Determinants of health insurance enrolment in Ghana: Evidence from three national household surveys

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dc.contributor.authorAikins, M.
dc.contributor.authorSalari, P.
dc.contributor.authorAkweongo, P.
dc.contributor.authorTediosi, F.
dc.date.accessioned2019-11-27T13:52:48Z
dc.date.available2019-11-27T13:52:48Z
dc.date.issued2019-08-21
dc.descriptionResearch Articleen_US
dc.description.abstractIn 2003, Ghana implemented a National Health Insurance Scheme (NHIS) to move towards Universal Health Coverage. NHIS enrolment is mandatory for all Ghanaians, but the most recent estimates show that coverage stands under 40%. The evidence on the relationship between socio-economic characteristics and NHIS enrolment is mixed, and comes mainly from studies conducted in a few areas. Therefore, in this study we investigate the socio-economic determinants of NHIS enrolment using three recent national household surveys. We used data from the Ghanaian Demographic and Health Survey conducted in 2014, the Multiple Indicator Cluster Survey conducted in 2011 and the sixth wave of the Ghana Living Standard Survey conducted in 2012–13. Given the multilevel nature of the three databases, we use multilevel logistic regression models to estimate the probability of enrolment for women and men separately. We used three levels of analysis: geographical clusters, household and individual units. We found that education, wealth, marital status—and to some extent— age were positively associated with enrolment. Furthermore, we found that enrolment was correlated with the type of occupation. The analyses of three national household surveys highlight the challenges of understanding the complex dynamics of factors contributing to low NHIS enrolment rates. The results indicate that current policies aimed at identifying and subsidizing underprivileged population groups might insufficiently encourage health insurance enrolmenten_US
dc.description.sponsorshipSwiss Program for Research on Global Issues for Development. This is a joint programme by the Swiss National Science Foundation (SNSF) and the Swiss Agency for Development and Cooperation (SDC).en_US
dc.identifier.otherdoi: 10.1093/heapol/czz079
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/33871
dc.language.isoenen_US
dc.publisherHealth Policy and Planningen_US
dc.relation.ispartofseries34;8
dc.subjectGhanaen_US
dc.subjecthealth insuranceen_US
dc.subjecthousehold surveysen_US
dc.subjectNHISen_US
dc.subjectdeterminants of enrolmenten_US
dc.titleDeterminants of health insurance enrolment in Ghana: Evidence from three national household surveysen_US
dc.typeArticleen_US

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