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Equity in Health Care Financing in Ghana
Includes bibliographical references.
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| Main Author: | |
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Health Economics Unit
2014
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| _version_ | 1867613237327953920 |
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| access_status_str | Open Access |
| author | Akazili, James |
| author2 | McIntyre, Di |
| author_browse | Akazili, James McIntyre, Di |
| author_facet | McIntyre, Di Akazili, James |
| author_sort | Akazili, James |
| collection | Thesis |
| description | Includes bibliographical references. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/9390 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:57.328Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2014 |
| publishDateRange | 2014 |
| publishDateSort | 2014 |
| publisher | Health Economics Unit |
| publisherStr | Health Economics Unit |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/9390 Equity in Health Care Financing in Ghana Akazili, James McIntyre, Di Public Health Includes bibliographical references. Financial risk 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". The study (the first of kind in Ghana) measured the relative progressivity of health care financing mechanisms, the catastrophic and impoverishment effect of direct health care payments, as well as evaluating the factors affecting enrolment in the national health insurance scheme (NHIS), which is the intended means for achieving equitable health financing and universal coverage in Ghana. To achieve the purpose of the study, 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 ministries and departments, and further complemented with primary household data collected in six districts. In addition 44 focus group discussions with different groups of people and communities were conducted. In-depth interviews were also conducted with six managers of District NHI schemes as well as the NHIS headquarters. The study found that generally Ghana's health care financing system is progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes which account for over 50% of health care funding. The national health insurance levy is mildly progressive as indicated by a Kakwani index of 0.045. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are associated with significant catastrophic and impoverishment effects on households. The results also indicate that high premiums, ineffective exemptions, fragmented funding pools and perceived poor quality of care affect the expansion of the NHIS. For Ghana to attain adequate financial protection and ultimately achieve universal coverage, it needs to extend cover to the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the NHI. Furthermore, the funding pool for health care needs to grow and this can be achieved by improving the efficiency of tax collection and increasing the budgetary allocation to the health sector. 2014-11-08T14:30:21Z 2014-11-08T14:30:21Z 2010 Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/9390 eng application/pdf Health Economics Unit Faculty of Health Sciences University of Cape Town |
| spellingShingle | Public Health Akazili, James Equity in Health Care Financing in Ghana |
| thesis_degree_str | Doctoral |
| title | Equity in Health Care Financing in Ghana |
| title_full | Equity in Health Care Financing in Ghana |
| title_fullStr | Equity in Health Care Financing in Ghana |
| title_full_unstemmed | Equity in Health Care Financing in Ghana |
| title_short | Equity in Health Care Financing in Ghana |
| title_sort | equity in health care financing in ghana |
| topic | Public Health |
| url | http://hdl.handle.net/11427/9390 |
| work_keys_str_mv | AT akazilijames equityinhealthcarefinancinginghana |