Does a provider payment method affect membership retention in a health insurance scheme? a mixed method study of Ghana’s capitation payment for primary care

Andoh-Adjei, Francis-Xavier; Wal, Renske van der; Nsiah-Boateng, Eric; Asante, Felix Ankomah; Velden, Koos van der; Spaan, Ernst

doi:10.1186/s12913-018-2859-6

Cited by 22 publications

(28 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first-generation cephalosporins are currently not covered by the National Health Insurance Scheme (NHIS), a health insurance scheme introduced to provide financial access to healthcare for all Ghanaian residents, a possible reason why they were not prescribed. Most of the clients who attend this facility have subscribed to the NHIS and were probably unwilling to pay for medicines that were not covered by this scheme [ 16 ]. In the era of antimicrobial resistance, it is important to limit the use of broad-spectrum antimicrobials and rather opt for limited-spectrum antimicrobials that are still efficacious.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Prescription Pattern in Ho Teaching Hospital, Ghana: Seasonal Determination Using a Point Prevalence Survey

et al. 2021

View full text Add to dashboard Cite

A standardised Global Point Prevalence Survey (PPS) tool was used to determine the antimicrobial prescription pattern in the Ho Teaching Hospital on two separate occasions in a total of 14 wards in the hospital, including dedicated wards for paediatrics and neonates. Manually collected and anonymised data were entered, validated, analysed and reported using a web-based global PPS application. With 147 and 153 patients considered in the July 2019 and January 2020 surveys, respectively, 98 patients (66.7%) and 84 patients (54.9%) had received one or more antimicrobials. The prevalence of antimicrobial use in the adult wards was 64.3% (72/112) and 53.4% (63/118) in the first and second surveys, respectively. The prevalence in the paediatric wards was 60.0% (12/20) and 62.5% (10/16), respectively, in the two surveys, while that in the neonatal wards was 93.3% (14/15) and 57.9% (11/19), respectively. β−lactams were the most used antibiotics in both periods. Malaria was the most common diagnosis requiring the use of antimicrobials in July 2019, accounting for 19.4% of the diagnoses, whereas in January 2020, it was skin and soft-tissue conditions (28.1%). This reflects a seasonal association between malaria and rainfall patterns. Out of the antimicrobials prescribed during each of the survey periods, 95% were used for empirical treatment, and this could be attributed to a number of reasons, including logistical challenges, among others, that require further exploration in the context of local, national and international policy recommendations.

show abstract

Section: Discussionmentioning

confidence: 99%

Antimicrobial Prescription Pattern in Ho Teaching Hospital, Ghana: Seasonal Determination Using a Point Prevalence Survey

et al. 2021

View full text Add to dashboard Cite

show abstract

“…62,63 The access and financial protection provided by the scheme have improved health-seeking behaviors and reduced risky health behaviors such as self-medication among Ghanaians. 64 Though some studies 42,65 reported a positive attitude of providers towards service delivery, others 10 reported poor attitudes of providers. Use of traditional medicine was high amongst both insured and uninsured but had no association with insurance status.…”

Section: Service Deliverymentioning

confidence: 99%

<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

View full text Add to dashboard Cite

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.

show abstract

“…Some of these have focused on subscribers’ perception [ 5 , 15 , 16 ] and determinants of enrolment [ 6 , 17 – 22 ]. Others have also investigated the retention of subscribers [ 23 ], reducing medical claims cost [ 24 ], sustainability of the scheme [ 25 ], equity in accessibility [ 26 – 28 ], variation in coverage [ 29 ], quality healthcare assessment [ 30 ] and trends in subscription [ 13 ]. Despite comprehensive research on the NHIS, none of these studies have, to the best of our knowledge, focused on the position of women as to whether NHIS is helping pregnant women in accessing health services or not.…”

Section: Introductionmentioning

confidence: 99%

Is the National Health Insurance Scheme helping pregnant women in accessing health services? Analysis of the 2014 Ghana demographic and Health survey

Ameyaw

Baatiema

Seidu

2021

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Increasing the use of healthcare is a significant step in improving health outcomes in both the short and long term. However, the degree of the relationship between utilization of health services and health outcomes is affected by the quality of the services rendered, the timeliness of treatment and follow-up care. In this study, we investigated whether the National Health Insurance Scheme (NHIS) is helping pregnant women in accessing health services in Ghana. Methods Data for the study were obtained from the women’s file of the 2014 Ghana Demographic and Health Survey. All women with birth history and aged 15–49 constituted our sample (n = 4271). We employed binary logistic regression analysis in investigating whether the NHIS was helping pregnant women in accessing health service. Statistical significance was set at <0.05. Results Most women had subscribed to the NHIS [67.0%]. Of the subscribed women, 78.2% indicated that the NHIS is helping pregnant women in accessing healthcare. Women who had subscribed to the NHIS were more likely to report that it is helping pregnant women in accessing health service [aOR = 1.70, CI = 1.38–2.10]. We further noted that women who had at least four antenatal visits were more likely to indicate that NHIS is helping pregnant women in accessing health services [aOR = 3.01, CI = 2.20–4.14]. Women with secondary level of education [aOR= 1.42; CI: 1.04–1.92] and those in the richest wealth quintile [aOR = 3.51; CI = 1.94–6.34] had higher odds of indicating that NHIS is helping pregnant women in accessing healthcare. However, women aged 45–49 [aOR = 0.49; CI = 0.26–0.94], women in the Greater Accra [aOR = 0.29; CI = 0.16–0.53], Eastern [aOR = 0.12; CI = 0.07–0.21], Northern [aOR = 0.29; CI = 0.12–0.66] and Upper East [aOR = 0.17; CI = 0.09–0.31] regions had lower odds of reporting that NHIS is helping pregnant women in accessing health services. Conclusion To enhance positive perception towards the use of health services among pregnant women, non-subscribers need to be encouraged to enrol on the NHIS. Together with non-governmental organizations dedicated to maternal and child health issues, the Ghana Health Service’s Maternal and Child Health Unit could strengthen efforts to educate pregnant women on the importance of NHIS in maternity care.

show abstract

Does a provider payment method affect membership retention in a health insurance scheme? a mixed method study of Ghana’s capitation payment for primary care

Cited by 22 publications

References 33 publications

Antimicrobial Prescription Pattern in Ho Teaching Hospital, Ghana: Seasonal Determination Using a Point Prevalence Survey

Antimicrobial Prescription Pattern in Ho Teaching Hospital, Ghana: Seasonal Determination Using a Point Prevalence Survey

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

Is the National Health Insurance Scheme helping pregnant women in accessing health services? Analysis of the 2014 Ghana demographic and Health survey

Contact Info

Product

Resources

About