Beyond Minimisation of Personal Healthcare Financing Risks: An Ethnographic Study of Motivations for Joining Ghana’s Health Insurance Scheme in Daakye District

Abstract

This article discusses the manner in which local contexts influence people to join health insurance schemes. The text is based on an ethnographic study that explored the modes of use of Ghana's National Health Insurance Scheme (NHIS) in the Daakye District, Ghana. The content is drawn from the author's Master of Anthropology thesis and the themes that emerged from participant observation and interviews with thirty respondents. Five reasons why people joined the NHIS in the research locality are presented. The findings show that 1) the prevailing sociocultural realities of Daakye District - where individuals saw themselves as being part of families, with socio-economic obligations - influenced how the local people received and used the NHIS; 2) people bought health insurance policies to minimise the healthcare financial risks for themselves and their families and other strategic reasons and 3) the conceptual framing of Ghana's NHIS policy was biased towards the individual rather than families. The study recommends a review of the individual focus of the NHIS to improve its cost effectiveness and operational efficiencies.