Health insurance subscription among women in reproductive age in Ghana: do socio-demographics matter?

Abstract

BackgroundPremised that health insurance schemes in Africa have only been introduced recently and continue evolving, various concerns have been raised regarding their effectiveness in improving utilisation of orthodox health care and the reduction of out-of-pocket expenditures for their population, particularly women.ObjectiveTo examine the effects of socio-demographics on health insurance subscription among women in Ghana.MethodsThe study draws on the 2014 Ghana Demographic and Health Survey. Bivariate descriptive analysis and binary logistic regression were used to analyse the data.ResultsWealth status, age, religion, birth parity, marriage and ecological zone were found to have significantly predicted health insurance subscription among women in reproductive age in Ghana. Urban dwellers, women who are nulliparous, those with no or low levels of education, African traditionalists and the poor were those who largely did not subscribe to the scheme.ConclusionThe findings underscore the need for the National Health Insurance Authority to carry out more education in association with the National Commission for Civic Education and the Information Services Department to recruit more urban dwellers, nulliparous women, those with no or low levels of education, African traditionalists and the poor unto the scheme.

What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

“…Thus, it was realised that the probability of giving birth at a health facility increased by education, not only for the women but also for their partners. These findings are thus in congruence with previous studies which found education as a strong determinant of health care service and facility use [23, 28–30]. The fact that partner's education predicted the choice of place of delivery among the women, however, supports the argument that men usually control decision-making in the home, including women's health decision-making [31, 32].…”

“…This points to long distances that are usually travelled by rural women in order to access maternal health care as found in previous studies [23, 27]. Roads in these rural areas are also mainly in a deplorable state [33, 34].…”

“…The findings where the poorest women had the worst utilisation of health care facilities for delivery were probably because they have to pay for health care, which is usually problematic for them as argued by Amu and Dickson [23]. The authors noted that even though Ghana's National Health Insurance Scheme, introduced in 2003, was designed to be pro-poor, many of the poor are unable to subscribe to the scheme due to their inability to afford annual premiums required to access health care free of all charges at the point of service delivery.…”

The Influence of Health Insurance on the Utilization of Maternal Health Care Services in Kumba Health District: A Community-based Assessment

“…Our findings are similar to those of Jean et al [9] in Douala-Cameroon, where lack of awareness and limited knowledge on the basic concepts of CBHI, and high premiums were reasons for low insurance enrollment. Amuh A. H et al [16] in Ghana found that the major barriers to health insurance subscription included; long queues and waiting time, and negative attitude of service providers both at the healthcare facilities and the health insurance office.…”

Determinants of Skilled Birth Attendance in the Northern Parts of Ghana

“…These ascriptions normally make male partners the heads of their respective households. As heads of households, the males mainly decide the means of healthcare accessibility including where the women should seek care [39]. Male partner involvement refers to "the various ways in which men relate to reproductive health problems and programmes, reproductive rights, and reproductive behavior" [40].…”