Understanding qualitative and community indicators of poverty for national health insurance scheme exemptions in Ghana

Aboagye, Da Costa, South, Jane and Khan, Hafiz ORCID: https://orcid.org/0000-0002-1817-3730 (2019) Understanding qualitative and community indicators of poverty for national health insurance scheme exemptions in Ghana. Illness, Crisis & Loss. ISSN 1054-1373

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Abstract

The exemptions of the National Health Insurance Scheme (NHIS) for poor people in Ghana have not been sufficiently explored. Using a qualitative approach that involved gathering and analysing viewpoints from the community, this paper investigates the factors that are used to determine NHIS exemptions in Ghana. Focus group discussions (FGDs) and interviews of key informants (KIs) were conducted during the period (August 2015 to August 2016) within the Ashanti and Greater Accra regions in Ghana. Nine FGDs were conducted in nine different communities with 72 respondents. Nine KIs, including local and national policy-makers, civil servants and local community members were also interviewed. A sampling method was adopted to capture a range of understandings of community indicators of poverty for NHIS exemptions. Community perceptions of the indicators of poverty included interconnected themes of income, employment, education, assets, and social marginalisation. The findings highlight contextual and community descriptions associated with exemptions, of which poverty is a predictor, and discovered that to identify the indigent for exemptions based only on income and quantitative measures is not enough. The results are significant for a number of reasons including poor fit with official measures and the neglect of lay perspectives. For practice implications, our findings show that communities should be principal stakeholders for describing the disadvantaged groups that require exemptions.

Item Type: Article
Additional Information: Copyright © 2019, © SAGE Publications Acknowledgements: The research was conducted as part of a doctoral study at Leeds Beckett University. The authors would like to thank Professor Rachael Dixey who was the Director of Studies until 2016 and contributed to the study design and analysis.
Uncontrolled Keywords: Exemptions, NHIS, Ghana, Community, poverty
Subjects: Medicine and health > Health promotion and public health
Depositing User: Hafiz Khan
Date Deposited: 19 May 2019 10:38
Last Modified: 04 Feb 2020 16:31
URI: http://repository.uwl.ac.uk/id/eprint/6097

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