Barriers and motivations for health insurance subscription in Cape Coast, Ghana: a qualitative study
Barriers and motivations for health insurance subscription in Cape Coast, Ghana: a qualitative study
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DOI：
10.1186/s13690-017-0192-x
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发表时间：
2017-05-29
影响因子：
3.3
通讯作者：
Darteh, Eugene Kofuor Maafo
中科院分区：
文献类型：
--
作者：
Kumi-Kyereme, Akwasi;Amu, Hubert;Darteh, Eugene Kofuor Maafo
背景：加纳国家健康保险计划于 2003 年建立，其主要目标之一是减轻全额成本回收政策的经济负担，特别是穷人的经济负担。然而，目前该计划的大多数认购者都是上层财富五分之一的个人，因为社会上的穷人还没有认购。我们探讨了加纳海岸角大都市购买健康保险的动机因素和障碍。方法：本研究使用深度访谈指南，从 30 名有意选择的国民健康保险计划订阅者和非订阅者中收集了定性数据。结果：确定的主要动机因素是：负担得起的健康保险费、获得免费药品以及应对不可预见的健康挑战的社会保障。研究发现，朋友、家人和同事的鼓励也能激励人们购买健康保险。订阅健康保险的主要障碍包括：医疗机构和健康保险办公室的排队和等待时间长，药品质量差，服务提供者态度消极。该研究强调国家健康保险管理局需要进行强化教育，以改变人们对健康保险药品质量的负面看法。还应努力减少使用国民健康保险计划卡获得医疗服务的等待时间。这将激励更多的人订阅或更新其会员资格。结论：所发现的障碍意味着人们可能在随后的几年中不再订阅该计划。因此，这将无法实现该计划实现全民医疗保健覆盖的目标。
Background: One of the main objectives of the Ghana National Health Insurance Scheme, at its establishment in 2003, was to ease financial burden of the full cost recovery policy, particularly on the poor. However, currently, majority of the scheme's subscribers are individuals in the upper wealth quintile, as the poor in society rather have not subscribed. We explored the motivational factors as well as the barriers to health insurance subscription in the Cape Coast Metropolis of Ghana.Methods: This study collected qualitative data from 30 purposively selected subscribers and non-subscribers to the National Health Insurance Scheme using an in-depth interview guide.Results: Major motivational factors identified were; affordable health insurance premium, access to free drugs, and social security against unforeseen health challenges. Encouragement by friends, family members, and colleagues, was also found to motivate subscription to the health insurance. The major barriers to health insurance subscription included; long queues and waiting time, perceived poor quality of drugs, and negative attitude of service providers both at the healthcare facilities and the health insurance office. The study underscores the need for the National Health Insurance Authority to conduct intensive education to change the negative perception people have regarding the quality of health insurance drugs. Efforts should also be made to reduce the waiting time in accessing healthcare with the National Health Insurance Scheme card. This would motivate more people to subscribe or renew their membership.Conclusions: The implication of barriers found is that people may not subscribe to the scheme in subsequent years. This would, therefore, consequently defeat the objective of achieving universal healthcare coverage with the scheme.