Sustaining the NHIS- the case of non- renewal of membership with Berekum district health insurance scheme

Thumbnail Image
Journal Title
Journal ISSN
Volume Title
Background: It has been estimated that millions of people are faced with problem of financing health care globally. Further the cash and carry system was also an obstacle for many people to access healthcare in most developing countries like Ghana. As a result of this, health insurance has been adopted as an alternative way of financing health care in order to increase access to health care by most developing countries. In 2004, Berekum District NHIS registered 69,000 people in the district representing 70% of the total population. Since then the scheme has not been able to maintain its membership as some members drop out of the scheme every year. Therefore, the research sort to find out why people are not renewing their membership with the scheme. Hence the topic for this study is ‘Sustaining the NHIS- The case of non-renewal of membership with the scheme. Methods: A cross sectional study design was used and the study subjects were adults aged 18 years and above in the district, who were members of the Berekum District Health Insurance Scheme in 2007 and did not renew their membership in 2008. The study subjects were electronically selected randomly and records about them, retrieved from the insurance enrolment database were used, to trace the study subjects to their residence where the interview guides were administered onto them. A descriptive analysis was done. Results: Majority of respondents mentioned scheme management related reasons such as high premium, large family size, unfavourable timing for premium collection, no immediate benefit for non-renewal. In addition lack of community involvement in fixing premium was mentioned. Further issues relating to quality of healthcare receive from service providers were also mentioned as reasons for non-renewal of membership such as delay of insured clients at health facility, fewer and non-availability of insured drugs at facility. Most respondents were also identified to have poor understanding of health insurance concept. Conclusion: With reference to the above findings there is need for strong collaborative effort between the stakeholders of the District health insurance scheme to put in place strategic interventions along side with the recommendations of this report to ensure that, the citizens of the district if not all would enroll onto the scheme. Hence, the success of the scheme.
A dissertation submitted to the school of postgraduate studies, Kwame Nkrumah University of Science and Technology, Kumasi-Ghana, in partial fulfilment of the requirement for the degree of Master of Public Health in Health Services Planning And Management