↓ Skip to main content

Differences in the determinants of health insurance enrolment among working-age adults in two regions in Ghana

Overview of attention for article published in BMC Health Services Research, May 2018
Altmetric Badge

Readers on

mendeley
18 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Differences in the determinants of health insurance enrolment among working-age adults in two regions in Ghana
Published in
BMC Health Services Research, May 2018
DOI 10.1186/s12913-018-3192-9
Pubmed ID
Authors

Stephen Kwasi Opoku Duku

Abstract

Ghana's National Health Insurance Scheme (NHIS) has achieved varying levels of enrolment within the regions with different rural-urban populations with associated income inequalities. This study sought to investigate the differences in the determinants of enrolment between the Greater Accra (GAR) and Western (WR) regions of Ghana to inform the NHIS reforms. Data from 4214 adults, 18 years and above from a household survey conducted in the two regions was analyzed. Bivariate analysis (t-test for continuous and Pearson chi-square for categorical) was performed to examine differences in respondents characteristics (socio-economic and insurance enrolment) between the two regions for the total, urban and rural samples. Logistic regression estimation was performed to establish differences in determinant of enrolment between the regions. Age, sex, educational level, marital status, health status and travel time to nearest health facility were identified as determinants of enrolment in both regions and among the rural and urban residents within the regions. Although the rich and richest in both regions are more likely to enroll than the poor and poorest, the odds of enrolment for the urban richest in the WR is about twice that of GAR whiles the odds of enrolment for the rural richest in the GAR is also about twice that of the WR. Those who visit public facilities in the GAR are more likely to enroll than those in WR for the total and urban samples. However, those who visit private facilities in rural communities in both regions are more likely to enroll. Differences in the NHIS enrolment between the regions is as a result of differences in socio-economic factors that are intrinsic in the regions and impact on the inhabitants' ability to afford insurance premium. Policymakers should determine NHIS premium differently at the district level based on socio-economic activities and income levels within the districts.

Mendeley readers

The data shown below were compiled from readership statistics for 18 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 18 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 6 33%
Researcher 4 22%
Student > Ph. D. Student 4 22%
Unspecified 3 17%
Student > Doctoral Student 1 6%
Other 0 0%
Readers by discipline Count As %
Nursing and Health Professions 6 33%
Economics, Econometrics and Finance 3 17%
Unspecified 3 17%
Social Sciences 3 17%
Medicine and Dentistry 3 17%
Other 0 0%