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This paper seeks to answer a simple question; what happens to maternal health seeking-behavior when user-fees are eliminated? We analyze this question empirically by investigating the effects of the free maternal health care (Health Insurance) policy instituted by the government of Ghana, on a variety of health utilization measures and child survival outcomes. Using robust linear and binomial logistic estimation techniques, we find evidence from over 4,000 households, that eliminating user-fees significantly increases the utilization of skilled delivery assistance whilst simultaneously reducing the number of deliveries assisted by unskilled birth attendants. Utilization of antenatal and postnatal care experience similar effects with user-fee elimination. Even though intention to use contraceptives increases with enrollment in the programme, education is found to be more important than health insurance in influencing the number of children a woman desires to have. This paper provides empirical support for the growing calls for removal of user-fees, in order to expand healthcare access and promote inclusion.

Our paper investigates the implications of asymmetric non-tax revenue information for tax morale using micro data from thirty-six African countries. We utilize a model in which agents form their perceptions about the sufficiency of government non-tax revenue for development financing under asymmetric information conditions. We then construct a composite index of information access that generates predictions about these perceptions and tax morale at the household level. Two important predictions emerge: (i) in the presence of asymmetric information, households overestimate the ability of non-tax revenues alone to finance development, which (ii) has significant negative effects on household-level tax morale. Our findings - which are robust across specifications and controls of cross-country fixed differences in tax morale - provide evidence that improvement in government information supply regarding the use of non-tax revenues, beyond annual budget readings and households tax obligations, could significantly enhance tax morale and compliance.