Abstract
BackgroundOlder people utilise more healthcare services and are likely to incur higher healthcare expenditure, however, data on their healthcare financing mechanisms are scarce in low-and middle- income countries including Ghana. In this study, we aimed at exploring how poor older people finance their healthcare in rural Ghana.MethodsWe conducted in-depth interviews and focus group discussions with 60 study participants comprising 30 poor older people, 15 healthcare providers and 15 caregivers in Atwima Nwabiagya District of Ghana. Data were analysed using thematic analytical framework and presented based on an a posteriori inductive reduction approach.ResultsThe study revealed that poor older people finance their healthcare through personal income, family support, Livelihood Empowerment Against Poverty grants and National Health Insurance Scheme subscription. It was also found that poor older people spent between GH¢ 20 and 250 on drugs, laboratory test and hospitalisation anytime they access a healthcare facility.ConclusionThe findings contribute to our understanding of how poor older people finance their healthcare in rural Ghana. We argue that health stakeholders should strengthen healthcare financing mechanisms for poor older people for optimal healthcare use.
Highlights
Discussions on sustainable healthcare financing mechanisms for vulnerable people are still ongoing [1]
Data from this study drew on reports and findings from one of the qualitative sections of the original study exploring how poor older people finance their healthcare in rural Ghana
All the poor older people had enrolled on the National Health Insurance Scheme (NHIS) before but 7 had not renewed their NHIS card because they did not know that the card must be renewed annually
Summary
Discussions on sustainable healthcare financing mechanisms for vulnerable people are still ongoing [1]. Ghana’s healthcare system was financed by tax revenue and external assistance without any charges at the point of service [1]. This was due to the political ideology of promoting free healthcare and education in the country [3]. To improve financial accessibility for the poorest and most vulnerable, there is a free membership of the NHIS to certain portions of the population—exempt group. This group consists of Social Security and National Insurance. We aimed at exploring how poor older people finance their healthcare in rural Ghana
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