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Evaluation of Community Perspectives on National Health Insurance Policy to Health Service Delivery in Ghana,

Category: Journal Articles


Aboagye, Da Costa, Khan, Hafiz and South, Jane (2018) Evaluation of community perspectives on National Health Insurance Policy to health service delivery in Ghana. Illness, Crisis & Loss. ISSN 1054-1373


The paper aims to examine National Health Insurance Scheme (NHIS) policy from the perspective of local communities. Qualitative data from nine key informant interviews and seventy-two community respondents in nine focus group discussions (FGD) were conducted. The FGDs took place in seven different communities in seven regions of Ghana. The data were analysed using thematic network approach. The findings noted a disconnection between NHIS policy and community life. More so, the findings showed an explicit link between equity and access with its impacts on health outcomes. The qualitative results indicated lack of voice and understanding as features limiting people from accessing the NHIS facilities. Understanding of equity as a key theme revealed: first, lack of stakeholder engagement and consultation or participation in the NHIS decision making process. Second it was established that while the policy indicated a will to include all the core poor for an equitable NHIS, there is lack of willingness to implement this aim fully. Finally, despite being a pro- poor intervention by name, practical management of the NHIS is transmitted down vertical silos from the national level, with the lack of joined-up government at the centre undermining local partnerships. Thus, not only are national expectations being dashed locally, local expectations are dashed nationally. The paper proposes that community viewpoints should be given higher priority given that NHIS has since its inception been associated with medical treatments and biomedical paradigm. Promoting community participation, understanding and voices should be recognised to shape the future NHIS policy and practice.