“Let’s talk about money”: how do poor older people finance their healthcare in rural Ghana? A qualitative study

Abstract

Background Older people utilise more healthcare services and are likely to incur higher healthcare expenditure, however, data on their healthcare financing mechanisms are scarce in low-and middle- income countries including Ghana. In this study, we aimed at exploring how poor older people finance their healthcare in rural Ghana. Methods We conducted in-depth interviews and focus group discussions with 60 study participants comprising 30 poor older people, 15 healthcare providers and 15 caregivers in Atwima Nwabiagya District of Ghana. Data were analysed using thematic analytical framework and presented based on an a posteriori inductive reduction approach. Results The study revealed that poor older people finance their healthcare through personal income, family support, Livelihood Empowerment Against Poverty grants and National Health Insurance Scheme subscription. It was also found that poor older people spent between GH¢ 20 and 250 on drugs, laboratory test and hospitalisation anytime they access a healthcare facility. Conclusion The findings contribute to our understanding of how poor older people finance their healthcare in rural Ghana. We argue that health stakeholders should strengthen healthcare financing mechanisms for poor older people for optimal healthcare use.

Barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in the Atwima Nwabiagya District of Ghana

“…This current study used methods from our previously published works. Details of the methods have been reported elsewhere [38,39]. Like our previously published studies, this study took place in three purposively selected rural communities (Kobeng, Amadum-Adankwame, and Offinso Adagya) and five formal healthcare facilities (Nkawie Toase Government Hospital, Afari Community Hospital, Akropong Health Centre, Dr. Frimpong Boateng Medical Centre, and Mount.…”

“…Healthcare providers were purposively selected because of their in-depth knowledge on the subject matter as well as the important role they play in healthcare use [44,48]. On the other hand, a convenience sampling technique offered the study the flexibility to select specific respondents like the caregivers and poor older people based on their availability and readiness [38,39,49,50].…”

“…In this study, poor older people were defined as those who are 65 years or more and are enrolled in the Livelihood Empowerment Against Poverty (LEAP) programme [38,39]. Sponsored by the World Bank, United Nations International Children's Emergency Fund and Government of Ghana, the LEAP programme provides a financial package to extremely poor households including older people aged 65 years or more [40,41].…”

“…The recipients receive between GH¢ 64 and 106 (US$ 13. 42-22.23 as at the period of the study) every 2 months [39]. Beneficiaries have the opportunity to determine how to spend the LEAP grant on their basic needs such as healthcare [39].…”

“…42-22.23 as at the period of the study) every 2 months [39]. Beneficiaries have the opportunity to determine how to spend the LEAP grant on their basic needs such as healthcare [39]. It further provides a free enrollment in the National Health Insurance Scheme (NHIS) for beneficiaries [40] with the aim of improving their healthcare utilisation [42].…”