UGSpace Repository :: Browsing by Author "Asante, F.A."

Browsing by Author "Asante, F.A."

Now showing 1 - 20 of 39

Actor roles and linkages in the agricultural innovation system: options for establishing a cocoa innovation platform in Ghana
(Taylor & Francis Group, 2021) Onumah, J.A.; Asante, F.A.; Osei, R.D.
Innovation platforms promote interactions among actors in an innovation system. Given the importance of the cocoa sub-sector to the Ghanaian economy, having an innovation platform is imperative for increasing innovative performance. Using qualitative data collection tools we obtained in-depth information on the roles and linkages of actors to provide options for the establishment/strengthening of the cocoa innovation platform in Ghana. Findings from the thematic and social network analysis suggest that stimulating the participation of farmer groups, actors in research, extension, policy, and the private sector is important as they have the power to attract and sustain relevant actors to the network and hold the structure of the cocoa innovation platform together. The study contributes to the literature by being the first study that has applied the SNA tool to the cocoa innovation system in Ghana and also by emphasizing the prominent role farmers and private sector actors play in such networks.
Adaptation to Urban Floods Among the Poor in the Accra Metropolitan Area
(University of Ghana, 2014-12) Abeka, E.A.; Asante, F.A.; Codjoe, S.N.; Laube, W.; University of Ghana, College of Humanities, Institute of Statistical, Social and Economic Research
Urbanisation and climate change are likely to induce more floods in African cities. Nonetheless, studies on public and private adaptation to floods that centre on the urban poor in Africa are scanty. Studies in this area largely reflect the structuralist conception of adaptation. This study departs from this top-down approach as it explores household and public adaptation to urban floods among the poor in Accra from an actor-oriented perspective. Specifically, the study objectives are to: a) analyse the causes of flooding in poor urban communities in Accra from various actor perspectives; b) understand the actions and challenges of actors involved in flood adaptation; and c) determine the correlates of household flood risk and private proactive adaptation choices among the poor in Accra. The study applied both exploratory and cross-sectional designs. Data collection methods under the exploratory design were literature review, in-depth interviews with key informants and focus group discussions in three communities, namely, Glefe, Mpoase and Agbogbloshie. A mini workshop for stakeholders in flood adaptation in Accra was organised to brainstorm on challenges within the network of actors. The study employed Kendall‟s Co-efficient of Concordance, network maps and content analyses of in-depth interviews as well as focus group discussions to achieve the first and second objectives. The cross-sectional aspect of the study involved structured interviews with 330 households selected through multi-stage sampling and using logistic and ordered probability regressions to analyse the results of the household survey to achieve objective three. The study found out that the level agreement on the perceived causes of flooding among actors involved flood adaptation in Accra was rather low. The differences in opinion were influenced by externalisation of blame and responsibility among actors as well as different actor interests. The challenges to public adaptation to urban floods in Accra are legal pluralism, strict adherence to organisational goals among formal institutions involved in flood adaptation and poor integration of local knowledge into formal flood abatement systems. There is also mistrust between local communities and the metropolitan level actors. At the household level, the predictors of flood adaptation choices were tenancy status, home elevation, type of wall material, perceptions about future occurrence of floods, perceived adaptation cost, perceived adaptation efficacy and availability of bonding social capital. The study also found out that taking precautionary measures ahead of floods and living in sandcrete houses away from water bodies and at high elevations reduced household susceptibility to property damage or loss from urban floods. The study recommends streamlining power relations among institutions involved in flood adaptation and integrating informal actors into the formal flood adaptation structures at the metropolitan level. Awareness creation programmes should focus on zoning regulations, future occurrence of floods and construction materials/methods in flood zones. Finally, in-situ community upgrading, flood zone planning and enforcement of zoning regulations is also recommended to minimise exposure to flood risk in the study communities.
Application of theory of planned behaviour to households’ source separation behaviour in Ghana
(Management of Environmental Quality: An International Journal, 2018-01) Alhassan, H.; Asante, F.A.; Oteng-Ababio, M.; Bawakyillenuo, S.
