The National Health Insurance Scheme in Ghana's Upper West Region: A gendered perspective of insurance acquisition in a resource-poor setting

Social Science and Medicine

Volumn 122, Issue , 2014, Pages 103-112

  Dixon, Jenna ^a   Luginaah, Isaac ^b   Mkandawire, Paul ^c  

^a UNIVERSITY OF WATERLOO   (Canada)

^b UNIVERSITY OF WESTERN ONTARIO   (Canada)

^c CARLETON UNIVERSITY   (Canada)

Author keywords

Access to care; Education; Equity; Gender; Ghana; Health insurance; Poverty; Upper west region

Indexed keywords

EDUCATION; EQUITY; GENDER; HEALTH CARE; HEALTH INSURANCE; POVERTY; RESOURCE ALLOCATION;

ARTICLE; CONCEPTUAL FRAMEWORK; CONTROLLED STUDY; EDUCATION; FEMALE; GENDER; GEOGRAPHY; GHANA; HEALTH CARE ACCESS; HEALTH CARE POLICY; HEALTH INSURANCE; HOUSEHOLD; HUMAN; MALE; MUSLIM; NATIONAL HEALTH INSURANCE; POVERTY; RESOURCE ALLOCATION; ADOLESCENT; ADULT; DEMOGRAPHY; HEALTH CARE DELIVERY; HEALTH STATUS; MIDDLE AGED; PUBLIC HEALTH; SEX DIFFERENCE; SOCIOECONOMICS; STATISTICS AND NUMERICAL DATA; YOUNG ADULT;

GHANA; UPPER WEST REGION;

ADOLESCENT; ADULT; FEMALE; GHANA; HEALTH SERVICES ACCESSIBILITY; HEALTH STATUS; HUMANS; INSURANCE, HEALTH; MALE; MIDDLE AGED; NATIONAL HEALTH PROGRAMS; RESIDENCE CHARACTERISTICS; SEX FACTORS; SOCIOECONOMIC FACTORS; YOUNG ADULT;

EID: 84908381728     PISSN: 02779536     EISSN: 18735347     Source Type: Journal    
DOI: 10.1016/j.socscimed.2014.10.028     Document Type: Article

References (78)

