Determinants of paying national health insurance premium with mobile phone in Ghana: a cross-sectional prospective study

Abstract

IntroductionIn an effort to increase Ghana’s National Health Insurance Scheme (NHIS) enrollment and retention rates, the NHIS introduced membership renewal and premium payment by mobile phone. The success of such an innovation dependents on many factors including personal and community characteristics of members.ObjectiveThe objective of the study is to investigate the determinants of renewing membership and paying the NHIS premium through a mobile phone.MethodologyThe prospective cross-sectional survey was used to solicit the required information from about 1192 respondents living in Kumasi Metropolis, Atwima Nwabiaya and Sekyere Central Districts of Ghana. Logistic regression model was employed to estimate the determinants of paying the NHIS premium with the mobile phone.ResultsThe study found that factors including residing in an urban area (Kumasi metropolis), senior high education, tertiary education and informal employees are the determinants of paying the NHIS premium with the mobile phone.ConclusionIt is recommended that the NHIS consider making the mobile payment as simple as possible for the less educated and the rural members to access it.

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“…58 Some applications to revenue mobilisation and pooling have also been documented: in Ghana, mobile phone apps have simplified payment of health insurance contributions and enrolment reminders. 59 Fourth, little has been documented about any actual adjustments to financing arrangements to facilitate online and digital delivery of PHC, beyond measures to include remote consultations in insurance benefit packages. However, this area is developing rapidly (for example, the introduction of Babyl, an artificial intelligence-supported digital health service provider, i n Rwanda) 60 and often without formal assessment or evaluation.…”

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“…For instance, out of the 40% of the people who have registered for NHIS in Kintampo north municipality as at 2016, only 24.9% have renewed their annual premiums with the remaining (about 75%) citing high cost of premium (GHS30.00; $5.43 per year) as the main barrier (34,35). Distance to and cost of travel to NHIS offices, and delays were also found to be barriers to NHIS registration (34,36).…”

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“…Therefore, mobile money users enjoy the benefits of low transaction costs when paying premiums, convenience (do not have to travel to banks to queue and make payments), and reduction in transportation costs. In Ghana, Boaheng et al found that urban and rural informal sector workers were more likely than unemployed to pay their social health insurance premiums using mobile money. The benefits provided by the technology might have reduced the drop‐out rate from NHIF thereby increasing mobile money users' probability of being enrolled in NHIF.…”