scholarly journals An exploration of moral hazard behaviors under the national health insurance scheme in Northern Ghana: a qualitative study

2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Cornelius Debpuur ◽  
Maxwell Ayindenaba Dalaba ◽  
Samuel Chatio ◽  
Martin Adjuik ◽  
Patricia Akweongo
Keyword(s):  
Health Insurance ◽  
Qualitative Study ◽  
Moral Hazard ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Northern Ghana ◽  
Insurance Scheme

scholarly journals Unawareness of health insurance expiration status among women of reproductive age in Northern Ghana: implications for achieving universal health coverage

2019 ◽  
Vol 38 (1) ◽  
Author(s):  
Edmund Wedam Kanmiki ◽  
Ayaga A. Bawah ◽  
James Akazili ◽  
Isaiah Agorinyah ◽  
John Koku Awoonor-Williams ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Reproductive Age ◽  
Northern Ghana ◽  
Women Of Reproductive Age ◽  
Insurance Scheme ◽  
Insurance Card

Abstract 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.

scholarly journals The state of enrollment on the National Health Insurance Scheme in rural Ghana after eight years of implementation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Anthony Kwarteng ◽  
James Akazili ◽  
Paul Welaga ◽  
Philip Ayizem Dalinjong ◽  
Kwaku Poku Asante ◽  
...  
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Care Expenditures ◽  
Health Insurance Scheme ◽  
Northern Ghana ◽  
Insurance Scheme ◽  
Factors Associated ◽  
The Poor

Abstract Background In 2004, Ghana implemented a national health insurance scheme (NHIS) as a step towards achieving universal health coverage. In this paper, we assessed the level of enrollment and factors associated with NHIS membership in two predominantly rural districts of northern Ghana after eight years of implementation, with focus on the poor and vulnerable populations. Methods A cross-sectional survey was conducted from July 2012 to December 2012 among 11,175 randomly sampled households with their heads as respondents. Information on NHIS status, category of membership and socio-demographic characteristics of household members was obtained using a structured questionnaire. Principal component analysis was used to compute wealth index from household assets as estimates of socio-economic status (SES). The factors associated with NHIS enrollment were assessed using logistic regression models. The reasons behind enrollment decisions of each household member were further investigated against their SES. Results Approximately half of the sampled population of 39,262 were registered with a valid NHIS card; 53.2% of these were through voluntary subscriptions by payment of premium whilst the remaining (46.8%) comprising of children below the ages of 18 years, elderly 70 years and above, pregnant women and formal sector workers were exempt from premium payment. Despite an exemption policy to ameliorate the poor and vulnerable households against catastrophic health care expenditures, only 0.5% of NHIS membership representing 1.2% of total exemptions granted on accounts of poverty and other social vulnerabilities was applied for the poor. Yet, cost of premium was the main barrier to NHIS registration (92.6%) and non-renewal (78.8%), with members of the lowest SES being worst affected. Children below the ages of 18 years, females, urban residents and those with higher education and SES were significantly more likely to be enrolled with the scheme. Conclusions Despite the introduction of policy exemptions as an equity measure, the poorest of the poor were rarely identified for exemption. The government must urgently resource the Department of Social Welfare to identify the poor for NHIS enrollment.

scholarly journals Factors Affecting Utilization of the National Health Insurance Scheme by Federal Civil Servants in Rivers State, Nigeria

2021 ◽  
Vol 58 ◽  
pp. 004695802110176
Author(s):  
Obelebra Adebiyi ◽  
Foluke Olukemi Adeniji
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Workers ◽  
Civil Servants ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Rivers State

The National Health Insurance Scheme (NHIS) of Nigeria was established in 2005. This study assessed the utilization of health care and associated factors amongst the federal civil servants using the NHIS in Rivers state. This was a descriptive cross-sectional study using self-administered questionnaires. Data were collated and analyzed using SPSS version 21.0. A Chi-square test was carried out. The level of Confidence was set at 95%, and the P-value ≤ .05. Out of a total of 334 respondents, 280 (83.8%) were enrolled for NHIS, 203 (72.5%) utilized the services of the scheme. Most 181 (82.1%) of the respondents who utilized visited the facility at least once in the preceding year. Although, 123 (43.9%) of the respondents made payments at a point of access to health care services, overall there was a reduction in out of pocket payment. Possession of NHIS card, the attitude of health workers, and patients’ satisfaction were found to significantly affect utilization P ≤ .05. Regression analysis shows age and income to be a predictor of utilization of the NHIS. Though utilization is high, effort should be made to remove payment at the point of access and improving the harsh attitude of some of the health workers.

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