomnyaschy, L. (2009). Socioeconomic gradients in infant health across race and ethnicity. Maternal and Child Health Journal, 13(6), 720–731.

    Article  PubMed  Google Scholar 

  7. Chuku, S. N. (2008). Low birth weight in Nigeria: Does antenatal care matter? Master’s Thesis. Institute of Social Studies, The Hague, Netherlands.

  8. United Nations (2002). A World Fit for Children. UN General Assembly Special Resolution Document # A/RES/S-27/2. New York, NY.

  9. Ezeaka, V., Eroha, E., & Egri-Okwaji, W. T. (2003). Maternal socio-biological factors associated with low birth weight in Lagos, Nigeria. Nigerian Quarterly Journal of Hospital Medicine, 13, 1–2.

    Google Scholar 

  10. Klufio, C. A., Lassey, A. T., Annan, B. D., & Wilson, J. B. (2001). Birthweight distribution at Korle-Bu Teaching Hospital, Ghana. East African Medical Journal, 78(8).

  11. Zeleke, B. M., Zelalem, M., & Mohammed, N. (2012). Incidence and correlates of low birth weight at a referral hospital in Northwest Ethiopia. Pan African Medical Journal, 12(4). Accessed from. http://www.panafrican-med-journal.com/content/article/12/4/full/ (3 March 2013).

  12. Andersson, R., & Bergstrom, S. (1997). Maternal nutrition and socio-economic status as determinants of birthweight in chronically malnourished African women. Tropical Medicine & International Health, 2(11), 1080–1087.

    Article  CAS  Google Scholar 

  13. Laar, A. K., Ampofo, W., Tuakli, J. M., Norgbe, G. K., & Quakyi, I. A. (2010). Preterm delivery and low birth weight among neonates born to HIV-positive and HIV-negative Ghanaian women. Journal of Public Health and Epidemiology, 2(9), 224–237.

    Google Scholar 

  14. Oduro, A. R., Ansah, P., Hodgson, A., Afful, T. M., Baiden, F., Adongo, P., et al. (2006). Trends in the prevalence of female genital mutilation and its effect on delivery outcomes in the Kassena-Nankana District of Northern Ghana. Ghana Medical Journal, 40(3), 87–92.

    PubMed Central  PubMed  Google Scholar 

  15. Ghana Health Service (2009). The health sector in Ghana: Facts and figures. Annual Report. Accra, Ghana.

  16. Horton, R. (2001). Ghana: Defining the African challenge. The Lancet, 358, 2141–2149.

    Article  CAS  Google Scholar 

  17. Mills, A. (1998). Health policy reforms and their impact on the practice of tropical medicine. British Medical Bulletin, 54(2), 503–513.

    Article  CAS  PubMed  Google Scholar 

  18. Mensah, J., & Oppong, J. R. ((2009)). Maternity protections and health insurance in Africa: Comparative overview of Ghana, Kenya, Uganda and Tanzania. Geneva: Working Paper—Social Security Department, ILO.

    Google Scholar 

  19. Witter, S., Adjei, S., Amar-Klemesu, M., & Graham, W. (2009). Providing free maternal health care: Ten lessons from an evaluation of the national delivery exemption policy in Ghana. Global Health Action,. doi:10.3402/gha.v2i0.1881.

    PubMed Central  PubMed  Google Scholar 

  20. Ghana Statistical Service. (2008). Ghana living standards survey: Report of the fifth round (GLSS 5). Ghana: Accra.

    Google Scholar 

  21. Badasu, D. M. (2004). Implementation of Ghana’s health user fee policy and the exemption of the poor. African Population Studies (Supplement A), 19, 285–302.

    Google Scholar 

  22. Heyen-Perschon, J. (2005). Report on current situation in the health sector of Ghana and possible roles for appropriate transport technology and transport related communication interventions. Wohltof, Germany: ITDP-Europe/USAID Funded Document.

    Google Scholar 

  23. United Nations (2009). Ghana: Tamale City Profile. UN-HABITAT Publication Document # HS/1215/09E. Nairobi, Kenya.

  24. Mills, S., Williams, J. E., Adjuik, M., & Hodgson, A. (2008). Use of health professionals for delivery following the availability of free obstetric care in Northern Ghana. Maternal and Child Health Journal, 12, 509–518.

