Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme

Abstract Background Following years of out-of-pocket payment for healthcare, some countries in Africa including Ghana, Kenya and Rwanda have instituted social health protection programs through health insurance to provide access to quality and affordable healthcare especially for the poor. This pape...

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Main Author: Fidelia A. A. Dake
Format: Article
Language:English
Published: BMC 2018-06-01
Series:International Journal for Equity in Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12939-018-0793-1
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spelling doaj-159e6c3808f84aefbec8785ae3679e682020-11-25T02:34:01ZengBMCInternational Journal for Equity in Health1475-92762018-06-0117111010.1186/s12939-018-0793-1Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance SchemeFidelia A. A. Dake0Regional Institute for Population Studies, University of GhanaAbstract Background Following years of out-of-pocket payment for healthcare, some countries in Africa including Ghana, Kenya and Rwanda have instituted social health protection programs through health insurance to provide access to quality and affordable healthcare especially for the poor. This paper examines equity in coverage under Ghana’s National Health Insurance Scheme (NHIS). Methods Secondary data from the 2008 Ghana Demographic and Health Survey based on an analytical sample of 4821 females (15–49 years) and 4568 males (15–59 years) were analysed using descriptive, bivariate and multivariate methods. Concentration curves and indices were used to examine equity in coverage on the NHIS. Results As at 2008, more than 60% of Ghanaians aged 15–59 years were not covered under the NHIS with slightly more females (38.9%) than males (29.7%) covered. Coverage was highest among the highly educated, professionals, those from households in the richest wealth quintile and urban residents. Lack of coverage was most concentrated among the poor. Conclusions Universal coverage under the NHIS is far from being achieved with marked exclusion of the poor. There is the need for deliberate action to enrol the poor under the NHIS.http://link.springer.com/article/10.1186/s12939-018-0793-1Universal health coverageNational Health Insurance SchemeGhanaEquity
collection DOAJ
language English
format Article
sources DOAJ
author Fidelia A. A. Dake
spellingShingle Fidelia A. A. Dake
Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme
International Journal for Equity in Health
Universal health coverage
National Health Insurance Scheme
Ghana
Equity
author_facet Fidelia A. A. Dake
author_sort Fidelia A. A. Dake
title Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme
title_short Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme
title_full Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme
title_fullStr Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme
title_full_unstemmed Examining equity in health insurance coverage: an analysis of Ghana’s National Health Insurance Scheme
title_sort examining equity in health insurance coverage: an analysis of ghana’s national health insurance scheme
publisher BMC
series International Journal for Equity in Health
issn 1475-9276
publishDate 2018-06-01
description Abstract Background Following years of out-of-pocket payment for healthcare, some countries in Africa including Ghana, Kenya and Rwanda have instituted social health protection programs through health insurance to provide access to quality and affordable healthcare especially for the poor. This paper examines equity in coverage under Ghana’s National Health Insurance Scheme (NHIS). Methods Secondary data from the 2008 Ghana Demographic and Health Survey based on an analytical sample of 4821 females (15–49 years) and 4568 males (15–59 years) were analysed using descriptive, bivariate and multivariate methods. Concentration curves and indices were used to examine equity in coverage on the NHIS. Results As at 2008, more than 60% of Ghanaians aged 15–59 years were not covered under the NHIS with slightly more females (38.9%) than males (29.7%) covered. Coverage was highest among the highly educated, professionals, those from households in the richest wealth quintile and urban residents. Lack of coverage was most concentrated among the poor. Conclusions Universal coverage under the NHIS is far from being achieved with marked exclusion of the poor. There is the need for deliberate action to enrol the poor under the NHIS.
topic Universal health coverage
National Health Insurance Scheme
Ghana
Equity
url http://link.springer.com/article/10.1186/s12939-018-0793-1
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