Health Financing in Ghana

Schieber, George; Cashin, Cheryl; Saleh, Karima; Lavado, Rouselle F.

doi:10.1596/978-0-8213-9566-0

Cited by 64 publications

(89 citation statements)

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“…This hampers their ability to mobilize adequate resources required for achieving equity in healthcare. This finding agree with Tabor (2005) & Schieber et al (2012 that found that CBHIs face a challenge of mobilizing sufficient resources attributable to their small size and the contributory capacity of the target population (Tabor, 2005;Schieber et al, 2012). Finding on the trends of total premiums collected, healthcare cost reimbursements, administration cost and deficit or surplus in CBHIs between 2010-2015 shows an up and down fluctuation of the total premiums collected, healthcare cost reimbursements and deficit or surplus while the administration cost remained constant throughout the entire period.…”

Section: Cronbach's Alpha Coefficients Ave and Kmo Values For MIX Ofsupporting

confidence: 92%

“…Some of the distinguishing characteristic of CBHIs is the enlisting community's participation that allows community's involvement in setting the premium employment of traditional self-help and social mobilization strategies that have been embraced by the poor in low income (Tabor, 2005;Schieber et al, 2012). They can therefore be employed innovatively in identifying pockets of exclusion in healthcare access for the poorest and socially excluded groups.…”

Section: Of Contributionsmentioning

confidence: 99%

“…to healthcare for the informal sector by enlisting the informal sector through small groups which eventually merged to larger schemes (Criel & Van Dormael, 1999;Poletti, Balabanova, Ghazaryan, Kamal-Yanni, Kocharyan, Arakelyan & Hakobyan, 2007;Fernandes et al, 2009;WHO, 2010;Durairaj, D'Almeida, & Kirigia, 2010;Schieber, Cashin, Saleh & Lavado, 2012). In Kenya CBHI schemes have evolved over time to take care of healthcare financing requirements of the low income households who have been left out of mainstream prepaid schemes (MoH, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Implications of Contributions to Equity in Access of Health Care: A Case of Community Based Health Insurance Schemes in Kenya

Gitahi¹,

Njuguna²

2018

GJHS

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The realization of equity goals requires commitment and combination of contributions from all stakeholders in the healthcare sector under the stewardship of the government. The purpose of this study was to examine the mix of contributions in Community Based Health Insurance Schemes (CBHIs) and equity in healthcare in Kenya. The sample was composed of 318 members of management teams drawn from 82 CBHIs. Descriptive statistics, factor analysis, path analysis and multivariate regression analysis in structural modeling equation (SEM) were conducted to determine the mix of contributions in CBHIs and its bearing on equity in healthcare in CBHIs in Kenya. The study concludes that current mix of contributions is not adequate enough to guarantee equity in access of health care for the poor and vulnerable groups. For realization of equity in access of health care governments and sectoral partners should define the place of CBHIs within the national health policy to guide establishment of an optimal combination of contributions in CBHIs for increased access to care and financial risk protection for precluded groups.

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Section: Cronbach's Alpha Coefficients Ave and Kmo Values For MIX Ofsupporting

confidence: 92%

Section: Of Contributionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implications of Contributions to Equity in Access of Health Care: A Case of Community Based Health Insurance Schemes in Kenya

Gitahi¹,

Njuguna²

2018

GJHS

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“…It was supported by DFID and was believed by many to be externally financed, but in fact there were no additional resources at its disposal beyond existing budget support, and it appears that the NHIS has been funding it out of its internal resources, at least after the first year. Its sustainability is therefore bound up with that of the NHIS more broadly, and indeed adds to financial concerns already outlined in previous studies [16,19]. …”

Section: Discussionmentioning

confidence: 85%

An exploratory study of the policy process and early implementation of the free NHIS coverage for pregnant women in Ghana

