To Insure or Not to Insure: The Influence of National Health Insurance on Health Seeking Behaviour in the Kassena-Nankana District of Ghana

 

To insure or not to insure: The influence of National Health Insurance on health seeking behaviour in the Kassena-Nankana district of Ghana

 

Dalaba M.A ^1,2*, Akweongo P ², Aborigo R.A¹ and Ataguba J. E³

1. University of Heidelberg, Institute of Public Health, Im Neuenheimer Feld 324, 69120, Germany.
2. Navrongo Health Research Centre, P.O. Box 114, Navrongo, Ghana.

            Email:madalaba@yahoo.com, rayborigo@yahoo.com

1. Department of Health Policy, Planning and Management, University of Ghana, Legon.

            Email:akweongo@gmail.com

1. Health Economics Unit, University of Cape Town, South Africa.

            Email:john.Ataguba@uct.ac.za

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ABSTRACT

Background: In Ghana, the success of the National Health Insurance Scheme (NHIS) in improving access to health care since its implementation has not been extensively investigated. This study examines health heeking behaviours (HSB) of insured and uninsured households in the Kassena-Nankana District (KND) and the factors that influence household decision to enroll into the scheme.

Methods: The study uses a cross-sectional design.  A total of 422 household heads were interviewed. Binary logit model was fitted to determine factors that predict household enrolment. The choice of a particular type of provider was analysed using a multinomial logit model.

Results: About 64% of respondents were insured into the NHIS. Age, sex, marital status and socio-economic status were significant predictors of enrolment into the scheme. Insured households were more likely to seek care either from a formal public or private facility rather than resorting to self-treatment compared to their uninsured counterparts.

Conclusions: Though enrolment into the NHIS is increasing, the poor are still largely uninsured.  HSB varies between the insured and the uninsured which is mediated by socio-economic factors. There is therefore a need for considering alternatives to improve enrolment especially for the poor to address inequalities in access to health.