Experiences of the Insured and Non-Insured of the NHIS in Accessing Health-care in Tema, Ghana

Robert Teye Plahar, Dai Baozhen, Abubakar Saddiqque, Sandra Asantewaa Mensah

Abstract


The study analyzes the impacts emanating from the National Health Insurance Scheme in its attempt to ensuring that Ghanaians can access quality and affordable health-care. The study focuses on three hospitals; CJ Medical Centre, Sakumono Community Hospital and Tema General Hospital in the Tema, Ghana.

To realize the objectives, the study applies a mixed approach to collecting and analyzing data. An interview guide and semi-structured criteria are used in the collection of data. The collected data included qualitative and quantitative data and were analyzed using color coding based on emerging themes and SPSS 18 respectively. The study was able to establish that, comparatively, people insured by the NHIS have enhanced accessibility when it comes to health-care, than the non-insured. The insured enjoy benefits from the Scheme and together with their children below 18 years enjoy free laboratory, OPD dispensary and consultation services, and some surgical procedures in both private and public hospitals.

On the contrary, the non-insured have no option other than paying for the same services when in need of medical attention. However, non-insured who have cash at the ready are readily attended to while those enrolled on the NHIS may have to wait a bit longer to be served.

Recommendations include authorities ensuring claims are settled promptly, expansion of number of drugs and conditions covered by the NHIS, reduction in premiums and measures to ensure health workers are not biased against the insured.


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References


Agyepong, I. A., & Adjei, S. (2008). Public social policy development and implementation: a case study of the Ghana National Health Insurance scheme. Health policy and planning, 23(2), 150-160. https://doi.org/10.1093/heapol/czn002

Asfaw, A., & Von Braun, J. (2004). Can community health insurance schemes shield the poor against the downside health effects of economic reforms? The case of rural Ethiopia. Health policy, 70(1), 97-108. https://doi.org/10.1016/j.healthpol.2004.02.005

Beaulieu, D. (2001). The Longer View: Moving Toward Population Health in the Federal Sector. In Advancing Federal Sector Health Care (pp. 5-16). Springer, New York, NY. https://doi.org/10.1007/978-1-4757-3439-3_1

Berk, M. L., & Monheit, A. (2001). The Concentration of Health Care Expenditures, Revisited. Health Affairs, 20(2), 9-18. https://doi.org/10.1377/hlthaff.20.2.9

Blanchet, N. J., Fink, G., & Osei-Akoto, I. (2012). The effect of Ghana’s National Health Insurance Scheme on health care utilisation. Ghana medical journal, 46(2), 76-84.

Brugiavini, A., & Pace, N. (2016). Extending health insurance in Ghana: effects of the National Health Insurance Scheme on maternity care. Health economics review, 6(1), 7. https://doi.org/10.1186/s13561-016-0083-9

Carrin, G., Waelkens, M. P., & Criel, B. (2005). Community‐based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Tropical medicine & international health, 10(8), 799-811. https://doi.org/10.1111/j.1365-3156.2005.01455.x

Chalkidou, K., Tunis, S., Lopert, R., Rochaix, L., Sawicki, P. T., Nasser, M., & Xerri, B. (2009). Comparative effectiveness research and evidence‐based health policy: experience from four countries. The Milbank Quarterly, 87(2), 339-367. https://doi.org/10.1111/j.1468-0009.2009.00560.x

Creese, A. L. (1991). User charges for health care: a review of recent experience. Health policy and planning, 6(4), 309-319. https://doi.org/10.1093/heapol/6.4.309

Fuseini, S., & Anthony, S. (2018). To: Plos One Knowledge, experiences and perceptions of the Ghana National Health Insurance Scheme in three districts. bioRxiv, 490359. https://doi.org/10.1101/490359

Geller, R. J. (2001). The first year of Health Improvement Programmes; views from directors of public health. Journal of Public Health, 23(1), 57-64. https://doi.org/10.1093/pubmed/23.1.57

History of Ghana. (2006). Wikipedia. Retrieved from: http://en.wikipedia.org/w/index

Jehu-Appiah, C., Aryeetey, G., Spaan, E., De Hoop, T., Agyepong, I., & Baltussen, R. (2011). Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why? Social science & medicine, 72(2), 157-165. https://doi.org/10.1016/j.socscimed.2010.10.025

Jütting, J. P. (2004). Do community-based health insurance schemes improve poor people’s access to health care? Evidence from rural Senegal. World development, 32(2), 273-288. https://doi.org/10.1016/j.worlddev.2003.10.001

Kritz, J. (2018). Building cross-sector collaboration using participatory action research to improve community health in an urban slum in Accra, Ghana. The Lancet Global Health, 6, S38. https://doi.org/10.1016/S2214-109X(18)30167-0

Nolan, B., & Turbat, V. (1995). Cost recovery in public health services in sub-Saharan Africa. The World Bank. https://doi.org/10.1596/0-8213-3240-6

Nsiah-Boateng, E. (2014). Claims Reimbursement Analysis of the National Health Insurance Scheme in Ghana. Value in Health, 17(7), A432. https://doi.org/10.1016/j.jval.2014.08.1101

Robertson, S. (2001). Health promotion in youth work settings. Health promotion–professional perspectives. 2nd edition. London: Palgrave & The open university, 169-188. https://doi.org/10.1007/978-1-137-11320-7_15

Seshamani, V. (2016). Faculty of 1000 evaluation for Extending health insurance in Ghana: effects of the National Health Insurance Scheme on maternity care. F1000 - Post-publication peer review of the biomedical literature. Health Policy and Planning, 10(3), 241-256. https://doi.org/10.3410/f.726178773.793514964

Willis, C. Y., & Leighton, C. (1995). Protecting the poor under cost recovery: the role of means testing. Health policy and planning, 10(3), 241-256. https://doi.org/10.1093/heapol/10.3.241

World Bank. (1988). Financing health services in developing countries : an agenda for reform (English). A World Bank policy study. Washington DC; World Bank. Financing health services in developing countries : an agenda for reform (English) | The World Bank. https://doi.org/10.1596/0-8213-0900-5

World Health Organisation (2009). World health statistics. World Health Organisation, Geneva.




DOI: https://doi.org/10.5296/jpag.v10i1.16130

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