Factors contributing to low uptake and renewal of health insurance: a qualitative study in Ghana

Simple item page
dc.contributor.authorFenny, A.P.
dc.contributor.authorKusi, A.
dc.contributor.authorArhinful, K.D.
dc.contributor.authorAsante, A.F.
dc.date.accessioned2019-02-04T09:46:29Z
dc.date.available2019-02-04T09:46:29Z
dc.date.issued2016
dc.description.abstractBackground: 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.en_US
dc.identifier.otherDOI 10.1186/s41256-016-0018-3
dc.identifier.other1:18, 1-10
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/27196
dc.language.isoenen_US
dc.subjectNational Health Insuranceen_US
dc.subjectSocioculturalen_US
dc.subjectBarriers to health careen_US
dc.subjectQualitative studyen_US
dc.titleFactors contributing to low uptake and renewal of health insurance: a qualitative study in Ghanaen_US
dc.typeArticleen_US

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Factors contributing to low uptake and renewal of health insurance. A qualitative study in Ghana.pdf
Size:
627.89 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.6 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Institute of Statistical, Social and Economic Research