1. Abdul-Korah G.B. 'Where is not home?': dagaaba migrants in the Brong Ahafo Region, 1980 to the present. Afr. Aff. 2007, 106:71-94.
2. Abdulai A., Delgado C.L. Determinants of nonfarm earnings of farm-based husbands and wives in Northern Ghana. Am. J. Agric. Econ. 1999, 81(1):117-130.
3. Agarwal B. 'Bargaining' and gender relations: within and beyond the household. Fem. Econ. 1997, 3(1):1-51.
4. Agyei-Mensah S. Poverty and HIV prevalence in Ghana: a geographical perspective. GeoJournal 2006, 66(4):311-324.
5. Al-Hassan R., Diao X. Regional Disparities in Ghana: Policy Options and Public Investment Implications 2007, International Food Policy Research Institute, Sustainable Solutions for Ending Hunger and Poverty IFPRI, Washington D.C, USA, Discussion paper February 2007.
6. Andersen R.M. Behavioral Model of Families' Use of Health Services. Research Series, 25 1968, Center for Health Administration Studies, University of Chicago, Chicago, IL.
7. Andersen R.M. Revisiting the behavior model and access to medical care: does it matter?. J.Health Soc. Behav. 1995, 36(1):1-10.
8. Archampong E.A. Reconciliation of women's rights and cultural practices: polygamy in Ghana. Commonw. Law Bull. 2010, 36(2):325-332.
9. Aryeetey G.C., Jehu-Appiah C., Spaan E., Agyepong I., Baltussen R. Costs, equity, efficiency and feasibility of identifying the poor in Ghana's National Health Insurance Scheme: empirical analysis of various strategies. Trop. Med. Int. Health 2012, 17:43-51.
10. Asante F., Aikins M. Does the NHIS Cover the Poor? 2008, Danida Health Sector Support Office paper.
11. Avotri J.Y., Walters V. "You just look at our work and see if you have any freedom on earth": Ghanaian women's accounts of their work and their health. Soc. Sci. Med. 1999, 48(9):1123-1133.
12. Barrett H., Browne A. Health, hygiene and maternal education: evidence from the Gambia. Soc. Sci. Med. 1996, 43(11):1579-1990.
13. Buor D. Analysing the primacy of distance in the utilization of health services in the Ahafo-Ano South district, Ghana. Int. J. Health Plan. Manag. 2003, 18(4):293-311.
14. Buor D. Gender and the utilisation of health services in the Ashanti Region, Ghana. Health Policy 2004, 69(3):375-388.
15. Caldwell J.C. Education as a factor in mortality decline an examination of Nigerian data. Popul. Stud. 1979, 33(3):395-413.
16. Caldwell J.C. Mass education as a determinant of the timing of fertility decline. Popul. Dev. Rev. 1980, 6(2):225-255.
17. Carr E. Development and the household: missing the point?. GeoJournal 2005, 62:71-83.
18. Cohen A., Siegelman P. Testing for adverse selection in insurance markets. J.Risk Insur. 2010, 77(1):39-84.
19. Coulombe H., Wodon Q. Poverty, Livelihoods, and Access to Basic Services in Ghana 2007, The World Bank, Washington, DC.
20. Criel B., Waelkens M.P. Declining subscriptions to the Maliando mutual health organisation in Guinea-Conakry (West africa): what is going wrong?. Soc. Sci. Med. 2003, 57(7):1205-1219.
21. Criel B., Atim C., Basaza R., Blaise P., Waelkens M.P. Editorial: community health insurance (CHI) in sub-Saharan Africa: researching the context. Trop. Med. Int. Health 2004, 9(10):1041-1043.
22. De Allegri M., Kouyaté B., Becher H., Gbangou A., Pokhrel S., Sanon M., Sauerborn R. Understanding enrolment in community health insurance in sub-Saharan Africa: a population-based case-control study in rural Burkina Faso. Bull. World Health Organ. 2006, 84(11):852-858.
23. De Allegri M., Sanon M., Bridges J., Sauerborn R. Understanding consumers' preferences and decision to enrol in community-based health insurance in rural West Africa. Health Policy 2006, 76(1):58-71.
24. Derbile E.K., van der Geest S. Repackaging exemptions under National Health Insurance in Ghana: how can access to care for the poor be improved?. Health Policy Plan. 2012, 10.1093/heapol/czs098.
25. DeRose L.F., Ezeh A.C. Men's influence on the onset and progress of fertility decline in Ghana, 1988-98. Popul. Stud. 2005, 59(2):197-210.
26. Dixon J., Tenkorang E.Y., Luginaah I. Ghana's National Health Insurance Scheme: helping the poor or leaving them behind?. Environ. Plan. C Gov. Policy 2011, 29:1102-1115.
27. Dixon J., Tenkorang E.Y., Luginaah I. Ghana's National Health Insurance Scheme: a national level investigation of members' perceptions of service provision. BMC Int. Health Hum. Rights 2013, 13(1):1-10.
