Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana

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dc.contributor.advisorAtaguba, Johnen_ZA
dc.contributor.authorDalaba, Maxwell Ayindenabaen_ZA
dc.date.accessioned2014-11-08T14:30:33Z
dc.date.available2014-11-08T14:30:33Z
dc.date.issued2009en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractThe National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 with the aim of mobilizing additional funds for health care, promoting equal access to reasonable health care, pool health risks, prevent impoverishment, and improve the efficiency and quality of health care. The success of the NHIS in improving access to health care since its implementation and the extent to which it has impacted on health seeking behaviour has not been extensively investigated. This study examines health-seeking behaviours of insured and uninsured households on the mutual health insurance scheme on health care access in the Kassena-Nankana District (KND) of northern Ghana and to determine the factors that influence household decision to enrol into the NHIS. The study is a cross sectional survey of 422 household heads randomly selected to represent rural, peri-urban and urban zones of KND. Data was analysed using STATA version 8.0. A binary logit model was used to determine factors that predict household enrolment into the NHIS. The choice of a particular type of provider with multiple outcomes was analysed using a multinomial logit model. Results showed that 72% of household heads were males and the average age was 51 years. Out of the 422 respondents, 64% were insured. Household heads of age 40 years and above, being a female household head, being married, and economic wealth positively influenced enrolment into the national health insurance scheme. Seventy four percent (74%) of the ill among the insured and 48% among uninsured sought care from public facilities while 14% among the insured and 8% among uninsured sought care from private facility. Also, self treatment among the insured was 13% and 44% among uninsured households. Results also showed that being a member of NHIS and being moderately or severely ill were associated with public health facility utilization. Household heads of 60 years or older was negatively associated with use of public health facilities. Similarly, a household that was insured, being a Muslim and the severity of illness of household member were positively associated with the use of private health care. The findings showed that the insured were more likely to use formal care providers than the uninsured. This implies that the NHI in the KND has improved the health seeking behaviour from the hitherto use of informal providers and self treatment to preferred use of formal providers.en_ZA
dc.identifier.apacitationDalaba, M. A. (2009). <i>Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/9391en_ZA
dc.identifier.chicagocitationDalaba, Maxwell Ayindenaba. <i>"Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2009. http://hdl.handle.net/11427/9391en_ZA
dc.identifier.citationDalaba, M. 2009. Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Dalaba, Maxwell Ayindenaba AB - The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003 with the aim of mobilizing additional funds for health care, promoting equal access to reasonable health care, pool health risks, prevent impoverishment, and improve the efficiency and quality of health care. The success of the NHIS in improving access to health care since its implementation and the extent to which it has impacted on health seeking behaviour has not been extensively investigated. This study examines health-seeking behaviours of insured and uninsured households on the mutual health insurance scheme on health care access in the Kassena-Nankana District (KND) of northern Ghana and to determine the factors that influence household decision to enrol into the NHIS. The study is a cross sectional survey of 422 household heads randomly selected to represent rural, peri-urban and urban zones of KND. Data was analysed using STATA version 8.0. A binary logit model was used to determine factors that predict household enrolment into the NHIS. The choice of a particular type of provider with multiple outcomes was analysed using a multinomial logit model. Results showed that 72% of household heads were males and the average age was 51 years. Out of the 422 respondents, 64% were insured. Household heads of age 40 years and above, being a female household head, being married, and economic wealth positively influenced enrolment into the national health insurance scheme. Seventy four percent (74%) of the ill among the insured and 48% among uninsured sought care from public facilities while 14% among the insured and 8% among uninsured sought care from private facility. Also, self treatment among the insured was 13% and 44% among uninsured households. Results also showed that being a member of NHIS and being moderately or severely ill were associated with public health facility utilization. Household heads of 60 years or older was negatively associated with use of public health facilities. Similarly, a household that was insured, being a Muslim and the severity of illness of household member were positively associated with the use of private health care. The findings showed that the insured were more likely to use formal care providers than the uninsured. This implies that the NHI in the KND has improved the health seeking behaviour from the hitherto use of informal providers and self treatment to preferred use of formal providers. DA - 2009 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana TI - Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana UR - http://hdl.handle.net/11427/9391 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9391
dc.identifier.vancouvercitationDalaba MA. Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2009 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9391en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherHealth Economicsen_ZA
dc.titleImpact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghanaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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