Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana
Bibliographic Data
| ID | 19517296 |
|---|---|
| Authors | James Akazili (0000-0003-3259-9794, Indepth Network, corresponding author), John Ele-Ojo Ataguba (0000-0002-7746-3826, University of Cape Town), John E Ataguba, Edmund Wedam Kanmiki (0000-0001-7175-5222, Navrongo Health Research Centre), John Owusu Gyapong (0000-0002-8415-1468, University of Health and Allied Sciences), John Gyapong, Osman Sankoh (0000-0003-4405-9808, University of the Witwatersrand), Abraham Oduro (0000-0002-4191-7419, Navrongo Health Research Centre), Di Mcintyre (0000-0001-6319-4111, University of Cape Town) |
| Year | 2017 |
| Volume | 17 |
| Issue | 1 |
| Pages | 13-13 |
| Publication date | 2017-12-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMC International Health and Human Rights (JOURNAL) |
| Journal identifiers | ISSN: 1472-698X • E-ISSN: 1472-698X |
| Publisher | Springer Science and Business Media LLC (PUBLISHER) |
| DOI | 10.1186/s12914-017-0121-7 |
| PMID | 28532403 |
| OpenAlex | W2618659287 |
| Language | EN |
| Citations received | 11 |
| References cited | 11 |
BACKGROUND: There is a global concern regarding how households could be protected from relatively large healthcare payments which are a major limitation to accessing healthcare. Such payments also endanger the welfare of households with the potential of moving households into extreme impoverishment. This paper examines the impoverishing effects of out-of-pocket (OOP) healthcare payments in Ghana prior to the introduction of Ghana's national health insurance scheme. METHODS: Data come from the Ghana Living Standard Survey 5 (2005/2006). Two poverty lines ($1.25 and $2.50 per capita per day at the 2005 purchasing power parity) are used in assessing the impoverishing effects of OOP healthcare payments. We computed the poverty headcount, poverty gap, normalized poverty gap and normalized mean poverty gap indices using both poverty lines. We examine these indicators at a national level and disaggregated by urban/rural locations, across the three geographical zones, and across the ten administrative regions in Ghana. Also the Pen's parade of "dwarfs and a few giants" is used to illustrate the decreasing welfare effects of OOP healthcare payments in Ghana. RESULTS: There was a high incidence and intensity of impoverishment due to OOP healthcare payments in Ghana. These payments contributed to a relative increase in poverty headcount by 9.4 and 3.8% using the $1.25/day and $2.5/day poverty lines, respectively. The relative poverty gap index was estimated at 42.7 and 10.5% respectively for the lower and upper poverty lines. Relative normalized mean poverty gap was estimated at 30.5 and 6.4%, respectively, for the lower and upper poverty lines. The percentage increase in poverty associated with OOP healthcare payments in Ghana is highest among households in the middle zone with an absolute increase estimated at 2.3% compared to the coastal and northern zones. CONCLUSION: It is clear from the findings that without financial risk protection, households can be pushed into poverty due to OOP healthcare payments. Even relatively richer households are impoverished by OOP healthcare payments. This paper presents baseline indicators for evaluating the impact of Ghana's national health insurance scheme on impoverishment due to OOP healthcare payments
Business · Demographic economics · Economic growth · Economics · Environmental health · Health care · Payment · Per capita · Population · Poverty · Socioeconomics · Welfare · Agricultural risk and resilience · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine
NGOs, partnerships, and public-private discontent in Nepal's health care sector
New Health Care Reform and Impoverishment among Chronic Households in China
Household National Health Insurance Subscription and Learning Outcomes of Poor Children in Ghana
When I don't have money to buy the drugs, I just manage.’—Exploring the lived experience of persons with physical disabilities in accessing primary health care services in rural Ghana
Uncovering Multidimensional Determinants of Household Extreme Poverty in Southwest Papua, Indonesia
An assessment of financial catastrophe and impoverishment from out-of-pocket health care payments in Swaziland
Spatial disparities in impoverishing effects of out-of-pocket health payments in Malawi
Assessing medical impoverishment and associated factors in health care in Ethiopia
The effectiveness of a government-sponsored health protection scheme in reducing financial risks for the below-poverty-line population in Bangladesh
Determinants of health insurance enrolment in Ghana
Inequalities in the benefits of national health insurance on financial protection from out-of-pocket payments and access to health services
Analyzing Health Equity Using Household Survey Data
Household catastrophic health expenditure
Catastrophic payments for health care in Asia
Effect of payments for health care on poverty estimates in 11 countries in Asia
Catastrophe and impoverishment in paying for health care
The Economic Burden of Illness for Households in Developing Countries
Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana
Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana’s National Health Insurance Scheme
On the Concept of Health Capital and the Demand for Health
| Citations per year | 1.38 |
|---|---|
| Citation span | 2018 - 2025 (8) |
| Highly cited | No |