IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0003265.html
   My bibliography  Save this article

Regaining policy attention for a health insurance capitation payment reform in Ghana: A prospective policy analysis

Author

Listed:
  • Gilbert Abotisem Abiiro

Abstract

Capitation as a provider payment mechanism gained policy attention by the Ghana National Health Insurance Scheme (NHIS) in 2012 and was piloted in the Ashanti Region, Ghana. Recent studies revealed that the policy was suspended in 2017 due to inappropriate policy framing, actor contestations, unclear policy design characteristics, and an unfavorable political context. However, the NHIS still has interest in capitation as a provider payment option. Using the modified political process model, a prospective policy analysis was conducted to explore how to: i) appropriately reframe policy debates; ii) create political opportunities; and iii) mobilize resources to reattract policy attention to capitation in Ghana. Cross-sectional qualitative data were gathered in December, 2019 from semi-structured interviews with a purposive sample of 18 stakeholders and complemented with four community-level focus group discussions with 41 policy beneficiaries in the pilot region. All data were tape-recorded and transcribed. The analysis was thematic, using the NVivo 12 software. The results revealed that an appropriate reframing of the policy requires policy renaming, refinement of certain policy design characteristics (emergency care, capitation rates, choice and assignment of providers) and refocusing policy communication and advocacy on the health benefits of capitation instead of its cost containment intent. To create political opportunities for policy re-implementation, a politically sensitive approach with broader stakeholder consultations should be adopted. Policy advocacy and communication should be evidenced-based and led by politically neutral agents. An equitable capitation policy implementation requires resourcing health facilities, especially the lower-level facilities, with improved infrastructure, consumables, improved information management systems and well-trained personnel to enhance their service delivery capacities. The study concludes that there exists stakeholder interest in the capitation policy in Ghana and calls for an effective reframing, creation of political opportunities, and mobilization of needed resources to regain policy attention.