Purpose The purpose of this paper is to examine the factors that encourage households’ source separation behaviour in Accra and Tamale Metropolises in Ghana. Design/methodology/approach Using a cross-sectional design, 855 households of Ghana were interviewed based on the theoretical framework of the theory of planned behaviour (TPB). The ordered probit regression model was employed to examine the factors that influence households’ source separation intention. Findings The results indicated that educational attainment of head of household, total income of household, occupation type of household head, information, past experience with source separation, inconvenience in terms of time, space and availability of formal source separation scheme, attitude, subjective norm and the location of the respondents significantly predicted households’ solid waste separation intentions. Research limitations/implications The cross-sectional design does not determine causality but an association. Thus, future studies should examine actual household waste separation behaviour by using the experimental design to test the TPB model. Practical implications To promote solid waste separation at source, the public should be educated and provided with solid waste separation schemes that are efficient and compatible with households’ preference. Originality/value This study was partly motivated by the fact that despite the benefits associated with source separation, little attention has been given to formal source separation in Ghana. Moreover, there are limited studies on source separation behaviour in Ghana using the TPB as the theoretical framework.
Capacity constraints on local government environmental policies in Ghana
(Environmental Governance and Decentralisation, 2008-01) Asante, F.A.
This book examines how different countries define and address environmental issues, specifically in relation to intergovernmental relations: the creation of institutions, the assignment of powers, and the success of alternative solutions. It also investigates whether a systemic view of the environment has influenced the policy-making process. The broad perspective adopted includes a detailed analysis of seventeen countries in six continents by scholars from a range of disciplines – economics, political science, environmental science and law – thus producing novel material that moves away from the conventional treatment of decentralisation and the environment in economic literature.
Climate Change and Variability in Ghana: Stocktaking
(2015) Asante, F.A.; Amuakwa-Mensah, F.
This paper provides a holistic literature review of climate change and variability in Ghana by examining the impact and projections of climate change and variability in various sectors (agricultural, health and energy) and its implication on ecology, land use, poverty and welfare. The findings suggest that there is a projected high temperature and low rainfall in the years 2020, 2050 and 2080, and desertification is estimated to be proceeding at a rate of 20,000 hectares per annum. Sea-surface temperatures will increase in Ghana’s waters and this will have drastic effects on fishery. There will be a reduction in the suitability of weather within the current cocoa-growing areas in Ghana by 2050 and an increase evapotranspiration of the cocoa trees. Furthermore, rice and rooted crops (especially cassava) production are expected to be low. Hydropower generation is also at risk and there will be an increase in the incidence rate of measles, diarrheal cases, guinea worm infestation, malaria, cholera, cerebro-spinal meningitis and other water related diseases due to the current climate projections and variability. These negative impacts of climate change and variability worsens the plight of the poor, who are mostly women and children.
Common mental disorders, economic growth and development: Economic consequences and measurement issues
(2016) Asante, F.A.; Dzator, J.; Dzator, M.; Ahiadeke, C.
