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Determinants of enrollment in the NHIS for women in Ghana

Kusi, A., Fenny, A. P., Arhinful, D. K. , Asante, F. A. & Parmar, D. (2018). Determinants of enrollment in the NHIS for women in Ghana. International Journal of Social Economics, 45(9), pp. 1318-1334. doi: 10.1108/IJSE-10-2016-0291


The National Health Insurance Scheme (NHIS) was introduced in 2005 to provide equitable access to healthcare. Furthermore, concessions were made for pregnant women, yet inequities in access continue to exist. This study explores whether dimensions of social exclusion explain why some groups of women are not benefitting from the scheme.

Data was collected from 4050 representative households in five districts. Logistic regression is used to examine the factors that determine enrolment of women under the NHIS.

The study sample consists of a sub-sample of 3,173 women out of whom 58% were insured. The majority (64.9%) of the women were in the reproductive age (15-45 years). The results show that wealth status, age, health status, locality, perception about the quality of care at health facilities and perception of the NHIS, are the key factors that determine enrolment into the scheme.

With women dominating the informal sector of Ghana’s economy which is often characterised by relatively low incomes, these inequities in access need to be addressed.

Publication Type: Article
Publisher Keywords: health insurance, enrolment, women, household survey, social health protection
Departments: School of Health & Psychological Sciences > Healthcare Services Research & Management
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