Community participation in health care financing (The Case of Health Insurance in West Gonja District)

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Over the years, the cost of health care has been increasing significantly thus reducing access to effective health care, It is the intention of government to ensure access to health services by investing in health to make it affordable, having recognised that health is a key ingredient to the formation human capital and hence the sustenance of socio-economic development. However, recent economic events have made it clear that government cannot continue to provide adequate resources or the effective running of the health system. This is evident from government’s financial allocation to the Ministry of Health, which has been shrinking over the past decade. The need to introduce health insurance s an alternate form of health sector financing has therefore been advocate and the need is more compelling now than ever. Nonetheless, opinion are divided as to whether our rural communities will accept an effectively contribute to an insurance scheme and whether such schemes re sustainable. The objective of this study was to find out if the scheme at West Gonja was popular and sustainable. Discussions were held with the communities and with key players of the scheme. The study found that health insurance was very popular amongst the people and is seen as a panacea their inability to pay for health care services on demand. A major finding was that community health insurance can increase effective access to health care and provides reso11rcés for continuous improvement in quality care. For purposes of sustainability, it as noted that he communities wanted to have a say in the management of the scheme particularly on the setting of premiums. It was realised that, minimal involvement can lead to minimal appreciation f t1hé positive consequences of insurance. A participatory approach the scheme would yield higher dividends.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of the Degree of Master of Science in Health Services Planning and Management, 1999