A large number of studies have attempted to discern the causes of low productivity and slow growth in developing countries especially in Sub-Saharan Africa (SSA). The effects of global economic integration, corruption, geography, financial aid and human capital indicators such as education have been widely explored. Despite the significant contribution of common mental disorders (CMDs) to poverty and to the burden of disease, mainstream growth analyses have not yet integrated the body of scholarship that identifies the linkages between CMDs and growth. There are potential benefits of prioritising CMDs in development strategies but there are several challenges. Among the greatest challenges is patchy mental health record. Poor data hinders the conceptualisation and the analyses of the effect of common mental disorders on economic growth and development. This paper explores the theoretical and empirical macro-growth effects of CMDs in sub-Saharan Africa. Preliminary theorizing and evidence suggest that improvement in CMDs is likely to be a stimulus to growth in SSA. We explore further the performance of a non-psychometric instrument known as the K-6 as a cost-effective instrument with which to measure community mental health in household surveys across populations that have various levels of infrastructure and literacy. The K-6 instrument which is a semi-structured questionnaire includes six non-specific psychometric items measuring negative affective states or psychological distress. We also collect socioeconomic data during the survey which enabled us to study the determinants of common mental health conditions among urban and rural households in Ghana. Urban and rural communities were analysed separately because they may demonstrate different determinants of CMDs. We report the outcome of the simple non-psychometric survey as well as the results from logistic regressions showing the factors that affect common mental disorders among the survey respondents. The results show that both urban and rural groups experienced diminished mental health during the food and fuel price hikes of 2008 and 2009, and from the global financial crises over the same period, compared with those who reported no mental distress. The coefficients from the logistic regression estimated by the maximum likelihood show spatial variations in mental health indicators by age, education, and per capita income. For this study, gender did not appear to be a good predictor of any of the specific psychological distress measures assessed.
Contested causes of flooding in poor urban areas in Accra, Ghana: an actor-oriented perspective
(Environment, Development and Sustainability, 2019-02) Abeka, E.; Asante, F.A.; Laube, W.; Codjoe, S.N.A.
It is well known that urbanisation and climate change are likely to induce more floods in existing flood-prone African cities. Previous contributions on the causes of flooding in urban areas mostly do not consider the actors involved in adaptation and do not acknowledge the diversity of knowledge they possess. In this study, the causes of urban floods in an African city are explored from an actor-oriented perspective. The Kendall coefficient of concordance method is used to analyse interviews with household members and community leaders living in flood-prone communities as well as technocrats involved in public flood adaptation at the metropolitan level. The level of agreement on the causes of flooding is low among the actors, making the case for integrating informal actors into the formal flood adaptation structures at the metropolitan level. This will harness the diversity of knowledge on how flood risk unfolds for the purpose of local adaptation to urban floods in African cities. © 2019, Springer Nature B.V.
Cost-effectiveness analysis of alcohol handrub for the prevention of neonatal bloodstream infections: Evidence from HAIGhana study
(PLOS ONE, 2022) Fenny, A.P.; Otieku, E.; Labi, K.A-K.; Asante, F.A.; Enemark, U.
Published evidence of the cost-effectiveness of alcohol-based handrub (ABH) for the prevention of neonatal bloodstream infections (BSI) is limited in sub-Saharan Africa. Therefore, this study evaluates the cost-effectiveness of a multimodal hand hygiene involving alcoholbased hand rub (ABH) for the prevention of neonatal BSI in a neonatal intensive care unit (NICU) setting in Ghana using data from HAI-Ghana study. Design was a before and after intervention study using economic evaluation model to assess the cost-effectiveness of a multimodal hand hygiene strategy involving alcohol-based hand rub plus soap and water compared to existing practice of using only soap and water. We measured effect and cost by subtracting outcomes without the intervention from outcomes with the intervention. The primary outcome measure is the number of neonatal BSI episode averted with the intervention and the consequent cost savings from patient and provider perspectives. The before and after intervention studies lasted four months each, spanning October 2017 to January 2018 and December 2018 to March 2019, respectively. The analysis shows that the ABH program was effective in reducing patient cost of neonatal BSI by 41.7% and BSI-attributable hospital cost by 48.5%. Further, neonatal BSI-attributable deaths and extra length of hospital stay (LOS) decreased by 73% and 50% respectively. Also, the post-intervention assessment revealed the ABH program contributed to 16% decline in the incidence of neonatal BSI at the NICU. The intervention is a simple and adaptable strategy with cost-saving potential when carefully scaled up across the country. Though the cost of the intervention may be more relative to using just soap and water for hand hygiene, the outcome is a good reason for investment into the intervention to reduce the incidence of neonatal BSI and the associated costs from patient and providers’ perspectives.
