The Effect of Health Financing Reforms on incidence and management of childhood infections in Ghana: A matching difference in differences impact evaluation

In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea. Nigeria was considered as a control country and using four data points (pre and post reforms periods) from the demographic health surveys, we calculate the probability of treatment based on background covariates. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05. After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points).This denotes that introducing health financing reforms can have marginal impact on child health outcomes.