Table 1 Historical timelines and mapping of maternal fee exemption policies in Ghana
Year | Policy instrument | Policy content |
|---|---|---|
1963 | Letter | ‘The Minister has directed that with immediate effect all antenatal services provided at Government hospitals should be for free’ |
1969 | Hospital Fees Decree. National Liberation Council Decree, 360 | ‘Except in respect of accommodation and maintenance fees specified in the Second Schedule to this Decree and subject to any other provision of this Decree, no fees shall be paid in a hospital by |
- (b) any persons in respect of antenatal care at a Clinic or Health Centre; | ||
- (c) any multiparous patient with a history of five or more pregnancies, or any patient referred to a maternity or other hospital from a clinic or health centre or any patient referred to any such hospital by a registered midwife or registered medical practitioner’ | ||
1971 | Hospital Fees Act, 387 | ‘No fees other than the fees prescribed for accommodation and maintenance shall be paid in respect of services rendered in a hospital to |
- (b) any person other than a non-resident alien in respect of antenatal care at a health post, rural health centre or clinic, or any other hospital specified by the Director of Medical Services by notice published in the Gazette; | ||
- (c) any maternity patient who has had four or more child births; | ||
- (d) any maternity patient referred to a hospital from a clinic or health centre; | ||
- (e) any maternity patient referred to a hospital by a registered midwife or registered medical practitioner’ | ||
1983 | Hospital Fees Regulation. Legislative Instrument 1277 | ‘No fees other than hospital accommodations and catering services shall be paid in any Government hospital or clinic in respect of |
– (i) antenatal and post-natal services | ||
1985 | Hospital Fees Regulation. Legislative Instrument 1313 | ‘No fees other than hospital accommodations and catering services shall be paid in any Government hospital or clinic in respect of |
– (i) antenatal and post-natal services | ||
1997 | November 1997 Ministry of Health Guidelines | ‘Exemption for antenatal service (first 4 antenatal care visits) in government health facilities’ |
2003 | Annual Programme of Work, 2004 | ‘User fee exemption for maternal service in Northern, Upper-West, Upper-East and Central Regions in government, private and mission health facilities’ |
2005 | Annual Programme of Work, 2005. | ‘User fee exemption for maternal service in all ten regions in government, private and mission health facilities’ |
2008 | June 2008. Ministry of Health guidelines | ‘National Health Insurance Scheme premium exemption for all pregnant women in Ghana’ |