Cost-pricing of Fertilizer and its Challenges in a Subsidized Market: The Case of Ghana
(Ghana Social Science Journal, 2015-05) Asante, F.A.; Awo, M.A.; Agyei-Sasu, F.
This paper aims to examine the distribution of subsidized fertilizer in Ghana. In this regard, fertilizer cost, market price build-up and profit margins of five major fertilizer market centers in Ghana were analysed. The current challenges in the fertilizer industry identified by this study were also analysed. The objectives set out in this work were attained through desk reviews and in-depth interview with major actors in the fertilizer value chain in Ghana. The study found that in the supply chain of fertilizer handling, storage and transportation activities, costs increase from importers down to farmers. Also, the farther away a market center is from the Tema port, the more transportation adds on to the price buildup. In order to deal with bottlenecks regarding the fertilizer supply chain, this paper recommends tackling issues related to transportation lapses, as well as to timeliness of arrival and offloading of imported fertilizer
Costs and Extra Length of Stay because of Neonatal Bloodstream Infection at a Teaching Hospital in Ghana.
(Adis, 2021) Fenny, A.P.; Otieku, E.; Labi, K.A.; Asante, F.A.; Enemark, U.
There are no published studies on the costs of hospital-acquired neonatal bloodstream infection (BSI) in Ghana. Therefore, this study aims to calculate the cost and extra length of stay (LOS) of neonatal BSI. A prospective case–control study was undertaken at the neonatal intensive care unit (NICU) of Korle Bu Teaching Hospital (KBTH) in Ghana. Methods The clinical data of 357 neonates were prospectively analysed. Overall, 100 neonates with BSI and 100 control neonates without BSI were matched by weight, sex and type of delivery. The direct and indirect costs to neonates and their caregivers was obtained on a daily basis. The cost of drugs was confrmed with the Pharmacy Department at KBTH. A count data model, specifcally negative binomial regression, was employed to estimate the extra LOS in the NICU due to neonatal BSI. The study analyzed the total, average and marginal costs of neonatal BSI for the case and control groups from the perspective of the patients/carers/providers. Fifty-four percent of the total sample were born with a low birth weight. Neonates with BSI recorded higher costs compared with neonates without BSI. The highest diference in direct costs was recorded among neonates with extremely low birth weight (US$732), which is 67% higher than similar neonates without BSI. The regression estimates show a signifcant correlation between neonatal BSI and LOS in the NICU (p<0.001). Neonates with BSI stayed an additional 10 days in the NICU compared with their matched cohort. The LOS varies signifcantly depending on the neonate’s weight at birth. The extra days range from 1 day for neonates defned as macrosomia to 15 extra days for extremely low birth weight neonates. Neonatal BSI was signifcantly associated with prolonged LOS. The continuous presence of experienced medical staf, as well as parents, to monitor newborns during their stay on the ward has enormous economic burden on both hospitals and caregivers
Decentralization & poverty reduction
(The Economy of Ghana: Analytical Perspectives on Stability, Growth and Poverty, 2010-01) Asante, F.A.; Ayee, J.R.A.
Introduction Decentralization has been considered by many as one of the most important strategies on the agenda of public sector reform. This is because donors and governments in sub-Saharan Africa have considered decentralization as a strategy that will bring service delivery closer to consumers, improve the responsiveness of the central government to public demands and thereby reduce poverty, improve the efficiency and quality of public services and empower lower units to feel more involved and in control. In this connection, decentralization is linked to the concept of subsidiarity, that is, making decisions at the lowest feasible level. It is also meant to reduce overload and congestion at the centre and speed up operational decision-making and implementation by minimizing the bottlenecks associated with over-centralization of powers and functions at just one or two points in the hierarchy of a public service organization or ministry; in other words, greater efficiency of public management, arising from improved co-ordination and shorter decision-making hierarchies (‘less bureaucracy’), and improvements in political stability through the legitimization of differences in local needs and perspectives (pluralism). Consequently, decentralization seeks to increase the operational autonomy of line managers and agencies, leaving only broad policy guidelines to be worked out at the centre (Smith, 1985; Rondinelli et al., 1989; Mawhood, 1993; Crook and Manor, 1998; Wunsch and Olowu, 1995; Olowu and Wunsch, 2004). © James Currey Ltd 2007.
Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study
(International Journal of Social Economics, 2018-04) Kusi, A.; Fenny, A.; Arhinful, D.K.; Asante, F.A.; Parmar, D.
Purpose The National Health Insurance Scheme (NHIS) was introduced in 2005 to provide equitable access to healthcare. Furthermore, concessions were made for pregnant women, yet inequities in access continue to exist. The purpose of this paper is to explore whether dimensions of social exclusion explain why some groups of women are not benefitting from the scheme. Design/methodology/approach Data were collected from 4,050 representative households in five districts. Logistic regression is used to examine the factors that determine enrolment of women under the NHIS. Findings The study sample consists of a sub-sample of 3,173 women out of whom 58 per cent were insured. The majority (64.9 per cent) of the women were in the reproductive age (15–45 years). The results show that wealth status, age, health status, locality, perception about the quality of care at health facilities and perception of the NHIS, are the key factors that determine enrolment into the scheme. Practical implications By conceptualising social exclusion as the multi-dimensional processes driven by unequal power relationships which lead to differential inclusion and exclusion in social systems, the study provides evidence to show that certain groups of women are systemically excluded from participating in the NHIS. Social implications With women dominating the informal sector of Ghana’s economy which is often characterised by relatively low incomes, these inequities in access need to be addressed. Originality/value Although gender equality incorporates discussions on issues affecting men and women this paper focusses on women in Ghana due to disadvantaged position in which many of them find themselves in terms of access to resources. Almost all of the identified barriers in previous studies have been worsened by gender with women generally facing greater difficulties in accessing adequate care. Few of these papers have taken account the specific health needs and gender-specific constraints of women in the NHIS. The authors aim to fill this gap by using a social exclusion lens to explore whether Ghanaian women (i.e. 15 years and above) are participating in the NHIS and examine the processes by which exclusion occurs and what explains the patterns observed.
The Determinants of Health and Nutrition of Children Under. Five in Ghana.
(University of Ghana, 1994-09) Asante, F.A.; Asenso-Okyere, W. K.; Fosu, K.Y.; University of Ghana, College of Basic and Applied Sciences, School of Agriculture, Department of Agricultural Economics and Agribusiness
This study examines the determinants of health and nutrition of children under five in Ghana using data on 2127 children and their households drawn from the Ghana Living Standards Survey in 1987/88 (GLSS I). The study reveals that Ghanaian children of 0 to 59 months obtain 82.7 percent of the recommended required daily allowance of calorie intake. Also the children weighed 9.9 percent higher than the recommended weight of 12.0 kg. It was further shown that the level of undernutrition of children under-five has not changed since 1980. About 29.5 percent of children are chronically undernourished, 27.2 percent are underweight and 7.1 percent are acutely undernourished. ,, Empirical results show that a 10 percent increases in income (proxied by total expenditure), household size in adult equivalent, relative prices of millet, garri, cocoyam and plantain to maize result in an increase of 9.56 percent, 0.73 percent, 5.45 percent, 6.04 percent, 3.33 percent and 3.45 percent of food available to the household, respectively. Similarly, a 10 percent increase in the relative prices of yam, cassava and guinea corn to maize result in a decrease in food availability to the household by 21.29 percent, 10.46 percent and 2.97 percent, respectively. The study further shows that food intake of the child and the genetic factors of parents have important roles in the determination of the health condition of children with elasticities of 0.019 and 0.445 respectively. Policy experiments with household expenditure, household size in adult equivalent, price of cassava and price of maize showed that percentage changes in the mean expenditures give the greatest impact on the food available to the child while percentage changes in the mean hous.ehold size in adult equivalent give the least impact.
Do farmer-actor interactions in the agricultural innovation system drive technological innovation adoption in Ghana?
