Studies on strategies to increase national health insurance scheme's enrolment and retention rates; case of Ashanti Region, Ghana

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Date
2017-04
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KNUST
Abstract
ABSTRACT The discouraging rates of enrollment and retention on Ghana’s National Health Insurance Scheme (NHIS) due to non-affordability of the cost of paying premium under the existing payment mode are a persistent source of worry to administrators of the scheme and the nation at large. This study explores a proposed Mobile Phone Payment System (MPPS) that can allow premium payment on pro-rata basis. The study used both qualitative study and quantitative cross-sectional survey to solicit the required information from an ICT specialist, NHIS experts and about 1152 respondents living in Kumasi Metropolis, Atwima Nwabiaya and Sekyere Central Districts of Ghana. The study’s findings indicate that the feasible rate of cost of collecting premiums through the MPPS is between 0-22%. The empirical results have revealed that the insured individual is more than 2 times as likely to remain insured while the uninsured individual is less likely to remain uninsured when payment of NHIS premium is pro-rata. The study findings further reveal that there is a statistically significant relationship between a savings rate of 38% on cost of medical care for outpatient services when insured and enrollment or retention in NHIS (p<0.0001). This finding implies that about 93.98% of individuals who have never enrolled were likely to enroll on the NHIS while 99.53% of those who have ever enrolled were also likely to remain on the NHIS based on the knowledge of the savings rate on medical fee for out-patient services' when insured. It is recommended therefore that the National Health Insurance Authority (NHIA) consider this payment system that has the potential of increasing the enrollment and retention of uninsured and insured respectively in NHIS especially those in the informal sector.
Description
A thesis submitted to the school of graduate studies, Kumasi in fulfilment of the requirements for the award of the Degree of Doctor of Philosophy in Economics.
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