Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana

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dc.contributor.authorAkazili, James
dc.contributor.authorAtaguba, John Ele-Ojo
dc.contributor.authorKanmiki, Edmund Wedam
dc.contributor.authorGyapong, John
dc.contributor.authorSankoh, Osman
dc.contributor.authorOduro, Abraham
dc.contributor.authorMcIntyre, Di
dc.date.accessioned2021-10-08T06:20:32Z
dc.date.available2021-10-08T06:20:32Z
dc.date.issued2017
dc.description.abstractBACKGROUND: There is a global concern regarding how households could be protected from relatively large healthcare payments which are a major limitation to accessing healthcare. Such payments also endanger the welfare of households with the potential of moving households into extreme impoverishment. This paper examines the impoverishing effects of out-of-pocket (OOP) healthcare payments in Ghana prior to the introduction of Ghana's national health insurance scheme. METHODS: Data come from the Ghana Living Standard Survey 5 (2005/2006). Two poverty lines ($1.25 and $2.50 per capita per day at the 2005 purchasing power parity) are used in assessing the impoverishing effects of OOP healthcare payments. We computed the poverty headcount, poverty gap, normalized poverty gap and normalized mean poverty gap indices using both poverty lines. We examine these indicators at a national level and disaggregated by urban/rural locations, across the three geographical zones, and across the ten administrative regions in Ghana. Also the Pen's parade of "dwarfs and a few giants" is used to illustrate the decreasing welfare effects of OOP healthcare payments in Ghana. RESULTS: There was a high incidence and intensity of impoverishment due to OOP healthcare payments in Ghana. These payments contributed to a relative increase in poverty headcount by 9.4 and 3.8% using the $1.25/day and $2.5/day poverty lines, respectively. The relative poverty gap index was estimated at 42.7 and 10.5% respectively for the lower and upper poverty lines. Relative normalized mean poverty gap was estimated at 30.5 and 6.4%, respectively, for the lower and upper poverty lines. The percentage increase in poverty associated with OOP healthcare payments in Ghana is highest among households in the middle zone with an absolute increase estimated at 2.3% compared to the coastal and northern zones. CONCLUSION: It is clear from the findings that without financial risk protection, households can be pushed into poverty due to OOP healthcare payments. Even relatively richer households are impoverished by OOP healthcare payments. This paper presents baseline indicators for evaluating the impact of Ghana's national health insurance scheme on impoverishment due to OOP healthcare payments.
dc.identifier.apacitationAkazili, J., Ataguba, J. E., Kanmiki, E. W., Gyapong, J., Sankoh, O., Oduro, A., & McIntyre, D. (2017). Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana. <i>BMC International Health and Human Rights</i>, 17(1), 174 - 177. http://hdl.handle.net/11427/34299en_ZA
dc.identifier.chicagocitationAkazili, James, John Ele-Ojo Ataguba, Edmund Wedam Kanmiki, John Gyapong, Osman Sankoh, Abraham Oduro, and Di McIntyre "Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana." <i>BMC International Health and Human Rights</i> 17, 1. (2017): 174 - 177. http://hdl.handle.net/11427/34299en_ZA
dc.identifier.citationAkazili, J., Ataguba, J.E., Kanmiki, E.W., Gyapong, J., Sankoh, O., Oduro, A. & McIntyre, D. 2017. Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana. <i>BMC International Health and Human Rights.</i> 17(1):174 - 177. http://hdl.handle.net/11427/34299en_ZA
dc.identifier.issn1472-698X
dc.identifier.ris TY - Journal Article AU - Akazili, James AU - Ataguba, John Ele-Ojo AU - Kanmiki, Edmund Wedam AU - Gyapong, John AU - Sankoh, Osman AU - Oduro, Abraham AU - McIntyre, Di AB - BACKGROUND: There is a global concern regarding how households could be protected from relatively large healthcare payments which are a major limitation to accessing healthcare. Such payments also endanger the welfare of households with the potential of moving households into extreme impoverishment. This paper examines the impoverishing effects of out-of-pocket (OOP) healthcare payments in Ghana prior to the introduction of Ghana's national health insurance scheme. METHODS: Data come from the Ghana Living Standard Survey 5 (2005/2006). Two poverty lines ($1.25 and $2.50 per capita per day at the 2005 purchasing power parity) are used in assessing the impoverishing effects of OOP healthcare payments. We computed the poverty headcount, poverty gap, normalized poverty gap and normalized mean poverty gap indices using both poverty lines. We examine these indicators at a national level and disaggregated by urban/rural locations, across the three geographical zones, and across the ten administrative regions in Ghana. Also the Pen's parade of "dwarfs and a few giants" is used to illustrate the decreasing welfare effects of OOP healthcare payments in Ghana. RESULTS: There was a high incidence and intensity of impoverishment due to OOP healthcare payments in Ghana. These payments contributed to a relative increase in poverty headcount by 9.4 and 3.8% using the $1.25/day and $2.5/day poverty lines, respectively. The relative poverty gap index was estimated at 42.7 and 10.5% respectively for the lower and upper poverty lines. Relative normalized mean poverty gap was estimated at 30.5 and 6.4%, respectively, for the lower and upper poverty lines. The percentage increase in poverty associated with OOP healthcare payments in Ghana is highest among households in the middle zone with an absolute increase estimated at 2.3% compared to the coastal and northern zones. CONCLUSION: It is clear from the findings that without financial risk protection, households can be pushed into poverty due to OOP healthcare payments. Even relatively richer households are impoverished by OOP healthcare payments. This paper presents baseline indicators for evaluating the impact of Ghana's national health insurance scheme on impoverishment due to OOP healthcare payments. DA - 2017 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC International Health and Human Rights LK - https://open.uct.ac.za PY - 2017 SM - 1472-698X T1 - Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana TI - Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana UR - http://hdl.handle.net/11427/34299 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/34299
dc.identifier.vancouvercitationAkazili J, Ataguba JE, Kanmiki EW, Gyapong J, Sankoh O, Oduro A, et al. Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana. BMC International Health and Human Rights. 2017;17(1):174 - 177. http://hdl.handle.net/11427/34299.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceBMC International Health and Human Rights
dc.source.journalissue1
dc.source.journalvolume17
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12914-017-0121-7
dc.subject.otherHealth insurance
dc.subject.otherFinancial risk protection
dc.subject.otherGhana
dc.subject.otherOut-of-pocket healthcare payments
dc.subject.otherResearch Article
dc.subject.otherImpoverishment
dc.titleAssessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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