(African Journal of Science, Technology, Innovation and Development, 2022) Onumah, J.A.; Asante, F.A.; Osei, R.D.; Asare-Nuamah, P.
The low level of technological innovation adoption among farmers has been a development concern. However, not much attention has been paid to how agricultural innovation system actors contribute to the adoption of technological innovations among farmers. This paper, therefore, analyzed the factors that drive the adoption of technological innovations using the agricultural innovation system concept. The study adopted a mixed-methods approach where qualitative data from focus group discussions was used to triangulate findings obtained from the quantitative data analyzed. A two-period panel data set of 3486 observations of randomly sampled agricultural households across Ghana was analyzed using descriptive statistics and the multinomial logit regression model. Findings showed that farmers with strong ties in the innovation system had a higher probability of adopting multiple sets of innovations, compared to those with weaker linkages. Platforms that encourage actor interactions, such as innovation platforms, should be strengthened to increase the innovative performance of smallholder farmers. This study is one of the few that has quantified the effect the agricultural innovation system has on the adoption of innovations and hence makes a positive contribution to the budding literature regarding the importance of unpacking actor interactions whilst considering a holistic inquiry of the agricultural innovation system.
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
(BMC Health Services Research, 2018-01) Andoh-Adjei, F.X.; Van Der Wal, R.; Nsiah-Boateng, E.; Asante, F.A.; Van Der Velden, K.; Spaan, E.
Background Ghana introduced a National Health Insurance Scheme (NHIS) in 2003 applying fee-for-service method for paying NHIS-credentialed health care providers. The National Health Insurance Authority (NHIA) later introduced diagnosis-related-grouping (DRG) payment to contain cost without much success. The NHIA then introduced capitation payment, a decision that attracted complaints of falling enrolment and renewal rates from stakeholders. This study was done to provide evidence on this trend to guide policy debate on the issue. Methods We applied mixed method design to the study. We did a trend analysis of NHIS membership data in Ashanti, Volta and Central regions to assess growth rate; performed independent-sample t-test to compare sample means of the three regions and analysed data from individual in-depth interviews to determine any relationship between capitation payment and subscribers’ renewal decision. Results Results of new enrolment data analysis showed differences in mean growth rates between Ashanti (M = 30.15, SE 3.03) and Volta (M = 40.72, SE 3.10), p = 0.041; r = 0. 15; and between Ashanti and Central (M = 47.38, SE6.49) p = 0.043; r = 0. 42. Analysis of membership renewal data, however, showed no significant differences in mean growth rates between Ashanti (M = 65.47, SE 6.67) and Volta (M = 69.29, SE 5.04), p = 0.660; r = 0.03; and between Ashanti and Central (M = 50.51, SE 9.49), p = 0.233. Analysis of both new enrolment and renewal data also showed no significant differences in mean growth rates between Ashanti (M = − 13.76, SE 17.68) and Volta (M = 5.48, SE 5.50), p = 0.329; and between Ashanti and Central (M = − 6.47, SE 12.68), p = 0.746. However, capitation payment had some effect in Ashanti compared with Volta (r = 0. 12) and Central (r = 0. 14); but could not be sustained beyond 2012. Responses from the in-depth interviews did not also show that capitation payment is a key factor in subscribers’ renewal decision. Conclusion Capitation payment had a small but unsustainable effect on membership growth rate in the Ashanti region. Factors other than capitation payment may have played a more significant role in subscribers’ enrolment and renewal decisions in the Ashanti region of Ghana.
Does capitation payment under national health insurance affect subscribers' trust in their primary care provider? a cross-sectional survey of insurance subscribers in Ghana
(BioMed Central Ltd., 2016) Andoh-Adjei, F.-X.; Cornelissen, D.; Asante, F.A.; Spaan, E.; Van Der Velden, K.
