Trends and characteristics of enrolment in the National Health Insurance Scheme in Ghana: a quantitative analysis of longitudinal data

Nsiah-Boateng, Eric

doi:10.1186/s41256-018-0087-6

Cited by 45 publications

(40 citation statements)

References 41 publications

(61 reference statements)

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“…There is also the need for policy makers to address reported cases of illegal charges at the healthcare facilities. Our finding is consistent with similar studies on the NHIS [31, 38, 39].…”

Section: Discussionsupporting

confidence: 94%

Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana: a cross-sectional study

et al. 2019

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BackgroundEarlier studies have found significant associations between sociodemographic factors and enrolment in the National Health Insurance Scheme (NHIS) in Ghana. These studies were mainly household surveys in relatively rural areas with high incidence of poverty. To expand the scope of existing evidence, this paper examines policy design factors associated with enrolment and dropout of the scheme in an urban poor district using routine secondary data.MethodsThis study is a cross-sectional quantitative analysis of 2014–2016 NHIS enrolment data of the Ashiedu Keteke district office. Descriptive and multivariate logistic regression analyses were performed to examine sociodemographic factors associated with NHIS enrolment and dropout.ResultsA total of 215,724 individuals enrolled in the NHIS over the period under study, of which 98,232 (46%) were new members. About 41% of existing members in 2014 dropped out of the NHIS in 2015 and 53% of those in 2015 dropped out in 2016. The indigents (core poor) are significantly more likely to enrol and to drop out of the NHIS. However, the males, informal sector employees, social security and national insurance trust (SSNIT) contributors, and the aged (70+ years) are significantly less likely to enrol in the NHIS but more likely to retain coverage.ConclusionsA considerable number of members are dropping out of the NHIS. The indigents in particular, are increasingly enrolling in and dropping out of the NHIS whilst the males, informal sector employees, SSNIT contributors and the aged are not enrolling as expected but increasingly retaining coverage. Policy reforms to ensuring continued growth towards realization of universal health coverage should take these factors into consideration.Electronic supplementary materialThe online version of this article (10.1186/s13561-019-0241-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 94%

Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana: a cross-sectional study

et al. 2019

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“…This comprises close to 60% of the insured population who are exempt from paying premiums and registration fees. As of 2017, 35% of the Ghanaian population was actively enrolled in the scheme with ongoing plans by the government to expand enrollment of the uninsured [17]. NHIS has been praised for its efforts in achieving equity and inclusion in health insurance schemes in LMICs and has served as a model for many countries in Sub-Saharan Africa that are undergoing health reform [18].…”

Section: The Experience Of Ghana With Universal Health Coveragementioning

confidence: 99%

Does insurance protect individuals from catastrophic payments for surgical care? An analysis of Ghana’s National Health Insurance Scheme at Korle-Bu teaching Hospital

Okoroh

Sarpong

Essoun

et al. 2020

BMC Health Serv Res

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Background: According to the World Health Organization, essential surgery should be recognized as an essential component of universal health coverage. In Ghana, insurance is associated with a reduction in maternal mortality and improved access to essential medications, but whether it eliminates financial barriers to surgery is unknown. This study tested the hypothesis that insurance protects surgical patients against financial catastrophe. Methods: We interviewed patients admitted to the general surgery wards of Korle-Bu Teaching Hospital (KBTH) between February 1, 2017-October 1, 2017 to obtain demographic data, income, occupation, household expenditures, and insurance status. Surgical diagnoses and procedures, procedural fees, and anesthesia fees incurred were collected through chart review. The data were collected on a Qualtrics platform and analyzed in STATA version 14.1. Fisher exact and Student T-tests were used to compare the insured and uninsured groups. Threshold for financial catastrophe was defined as health costs that exceeded 10% of household expenditures, 40% of non-food expenditures, or 20% of the individual's income. Results: Among 196 enrolled patients, insured patients were slightly older [mean 49 years vs 40 years P < 0.05] and more of them were female [65% vs 41% p < 0.05]. Laparotomy (22.2%) was the most common surgical procedure for both groups. Depending on the definition, 58-87% of insured patients would face financial catastrophe, versus 83-98% of uninsured patients (all comparisons by definition were significant, p < .05). Conclusion: This study-the first to evaluate the impact of insurance on financial risk protection for surgical patients in Ghana-found that although insured patients were less likely than uninsured to face financial catastrophe as a result of their surgery, more than half of insured surgical patients treated at KBTH were not protected from financial catastrophe under the Ghana's national health insurance scheme due to out-of-pocket payments. Government-specific strategies to increase the proportion of cost covered and to enroll the uninsured is crucial to achieving universal health coverage inclusive of surgical care. Trial registration: Registered at www.clinical trials.gov identifier NCT03604458.

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“…The National Health Insurance Scheme (NHIS) was introduced in 2004 as an alternative healthcare financing mechanism in Ghana [6]. The NHIS provides free enrollment for Social Security and National Insurance Trust (SSNIT) retirees, persons aged 70 years or older, pregnant women, children under 18 years and paupers [7].…”

Section: Introductionmentioning

confidence: 99%

“…The national enrollment rates of NHIS in 2010, 2015 and 2017 were 33% (8.2 million), 41% (11.3 million) and 35% (10.3 million) respectively. With this, the enrollment rate of NHIS among informal sector workers in 2017 was 29.8% [6], which is below the 2017 national enrollment rate. This shows that informal sector workers have a low enrollment rate in NHIS despite their frequent exposure to occupational hazards [10] such as physical, chemical, biological [11] and other occupational injuries [12].…”

Section: Introductionmentioning

confidence: 99%

Predictors of enrollment in a health protection scheme among informal sector workers in Kumasi Metropolis of Ghana

2019

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ObjectiveInformal sector workers are exposed to occupational hazards which could escalate their healthcare expenditures. Thus, enrollment in a health protection scheme among informal sector workers is useful for reducing their catastrophic healthcare expenditures. However, there is scant information on factors predicting their enrollment in the National Health Insurance Scheme (NHIS) in Ghana, a gap this quantitative study aims to fill. A sample of 350 informal sector workers was involved in a cross-sectional survey.ResultsApproximately 17% of the participants were enrolled in NHIS. Respondents who had worked between 5 and 7 years were significantly more likely to enroll in NHIS compared with those who had worked below 2 years (AOR = 13.159, CI 1.135–152.596, p = 0.039). The study further found that apprentices (AOR = 0.72, CI 0.353–1.056, p = 0.005) were less likely to enroll in NHIS compared with their masters. Participants who were exposed to electrical hazards (AOR = 2.93, CI 1.56–5.10, p = 0.013) and suffered from occupational diseases (AOR = 2.75, CI 1.743–5.17, p = 0.001) were significantly more likely to enroll in NHIS. Also, respondents who were non-Christians were significantly less likely to enroll in NHIS compared with their respective counterparts (AOR = 0.726, CI 0.067–2.503, p = 0.011). The findings are useful for increasing the NHIS enrollment rate among informal sector workers in Ghana.

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Trends and characteristics of enrolment in the National Health Insurance Scheme in Ghana: a quantitative analysis of longitudinal data

Cited by 45 publications

References 41 publications

Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana: a cross-sectional study

Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana: a cross-sectional study

Does insurance protect individuals from catastrophic payments for surgical care? An analysis of Ghana’s National Health Insurance Scheme at Korle-Bu teaching Hospital

Predictors of enrollment in a health protection scheme among informal sector workers in Kumasi Metropolis of Ghana

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