| Description |
Like most nations of the world, the leadership of Ghana, irrespective of political regime, has both formulated and subsequently implemented several national development policies in the quest of improving the lives of her citizenry. These procedures, in some cases, have been aligned with global goals of bridging the disparities that exist in the healthcare delivery system. Immediately following independence, the newly formed government implemented free access to primary healthcare in every public health facility. However, the economic challenges over time led to policy changes that introduced the infamous "Cash-and-Carry" program, which numerous empirical studies have concluded was detrimental to the healthcare seeking behaviors of residents. Through this system, patients were made to pay instantly out of pocket the total cost for their treatments. The National Health Insurance Scheme (NHIS) was introduced in 2005 with the policy objective of getting all residents in Ghana access to quality, affordable healthcare services within a limited period of time. Despite some landmark progress that has been achieved since its implementation, complete coverage through this scheme has not been met and the membership rates tend to vary among the administrative regions of the country. Other findings indicate that many economically disadvantaged citizens are being left behind. The primary purpose of this study is to evaluate the NHIS and predict membership among households in the Barekese subdistrict of the Ashanti Region of Ghana. iv Chapter 1 of this dissertation provides a brief introduction to the content of this series of projects. Chapter 2 is devoted to a historic narrative on the financing of the healthcare delivery system in the context of the subregion where Ghana is geographically located, including the past and present trends in the country, with some direct insight into the context of the Barekese subdistrict. Chapter 3 and 4, respectively, provide an analysis of both nonspatial and spatial factors that predict complete household enrollment into the mandatory health program, taking into consideration the rural nature of the study settings and socioeconomic indicators of the inhabitants of the included communities. Chapter 5 summarizes conclusions and lessons drawn from this research and provides recommendations for future work. The primary audience for this project is policy and decision makers, who have a responsibility for helping to make the scheme a success and a model for others to emulate, and the scientific community at large. |
