Effects of the maternal-free healthcare pilot policy on infant deaths in Ghana

User fee elimination policies have been implemented in developing countries to eliminate financial obstacles that limit pregnant women’s access to healthcare services. Numerous studies have revealed a positive association between the elimination of delivery fees and the uptake of maternal health services. However, only a few studies have examined its impact on neonatal and infant mortality rates (NIMRs). This study investigated the effect of the maternal-free healthcare pilot policy implemented from 2003 to 2005 in the Northern, Upper West, Upper East, and Central regions of Ghana on neonatal and infant mortality. We used the Ghana Demographic and Health Survey datasets for 2003 and 2008 and a difference-in-difference estimation approach for analysis. The maternal-free healthcare pilot policy was associated with a 3.3 percentage points and 3.6 percentage points reduction in neonatal and infant deaths in the treatment regions. The likelihood of infant death in the treatment regions was lower than that in the comparison regions during the pilot period. Neonatal and infant health policies should incorporate maternal health components to ensure the maximum benefit for the child from conception to less than one year.