Researchers in the School of Government
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Item Development policy planning in Ghana: The case of health care provision(European Scientific Institute, 2014) Alatinga, Kennedy A.; Williams, John J.This paper examines the historical development of health policy in Ghana within the framework of financial, geographical accessibility and the availability of health care. Historically, health policy has been urban biased, and largely focused on financial accessibility. Even Nkrumah's free health care policy could not adequately address the problem of inadequate health professionals and facilities in the rural areas.The study also established that poverty is also largely a rural phenomenon.The poor benefit less from the National Health Insurance Scheme (NHIS). This situation makes the NHIS lack social equity, the very reason for its being. We recommend that government should expand health facilities in the rural areas, and introduce attractive incentive packages to attract and retain health professionals in such areas. There is an urgent need for rigorous criteria to be developed by the NHIS to identify the very poor for health insurance premium exemptions.Item Towards universal health coverage: Exploring the determinants of household enrolment into National Health Insurance in the Kassena Nankana District, Ghana(Faculty of Integrated Development Studies, University for Development studies, 2015) Williams, John J.; Alatinga, Kennedy A.This study investigates the determinants of household participation in National Health Insurance Scheme (NHIS) in the Kassena-Nankana District in Ghana. In order to achieve this purpose, a cross-sectional survey was used to collect data from 417 randomly selected household heads. The results established that the NHIS is making incremental progress towards achieving universal health coverage because majority (67%) of the sampled population was enrolled in the NHIS. However, further analysis of the data highlighted both the challenge of achieving equity of participation in health insurance and the yawning financial barriers to accessing health care for poor households and those employed in the informal sector. For example, majority (77%) of uninsured households indicated that they were not enrolled in the NHIS because they could not afford the cost of insurance premiums. The research findings showed that income, socio-economic status (SES), formal employment, educational status, and gender amongst others, significantly determine household enrolment in health insurance. In order to increase the enrolment of the poor in the NHIS, and of achieving universal health coverage, the authors recommend that the government considers using payroll deductions to finance the health care needs of all formal sector employees while financing the health care of the rest of the population using tax revenues. It is also recommeded that the NHIS considers making the payment of insurance premium flexible, such as allowing housholds to pay in installments or in kind.