Browsing by Author "Arhinful, K.D."
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Item Factors contributing to low uptake and renewal of health insurance: a qualitative study in Ghana(2016) Fenny, A.P.; Kusi, A.; Arhinful, K.D.; Asante, A.F.Background: The effort to expand access to healthcare and reduce health inequalities in many low income countries have meant that many have adopted different levels of social health protection mechanisms. Ghana introduced a National Health Insurance Scheme (NHIS) in 2005 with the aim of removing previous barriers created by the user fees financing system. Although the NHIS has made health accessible to some category of people, the majority of Ghanaians (60 %) are not enroled on the scheme. Earlier studies have looked at various factors that account for this low uptake. However, we recognise that this qualitative study will nuance the depth of these barriers to enrolment. Methods: Minimally structured, qualitative interviews were conducted with key stakeholders at the district, regional and national levels. Focus group discussions were also undertaken at the community level. Using an inductive and content analytic approach, the transcripts were analyzed to identify and define categories that explain low uptake of health insurance. Results: The results are presented under two broad themes: sociocultural and systemic factors. Sociocultural factors identified were 1) vulnerability within certain groups such as the aged and the disabled groups which impeded access to the NHIS 2) cultural and religious norms which discouraged enrolment into the scheme. System-wide factors were 1) inadequate distribution of social infrastructure such as healthcare facilities, 2) weak administrative processes within the NHIS, and 3) poor quality of care. Conclusions: Mapping the interplay of these dynamic relations between the NHIS, its clients and service providers, the study identifies critical factors at the policy-making level, service provider level, and client level (reflective in household and community level institutional arrangements) that affect enrolment in the scheme. Our findings inform a number of potential reforms in the area of distribution of health resources and cost containment to expand coverage, increase choices and meeting the needs of the end user.Item Selective Indices of Health Seeking Behaviour among Ghanaians. A Study of Herbal and Orthodox Medical Regimens(University of Ghana, 1992-09) Arhinful, K.D.; Senah, K.A.; University of Ghana, College of Humanities, School of Social Sciences, Department of SociologyThis study concerns the determinants of the differential use of health care regimens. The focus is on herbal and orthodox medical regimens. Its central theme is that socio-cultural determinants constitute important factors that influence the sick in the selection of a health care regimen in developing African countries. The study pursues this theme by examining the complaint patterns of the two medical regimens, ascertaining the motivations that account for the basis of preference, the criteria upon which a therapeutic choice is made and the underlying motivations upon which the outcome is evaluated. The importance of the task is to gain a better understanding of health seeking behaviour of the sick in times of illness. Significant findings reflecting motivational and socio-cultural factors are made that tend to offer an explanation to the differential use of alternate health care resources. Knowledge of nature of illness (in terms of type and severity) predisposes one to choose a therapy which he considers appropriate from experience. The choice is usually organized in a "hierarchy of resorts". Herbal regimens appear to be used as "last" resorts in the hierarchy. The most important finding is that choice appears to be a function of the nature of illness and the perceived coverage capacity of a facility in terms of availability, accessibility, acceptability, contact and effective coverage. Overall, clients perceive service capacity of herbal treatment to be wider and better than orthodox treatment. Such a finding, it is suggested, has significant implications for public health in terms of the promotion of herbal medicine. By way of theoretical implication the study lends support to previous findings on the importance of efficacy testing in the differential use of health care resource (Colson 1971).