Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study

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dc.contributor.authorKusi, A.
dc.contributor.authorFenny, A.
dc.contributor.authorArhinful, D.K.
dc.contributor.authorAsante, F.A.
dc.contributor.authorParmar, D.
dc.date.accessioned2019-06-27T11:11:32Z
dc.date.available2019-06-27T11:11:32Z
dc.date.issued2018-04
dc.description.abstractPurpose The National Health Insurance Scheme (NHIS) was introduced in 2005 to provide equitable access to healthcare. Furthermore, concessions were made for pregnant women, yet inequities in access continue to exist. The purpose of this paper is to explore whether dimensions of social exclusion explain why some groups of women are not benefitting from the scheme. Design/methodology/approach Data were collected from 4,050 representative households in five districts. Logistic regression is used to examine the factors that determine enrolment of women under the NHIS. Findings The study sample consists of a sub-sample of 3,173 women out of whom 58 per cent were insured. The majority (64.9 per cent) of the women were in the reproductive age (15–45 years). The results show that wealth status, age, health status, locality, perception about the quality of care at health facilities and perception of the NHIS, are the key factors that determine enrolment into the scheme. Practical implications By conceptualising social exclusion as the multi-dimensional processes driven by unequal power relationships which lead to differential inclusion and exclusion in social systems, the study provides evidence to show that certain groups of women are systemically excluded from participating in the NHIS. Social implications With women dominating the informal sector of Ghana’s economy which is often characterised by relatively low incomes, these inequities in access need to be addressed. Originality/value Although gender equality incorporates discussions on issues affecting men and women this paper focusses on women in Ghana due to disadvantaged position in which many of them find themselves in terms of access to resources. Almost all of the identified barriers in previous studies have been worsened by gender with women generally facing greater difficulties in accessing adequate care. Few of these papers have taken account the specific health needs and gender-specific constraints of women in the NHIS. The authors aim to fill this gap by using a social exclusion lens to explore whether Ghanaian women (i.e. 15 years and above) are participating in the NHIS and examine the processes by which exclusion occurs and what explains the patterns observed.en_US
dc.identifier.citationAnthony Kusi, Ama Fenny, Daniel Kojo Arhinful, Felix Ankomah Asante, Divya Parmar, (2018) "Determinants of enrolment in the NHIS for women in Ghana – a cross sectional study", International Journal of Social Economics, Vol. 45 Issue: 9, pp.1318-1334, https://doi.org/10.1108/IJSE-10-2016-0291en_US
dc.identifier.otherhttps://doi.org/10.1108/IJSE-10-2016-0291
dc.identifier.otherVol. 45 Issue: 9, pp.1318-1334
dc.identifier.urihttp://ugspace.ug.edu.gh/handle/123456789/31076
dc.language.isoenen_US
dc.publisherInternational Journal of Social Economicsen_US
dc.subjectHousehold surveyen_US
dc.subjectGhanaen_US
dc.subjectWomenen_US
dc.subjectHealth insuranceen_US
dc.subjectEnrolmenten_US
dc.subjectSocial health protectionen_US
dc.titleDeterminants of enrolment in the NHIS for women in Ghana – a cross sectional studyen_US
dc.typeArticleen_US

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