Journal article
Unawareness of health insurance expiration status among women of reproductive age in Northern Ghana: implications for achieving universal health coverage.
- Kanmiki EW Regional Institute for Population Studies, University of Ghana, Accra, Ghana. eddy100@hotmail.com.
- Bawah AA Regional Institute for Population Studies, University of Ghana, Accra, Ghana.
- Akazili J Research and Development Division, Ghana Health Service, Accra, Ghana.
- Agorinyah I Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
- Awoonor-Williams JK Policy, Planning, Monitoring and Evaluation Division, Ghana Health Service, Accra, Ghana.
- Phillips JF Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, USA.
- Kassak KM Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
- 2019-11-29
Published in:
- Journal of health, population, and nutrition. - 2019
Ghana
Health insurance
Unawareness
Universal health coverage
Adolescent
Adult
Cross-Sectional Studies
Female
Ghana
Health Services Accessibility
Humans
Insurance Benefits
Medically Uninsured
Middle Aged
National Health Programs
Poverty
Surveys and Questionnaires
Universal Health Insurance
Women
Young Adult
English
BACKGROUND
Ghana implemented a national health insurance scheme in 2005 to promote the provision of accessible, affordable, and equitable healthcare by eliminating service user fees. Termed the National Health Insurance Scheme (NHIS), its active enrollment has remained low despite a decade of program implementation. This study assesses factors explaining this problem by examining the correlates of insurance status unawareness among women of reproductive age.
METHODS
In 2015, a random probability cross-sectional survey of 5914 reproductive-aged women was compiled in the Upper East Region, an impoverished and remote region in Northern Ghana. During the survey, two questions related to the NHIS were asked: "Have you ever registered with the NHIS?" and "Do you currently have a valid NHIS card?" If the answer to the second question was yes, the respondents were requested to show their insurance card, thereby enabling interviewers to determine if the NHIS requirement of annual renewal had been met. Results are based on the tabulation of the prevalence of unawareness status, tests of bivariate associations, and multivariate estimation of regression adjusted effects.
RESULTS
Of the 5914 respondents, 3614 (61.1%) who reported that they were actively enrolled in the NHIS could produce their insurance cards upon request. Of these respondents, 1243 (34.4%) had expired cards. Factors that significantly predicted unawareness of card expiration were occupation, district of residence, and socio-economic status. Relative to other occupational categories, farmers were the most likely to be unaware of their card invalidity. Respondents residing in three of the study districts were less aware of their insurance card validity than the other four study districts. Unawareness was observed to increase monotonically with relative poverty.
CONCLUSION
Unawareness of insurance care validity status contributes to low active enrollment in Ghana's NHIS. Educational messages aimed at improving health insurance coverage should include the promotion of annual renewal and also should focus on the information needs of farmers and low socio-economic groups.
Ghana implemented a national health insurance scheme in 2005 to promote the provision of accessible, affordable, and equitable healthcare by eliminating service user fees. Termed the National Health Insurance Scheme (NHIS), its active enrollment has remained low despite a decade of program implementation. This study assesses factors explaining this problem by examining the correlates of insurance status unawareness among women of reproductive age.
METHODS
In 2015, a random probability cross-sectional survey of 5914 reproductive-aged women was compiled in the Upper East Region, an impoverished and remote region in Northern Ghana. During the survey, two questions related to the NHIS were asked: "Have you ever registered with the NHIS?" and "Do you currently have a valid NHIS card?" If the answer to the second question was yes, the respondents were requested to show their insurance card, thereby enabling interviewers to determine if the NHIS requirement of annual renewal had been met. Results are based on the tabulation of the prevalence of unawareness status, tests of bivariate associations, and multivariate estimation of regression adjusted effects.
RESULTS
Of the 5914 respondents, 3614 (61.1%) who reported that they were actively enrolled in the NHIS could produce their insurance cards upon request. Of these respondents, 1243 (34.4%) had expired cards. Factors that significantly predicted unawareness of card expiration were occupation, district of residence, and socio-economic status. Relative to other occupational categories, farmers were the most likely to be unaware of their card invalidity. Respondents residing in three of the study districts were less aware of their insurance card validity than the other four study districts. Unawareness was observed to increase monotonically with relative poverty.
CONCLUSION
Unawareness of insurance care validity status contributes to low active enrollment in Ghana's NHIS. Educational messages aimed at improving health insurance coverage should include the promotion of annual renewal and also should focus on the information needs of farmers and low socio-economic groups.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s41043-019-0190-4
- PMID 31775904
- Persistent URL
- https://folia.unifr.ch/global/documents/299260
Statistics
Document views: 19
File downloads: