National health insurance coverage and socio-economic status in a rural district of Ghana.
Trop Med Int Health
; 15(2): 191-7, 2010 Feb.
Article
em En
| MEDLINE
| ID: mdl-19961565
ABSTRACT
OBJECTIVE:
To explore the association between socio-economic status (SES) and health insurance subscription to the Ghanaian National Health Insurance Scheme (NHIS) of residents of the Asante Akim North district of the Ashanti Region, Ghana.METHODS:
In the course of a community survey, data on asset variables (e.g. electricity, housing conditions and other variables) and on NHIS subscription were collected on the household level in 99 villages. Using principal components analysis, households were classified into three categories of SES (20% high, 40% middle and 40% low SES). Odds ratios of NHIS subscription were calculated for all SES categories, using the low category as the reference group and adjusting for travelling time to health facilities by public transport.RESULTS:
Of the 7223 households surveyed, 38% subscribed to the NHIS, of these 21% were low, 43% middle and 60% high SES households. SES was significantly associated with NHIS subscription (high SES OR 4.9, 95% CI 4.3-5.7; middle SES OR 2.5, 95% CI 2.2-2.9; low SES OR 1, reference group).CONCLUSION:
Four years after its introduction, the NHIS has reached subscription rates of 38% in the district surveyed. However, to achieve the aim of assuring universal access to health care facilities for all residents of Ghana, in particular for individuals living under socio-economic constraints, increasing subscription rates are necessary.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
/
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Classe Social
/
Cobertura do Seguro
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Países em Desenvolvimento
/
Seguro Saúde
Tipo de estudo:
Health_economic_evaluation
Aspecto:
Determinantes_sociais_saude
Limite:
Adolescent
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Adult
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Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
Trop Med Int Health
Ano de publicação:
2010
Tipo de documento:
Article