    Article  PubMed  Google Scholar 

  25. Sulzbach, S., Garshong, B., & Owusu-Banahene, G. (2005). Evaluating the Effects of the National Health Insurance Act in Ghana: Baseline Report. (Partners for Health Reformplus, No. TE 090). Bethesda, MD.

  26. Gumanga, S. K., Kolbila, D. Z., Gandau, B. B., Munkaila, A., Malechi, H., & Kyei-Aboagye, K. (2011). Trends in maternal mortality in Tamale Teaching Hospital, Ghana. Ghana Medical Journal, 45(3), 105–110.

    PubMed Central  CAS  PubMed  Google Scholar 

  27. Assefa, N. B., Berhane, Y., & Worku, A. (2012). Wealth status, mid upper arm circumference (MUAC) and antenatal care (ANC) are determinants for low birth weight in Kersa, Ethiopia. PLoS One, 7(6), e39957. doi:10.1371/journal.pone.0039957.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Khorshidi, M., Nooshirvanpour, P., & Najafi, S. (2013). Incidence of low birth weight in Mazandaran Province, Northern Iran. Oman Medical Journal, 28(1), 39–41. doi:10.5001/omj.2013.09.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Yadav, M., & Lee, N. (2013). Maternal factors in predicting low birth weight babies. Medical Journal of Malaysia, 68(1), 44–47.

    PubMed  Google Scholar 

  30. David, R. J., & Collins, R. W. (1997). Differing birth weight among infants of U.S.-born blacks, African-born blacks, and U.S.-born whites. Retrieved from. http://www.nejm.org/doi/pdf/10.1056/NEJM199710233371706 (9 July 2012).

  31. Coutinho, P. R., Cecatti, J. G., Surita, F.G., Costa, M. L., & Morais, S. S. (2011). Perinatal outcomes associated with low birth weight in a historical cohort. Reproductive Health, 8(18).

  32. Kogan, M., Alexander, G., Kotelchuck, M., MacDorman, M., Buekens, P., & Papiernik, E. (2000). Trends in twin birth outcomes and prenatal care utilization in the United States, 1981–1997. JAMA, 284(3), 335–341. doi:10.1001/jama.284.3.335.

    Article  CAS  PubMed  Google Scholar 

  33. Onyiriuka, A. (2011). Low birthweight infants in twins gestation. Current Pediatric Research, 15(1), 37–41.

    Google Scholar 

  34. Morse, S. B., Wu, S. S., Ma, C., Ariet, M., Reskeck, M., & Roth, J. (2006). Racial and gender differences in the viability of extremely low birth weight infants: A population-based study. Pediatrics. Retrieved from http://pediatrics.aappublications.org/content/117/1/e106.full.html. doi:10.1542/peds.2005-1286 (10 April 2013).

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Acknowledgments

This research paper was derived from the lead author’s doctoral dissertation. The authors wish to acknowledge the following staff of the Tamale Teaching Hospital for their immense assistance during the data collection at the hospital: Dr. David Kolbila, Dr. Abass Adam, Nathaniel Akorli, Hadia Anas, and Bawa Danladi. We also wish to express our gratitude to Hussein Abdul-Rahman, Abdul-Jalil Mohammed, Abdul-Shattar Abdulai, Awal Alhassan, and Nurudeen Haruna for their assistance with the research and records abstraction.

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Authors and Affiliations

  1. School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana

    Abdallah Ibrahim

  2. School of Community Health and Policy, Morgan State University, Baltimore, MD, 21251, USA

    Anne Marie O’Keefe, Anita Hawkins & Mian Bazle Hossain

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  1. Abdallah Ibrahim
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  2. Anne Marie O’Keefe
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  3. Anita Hawkins
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  4. Mian Bazle Hossain
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Correspondence to Abdallah Ibrahim.

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Ibrahim, A., O’Keefe, A.M., Hawkins, A. et al. Levels and Determinants of Low Birth Weight in Infants Delivered Under the National Health Insurance Scheme in Northern Ghana. Matern Child Health J 19, 1230–1236 (2015). https://doi.org/10.1007/s10995-014-1628-3

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