BackgroundThe introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS.MethodsWe conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers.ResultsThe study found that over 30 % of parents/caregivers spend more than Gh¢50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40 % of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children.ConclusionsEven though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs, parents/caregivers still face significant financial burden in the care of their wards. Stakeholders in health care delivery should therefore ensure that all children with NCDs including those excluded from the NHIS should be covered by NHIS. A special effort focusing on identifying children with NCDs within the lower income groups, especially from rural areas, in order to exempt them from any form of payment for their health care is recommended.

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This article explores the care that husbands in Accra, Ghana, provide for wives who have been diagnosed with cancer. Making use of an inductive, qualitative approach, the study analyzes observations of and in-depth ethnographic interviews conducted with five married female cancer patients and their husbands over a ten-month period. The results suggest a strong association among husbands' care, wives' responses to husbands' care, and cultural ideals of femininity and masculinity. The findings suggest that husbands' selective and often limited gender-based investments in unpaid care work make their sick wives exceedingly vulnerable in a context in which care for the terminally ill takes place predominately in familial settings.Résumé: Cet article explore les soins fournis par les maris aux femmes qui ont été diagnostiquées avec le cancer, à Accra, au Ghana. A l'aide d'une approche inductive, qualitative, l'étude analyse les observations extraites d'entretiens ethnographiques approfondis menés auprès de cinq femmes mariées, atteintes de cancer, et leurs maris, durant une période de dix mois. Les résultats suggèrent une forte association entre le soin des maris, les réponses des femmes aux soins des maris, et les idéaux culturels de féminité et de masculinité. Les résultats suggèrent que les investissements des maris dans la réalisation de soin non rémunérés qui sont fondés sur le genre et sont sélectifs et souvent limités, rendent les épouses malades très vulnéra-bles puisqu'elles se trouvent dans un contexte dans lequel les soins pour les malades en phase terminale a lieu principalement dans les milieux familiaux.