Witter

Garshong

Ridde

2013

International Journal for Equity in Health

118

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BackgroundPregnant women were offered free access to health care through National Health Insurance (NHIS) membership in Ghana in 2008, in the latest phase of policy reforms to ensure universal access to maternal health care. During the same year, free membership was made available to all children (under-18). This article presents an exploratory qualitative analysis of how the policy of free maternal membership was developed and how it is being implemented.MethodsThe study was based on a review of existing literature – grey and published – and on a key informant interviews (n = 13) carried out in March-June 2012. The key informants included representatives of the key stakeholders in the health system and public administration, largely at national level but also including two districts.ResultsThe introduction of the new policy for pregnant women was seen as primarily a political initiative, with limited stakeholder consultation. No costing was done prior to introduction, and no additional funds provided to the NHIS to support the policy after the first year. Guidelines had been issued but beyond collecting numbers of women registered, no additional monitoring and evaluation have yet been put in place to monitor its implementation. Awareness of the under-18 s policy amongst informants was so low that this component had to be removed from the final study. Initial barriers to access, such as pregnancy tests, were cited, but many appear to have been resolved now. Providers are concerned about the workload related to services and claims management but have benefited from increased financial resources. Users still face informal charges, and are reported to have responded differentially, with rises in antenatal care and in urban areas highlighted. Policy sustainability is linked to the survival of the NHIS as a whole.ConclusionsGhana has to be congratulated for its persistence in trying to address financial barriers. However, many themes from previous evaluations of exemptions policies in Ghana have recurred in this study – particularly, the difficulties of getting timely reimbursement to facilities, of controlling charging of patients, and of reaching the poorest. This suggests that providing free care through a national health insurance system has not solved systemic weaknesses. The wider concerns about raising the quality of care, and ensuring that all supply-side and demand-side elements are in place to make the policy effective will also take a longer term and bigger commitment.

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“…This is in view of the fact, that there is a social health insurance policy in place in Ghana—the National Health Insurance Scheme (NHIS) (Schieber, Cashin, Saleh, & Lavado, 2012). However, a recent evaluation of the policy shows a rather dismal outlook as out-of-pocket payments have soared as a result of several socio-economic and administrative challenges (Gros, 2016; Saleh, 2013; Schieber et al, 2012). The weak state of the NHIS apparently explains why the inpatients needed to be supported financially by their close acquaintances.…”

Section: Discussionmentioning

confidence: 99%

“ Who'll do all these if I'm not around?” : Bonding social capital and health and well-being of inpatients

Amoah¹,

Koduah

Gyasi³

2018

International Journal of Qualitative Studies on Health and Well

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Purpose: Although social capital influences health-related decisions and behavioural patterns in many developing countries, minimal attention has been paid to the nuances of its effect on healthcare. This paper examines how bonding social capital affects healthcare delivery for inpatients in Ghana. Methods: Semi-structured in-depth interviews were used and thematic analysis method employed to analyse the data. Interviews were conducted with health professionals and relatives and close friends of inpatients in three public health facilities in Ashanti region. Results: Relatives and close friends of inpatients were a critical source of instrumental support such as provision of meals, laundry services, running errands and financial assistance as well as emotional support. These functions—that were both ‘expected’ and ‘encouraged’— reduced the burden on the health facilities, which apparently had limited resources to offer adequate care. However, the relatives of inpatients sometimes inadvertently obstructed efficient healthcare delivery through actions such as extending ‘unapproved’ alternative care to patients. Moreover, the process of contributing towards health and well-being of the sick exposed the relatives to health risks due to poor living conditions. Conclusion: A well-defined and befitting role must be devised for at least an immediate social relation of inpatients to improve the positive effects of bonding social capital on healthcare delivery.

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Health Financing in Ghana

Cited by 64 publications

References 0 publications

Implications of Contributions to Equity in Access of Health Care: A Case of Community Based Health Insurance Schemes in Kenya

Implications of Contributions to Equity in Access of Health Care: A Case of Community Based Health Insurance Schemes in Kenya

An exploratory study of the policy process and early implementation of the free NHIS coverage for pregnant women in Ghana

“ Who'll do all these if I'm not around?” : Bonding social capital and health and well-being of inpatients

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