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Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana : a cross-sectional study

Nsiah-Boateng, Eric and Nonvignon, Justice and Aryeetey, Genevieve Cecelia and Salari, Paola and Tediosi, Fabrizio and Akweongo, Patricia and Aikins, Moses. (2019) Sociodemographic determinants of health insurance enrolment and dropout in urban district of Ghana : a cross-sectional study. Health economics review, 9. p. 23.

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Abstract

Earlier studies have found significant associations between sociodemographic factors and enrolment in the National Health Insurance Scheme (NHIS) in Ghana. These studies were mainly household surveys in relatively rural areas with high incidence of poverty. To expand the scope of existing evidence, this paper examines policy design factors associated with enrolment and dropout of the scheme in an urban poor district using routine secondary data.; This study is a cross-sectional quantitative analysis of 2014-2016 NHIS enrolment data of the Ashiedu Keteke district office. Descriptive and multivariate logistic regression analyses were performed to examine sociodemographic factors associated with NHIS enrolment and dropout.; A total of 215,724 individuals enrolled in the NHIS over the period under study, of which 98,232 (46%) were new members. About 41% of existing members in 2014 dropped out of the NHIS in 2015 and 53% of those in 2015 dropped out in 2016. The indigents (core poor) are significantly more likely to enrol and to drop out of the NHIS. However, the males, informal sector employees, social security and national insurance trust (SSNIT) contributors, and the aged (70+ years) are significantly less likely to enrol in the NHIS but more likely to retain coverage.; A considerable number of members are dropping out of the NHIS. The indigents in particular, are increasingly enrolling in and dropping out of the NHIS whilst the males, informal sector employees, SSNIT contributors and the aged are not enrolling as expected but increasingly retaining coverage. Policy reforms to ensuring continued growth towards realization of universal health coverage should take these factors into consideration.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Household Economics and Health Systems Research > Household Economy (Fink)
UniBasel Contributors:Tediosi, Fabrizio
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Springer
ISSN:2191-1991
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:10 Jul 2019 13:59
Deposited On:10 Jul 2019 13:59

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