کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
952767 927539 2011 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
پیش نمایش صفحه اول مقاله
Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?
چکیده انگلیسی

To improve equity in the provision of health care and provide risk protection to poor households, low-income countries are increasingly moving to social health insurance. Using data from a household survey of 3301 households conducted in 2009 this study aims to evaluate equity in enrollment in the National Health Insurance Scheme (NHIS) in Ghana and assess determinants of demand across socio-economic groups. Specifically by looking at how different predisposing (age, gender, education, occupation, family size, marital status, peer pressure and health beliefs etc) enabling (income, place of residence) need (health status) and social factors (perceptions) affect household decision to enrol and remain in the NHIS. Equity in enrollment is assessed by comparing enrollment between consumption quintiles. Determinants of enrolling in and dropping out from NHIS are assessed using a multinomial logit model after using PCA to evaluate respondent’s perceptions relating to schemes, providers and community health ‘beliefs and attitudes’. We find evidence of inequity in enrollment in the NHIS and significant differences in determinants of current and previous enrollment across socio-economic quintiles. Both current and previous enrollment is influenced by predisposing, enabling and social factors. There are, however, clear differences in determinants of enrollment between the rich and the poor. Policy makers need to recognize that extending enrollment will require recognition of all these complex factors in their design of interventions to stimulate enrollment.

Research highlights
► Evidence of inequities in enrollment in the NHIS in Ghana.
► Significant differences exist in determinants of enrollment between rich and poor.
►  Policy makers need to recognize that extending enrollment will require recognition of these various determinants.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Social Science & Medicine - Volume 72, Issue 2, January 2011, Pages 157–165
نویسندگان
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