An Assessment of the Effectiveness of Complementary Services in Ghana’s Social Protection Landscape: A Case Study of the Shai-Osudoku District

Abstract

The Livelihood Empowerment Against Poverty (LEAP) programme was integrated with the National Health Insurance Scheme (NHIS) to enhance social protection by offering free health coverage to poor and vulnerable populations. This research, carried out in the Shai Osodoku district of the Greater Accra region, utilized a mixed-methods approach to assess the effectiveness of this policy initiative. The research highlights critical gaps and achievements in the programme's implementation, with significant policy implications. Findings revealed a widespread lack of awareness among beneficiaries about their rights and entitlements under the LEAP-NHIS integration, resulting in underutilization of healthcare services. The study found that most beneficiaries were informed about the integration only during their initial LEAP enrolment. However, those enrolled prior to the programme’s full establishment remain uncertain about their eligibility for free health insurance renewal, exacerbating the programme's underutilization. Despite these challenges, the program positively impacted beneficiaries' health and well-being, with many participants expressing satisfaction, particularly regarding reduced financial burdens for accessing healthcare. However, the study identified areas of dissatisfaction and neutral responses, primarily due to limited awareness of services, challenges in accessing prescribed medications under the NHIS, and negative user experiences with healthcare providers. Furthermore, while grievance redress mechanisms are put in place to address grievances and enhance accountability, most beneficiaries reported being unaware of these feedback channels. The study concludes that the LEAP-NHIS integration demonstrates huge potential for improving social protection outcomes for vulnerable populations. Yet, its effectiveness is hindered by several operational challenges. The study recommends that efforts are put in place for enhanced awareness campaigns, improved service delivery, strengthened grievance systems, and greater stakeholder collaboration to maximize the program’s impact on vulnerable populations.