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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/2325

Title: Community health financing through prepayment schemes in the Kwaebibirem District Of Ghana - a Feasibility Study
Authors: Gyakobo, Mawuli Kotope
Issue Date: 13-Dec-2001
Series/Report no.: 2955;
Abstract: Health finance has seen different stages in Ghana. Medical care in the sixties was free but with the escalating health cost, the capacity of the Ministry of Health could no longer meet the subsidies and as such a form of cost recovery had to be introduced. The capacity of the Ministry of Health was even further undermined by the unstable economic performance, unprecedented rates of population growth and the immense cost that the HIV pandemic had exacted and continues to exact on the health budgets. Cost recovery took the form of “user fees” which was introduced in Ghana in July, 1985. Following the introduction of user fees, health service utilization fell and many people could not afford their health bills leading to high defaulting/absconding rates and as such loss of revenue to the health services as well as an increase in morbidity, mortality and disability rates. Due to the inability of the user fees to solve the ailing health finance in the country, a flurry of debate ensued culminating in the proposition of health insurance schemes to remedy the situation and hence this work. The study was cross - sectional with respect to Primary Data and Retrospective with respect to Secondary Data. Both quantitative and qualitative data were collected for analysis. Purposive (Convenience) Sampling was used to select five communities in which to collect Primary Data. The Houses and Households were hereafter chosen by Systematic Sampling and Simple Random Sampling respectively. Secondary Data was obtained from the District Hospital Records office. The results of the feasibility study revealed a fair basis for a Community Health Prepayment Scheme. The findings further revealed a fairly weak financial base with over 50% of the sampled population falling below the lower poverty line of ¢700,000.00 per adult per annum. The mean annual income was found to be ¢5,361,229.70 with 49.8% earning less than ¢500,000 per annum. However, the social acceptability was very high (96.6%). A monthly premium contribution schedule was established to range between ¢3,000 and ¢6,500 per capita. Both In - patient and Out-patient services was the choice priority of the people though holistic analysis favoured. In - patient services only for the now. The scheme design arrived at was the direct insurance type and the management body was to be the District Hospital on the basis of managerial /administrative efficiency as well as requisite capacity. Further studies into the following areas may be useful in the future: Actuarially determined premiums, scheme designs that will foster equity and qualitative studies to establish the reasons for certain choices and actions.
Description: A thesis submitted to the Department of Community Health, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, in partial fulfilment of the requirements for the award of Master of Science degree in Health Services Planning and Management, 2001
URI: http://hdl.handle.net/123456789/2325
Appears in Collections:College of Health Sciences

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