Assessment of the performance of the management of the Nkoranza Community Health Financing Scheme

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Recent economic events in most sub-Saharan African countries have made it impossible for governments to provide adequate resources for the effective running of the health sector. Health economists, WHO and some NGO’s, have advocated health insurance as an alternative form of financing health care. Communities are being encouraged to set up community financing schemes to improve the health status of its members. Such a type of scheme has been established at Nkoranza District in the Brong Ahafo region since 1992. This study assessed the performance of the management of the scheme and the perception of the community on the scheme. The assessment focused on the variable concepts of planning and decision-making, organizing, leading and control. Apart from obtaining data through questionnaires and discussions, interviews were held with community members and all stakeholders of the scheme. Findings and analysis indicate, amongst others, that the Nkoranza community-financing scheme was popular amongst the people of Nkoranza and seems to have reduced to some extent their financial barrier to health care. A significant recommendation (based on the findings of this study) is that the communities should be involved in the management of the scheme, particularly in the setting of the insurance premium. This would lead to, inter alia, improved management and generally to maximum positive consequences of the financing scheme. A participatory management style would ensure efficiency and yield effective results which would help sustain the scheme.
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana in partial fulfilment of the requirements for the degree of Master of Science in Health Services Planning and Management, 2000