Abstract
BackgroundThis study compares ownership of health insurance among Ghanaian women with respect to wealth status and spatial location. We explore the overarching research question by employing geographic and proxy means targeting through interactive analysis of wealth status and spatial issues.MethodsThe paper draws on the 2008 Ghana Demographic and Health Survey. Bivariate descriptive analysis coupled with binary logistic regression estimation technique was used to analyse the data.ResultsBy wealth status, the likelihood of purchasing insurance was significantly higher among respondents from the middle, richer and richest households compared to the poorest (reference category) and these differences widened more profoundly in the Northern areas after interacting wealth with zone of residence. Among women at the bottom of household wealth (poorest and poorer), there were no statistically significant differences in insurance subscription in all the areas.ConclusionsThe results underscore the relevance of geographic and proxy means targeting in identifying populations who may be need of special interventions as part of the efforts to increase enrolment as well as means of social protection against the vulnerable.
Highlights
This study compares ownership of health insurance among Ghanaian women with respect to wealth status and spatial location
The scheme is financed with funds from a National Health Insurance (NHI) levy, collected from an additional 2.5% on value-added tax (VAT); a monthly deduction of 2.5% from each formal sector worker’s contribution to the Social Security and National Insurance Trust (SSNIT) pension fund; interests from investments made by the scheme; an annual premium contribution from all informal sector workers and those formal sector workers who are not covered by the SSNIT pension scheme; and a registration fee paid by all National Health Insurance Scheme (NHIS) subscribers to their respective District Mutual Health Insurance Schemes (DMHIS) with which they are enrolled in the scheme
In respect of our main variables of interest, the proportion of registered women under the scheme increased with increase in wealth status (Table 1)
Summary
This study compares ownership of health insurance among Ghanaian women with respect to wealth status and spatial location. The cost of health care financing is one of the biggest social challenges and out-of-pocket payments present significant drains on household spending patterns, making health insurance one of the best social interventions [1]. The WHO [3] concept of equity in health financing states that individuals must be given the needed service based on the ability to pay. This calls for a system of financing that pools risks and resources from a greater majority to protect the most vulnerable against cost of illness [4,5,6]. Making health insurance in poor countries a reflection of social justice [7]
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