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Mandatory community-based health insurance schemes in Ghana : prospects and challenges

Includes bibliographical references (leaves 119-124).

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Bibliographic Details
Main Author: Sabi, William Kwasi
Other Authors: McIntyre, Di
Format: Thesis
Language:English
Published: Health Economics Unit 2014
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access_status_str Open Access
author Sabi, William Kwasi
author2 McIntyre, Di
author_browse McIntyre, Di
Sabi, William Kwasi
author_facet McIntyre, Di
Sabi, William Kwasi
author_sort Sabi, William Kwasi
collection Thesis
description Includes bibliographical references (leaves 119-124).
format Thesis
id oai:open.uct.ac.za:11427/9437
institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:33:28.738Z
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
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publisher Health Economics Unit
publisherStr Health Economics Unit
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spelling oai:open.uct.ac.za:11427/9437 Mandatory community-based health insurance schemes in Ghana : prospects and challenges Sabi, William Kwasi McIntyre, Di Health Economics Includes bibliographical references (leaves 119-124). Community-Based Health Insurance Schemes are new forms of health financing that can increase resources available for a national health system. These schemes are often regarded as not feasible. Evidence from recent experiences however; show that , if they are appropriately designed and managed they can be feasible and sustainable. The successes achieved by such schemes in Ghana motivated the government to make them a mandatory system of health financing. The main objective is that every resident of Ghana shall belong to a health insurance scheme that adequately covers him or her against "cash and carry" (i.e. user fees) in order to obtain access to a defined package of acceptable quality needed health services without having to pay at the point of receiving service. This study sought to undertake a critical comparative study of the performance of voluntary and mandatory community health financing schemes in Ghana and assess their prospects and challenges in their effort to improve efficiency, equity and the schemes' sustainability. The study, a qualitative one, employed descriptive survey techniques to evaluate the ability of schemes to finance their activities from their own sources and mechanisms put in place to cater for the poor and vulnerable, i.e. to evaluate with sustainability and equity respectively. The study also considered control measures to minimize cost escalation to assess efficiency. Focus group discussions, key informant interviews and document reviews were used to examine performance of voluntary and mandatory schemes in meeting those criteria. The study found that both voluntary and mandatory schemes were not self-sustainable due to low coverage and inadequate funds mobilized by the schemes. The main reasons for the general low enrolments are poverty, poor quality health service and limited benefit packages. The study showed that including out-patient (OPD) services in the benefit package and quality improvements in health service improve members' acceptability of insurance hence increase membership rates which will eventually increase schemes' sustainability. Efficient and effective administration of risk equalization fund will help reduce differences in districts' ability to raise revenue owing to different levels of economic activities as well as local morbidities. The study showed further that small community-based health insurance schemes (CBHIS) could be sub-district level financial intermediaries for the District Health Insurance Schemes. It was found in this study that a practical means testing mechanism to declare one poor in order to quality for exemption from contribution should be adopted. The study also suggests that alternative reimbursement mechanisms to fee-for-service need to be considered. The study suggests further research on equity in access and means testing. Such study should consider coming up with mechanisms for identifying the very poor in the communities and to put in place workable and sustainable measure to tackle the financial barriers to health care they face. 2014-11-09T15:51:40Z 2014-11-09T15:51:40Z 2005 Master Thesis Masters MPH http://hdl.handle.net/11427/9437 eng application/pdf Health Economics Unit Faculty of Health Sciences University of Cape Town
spellingShingle Health Economics
Sabi, William Kwasi
Mandatory community-based health insurance schemes in Ghana : prospects and challenges
thesis_degree_str Master's
title Mandatory community-based health insurance schemes in Ghana : prospects and challenges
title_full Mandatory community-based health insurance schemes in Ghana : prospects and challenges
title_fullStr Mandatory community-based health insurance schemes in Ghana : prospects and challenges
title_full_unstemmed Mandatory community-based health insurance schemes in Ghana : prospects and challenges
title_short Mandatory community-based health insurance schemes in Ghana : prospects and challenges
title_sort mandatory community based health insurance schemes in ghana prospects and challenges
topic Health Economics
url http://hdl.handle.net/11427/9437
work_keys_str_mv AT sabiwilliamkwasi mandatorycommunitybasedhealthinsuranceschemesinghanaprospectsandchallenges