Does the national health insurance scheme in Ghana reduce household cost of treating malaria in the Kassena-Nankana districts

Bibliographic Data

ID19531441
AuthorsMaxwell Ayindenaba Dalaba (0000-0002-7101-769X, Navrongo Health Research Centre, corresponding author), Patricia Akweongo (0000-0001-6728-3365, University of Ghana), Raymond A Aborigo (0000-0003-0642-9265, Monash University Malaysia), Raymond Aborigo, Timothy Awine (0000-0002-7340-6111, Navrongo Health Research Centre), Daniel Azongo (0000-0002-0210-3906, Navrongo Health Research Centre), Daniel Kweku Azongo, Prosper Asaana (Navrongo Health Research Centre), Frank Atuguba (Navrongo Health Research Centre), Abraham Oduro (0000-0002-4191-7419, Navrongo Health Research Centre)
Year2014
Volume7
Issue1
Pages23848-23848
Publication date2014-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueGlobal Health Action (JOURNAL)
Journal identifiersISSN: 1654-9716 • E-ISSN: 1654-9880
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.3402/gha.v7.23848
PMID24836443
OpenAlexW2038848827
LanguageEN
Citations received5
References cited12

INTRODUCTION: The Government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2003 to replace out-of-pocket (OOP) payment for health services with the inherent aim of reducing the direct cost of treating illness to households. OBJECTIVE: To assess the effects of the NHIS in reducing cost of treating malaria to households in the Kassena-Nankana districts of northern Ghana. METHODS: We conducted a cross-sectional survey between October 2009 and October 2011 in the Kassena-Nankana districts. A sample of 4,226 households was randomly drawn from the Navrongo Health and Demographic Surveillance System household database and administered a structured interview. The costs of malaria treatment were collected from the patient perspective. RESULTS: Of the 4,226 households visited, a total of 1,324 (31%) household members reported fever and 51% (675) reported treatment for malaria and provided information on where they sought care. Most respondents sought malaria treatment from formal health facilities 63% (424), with the remainder either self-medicating with drugs from chemical shops 32% (217) or with leftover drugs or herbs 5% (34). Most of those who sought care from formal health facilities were insured 79% (334). The average direct medical cost of treating malaria was GH¢3.2 (US$2.1) per case with the insured spending less (GH¢2.6/US$1.7) per case than the uninsured (GH¢3.2/US$2.1). The overall average cost (direct and indirect) incurred by households per malaria treatment was GH¢20.9 (US$13.9). Though the insured accounted for a larger proportion of admissions at health facilities 76% (31) than the uninsured 24% (10), the average amount households spent on the insured was less (GH¢4/US$2.7) than their uninsured counterparts (GH¢6.4/US$4.3). The difference was not statistically significant (p=0.2330). CONCLUSION: Even though some insured individuals made OOP payments for direct medical care, there is evidence that the NHIS has a protective effect on cost (outpatient and in-patient) of malaria treatment

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