Background: Ghana introduced capitation payment for primary care in 2012 with the view to containing escalating claims expenditure. This shift in provider payment method raised issues about its potential impact on patient-provider trust relationship and insured-patients' trust in the Ghana National Health Insurance Scheme. This paper presents findings of a study that explored insured-patients' perception about, and attitude towards capitation payment in Ghana; and determined whether capitation payment affect insured-patients' trust in their preferred primary care provider and the National Health Insurance Scheme in general. Methods: We adopted a survey design for the study. We administered closed-ended questionnaires to collect data from insurance card-bearing members aged 18 years and above. We performed both descriptive statistics to determine proportions of observations relating to the variables of interest and chi-square test statistics to determine differences within gender and setting. Results: Sixty-nine per cent (69 %) out of 344 of respondents selected hospital level of care as their primary care provider. The two most important motivations for the choice of a provider were proximity in terms of geographical access (40 %) and perceived quality of care (38 %). Eighty-eight per cent (88 %) rated their trust in their provider as (very) high. Eighty-two per cent (82 %) actively selected their providers. Eighty-eight per cent (88 %) had no intention to switch provider. A majority (91 %) would renew their membership when it expires. Female respondents (91 %; n = 281) were more likely to renew their membership than males (87 %; n = 63). Notwithstanding capitation payment experience, 81 % of respondents would recommend to their peers to enrol with the NHIS with rural dwellers (87 %; n = 156) being more likely to do so than urban dwellers (76 %; n = 188). Almost all respondents (92 %) rated the NHIS as (very) good. Conclusion: Health Insurance subscribers in Ghana have high trust in their primary care provider giving them quality care under capitation payment despite their negative attitude towards capitation payment. They are guided by proximity and quality of care considerations in their choice of provider. The NHIA would, however, have to address itself to the negative perceptions about the capitation payment policy.
Does the National Health Insurance Scheme provide financial protection to households in Ghana?
(2015-08-15) Kusi, A.; Hansen, K.S.; Asante, F.A.; Enemark, U.
Abstract Background Excessive healthcare payments can impede access to health services and also disrupt the welfare of households with no financial protection. Health insurance is expected to offer financial protection against health shocks. Ghana began the implementation of its National Health Insurance Scheme (NHIS) in 2004. The NHIS is aimed at removing the financial barrier to healthcare by limiting direct out-of-pocket health expenditures (OOPHE). The study examines the effect of the NHIS on OOPHE and how it protects households against catastrophic health expenditures. Methods Data was obtained from a cross-sectional representative household survey involving 2,430 households from three districts across Ghana. All OOPHE associated with treatment seeking for reported illness in the household in the last 4 weeks preceding the survey were analysed and compared between insured and uninsured persons. The incidence and intensity of catastrophic health expenditures (CHE) among households were measured by the catastrophic health payment method. The relative effect of NHIS on the incidence of CHE in the household was estimated by multiple logistic regression analysis. Results About 36% of households reported at least one illness during the 4 weeks period. Insured patients had significantly lower direct OOPHE for out-patient and in-patient care compared to the uninsured. On financial protection, the incidence of CHE was lower among insured households (2.9%) compared to the partially insured (3.7%) and the uninsured (4.0%) at the 40% threshold. The incidence of CHE was however significantly lower among fully insured households (6.0%) which sought healthcare from NHIS accredited health facilities compared to the partially insured (10.1%) and the uninsured households (23.2%). The likelihood of a household incurring CHE was 4.2 times less likely for fully insured and 2.9 times less likely for partially insured households relative to being uninsured. The NHIS has however not completely eliminated OOPHE for the insured and their households. Conclusion The NHIS has significant effect in reducing OOPHE and offers financial protection against CHE for insured individuals and their households though they still made some out-of-pocket payments. Efforts should aim at eliminating OOPHE for the insured if the objective for establishing the NHIS is to be achieved.
Does the National Health Insurance Scheme provide financial protection to households in Ghana?
(BMC Health Services Research, 2015-08) Kusi, A.; Hansen, K.S.; Asante, F.A.; Enemark, U.
