Access to Maternal Healthcare Services under the National Health Insurance Policy in the Upper West Region, Ghana

Health insurance coverage provides the spring board for pregnant women to access and utilise maternal healthcare services. Yet, studies on health insurance coverage, access and utilisation of maternal healthcare are a handful. Consequently, this study examines women’s access and utilisation of maternal healthcare services under the free maternal health policy in two districts in northern Ghana. The study adopted the mixed research approach with the aid of the cross-sectional design involving 212 respondents. An interview schedule was utilised in the collection of data. Percentages, Chi-square test for independence and Mann-Whitney U test as well as thematic analysis were used to analyse the data. The study revealed that 93.9% of the respondents had enrolled unto the national health insurance scheme and 98.6% of them went for antennal care. Majority (66.5%) of them had facility-based delivery. However, 79.7% of them incur cost in seeking delivery care. In brief, health insurance coverage appears to contribute to improved access and utilisation of maternal healthcare services in the two districts. Nonetheless, the government should provide the basic items that are needed for delivery to lessen the cost burden associated with facility-based delivery

Local Knowledge and Community–Based Assessment of Environmental Change in Ghana

Although much scientific knowledge exists about global environmental change, two kinds oflimitations arise: limited scientific understanding about first, localized geographic specificitiesand second, the perspectives of the affected populations, the communities. This paper contributesto an understanding of local knowledge on environmental change through Community RiskAssessment (CRA) in Ghana. Qualitative methods of data collection, particularly ParticipatoryRural Appraisal (PRA) methods were employed for data collection and complemented with asurvey of 200 farmers. The paper highlights three key findings. First, it underscores the potentialrole of local knowledge in CRA and in contributing to an understanding that environmental changehas been primarily negative, as in a deteriorating climate and the natural environment. Secondly,that local knowledge on vulnerability to climate change revealed multiple exposures to climaticextremes such as drought, heavy rainfall, floods and rainstorms.  However, drought andrainstorms were identified as the highest risk stressors with disruptive or damaging consequenceson livelihoods of local populations. Communities also had their knowledge of change in the naturalenvironment. The primary stressors of environmental change were identified as deforestation andland degradation and anthropogenic factors as the primary drivers of such changes. Thirdly, thatthere is great potential for a role of local knowledge in environmental change research andadaptation in Africa and wherever such knowledge exists. This is because the outcomes are bothscientific and relevant for Environmental Change Mitigation and Adaptation Planning (ECMAP)