Who pays for health care in Ghana?

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dc.contributor.authorAkazili, Jamesen_ZA
dc.contributor.authorGyapong, Johnen_ZA
dc.contributor.authorMcIntyre, Dianeen_ZA
dc.date.accessioned2015-10-28T06:55:08Z
dc.date.available2015-10-28T06:55:08Z
dc.date.issued2011en_ZA
dc.description.abstractBACKGROUND:Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. METHODS: Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. RESULTS: Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. CONCLUSION: For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the National Health Insurance. Furthermore, the pre-payment funding pool for health care needs to grow so budgetary allocation to the health sector can be enhanced.en_ZA
dc.identifier.apacitationAkazili, J., Gyapong, J., & McIntyre, D. (2011). Who pays for health care in Ghana?. <i>International Journal for Equity in Health</i>, http://hdl.handle.net/11427/14440en_ZA
dc.identifier.chicagocitationAkazili, James, John Gyapong, and Diane McIntyre "Who pays for health care in Ghana?." <i>International Journal for Equity in Health</i> (2011) http://hdl.handle.net/11427/14440en_ZA
dc.identifier.citationAkazili, J., Gyapong, J., & McIntyre, D. (2011). Who pays for health care in Ghana. Int J Equity Health, 10(26), 1-13.en_ZA
dc.identifier.ris TY - Journal Article AU - Akazili, James AU - Gyapong, John AU - McIntyre, Diane AB - BACKGROUND:Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. METHODS: Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. RESULTS: Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. CONCLUSION: For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the National Health Insurance. Furthermore, the pre-payment funding pool for health care needs to grow so budgetary allocation to the health sector can be enhanced. DA - 2011 DB - OpenUCT DO - 10.1186/1475-9276-10-26 DP - University of Cape Town J1 - International Journal for Equity in Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2011 T1 - Who pays for health care in Ghana? TI - Who pays for health care in Ghana? UR - http://hdl.handle.net/11427/14440 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14440
dc.identifier.urihttp://dx.doi.org/10.1186/1475-9276-10-26
dc.identifier.vancouvercitationAkazili J, Gyapong J, McIntyre D. Who pays for health care in Ghana?. International Journal for Equity in Health. 2011; http://hdl.handle.net/11427/14440.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2011 Akazili et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceInternational Journal for Equity in Healthen_ZA
dc.source.urihttp://www.equityhealthj.com/en_ZA
dc.subject.otherHealth care financingen_ZA
dc.subject.otherNational health insuranceen_ZA
dc.subject.otherGhanaen_ZA
dc.titleWho pays for health care in Ghana?en_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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