Suggested Citation

  • Gilbert Abotisem Abiiro, 2024. "Regaining policy attention for a health insurance capitation payment reform in Ghana: A prospective policy analysis," PLOS Global Public Health, Public Library of Science, vol. 4(5), pages 1-18, May.
    • Handle: RePEc:plo:pgph00:0003265
    DOI: 10.1371/journal.pgph.0003265
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0003265
    Download Restriction: no
    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0003265&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pgph.0003265?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jegers, Marc & Kesteloot, Katrien & De Graeve, Diana & Gilles, Willem, 2002. "A typology for provider payment systems in health care," Health Policy, Elsevier, vol. 60(3), pages 255-273, June.
    2. Stokes, Jonathan & Struckmann, Verena & Kristensen, Søren Rud & Fuchs, Sabine & van Ginneken, Ewout & Tsiachristas, Apostolos & Rutten van Mölken, Maureen & Sutton, Matt, 2018. "Towards incentivising integration: A typology of payments for integrated care," Health Policy, Elsevier, vol. 122(9), pages 963-969.
    3. Jeremy Shiffman & Stephanie Smith, 2007. "Generation of Political Priority for Global Health Initiatives: A Framework and Case Study of Maternal Mortality," Working Papers 129, Center for Global Development.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Siddiqui, Shayzal & Smith-Morris, Carolyn, 2022. "Professional competition amidst intractable maternal mortality: Midwifery in rural Pakistan during the COVID-19 pandemic," Social Science & Medicine, Elsevier, vol. 313(C).
    2. Mads Leth Felsager Jakobsen & Thomas Pallesen, 2017. "Performance Budgeting in Practice: the Case of Danish Hospital Management," Public Organization Review, Springer, vol. 17(2), pages 255-273, June.
    3. Gifford, Rachel & Molleman, Eric & van der Vaart, Taco, 2024. "It's a jungle out there: Understanding physician payment and its role in group dynamics," Social Science & Medicine, Elsevier, vol. 350(C).
    4. Sandberg, Kristin Ingstad & Andresen, Steinar & Bjune, Gunnar, 2010. "A new approach to global health institutions? A case study of new vaccine introduction and the formation of the GAVI Alliance," Social Science & Medicine, Elsevier, vol. 71(7), pages 1349-1356, October.
    5. Gillespie, Stuart & van den Bold, Mara, 2015. "Stories of change in nutrition: A tool pool," IFPRI discussion papers 1494, International Food Policy Research Institute (IFPRI).
    6. Małgorzata Gałązka-Sobotka & Aldona Frączkiewicz-Wronka & Iwona Kowalska-Bobko & Hanna Kelm & Karolina Szymaniec-Mlicka, 2021. "HB-HTA as an implementation problem in Polish health policy," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-24, September.
    7. Stoop, Annerieke & de Bruin, Simone R. & Wistow, Gerald & Billings, Jenny & Ruppe, Georg & Leichsenring, Kai & Obermann, Konrad & Baan, Caroline A. & Nijpels, Giel, 2019. "Exploring improvement plans of fourteen European integrated care sites for older people with complex needs," Health Policy, Elsevier, vol. 123(12), pages 1135-1154.
    8. Simmons, Cassandra & Pot, Mirjam & Lorenz-Dant, Klara & Leichsenring, Kai, 2024. "Disentangling the impact of alternative payment models and associated service delivery models on quality of chronic care: A scoping review," Health Policy, Elsevier, vol. 143(C).
    9. Fengrong Liu & Jiayu Chen & Chaozhu Li & Fenghui Xu, 2023. "Cost Sharing and Cost Shifting Mechanisms under a per Diem Payment System in a County of China," IJERPH, MDPI, vol. 20(3), pages 1-12, January.
    10. Melberg, Andrea & Diallo, Abdoulaye Hama & Storeng, Katerini T. & Tylleskär, Thorkild & Moland, Karen Marie, 2018. "Policy, paperwork and ‘postographs’: Global indicators and maternity care documentation in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 215(C), pages 28-35.
    11. Koduah, Augustina & Agyepong, Irene Akua & van Dijk, Han, 2016. "‘The one with the purse makes policy’: Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana," Social Science & Medicine, Elsevier, vol. 167(C), pages 79-87.
    12. Thomas Reindersma & Isabelle Fabbricotti & Kees Ahaus & Sandra Sülz, 2022. "Integrated Payment, Fragmented Realities? A Discourse Analysis of Integrated Payment in the Netherlands," IJERPH, MDPI, vol. 19(14), pages 1-14, July.
    13. Nolan, Anne, 2019. "Reforming the delivery of public dental services in Ireland: potential cost implications," Research Series, Economic and Social Research Institute (ESRI), number RS80.
    14. Yuxue Yang & Xuejiao Tan & Yafei Shi & Jun Deng, 2023. "What are the core concerns of policy analysis? A multidisciplinary investigation based on in-depth bibliometric analysis," Palgrave Communications, Palgrave Macmillan, vol. 10(1), pages 1-12, December.
    15. Litchfield, Ian & Kingston, Beth & Narga, Dee & Turner, Alice, 2022. "The move towards integrated care: Lessons learnt from managing patients with multiple morbidities in the UK," Health Policy, Elsevier, vol. 126(8), pages 777-785.
    16. Han, Lu & Koenig-Archibugi, Mathias & Opsahl, Tore, 2018. "The social network of international health aid," Social Science & Medicine, Elsevier, vol. 206(C), pages 67-74.
    17. Yandisa Ngqangashe & Maddie Heenan & Melanie Pescud, 2021. "Regulating Alcohol: Strategies Used by Actors to Influence COVID-19 Related Alcohol Bans in South Africa," IJERPH, MDPI, vol. 18(21), pages 1-16, October.
    18. Andersson, Tommy & Ellegård, Lina Maria & Enache, Andreea & Erlanson, Albin & Thami, Prakriti, 2024. "Multiple pricing for personal assistance services," Economic Modelling, Elsevier, vol. 141(C).
    19. Lisa Jamieson & Dandara Haag & Helena Schuch & Kostas Kapellas & Rui Arantes & W. Murray Thomson, 2020. "Indigenous Oral Health Inequalities at an International Level: A Commentary," IJERPH, MDPI, vol. 17(11), pages 1-6, June.
    20. Garcia-Lacalle, Javier & Martin, Emilio, 2010. "Rural vs urban hospital performance in a 'competitive' public health service," Social Science & Medicine, Elsevier, vol. 71(6), pages 1131-1140, September.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0003265. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.