Dataset Information

Health insurance and social capital in Ghana: a cluster randomised controlled trial.

ABSTRACT:

Background

The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003, enrolment is still far from the desired target of universal coverage. Low community engagement in the design and management of the system was identified as one of the main barriers. The aim of the current study was to explore the role of social capital in NHIS enrolment in two regions of Ghana, Western and Greater Accra.

Methods

The study involved a cluster-randomised controlled trial of 3246 clients of 64 healthcare facilities who completed both a baseline and a follow-up survey. Thirty-two facilities were randomly selected to receive two types of intervention. The remaining facilities served as control. The interventions were co-designed with stakeholders. Baseline and follow up surveys included measures of different types of social capital, as well as enrolment in the health insurance scheme.

Results

The study found that the interventions encouraged NHIS enrolment (from 40.29 to 49.39% (intervention group) versus 36.49 to 36.75% (control group)). Secondly, certain types of social capital are associated with increased enrolment (log-odds ratios (p-values) of three types of vertical social capital are 0.127 (ConclusionWe showed that the interventions helped to increase enrolment but that the positive effect was not realized by changes in social capital that we hypothesised based on result of the first phase of our study. Future research should aim to identify other community factors that are part of the enrolment process, whether other interventions to improve the quality of services could help to increase enrolment and, as a result, could provide community benefits in terms of social capital.Our findings can guide the NHIS in Ghana and other health organizations to enhance enrolment.

Trial registration

Ethical Clearance by Ghana Health Service Ethical Committee No. GHS-ERC 08.5.11.

SUBMITTER: Fenenga CJ

PROVIDER: S-EPMC6282266 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Health insurance and social capital in Ghana: a cluster randomised controlled trial.

Fenenga Christine J CJ Buzasi Katalin K Arhinful Daniel K DK Duku Stephen K O SKO Ogink Alice A Poortinga Wouter W

Global health research and policy 20181206

<h4>Background</h4>The National Health Insurance Scheme (NHIS) was introduced in Ghana in 2003, enrolment is still far from the desired target of universal coverage. Low community engagement in the design and management of the system was identified as one of the main barriers. The aim of the current study was to explore the role of social capital in NHIS enrolment in two regions of Ghana, Western and Greater Accra.<h4>Methods</h4>The study involved a cluster-randomised controlled trial of 3246 c ...[more]

PMID: 30534601

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Dataset Information

Health insurance and social capital in Ghana: a cluster randomised controlled trial.

Background

Methods

Results

Trial registration

Publications

Health insurance and social capital in Ghana: a cluster randomised controlled trial.

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