Abstract
BACKGROUND: In 2008, the Government of Ghana implemented a free maternal healthcare policy through the National Health Insurance Scheme to increase financial access to maternity care services and reduce perinatal and maternal mortality rates. As an area with less evidence, this study sought to explore healthcare providers' perceptions of the free maternal healthcare policy for quality healthcare delivery in Kwadaso Municipality, Ghana. METHODS: This study adopted a qualitative approach using an exploratory study design. Fifteen participants were purposefully included. Key informant interviews (KIIs) were conducted among administrators, doctors, physician assistants or nurses in charge, nurse managers, and midwives in charge of maternity units of the selected health facilities. The qualitative data were analyzed thematically. RESULTS: The study identified four key themes in the implementation of the free maternal healthcare policy: (1) Service coverage, characterized by broad inclusivity but marred by persistent co-payments for some services; (2) Human and financial resources, marked by adequate staffing alongside financial constraints affecting service delivery; (3) Facilities and equipment, highlighting spatial limitations and equipment shortages; and (4) Process of care and safety, demonstrating protocol adherence despite challenges in postnatal care follow-up. Overall, the policy was associated with notable reductions in maternal and neonatal morbidity and mortality. CONCLUSION: The free maternal healthcare policy improves access and outcomes but faces challenges in funding, infrastructure, and postnatal care. Addressing these gaps is vital for sustainable maternal healthcare improvements in Ghana.