28. Dixon J., Luginaah I.N., Mkandawire P. Gendered inequalities within Ghana's national health insurance scheme: are poor women being penalized with a late renewal policy?. J.Health Care Poor Underserved 2014, 25(3):1005-1020.
29. Dixon J., Tenkorang E.Y., Luginaah I.N., Kuuire V.Z., Boateng G.O. National health insurance scheme enrolment and antenatal care among women in Ghana: is there any relationship?. Trop. Med. Int. Health 2014, 19(1):98-106.
30. Dodoo F.N.A., Frost A.E. Gender in African population research: the fertility/reproductive health example. Annu. Rev. Sociol. 2008, 34:431-452.
31. Doyal L. Gender equity in health: debates and dilemmas. Soc. Sci. Med. 2000, 51:931-939.
32. Folbre N. Mothers on Their Own: Policy Issues for Developing Countries 1990, (Paper prepared for the Population Council and the International Center for Research on Women, New York).
33. Frost M.B., Forste R., Haas D.W. Maternal education and child nutritional status in Bolivia: finding the links. Soc. Sci. Med. 2005, 60(2):395-407.
34. Gelberg L., Andersen R.M., Leake B.D. The behavioral model for vulnerable populations: application to medical care use and outcomes for homeless people. Health Serv. Res. 2000, 34(6):1273-1302.
35. Ghana Statistical Service 2010 Population and Housing Census: Summary Report of Final Results 2012, Ghana Statistical Service, Accra, Available at: http://www.statsghana.gov.gh/docfiles/2010phc/Census2010_Summary_report_of_final_results.pdf.
36. Ghana Statistical Service (GSS), Ghana Health Service (GHS), & ICF Macro Ghana Demographic and Health Survey 2008 2009, GSS, GHS, and ICF Macro, Accra, Ghana.
37. Glewwe P. Why does mother's schooling raise child health in developing countries? Evidence from Morocco. J.Hum. Resour. 1999, 124-159.
38. Gwatkin D., Rutstein S., Johnson K., Suliman E., Wagstaff A., Amouzou A. Socio-economic Differences in Health, Nutrition, and Population Within Developing Countries: an Overview. Country Reports on HNP and Poverty 2007, The World Bank, Washington, D.C.
39. Gyimah S.O., Takyi B.K., Addai I. Challenges to the reproductive-health needs of African women: on religion and maternal health utilization in Ghana. Soc. Sci. Med. 2006, 62(12):2930-2944.
40. Haddad L., Hoddinott J. Women's income and boy girl anthropometric status in the Cote d'Ivoire. World Dev. 1994, 18(2):197-214.
41. Hsiaso W.C., Shaw R.P. Social Health Insurance for Developing Nations 2007, World Bank, Washington, D.C.
42. IMF (International Monetary Fund) IMF Country Report No. 12/203. Ghana: Poverty Reduction Strategy Paper 2012, International Monetary Fund, Washington, D.C.
43. Jehu-Appiah C., Aryeetey G., Spaan E., De Hoop T., Agyepong I., Baltussen R. Equity aspects of the National Health Insurance Scheme in Ghana: who is enrolling, who is not and why?. Soc. Sci. Med. 2011, 72(2):157-165.
44. Jütting J. Do community-based health insurance schemes improve poor people's access to health care? evidence from rural Senegal. World Dev. 2003, 32(2):273-288.
45. Kirigia J.M., Sambo L.G., Nganda B., Mwabu G.M., Chatora R., Mwase T. Determinants of health insurance ownership among South African women. BMC Health Serv. Res. 2005, 5(1):17.
46. Koch S., Alaba O. On health insurance and household decisions: a treatment effect analysis. Soc. Sci. Med. 2010, 70:175-182.
47. Konadu-Agyemang K. The best of times and the worst of times: structural adjustment programs and uneven development in Africa: the case of Ghana. Prof. Geogr. 2000, 52(3):469-483.
48. Kuuire V., Mkandawire P., Arku G., Luginaah I. 'Abandoning' farms in search of food: food remittance and household food security in Ghana. Afr. Geogr. Rev. 2013, 10.1080/19376812.2013.791630.
49. Lagomarsino G., Garabrant A., Adyas A., Muga R., Otoo N. Moving towards universal health coverage: health insurance reforms in nine developing countries in Africa and Asia. Lancet 2012, 380(9845):933-943.
50. Lim S.S., Winter-Nelson A., Arends-Kuenning M. Household bargaining power and agricultural supply response: evidence from Ethiopian coffee growers. World Dev. 2007, 35(7):1204-1220.
51. Lokshin M.M., Glinskaya E., Garcia M. The effect of early childhood development programmes on women's labour force participation and older children's schooling in Kenya. J.Afr. Econ. 2004, 13(2):240-276.
