Patterns of Enrolment and Use of Nhis By Leap Beneficiaries in The New Juaben Municipality

Abstract

The study focused on Patterns of enrolment and use of National Health Insurance Scheme (NHIS) by extremely poor households who are beneficiaries of a national cash transfer programme in Ghana known as Livelihood Empowerment Against Poverty (LEAP). The New-Juaben Municipality of the Eastern Region was selected as a case study because it has a high incidence of extremely poor people and a relatively low enrolment onto NHIS as compared to other districts in the Eastern Region. (NHIA 2014 Membership Report). The main objectives were to examine the patterns of enrolment and use of NHIS by LEAP beneficiaries, as well as administrative and operational challenges associated with enrolment. The study adopted a mixed method approach using both quantitative and qualitative methods. By means of a multi-stage sampling technique, primary data was collected through questionnaires for the quantitative aspect (N = 96) while the qualitative aspect included semi-structured interviews with 48 LEAP beneficiary household heads who have a total of 168 dependents. In addition, expert interviews were held with five staff of the National Health Insurance Authority (NHIA) in the New-Juaben Municipality. The main finding was that most of the LEAP beneficiary household heads and their dependents were enrolled on the LEAP in 2012 and 2013 with 91.7% enrolment onto the National Health Insurance Scheme. Yet, only 72.9% have been able to renew their NHIS cards. More than half of those whose cards were not renewed were children under 18 years. Although, all LEAP beneficiaries agreed that the NHIS had reduced their out-of pocket expenses, they were compelled to pay for some health services included in the minimum healthcare package that NHIS offered. On their part, the staff were challenged with inadequate logistics and network problems to facilitate the registration process. It is therefore essential for NHIA, the Ghana Health Service and the Ministry of Gender, Children and Social Protection to work together at addressing these logistics and practical challenges since countries with the highest enrolment onto the NHIS have resolved most of these challenges.