Background Excessive healthcare payments can impede access to health services and also disrupt the welfare of households with no financial protection. Health insurance is expected to offer financial protection against health shocks. Ghana began the implementation of its National Health Insurance Scheme (NHIS) in 2004. The NHIS is aimed at removing the financial barrier to healthcare by limiting direct out-of-pocket health expenditures (OOPHE). The study examines the effect of the NHIS on OOPHE and how it protects households against catastrophic health expenditures. Methods Data was obtained from a cross-sectional representative household survey involving 2,430 households from three districts across Ghana. All OOPHE associated with treatment seeking for reported illness in the household in the last 4 weeks preceding the survey were analysed and compared between insured and uninsured persons. The incidence and intensity of catastrophic health expenditures (CHE) among households were measured by the catastrophic health payment method. The relative effect of NHIS on the incidence of CHE in the household was estimated by multiple logistic regression analysis. Results About 36% of households reported at least one illness during the 4 weeks period. Insured patients had significantly lower direct OOPHE for out-patient and in-patient care compared to the uninsured. On financial protection, the incidence of CHE was lower among insured households (2.9%) compared to the partially insured (3.7%) and the uninsured (4.0%) at the 40% threshold. The incidence of CHE was however significantly lower among fully insured households (6.0%) which sought healthcare from NHIS accredited health facilities compared to the partially insured (10.1%) and the uninsured households (23.2%). The likelihood of a household incurring CHE was 4.2 times less likely for fully insured and 2.9 times less likely for partially insured households relative to being uninsured. The NHIS has however not completely eliminated OOPHE for the insured and their households. Conclusion The NHIS has significant effect in reducing OOPHE and offers financial protection against CHE for insured individuals and their households though they still made some out-of-pocket payments. Efforts should aim at eliminating OOPHE for the insured if the objective for establishing the NHIS is to be achieved.
Effects of rising food and oil prices on rural households in Ghana: A case study of selected communities in the dangme west district using the CBMS approach
(DLSU Business and Economics Review, 2010-07) Asante, F.A.; Tagoe, C.A.; Boakye, A.A.
This study sought to examine the effects of rising food and oil prices on rural households in Ghana in relation to their food, access to healthcare and education, changes in their work situations, their financial management practices, and their recreational and leisure practices using three selected communities in the Dangme West district of the Greater Accra region - Dodowa, Ningo, and Prampram. A total of 300 households were interviewed. The households were divided concerning the issue of whether their standard of living was better, worse or had remained the same. In general, households that indicated they were worse off currently than they were last year slightly outnumbered those who had seen improvements in their lives. © 2010 De La Salle University, Manila, Philippines.
The financial impact of puerperal infections on patients, carers and public hospitals in two regions in Ghana
(Wiley, 2021) Fenny, A.P.; Otieku, E.; Akufo, C.; Obeng-Nkrumah, N.; Asante, F.A.; Enemark, U.
Puerperal infection (PI) is a known maternal health problem globally. However, there is limited information on its economic impact on patients, carers, and public hospitals in lower-middle-income countries, such as Ghana. A prospective case-control study was undertaken in two regional hospitals to analyze the cost of PI. A total of 667 and 559 participants were enrolled in the study at the Greater Accra Regional Hospital (GARH) and the Eastern Regional Hospital (ERH), respectively. Total, average and marginal costs were analyzed between patients with and without PI. Within the study period, the prevalence of PI was 9.1% at ERH and 14.9% at GARH. Overall, patients with PI reported excess length of hospital stay (LOS), corresponding to 46.8% and 33.5% increases in average direct cost at ERH and GARH, respectively, compared with their control groups. In almost all cases, the attributable indirect cost was consistent with productivity loss. In both hospitals, patients with PI reported excess LOS and increased direct and indirect costs. The total cost of PI to society, which is the sum of the direct cost, productivity loss, and hospital cost, was higher in Greater Accra than in the Eastern region.

Browsing by Author "Asante, F.A."

Results Per Page

Sort Options