Analysing the Influence of Health Insurance Status on Peoples’ Health Seeking Behaviour in Rural Ghana

Asibey, Benedict Osei; Agyemang, Seth

doi:10.1155/2017/8486451

Cited by 21 publications

(21 citation statements)

References 20 publications

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“…Similar finding was reported by the study done in India on comprehensive health insurance program [14]. Similarly findings from our study was consistent with the results of other studies conducted in different types of health insurance program in Ghana, Republic Korea and Chhattisgarh, India [15,16,17].…”

Section: Health Service Utilizationsupporting

confidence: 93%

“…Ethnicity, family occupation, perceived health status of family and wealth status also had significant role in health service utilization among overall households. Similar study conducted in Ghana reported that educational status and monthly income were major determinants of health service utilization among overall study group [15]. The study conducted in Republic Korea reflects educational status and household wealth status had also significant difference in health service utilization [16].…”

Section: Health Service Utilizationmentioning

confidence: 52%

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Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

Bhatt

Dhami

Yadav

2019

Preprint

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Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias.Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method.Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group.Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.

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Section: Health Service Utilizationsupporting

confidence: 93%

Section: Health Service Utilizationmentioning

confidence: 52%

Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

Bhatt

Dhami

Yadav

2019

Preprint

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“…29,30 In terms of healthcare-seeking behavior, people who are registered in the scheme use healthcare services more than those who are not insured. [30][31][32][33] Though the NHIS increased access to healthcare, this access is far from universal, as it demands premium payment before one can access healthcare. Many studies 8,-32,-34-36 reported varying proportions of the population who are not covered by the scheme; a World Bank study 7 reported that only 40% of the Ghanaian population were enrolled in the scheme by 2013.…”

Section: Coveragementioning

confidence: 99%

<p>Implementation of the National Health Insurance Scheme (NHIS) in Ghana: Lessons for South Africa and Low- and Middle-Income Countries</p>

Christmals¹,

Aidam²

2020

RMHP

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Background: South Africa is having difficulties in rolling out the National Health Insurance (NHI) policy. There are ongoing arguments on whether the NHI will provide access to quality and equitable healthcare it is intended to and whether South Africa is ready to implement the policy. Many stakeholders believe the country needs more preparation if the policy will be successful. Ghana, on the other hand, has successfully implemented the National Health Insurance Scheme(NHIS) for over 15 years. Objective: This paper sought to explore the implementation of the NHIS in Ghana and the lessons South Africa and other low-and middle-income countries can learn from such a process. Methods: A scoping review was conducted using the Joanna Brigs Institute's System for the Unified Management, Assessment and Review of Information (SUMARI) and Mendeley reference manager to manage the review process. Journal articles published on the NHIS in Ghana from January 2003 to December 2018 were searched from Science Direct, PubMed, Scopus, CINAHL, and Medline using the keywords: Ghana, Health, and Insurance. Results: The implementation of the NHIS has provided access to healthcare for the Ghanaian population, especially to poor and vulnerable. Despite the successful implementation of the NHIS in Ghana, the scheme is challenged with poor coverage; poor quality of care; corruption and ineffective governance; poor stakeholder participation; lack of clarity on concepts in the policy; intense political influence; and poor financing. Conclusion: The marked inequity in the South African health system makes the implementation of the NHI inevitable. The challenges experienced in the implementation of the NHIS in Ghana are not new to the South African healthcare system. South Africa must learn from the experiences of Ghana,a context that shares common socio-cultural and economic factors and disease burden,in order to successfully implement the NHI.

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“…Therefore, all means to ensure good health, which includes the provision and use of health-care services, including maternal health services thus emerges as an important public health and policy issue and a matter of concern to stakeholders. This reflects in efforts to improve health outcomes and to meet international obligations to make health care broadly accessible [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

A Qualitative Study on the Pathways to Evidence-Based Antenatal Care in Periurban Ghana

Akowuah

Agyei‐Baffour

Asibey

2018

Obstetrics and Gynecology International

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Maternal health care has become a major concern on international fora in the 21st century. Even though major interventions have been taken to scale up maternal health care locally, nationally, and globally, adequate utilisation has not been achieved due to system-induced setbacks, especially in sub-Saharan Africa. The study explored the facilitators and barriers to antenatal care use in periurban Ghana. Seventeen (17) respondents consisting of four mothers receiving ANC services, four mothers receiving postnatal care with their ANC experience, four midwives, and four nurses with the District Public Health Nurse were involved in the study. The exploratory case study design was used with respondents comprising two focus groups and interview participants. Using thematic analysis, the results revealed that restrictive factors like travel time, long waiting time, transport cost, service cost, quality of service, and attitude of hospital staff still act as constraining factors even after the introduction of free maternal health care. The study concludes that practices like focused ANC and routine monitoring to facilities among others have increased utilisation. The study therefore recommends that to ensure adequate utilisation, the government and other stakeholders should offer support to the less-privileged mothers. Again, services should be easily available at facilities to pregnant women even if they are to be bought. It is further recommended that antenatal care services should be reoriented and clinical psychologists should be placed at all health centres to empower health staff on the best attitude towards clients. Interventions if mainstreamed into the national maternal health policy could be useful.

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Analysing the Influence of Health Insurance Status on Peoples’ Health Seeking Behaviour in Rural Ghana

Cited by 21 publications

References 20 publications

Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

<p>Implementation of the National Health Insurance Scheme (NHIS) in Ghana: Lessons for South Africa and Low- and Middle-Income Countries</p>

A Qualitative Study on the Pathways to Evidence-Based Antenatal Care in Periurban Ghana

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