This study examines the Impact of Mutual Health Insurance on Access and Quality of Health Care for the Rural Poor in Northern Ghana. The practical interest in Mutual Health Insurance is occasioned by the fact that many developing countries including Ghana are exploring new and innovative ways of dealing with the difficult issues of health care financing and access to health care especially for the rural poor. Using household surveys and focus group discussions, the study establishes that Mutual Health Insurance improves the poor access to health care as the insured use nearly 3 times of health facilities more than the uninsured. The insured equally pay relatively lower out-of-pocket fees than the uninsured at the point of demanding health care. Households with higher incomes generally enrol in health insurance while the poorest segment of the community risk being excluded because they cannot afford the insurance premiums. It is recommended that since the flat rate nature of insurance premiums is what prevents majority of households from enrolling in health insurance, the premiums could be made more flexible for the rural poor.
<p>In rural Ghana, provision of water facilities adopts the demand driven approach and the facilities are community managed. This approach emerged because the supply driven and centralised system of water facilities could not sustain access to potable water especially in rural areas. The demand driven approach is expected to guarantee sustainability in access to water. In 1994, Ghana launched the National Community Water and Sanitation Programme with Community Management as a core strategy. This paper assesses the role of community management model towards access to water in the Nadowli District in Ghana. Data was collected through households’ interviews, focus group discussions and key informants interviews in 10 communities in the District. The findings showed that the demand-driven, community management model, has improved access to potable water in Ghana and the District in particular. As at December 2008, 88.2% of the District population had access to potable water.</p>
This paper examines the interaction among actors in pastoral practices and right to access water in the Upper West Region of Ghana. Water rights, the environment and pastoral practices have been the main issues of discussion in many countries, and Ghana in particular. The focus has always been the negative effects of pastoral activities on environmental resources with less attention on the positive side of it. This paper presents findings on the relationship among various actors (government agencies, community members, herdsmen, livestock owners, and chiefs) in managing pastoral practices. Focus group discussions and key informant interviews were held with the various actors to understand their relationship with one another on pastoral practices and water rights in the Upper West Region of Ghana. The study revealed that the various actors perceive one another as the cause of weak management of pastoral practices in the area and as such blame each other in pastoral practices. This attitude (blame game) has affected the activities of all the actors with serious implications on social and food insecurity in the area.
Water supply has remained centralised and governments advanced several reasons (health benefits and increase in rural productivity) for the state-led water services delivery. This approach had budgetary and sustainability challenges. This led to a community-based management approach in which communities were required to contribute towards water supply and own the water supply. This paper explores households’ perception of who owns and controls community water systems that were provided under the ambit of community-based management regimes. The study was conducted in four communities in the Upper West Region of Ghana. Data were collected using two main sources: (i) a household survey, using questionnaires; and (ii) a platform, comprising 14 participants. The study found that there is a relationship between community contribution and ownership of the water systems. Community level actors argue that communities own the water systems, because they contributed towards capital cost and are responsible for operations and maintenance. Community level actors have control over the decisions of the water systems. Legal ownership resides in the government and communities manage the water systems and appropriate the returns, thus creating a sense of ownership of the water systems. As such, there is a dualistic ownership of the water systems.
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