Prevalence of health insurance enrolment and associated factors among persons with disabilities in Ghana

The role of gender in health insurance enrollment among geriatric caregivers: results from the 2022 informal caregiving, health, and healthcare survey in Ghana

BACKGROUND

Female informal caregivers of older adults experience a higher burden of physical and mental health problems compared to their male counterparts due to the greater intensity of care they provide. This is likely to result in an imbalance in health needs, including health insurance enrollment, between male and female informal caregivers of older adults. However, to date, no study is available on the role of gender in health insurance enrollment among informal caregivers of older adults in Ghana. This study examines the association between gender and health insurance enrollment among informal caregivers of older adults in Ghana.

METHODS

Cross-sectional data from the Informal Caregiving, Health, and Healthcare Survey among caregivers of older adults aged 50 years or above (N = 1,853 and mean ages =   39.15 years and  75.08 years of informal caregivers and their care recipients, respectively) in Ghana were analyzed. A binary logit regression model was used to estimate the association between gender and health insurance enrollment. All statistical inferences were made at the 5% significance level.

RESULTS

The final Model (3) showed that female informal caregivers were 2.70 times significantly more likely to enrol in a health insurance scheme than their male counterparts (AOR: 2.70, 95% CI: 2.09-3.48, p-value = 0.001). Apart from gender, the results revealed that participants aged 55-64 years (AOR = 2.38, 95%CI: 1.29-4.41, p-value = 0.006), with tertiary education (AOR: 3.62, 95% CI: 2.32-5.66, p-value = 0.001) and living with the care recipients (AOR: 1.50, 95% CI: 1.14-1.98, p-value = 0.003) were significantly more likely to enrol in a health insurance scheme than their counterparts. The findings further showed that those who earned between GH¢1000 and 1999 (US$99.50-198.50) monthly (AOR: 0.70, 95% CI: 0.52-0.95, p-value = 0.022) and were affiliated with African traditional religion (AOR: 0.30, 95%CI: 0.09-0.99, p-value = 0.048) were significantly less likely to enrol in a health insurance scheme than their counterparts.

CONCLUSION

Gender was a significant predictor of health insurance enrollment among informal caregivers of older adults. This finding contributes to the empirical debates on the role of gender in health insurance enrollment among informal caregivers of older adults. Policymakers need to develop gender-specific measures to address gender gaps in health insurance enrollment among informal caregivers of older adults in Ghana. Such health policies and programs should consider other significant demographic and socioeconomic factors associated with health insurance enrolment among informal caregivers of older adults in Ghana.

Family Needs Assessment of Patients with Cerebral Palsy Attending Two Hospitals in Accra, Ghana

BACKGROUND

The family represents the most essential and supportive environment for children with cerebral palsy (CP). To improve children's outcomes, it is crucial to consider the needs of families in order to offer family-centered care, which tailors services to these needs.

OBJECTIVE

We conducted a needs assessment to identify the family needs of patients with CP attending two hospitals in Accra.

METHODS

The study was a cross-sectional study involving primary caregivers of children with CP attending neurodevelopmental clinics. Structured questionnaires were used to collect data spanning an 8-month period. The data were summarized, and statistical inference was made.

RESULTS

Service needs identified were childcare, counseling, support groups, financial assistance, and recreational facilities. Information needs included adult education, job training/employment opportunities, education, health and social programs, knowledge about child development, and management of behavioral and feeding/nutrition problems. Reducing extensive travel time was desirable to improve access to healthcare. With the increasing severity of symptoms came the need for improved accessibility in the home to reduce the child's hardship, as well as assistive devices, recreational facilities, and respite for the caregiver(s).

CONCLUSION

Families of children with CP have information, service, and access needs related to their disease severity and family context.

Determinants of national health insurance enrolment among people at risk of statelessness in the Awutu Senya East Municipality and Gomoa East District of Ghana

BACKGROUND

This paper investigates the factors influencing the decision to enrol in Ghana's National Health Insurance Scheme (NHIS) among people at risk of statelessness, with emphasis on the individual's demographic and socioeconomic factors.  METHODS: The study used data from a cross-sectional household survey undertaken in the Awutu Senya East Municipality and Gomoa East District of Ghana's Central Region between March 9 and June 26, 2021, on healthcare utilization culture among people at risk of statelessness. Descriptive statistics and binary logistic regression were used in analysing data from a sample of 384 people at risk of statelessness.  RESULTS: The results reveal that about 51% of the at-risk population have ever enrolled while 48% of the respondents were enrolled on the NHIS at the time of the survey (active members). The majority of the enrolled members acquired their membership through self-payment of the enrolment fee. Additionally, respondents aged 26-35 had higher odds of enrolling, whiles those within 56-65 years had lower odds of enrolling in health insurance. Also, persons who are married and have a high school education or an equivalent qualification were more likely to enrol, while persons with no employment were less likely to enrol.

CONCLUSION

According to the paper, while the gap in coverage between rich and poor, married and single appears to have narrowed, these factors continue to determine NHIS coverage among people at risk of statelessness. The same is true for education. Efforts must be increased to ensure equal access to healthcare financing interventions for better access to health services.

Exploring heterogeneity of national health insurance scheme enrolment among persons in the informal sector

The Ghanaian government began implementing the National Health Insurance Scheme (NHIS) in 2005, anchored on the universal health coverage principle. However, informal sector workers contribute to the low enrolment into the scheme. This paper examines the factors that influence enrolment status in Ghana's NHIS among individuals in the informal sector. The study employed the fixed-effects logit model, using the Ghana Socioeconomic Panel Survey datasets. The findings revealed that gender, age, education, marital status, household size, physical activity, income, savings and subjective social welfare determine enrolment decisions of persons in the informal sector. Drivers of NHIS enrolment for male and female household heads were secondary education and household size. Heterogeneously, age, Junior High School education, married, physical activity, subjective social welfare and savings influenced only male-headed households' enrolment status. The study shows differences in enrolment status among rural and urban residents, as age, education, marital status, household size, and physical activity influenced rural residents, while for urban inhabitants', savings determined their NHIS enrolment decisions. However, gender, obesity, income and subjective social welfare predicted enrolment decisions for rural and urban residents. Finally, two variables, gender (male) and physical activity predicted the NHIS enrolment decision among the poor, whereas subjective social welfare and savings influenced the wealthiest enrolment decisions. For Ghana to achieve the Sustainable Development Goals of universal health coverage, the study recommends enhanced public education on NHIS benefits among informal workers to promote enrolment.