Factors Influencing Enrolment into the National Health Insurance Scheme: A Case Study of Lower Manya-Krobo Municipality - Eastern Region, Ghana

Abstract

Background: Health care financing is one of the major challenges facing the healthcare delivery sector in Ghana. Health financing in Ghana prior to independence was predominantly by out-of-pocket payments at the point of service use. Since 2003, the country introduced the National Health Insurance Scheme as a mean to lessen the burden of the people in terms of health care cost. However, over 15 years of its implementation, there is still the problem of enrolment and retention. This study was undertaken to determine the factors associated with enrolment and renewal into the National Health Insurance Scheme Methods: The study employed a cross-sectional study design with a quantitative approach to determine the factoring influencing NHIS enrolment in the Lower Manya Krobo Municipality. A total sample size of 362 was used and data were collected through questionnaire administration. Both descriptive and inferential statistics were performed to ascertain the relationships among variables. A p-value<0.05 was considered as significant level with 95% CI. Results: Almost all the respondents (98.1%) have heard about the Ghana Health Insurance Scheme. Major sources of such information were from Radio and Television, and family or relatives. NHIS enrollment stood at 69.1% and factors such as age (p=0.033), sex (p<0.001), educational level (p<0.001) and income status (p<0.05) were significantly associated with enrolment. Again, 90% had expressed their intentions to renew membership. Factors such as education, marital status, and income were also associated with respondents’ intentions to renew membership. Conclusion: Although NHIS enrolment was found to be higher than the national average, there was still over 30% of the respondents who were not and have never enrolled. More efforts are recommended to achieve total enrolment by all.