Browsing by Author "Chatio, S.T."
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Item Challenges and experiences in linking community level reported out-of-pocket health expenditures to health provider recorded health expenditures: Experience from the iHOPE project in Northern Ghana(PLOS ONE, 2021) Agorinya, I.A.; Dalaba, M.; Mensah, N.K.; Chatio, S.T.; Le, L.M.; Bacha, Y.D.; Sumboh, J.; Flores, G.; Edejer, T.T-T.; Ross, A.; Tediosi, F.; Akazil, J.Out of pocket health payment (OOPs) has been identified by the System of Health Accounts (SHA) as the largest source of health care financing in most low and middle-income countries. This means that most low and middle-income countries will rely on user fees and copayments to generate revenue, rationalize the use of services, contain health systems costs or improve health system efficiency and service quality. However, the accurate measurement of OOPs has been challenged by several limitations which are attributed to both sampling and non-sampling errors when OOPs are estimated from household surveys, the primary source of information in LICs and LMICs. The incorrect measurement of OOP health payments can undermine the credibility of current health spending estimates, an otherwise important indicator for tracking UHC, hence there is the need to address these limitations and improve the measurement of OOPs. In an attempt to improve the measurement of OOPs in surveys, the INDEPTH-Network Household out-of-pocket expenditure project (iHOPE) developed new modules on household health utilization and expenditure by repurposing the existing Ghana Living Standards Survey instrument and validating these new tools with a ‘gold standard’ (provider data) with the aim of proposing alternative approaches capable of producing reliable data for estimating OOPs in the context of National Health Accounts and for the purpose of monitoring financial protection in health. This paper reports on the challenges and opportunities in using and linking household reported out-of-pocket health expenditures to their corresponding provider records for the purpose of validating household reported out-of-pocket health expenditure in the iHOPE project.Item How does it affect service delivery under the National Health Insurance Scheme in Ghana? Health providers and insurance managers perspective on submission and reimbursement of claims(PLOS ONE, 2021) Akweongo, P.; Chatio, S.T.; Owusu, R.; Salari, P.; Tedisio, F.; Aikins, M.In 2003, the Government of Ghana launched the National Health Insurance Scheme (NHIS) to enable all Ghanaian residents to have access to health services at the point of care without financial difficulty. However, the system has faced a number of challenges relating to delays in submission and reimbursement of claims. This study assessed views of stakeholders on claims submission, processing and re-imbursement under the NHIS and how that affected health service delivery in Ghana. The study employed qualitative methods where in-depth interviews were conducted with stakeholders in three administrative regions in Ghana. Purposive sampling method was used to select health facilities and study participants for the interviews. QSR Nvivo 12 software was used to code the data into themes for thematic analysis. The results point to key barriers such as lack of qualified staff to process claims, unclear vetting procedure and the failure of National Health Insurance Scheme officers to draw the attention of health facility staff to resolve discrepancies on time. Participants perceived that lack of clarity, inaccurate data and the use of non-professional staff for NHIS claims vetting prolonged reimbursement of claims. This affected operations of credentialed health facilities including the provision of health services. It is perceived that unavailability of funds led to reuse of disposable medical supplies in health service delivery in credentialed health facilities. Stakeholders suggested that submission of genuine claims by health providers and regular monitoring of health facilities reduces errors on claims reports and delays in reimbursement of claims. Long delays in claims reimbursement, perceived vetting discrepancies affect health service delivery. Thus, effective collaboration of all stakeholders is necessary in order to develop a long-term strategy to address the issue under the NHIS to improve health service delivery.Item Publish and still perish? Learning to make the ‘right’ publishing choices in the Ghanaian academy(Higher Education Research & Development, 2023) Chatio, S.T.; Tindana, P.; Akweongo, P.; Mills, D.Publication in ‘reputable’, peer-reviewed and indexed journals has become a key requirement for promotion and career advancement in African universities. There is little research into how bibliometric measures of journal reputation are shaping the publishing strategies and practices of Africa-based researchers. This study, drawing on 43 in-depth interviews, explored the publishing choices, tactics and discourses of early-career academics at two different public universities in Ghana. Most participants felt under constant pressure to publish, and more than half invoked the ‘publish or perish’ aphorism unprompted in conversation. They were also very aware that one could ‘publish and perish’ by choosing the ‘wrong’ journals, such as those not on university-approved lists or in the main global citation indexes. Some regretted the journal choices they had made at the start of their careers, and had since learnt to make every publication ‘count’. Many invoked a moral and spatial dichotomy of low-quality ‘local’ journals versus reputable ‘international’ journals. Most participants felt that more training, supervision and mentorship would help them make the ‘right’ publishing choices. In a global research economy that sustains geographical inequalities and reputational hierarchies, journals published from Africa are increasingly viewed as the ‘wrong’ choice.