Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana

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dc.contributor.advisorMcIntyre, Dien_ZA
dc.contributor.authorDanso, Collins Akuamoahen_ZA
dc.date.accessioned2014-11-08T08:02:56Z
dc.date.available2014-11-08T08:02:56Z
dc.date.issued2006en_ZA
dc.descriptionIncludes bibliographical references (leaves 83-92).en_ZA
dc.description.abstractOne major challenge facing the international development community is how to finance and provide health care for the large informal sector in low and middle income countries. This is as a result of the inability of the traditional tax systems in most of these countries to generate the needed revenue to help meet the health needs of the citizens. In recent times, many countries in developing countries are increasingly depending on Community Based Insurance Schemes (CBHIS) as an alternative health care financing mechanism. In Ghana. the universal tax funded system of health care introduced in 1957 soon alter independence could not be sustained because of economic recession in the 1970's and 1980's forcing the government to introduce user fees in all public health institutions. User fees resulted in a decline in utilization of health services especially the poor and vulnerable group. This situation forced many communities to set up CBHIS meant to cover user fees charged at the health facilities. The success of some of these schemes and the fact that many Ghanaians do not have insurance cover led the government to introduce a National Health Insurance Scheme (NHIS) which is mandatory for all citizens. The law mandates all formal sector workers to contribute part of their social security contribution to the National Health Insurance Fund as premium, thus making it compulsory for them. Those in the informal sector are however required to voluntarily pay directly into their district schemes. Also, even though a proposal has been made to exempt the poor, no mechanism has been determined to identify poor households for subsidy. This study sought to undertake a critical evaluation of the role of CBHIS under the NHIS in extending health care coverage to the large informal sector (who are about 70% of the active labour force) in Ghana. Specifically, the study sought to determine factors that affect enrolment, to determine a practical mechanism to identify the poor and to gain an understanding of how other countries have increased health insurance coverage.en_ZA
dc.identifier.apacitationDanso, C. A. (2006). <i>Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/9343en_ZA
dc.identifier.chicagocitationDanso, Collins Akuamoah. <i>"Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2006. http://hdl.handle.net/11427/9343en_ZA
dc.identifier.citationDanso, C. 2006. Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Danso, Collins Akuamoah AB - One major challenge facing the international development community is how to finance and provide health care for the large informal sector in low and middle income countries. This is as a result of the inability of the traditional tax systems in most of these countries to generate the needed revenue to help meet the health needs of the citizens. In recent times, many countries in developing countries are increasingly depending on Community Based Insurance Schemes (CBHIS) as an alternative health care financing mechanism. In Ghana. the universal tax funded system of health care introduced in 1957 soon alter independence could not be sustained because of economic recession in the 1970's and 1980's forcing the government to introduce user fees in all public health institutions. User fees resulted in a decline in utilization of health services especially the poor and vulnerable group. This situation forced many communities to set up CBHIS meant to cover user fees charged at the health facilities. The success of some of these schemes and the fact that many Ghanaians do not have insurance cover led the government to introduce a National Health Insurance Scheme (NHIS) which is mandatory for all citizens. The law mandates all formal sector workers to contribute part of their social security contribution to the National Health Insurance Fund as premium, thus making it compulsory for them. Those in the informal sector are however required to voluntarily pay directly into their district schemes. Also, even though a proposal has been made to exempt the poor, no mechanism has been determined to identify poor households for subsidy. This study sought to undertake a critical evaluation of the role of CBHIS under the NHIS in extending health care coverage to the large informal sector (who are about 70% of the active labour force) in Ghana. Specifically, the study sought to determine factors that affect enrolment, to determine a practical mechanism to identify the poor and to gain an understanding of how other countries have increased health insurance coverage. DA - 2006 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 T1 - Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana TI - Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana UR - http://hdl.handle.net/11427/9343 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9343
dc.identifier.vancouvercitationDanso CA. Critical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghana. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2006 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9343en_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.otherPublic Healthen_ZA
dc.titleCritical evaluation of the role of community based health insurance schemes in extending health care coverage to the informal sector in Ghanaen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMMeden_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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