Abstract
This paper discusses social health insurance, healthcare utilization, financial protection and quality of care. The primary purpose of the research is to provide an overview of evidence from up-to-date studies about the effects of Ghana’s Social Health Insurance Scheme on improving access to healthcare, reducing financial hardship, and providing quality care for the insured. Systematization of the literary sources indicates that healthcare costs hinder poor people from accessing healthcare services when needed. Social health insurance is one intervention used to support individuals to access healthcare services irrespective of their socioeconomic status. The methodological basis of this study is a systematic literature review through the searches of PubMed and Google Scholar databases. The author included studies that assessed the effects of SHI on financial protection, access to healthcare and quality of care. He also excluded studies with limitations that will hinder the reliability of the review’s findings. The author screened, extracted data and cross-checked the extracted data. The systematic review presents the results of an empirical analysis, which identified 209 articles and included 14 studies in this review: financial protection (7 studies), healthcare utilization (4 studies) and quality of care (4 studies). Among these studies, one study reported both utilization and financial protection. These studies were published between 2014 and 2020. social health insurance provides strong evidence of a positive impact on improving access to healthcare and protecting insurees against financial hardship. However, most insured people were not satisfied with the quality of care from the social health insurance providers. The results of this review remain relevant to policymakers, especially in developing countries where social insurance is not available for poor and vulnerable people. With the political will and determination, social health insurance is possible in any developing country.
Highlights
Half of the world's population cannot access essential healthcare services because they are poor, and many are being driven into poverty because they must pay for their medical fees out of their own pockets (World Bank, 2017)
This systematic review included studies that use a cross-sectional, qualitative approach and mixed methods to assess the effects of Social Health Insurance (SHI) on healthcare utilization, financial protection, and quality of care in Ghana
Older people, and adults constituted the participants of this review, and the intervention used by these participants was Ghana's National Health Insurance Scheme, known as social health insurance
Summary
Half of the world's population cannot access essential healthcare services because they are poor, and many are being driven into poverty because they must pay for their medical fees out of their own pockets (World Bank, 2017). In Nigeria, the poor hardly have access to healthcare services because they lack the financial power to pay for healthcare services (Adedini et al, 2014; Akpomuvie, 2010). In Ghana, due to the inability of the poor and the financial burden attached to the poor in accessing healthcare services when needed, the Ghanaian government in 2013 established the National Health Insurance Scheme (NHIS) Act 650. The Act intended to «ensure equitable and universal access for all residents of Ghana to an acceptable quality of essential healthcare» (Nguyen et al, 2011; Okoroh et al, 2018). The Ghanian government designed the NHIS to accommodate different principles, one of which is solidarity, a desired virtue in Social Health Insurance (SHI) (Ministry of Health, 2004)
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