52. Luginaah I. Local gin (akpeteshie) and HIV/AIDS in the upper west region of Ghana: the need for preventive health policy. Health Place 2008, 14(4):806-816.
53. Mills A., Ataguba J.E., Akazili J., Borghi J., Garshong B., Makawia S., et al. Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage. Lancet 2012, 380(9837):126-133.
54. Ministry of Health Ghana Independent Review: Health Sector Programme of Work 2010 Final Report 2011, Available at:. http://www.moh-ghana.org/UploadFiles/Publications/Ghana__Health_Sector_Review_2010_final_220411120509055037.pdf.
55. Mkandawire P., Richmond C., Dixon J., Luginaah I.N., Tobias J. Hepatitis B in Ghana's upper west region: a hidden disease in need of national policy attention. Health Place 2013, 23:89-96.
56. Moss N.C. Gender equality and socioeconomic inequality: a framework for the patterning of women's health. Soc. Sci. Med. 2002, 54:649-661.
57. Müller I., Smith T., Mellor S., Rare L., Genton B. The effect of distance from home on attendance at a small rural health centre in Papua New Guinea. Int. J. Epidemiol. 1998, 27(5):878-884.
58. NHIA National Health Insurance Authority Annual Report 2009 2010, Available at: http://www.nhis.gov.gh/files/1%281%29.pdf.
59. NHIA National Health Insurance Authority Annual Report 2011 2012, Available at:. http://www.nhis.gov.gh/files/annualreport2011.pdf.
60. Nikièma B., Haddad S., Potvin L. Women bargaining to seek healthcare: norms, domestic practices, and implications in rural Burkina Faso. World Dev. 2008, 36(4):608-624.
61. O'Rouke D., Blair J. Improving random respondent selection in telephone surveys. J.Mark. Res. 1983, 20(4):428-432.
62. Porter G. Living in a walking world: rural mobility and social equity issues in sub-Saharan Africa. World Dev. 2002, 30(2):285-300.
63. Porter G. 'I think a woman who travels a lot is befriending other men and that's why she travels': mobility constraints and their implications for rural women and girls in sub-Saharan Africa. Gend. Place Cult. 2011, 18(01):65-81.
64. Rutstein S.O. The DHS wealth index: approaches for rural and urban areas. Demogr. Health Res. 2008, 60. DHS Working Papers, Available at:. http://www.measuredhs.com/pubs/pdf/CR6/CR6.pdf.
65. Sahn D.E., Stifel D.C. Poverty comparisons over time and across countries in africa. World Dev. 2000, 28(12):2123-2155.
66. Sarpong N., Loag W., Fobil J., Meyer C.G., Adu-Sarkodie Y., May J., Schwarz N.G. National health insurance coverage and socio-economic status in a rural district of Ghana. Trop. Med. Int. Health 2010, 15(2):191-197.
67. Sen A.K. Gender and cooperative conflicts. Persistent Inequalities: Women and World Development 1990, Oxford University Press, New York. I. Tinker (Ed.).
68. Songsore J. Regional development in Ghana: The theory and the reality 2011, Woeli Publishing Services, Accra.
69. Tenkorang E., Owusu G. Correlates of HIV testing among women in Ghana: some evidence from the demographic and Health Surveys. AIDS Care 2010, 22:296-307.
70. Thomas R.G. Education in northern Ghana, 1906-1940: a study in colonial paradox. Int. J. Afr. Hist. Stud. 1974, 7(3):427-467.
71. Tolhurst R., Nyonator F.K. Looking within the household: gender roles and responses to malaria in Ghana. Trans. R. Soc. Trop. Med. Hyg. 2006, 100(4):321-326.
72. Tolhurst R., Amekudzi Y.P., Nyonator F.K., Bertel Squire S., Theobald S. "He will ask why the child gets sick so often": the gendered dynamics of intra-household bargaining over healthcare for children with fever in the Volta Region of Ghana. Soc. Sci. Med. 2008, 66(5):1106-1117.
73. Turshen M. Commentary: gender and health. J.Public Health Policy 2007, 28:319-321.
74. Watkins S.C. The fertility transition: Europe and the third world compared. Sociol. Forum 1987, 2(4):645-673.
75. WHO Children: reducing mortality. Fact sheet N°178. World Health Organization Available at:. http://www.who.int/mediacentre/factsheets/fs178/en/.
76. Williams R.L. Anote on robust variance estimation for cluster-correlated data. Biometrics 2000, 56:645-646.
77. Witter S., Garshong B. Something old or something new? Social health insurance in Ghana. BMC Int. Health Hum. Rights 2009, 9(1):20.
78. World Bank Africa Development Indicators 2012/13 2013, World Bank, Washington, DC, Available at:. https://openknowledge.worldbank.org/handle/10986/13504.