Abstract: Ghana’s National Health Insurance Scheme (NHIS) and the Free Maternal Health Care Policy (FMHCP) were established to remove financial barriers to maternal and neonatal healthcare. After twenty years, challenges remain in turning policy coverage into real protection. This paper critically assesses Ghana’s progress toward universal maternal healthcare from 2010 to 2025, using current data from the Ministry of Health and the World Health Organization (WHO), and comparing outcomes with Ontario, Canada’s publicly funded midwifery model. The results show significant improvements in antenatal visits and facility-based deliveries; however, ongoing inequalities persist due to delayed reimbursements, stock shortages, and workforce gaps. Recommendations include adopting digital claims systems, decentralizing funding processes, and expanding community midwifery services.

Keywords: Maternal health coverage, NHIS, free maternal policy, midwifery, Ghana, universal health coverage, equity.

Downloads: | DOI: 10.17148/IARJSET.2025.1211019