Global Social Welfare and Social Policy Debates: Ghana’s Health Insurance Scheme Promotion of the Well-Being of Vulnerable Groups

Abstract

This article analyses social welfare, social policy with individualist and collectivist theoretical perspectives. It discusses the well-being of vulnerable groups and their access to social services including healthcare in the implementation of the National Health Insurance Scheme (NHIS) in Ghana. The aim is to find out the extent of vulnerable groups enrollment and if their welfare and well-being have improved in the implementation of Ghana’s health insurance scheme. Also, it examines whether NHIS is a pro-poor social intervention program or not. Data sources include census data, documents from health insurance authority, in-depth interviews, focus group discussions, direct observations at social service delivery points. Purposive, cluster and snowball sampling techniques are used to select participants. The sample size is 107 participants with 12 months of intensive data collection in three phases from 2012, 2013 and ended on October 2014. Results show more vulnerable groups are enrolled in NHIS compared with contributors. This suggests people who do not pay annual premiums constituted most health insurance subscribers. Also, the results show health insurance covered 38% of Ghana’s population for the 10 years of implementation of NHIS (2004–2013). Despite the progressive increase in coverage of NHIS, there are still some implementation challenges. The research found certain behaviors, practices, and attitudes of some social service providers as inhibiting subscribers’ enrollment. Future research may focus on social intervention programs for vulnerable groups across states.