Only 34% of Ghanaians covered by National Health Insurance – Study

StethoscopeA new study by the University of Ghana says only 34% of the Ghanaian population is covered by the National Health Insurance Scheme.

A NewsRx report citing the study with the title ‘Refusal to enroll in Ghana’s National Health Insurance Scheme: is Affordability the Problem?’, notes that, “After a decade of its implementation, national coverage is just about 34% of the national population.

The study which uses data from a cross-sectional household survey involving 2,430 households from three districts in Ghana and was conducted between January-April, 2011, analyses affordability of the NHIS contribution using the household budget-based approach based on the normative definition of affordability.

“The burden of the NHIS contributions to households is assessed by relating the expected annual NHIS contribution to household non-food expenditure and total consumption expenditure. Households which cannot afford full insurance were identified. Results show that 66% of uninsured households and 70% of partially insured households could afford full insurance for their members,” the study says.

The study, according to the report, found that affordability of the NHIS contribution is often cited by households as a major barrier to enrolment without any rigorous analysis of this claim.

“In light of the global interest in achieving universal health insurance coverage, this study seeks to examine the extent to which affordability of the NHIS contribution is a barrier to full insurance for households and a burden on their resources,” the study adds.

According to the study, enroling all household members in the NHIS would account for 5.9% of household non-food expenditure or 2.0% of total expenditure but higher for households in the first (11.4%) and second (7.0%) socio-economic quintiles.

“All the households (29%) identified as unable to afford full insurance were in the two lower socio-economic quintiles and had large household sizes,” it says.

It notes also that non-financial factors relating to attributes of the insurer and health system problems also affect enrolment in the NHIS. Affordability of full insurance would be a burden on households with low socio-economic status and large household size. Innovative measures are needed to encourage abled households to enrol.

The study suggests that policy should aim at abolishing the registration fee for children, pricing insurance according to socio-economic status of households and addressing the inimical non-financial factors to increase NHIS coverage.

By Emmanuel K. Dogbevi

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