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Abstract
The study aimed at analysing the determinants of enrolment in the Ghana’s national health insurance scheme. This survey was carried out to collect cross-sectional information from a representative sample of 384 households using a pre-tested interviewer-administered questionnaire. Multistage sampling procedure was used to select the respondents. Binary logit model was used to estimate the determinants of enrolment to the scheme. The findings show that factors such as age, occupation, place of residence, income and wealth, play an important role in shaping individuals’ and households’ decision to enrol. Additionally, sex, marital status, household size, and distance significantly influenced individual’s decision to enrol whereas education influences household enrolment. It is recommended that appropriate educational packages be organised for the citizenry to encourage families to enrol, as the scheme prevents impoverishment resulting from catastrophic health expenditures and also improves access to healthcare. Targeted demand-side subsidy for the indigents would contribute to welfare gain and could help government achieve universal healthcare coverage. Keywords : National Health Insurance Scheme, Determinants, Enrolment, Healthcare and Ghana
Highlights
In recent years, populations in most industrial nations enjoy universal access to a comprehensive range of health services that are financed through a combination of tax revenues, social insurance, private insurance, and charges (Preker, 1998)
Logit model was used to estimate the determinants of enrolment at both individual and household levels
The results drawn from the logit models concluded that individuals’ decision to enrol on the scheme is significantly influenced by sex, age, marital status, government worker and artisan occupations, household size, distance, place of residence, income and wealth
Summary
Populations in most industrial nations enjoy universal access to a comprehensive range of health services that are financed through a combination of tax revenues, social insurance, private insurance, and charges (Preker, 1998). A number of low and middle-income countries such as Costa Rica, Malaysia, Sri Lanka, and Zambia have tried to follow a similar path, but the quest for financial protection against the cost of illness has been far from reality. Ill households in the low-income countries those in the rural areas continue to use home remedies, traditional healers, and local providers who are often outside the formal healthcare system. Over the past several years, some African countries have established national health insurance schemes to improve access to healthcare services because it avoids direct payment and spreads the financial risk among insured members
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