Crowding out of solidarity? Public health insurance versus informal transfer networks in Ghana

Strupat, Christoph; Klohn, Florian

doi:10.1016/j.worlddev.2017.11.004

Cited by 39 publications

(34 citation statements)

References 18 publications

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“…On the contrary, results for the impacts on OOP spending are mixed, with a few studies even finding increased household OOP spending particularly at high levels (Wagstaff & Lindelow, 2008;Wagstaff et al, 2009). 5 Nonetheless, our finding of negative effects on OOP payments does not represent an outlier in the literature (Wagstaff 2010;Bauhoff et al 2011;Limwattananon et al 2015;Strupat & Klohn 2018).…”

Section: Introductioncontrasting

confidence: 53%

“…Column (1) reports the effects of the NHIS on the full sample, which we estimate to be 21 percent. The estimated effect of the NHIS on medical expenditures is comparable to other estimates of the effect of universal health coverage on OOP payments, which find savings on medical expenditures ranging from 30 to 50 percent (Wagstaff, 2010;Bauhoff et al, 2011;Limwattananon et al, 2015;Strupat & Klohn, 2018). To explore the source of OOP savings from the introduction of the NHIS, the subsequent rows of Table 4 decompose the OOP payments between outpatient care and medicine purchases.…”

Section: Medical Expendituresmentioning

confidence: 57%

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The Social Value of Health Insurance Results from Ghana

Mandico¹,

Reichert²,

Strupat³

2019

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The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

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Section: Introductioncontrasting

confidence: 53%

Section: Medical Expendituresmentioning

confidence: 57%

The Social Value of Health Insurance Results from Ghana

Mandico¹,

Reichert²,

Strupat³

2019

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“…Mensah et al 40 also recorded that insurance leads to improvements in perinatal health indicators for women. Nguyen et al, 8 Strupat and Klohn, 71 and Aryeetey et al 72 also found that the uninsured had more health expenses than the insured. Therefore, the insured sought to use health services more than the uninsured.…”

Section: Discussionmentioning

confidence: 97%

<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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“…There is a large literature that has examined the effect of specific social protection instruments. For instance, in the context of low and middle income countries a number of papers have demonstrated the effect of cash transfer programmes on food consumption, health and educational outcomes (Behrman & Hoddinott, 2005;Burchi, Scarlato, & D'Agostino, 2016;Hidrobo, Hoddinott, Kumar, & Olivier, 2018), the effect of public works programmes on asset-building, climatic risks and food security (Anderson, Mekonnen, & Stage, 2011;Gilligan, Hoddinott, & Taffesse, 2009), and the effect of health insurance schemes on health care utilisation and financial protection on the one hand (Mebratie et al, 2013;Pagán, Puig, & Soldo, 2007;Strupat & Klohn, 2018) and on borrowing and assets sales on the other (Yilma et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Linking Social Protection Schemes: The Joint Effects of a Public Works and a Health Insurance Programme in Ethiopia

Shigute

Strupat

Burchi

et al. 2019

The Journal of Development Studies

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In developing countries and in particular in sub-Saharan Africa, social protection schemes tend to operate in silos. However, schemes targeting the same geographical areas may have synergies that have not yet been examined, and which are worth scrutinising. This paper contributes to this knowledge gap by examining the joint impacts of two social protection programmes in Ethiopia, that is, the Productive Safety Net Programme and a Community Based Health Insurance Scheme. Based on three rounds of individual level panel data and several rounds of qualitative interviews, we find that individuals covered by both programmes, as opposed to neither or only one of the two programmes, provide greater labour supply, have larger livestock holdings, and have a lower amount of outstanding loans. Furthermore, joint participation is associated with greater use of modern health care facilities as compared to participating only in the safety net programme. These results show that bundling of interventions enhances protection against multiple risks and that linking social protection schemes yields more than the sum of their individual effects.

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Crowding out of solidarity? Public health insurance versus informal transfer networks in Ghana

Cited by 39 publications

References 18 publications

The Social Value of Health Insurance Results from Ghana

The Social Value of Health Insurance Results from Ghana

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

Linking Social Protection Schemes: The Joint Effects of a Public Works and a Health Insurance Programme in Ethiopia

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