Households Sociodemographic Profile as Predictors of Health Insurance Uptake and Service Utilization: A Cross-Sectional Study in a Municipality of Ghana

Badu, Eric; Agyei‐Baffour, Peter; Acheampong, Isaac; Opoku, Maxwell Peprah; Addai-Donkor, Kwasi

doi:10.1155/2018/7814206

Cited by 29 publications

(33 citation statements)

References 25 publications

(100 reference statements)

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“…The study showed that the marital status plays significant role in utilizing social health insurance scheme and married household were more utilizing the schemes than the singles. 8 Indicators like ethnicity, religion showed no significant relationship in the enrollment of the social health insurance scheme as it basically focus on the household level than the individual level.…”

Section: Resultsmentioning

confidence: 98%

Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

Karanjit¹,

Mali²,

Khadka³

et al. 2020

Nepal Med Jor

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Introduction: For the reduction of financial burden and to achieve universal health care, Government of Nepal launched a security program called as Social Health Insurance Program. This study aimed to find the factors associated with the utilization of the social health insurance scheme. Methods: Descriptive cross-sectional study was conducted in the Bhaktapur Municipality ward no 2. 422 households were chosen using systematic random sampling. Questionnaires were used to measure the factors affecting the utilization. The collected data was entered in Epidata and analyzed in SPSS version 16. The data were presented in the frequency and percentage. Bivariate analysis was done to identify factors utilizing social health insurance. Factors having p value less than 0.05 was taken as significantly associated. Multivariate analysis was done to examine the association between the outcome variables. Results: Almost half of the general population (42.4 %) were utilizing social health insurance scheme and reason for not utilizing includes lack of confidence in the scheme and the services of the scheme, followed by high premium cost. Age (p=0.044), occupation (p= 0.049), wealth quintiles (p=<0.001) were found to be significantly associated with utilization of social health insurance. Logistic regression analysis showed that the odds of enrollment among very rich population group were lower than the medium (AOR 0.550, 95% CI 0.305-0.993) and rich population (AOR 0.557, 95% CI 0.316-0.981). Conclusions: Multiple factors were found to be associated with the utilization of the health insurance scheme which includes age of the household head, occupation of the household head, economic status, availability of the drugs and charge paid during their visit in the health care services, behavior showed by the health care provider, confidence in the scheme, satisfaction in the services that have been providing and source of the information.

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Section: Resultsmentioning

confidence: 98%

Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

Karanjit¹,

Mali²,

Khadka³

et al. 2020

Nepal Med Jor

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“…A study in Nambia concluded that sociodemographic factors (sex, education, and wealth) are associated with universal health care and financial coverage (45). Another study in Ghana also concluded that sociodemographic conditions (elders, women, poor education, and marginalized population) were associated with health services and financial coverage (46). Similar types of study in Vietnam showed that sociodemographic factors influenced health care service and patients satisfaction (47).…”

Section: Discussionmentioning

confidence: 99%

Structural Factors Responsible for Universal Health Coverage in Low- and Middle-Income Countries: Results From 118 Countries

Ranabhat

Jakovljević

Dhimal

et al. 2020

Front. Public Health

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Background: Demography, politics, economy, and governance appear to be the major structural factors for health and well-being. These factors have a significant role to play in achieving universal health coverage (UHC). The majority of previous studies did not highlight those factors. The aim of this study is to explore the basic structural factors (political stability, demography, gross national income, governance, and transparency) associated with a UHC index of low-and middle-income countries because for a long time there has be a stagnation achieving universal health coverage. Methodology: This study was a cross-sectional study applying multiple indices as variables. Low-and middle-income countries' selected indicators were the study variables. Data concerned the current political stability, sociodemographic status, gross national income (GNI), and governance status as independent variables and the UHC index of the countries as the dependent variable. Mean and standard deviations were used for the average values of the variables, a raw correlation was shown among variables and a hierarchical linear regression model was used for multi variate analysis. Results: Government health expenditure is 6% out of the total budget in upper middle countries (UMIC) and ∼5% in lower middle countries (LMIC) and low-income countries (LIC), population below poverty line is more than 2-fold higher in LIC in comparison with high income countries, UHC index, and socio-demographic index (SDI) index is similar in LMIC and LIC and slightly higher in UMIC. There is a positive association between government health expenditure, governance index, stability index, the SDI index, and GNI per capita and a negative association between populations below poverty line with UHC index. According to our full regression analysis model, governance, stability, and SDI index were associated with a significantly increased UHC index by 0.33, 0.41, and 0.57 (p < 0.05). Ranabhat et al. Structural Factors and UHC Conclusion: To achieve UHC, good governance, political stability, and demographic balance are prerequisites and addressing these factors would help to meet by 2030 across countries.

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“…Previous studies have also confirmed the role of ethnicity in determining the enrolment of households in the health insurance schemes. 32,40,41 Evidences from studies in various LMICs have shown a positive association between wealth or socio-economic status and health insurance uptake. 34,35,42,43 Bivariate and multivariate analyses in this study also confirmed a similar association.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Enrolment of Households in Nepal’s National Health Insurance Program

Ghimire

Sapkota

Poudyal

2019

Int J Health Policy Manag

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Background: Nepal has made remarkable efforts towards social health protection over the past several years. In 2016, the Government of Nepal introduced a National Health Insurance Program (NHIP) with an aim to ensure equitable and universal access to healthcare by all Nepalese citizens. Following the first year of operation, the scheme has covered 5 percent of its target population. There are wider concerns regarding the capacity of NHIP to achieve adequate population coverage and remain viable. In this context, this study aimed to identify the factors associated with enrolment of households in the NHIP.Methods: A cross-sectional household survey using face to face interview was carried out in 2 Palikas (municipalities) of Ilam district. 570 households were studied by recruiting equal number of NHIP enrolled and non-enrolled households. We used Pearson’s chi-square test and binary logistic regression to identify the factors associated with household’s enrolment in NHIP. All statistical analyses were performed using IBM SPSS version 23 software.Results: Enrolment of households in NHIP was found to be associated with ethnicity, socio-economic status, past experience of acute illness in family and presence of chronic illness. The households that belonged to higher socio-economic status were about 4 times more likely to enrol in the scheme. It was also observed that households from privileged ethnic groups such as Brahmin, Chhetri, Gurung, and Newar were 1.7 times more likely to enrol in NHIP compared to those from underprivileged ethnic groups such as janajatis (indigenous people) and dalits (the oppressed). The households with illness experience in 3 months preceding the survey were about 1.5 times more likely to enrol in NHIP compared to households that did not have such experience. Similarly, households in which at least one of the members was chronically ill were 1.8 times more likely to enrol compared to households with no chronic illness.Conclusion: Belonging to the privileged ethnic group, having a higher socio-economic status, experiencing an acute illness and presence of chronically ill member in the family are the factors associated with enrolment of households in NHIP. This study revealed gaps in enrolment between rich-poor households and privileged-underprivileged ethnic groups. Extension of health insurance coverage to poor and marginalized households is therefore needed to increase equity and accelerate the pace towards achieving universal health coverage.

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Households Sociodemographic Profile as Predictors of Health Insurance Uptake and Service Utilization: A Cross-Sectional Study in a Municipality of Ghana

Cited by 29 publications

References 25 publications

Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

Structural Factors Responsible for Universal Health Coverage in Low- and Middle-Income Countries: Results From 118 Countries

Factors Associated with Enrolment of Households in Nepal’s National Health Insurance Program

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