IDEAS home Printed from https://ideas.repec.org/p/eca/wpaper/2013-246227.html
   My bibliography  Save this paper

Does National Health Insurance Improve Children's Health ?National and Regional Evidence from Ghana

Author

Listed:
  • Lisa Bagnoli

Abstract

This paper uses a propensity score matching approach to assess the impact of Ghana’s National Health Insurance Scheme (NHIS) on health utilization and health outcomes for children under five years old using a nationally representative Multiple Indicator Cluster Survey from 2011. The results show that even though health insurance is free for children, around half of them are not insured, with the probability of enrollment being significantly affected by many characteristics. Nationally, the insurance increases both health care utilization and the overall health status of children. Nevertheless, there are important discrepancies across regional results suggesting that the largest gains are found in the poorest regions, which correspond to those with the worse average health outcomes. However, some other regions present none or only very limited gains attributable to the insurance.

Suggested Citation

  • Lisa Bagnoli, 2017. "Does National Health Insurance Improve Children's Health ?National and Regional Evidence from Ghana," Working Papers ECARES ECARES 2017-03, ULB -- Universite Libre de Bruxelles.
    • Handle: RePEc:eca:wpaper:2013/246227
    as

    Download full text from publisher

    File URL: https://dipot.ulb.ac.be/dspace/bitstream/2013/246227/3/2017-03-BAGNOLI-doesnational.pdf
    File Function: Full text for the whole work, or for a work part
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Dow, William H. & Schmeer, Kammi K., 2003. "Health insurance and child mortality in Costa Rica," Social Science & Medicine, Elsevier, vol. 57(6), pages 975-986, September.
    2. Binagwaho, Agnes & Hartwig, Renate & Ingeri, Denyse & Makaka, Andrew, 2012. "Mutual health insurance and its contribution to improving child health in Rwanda," Passauer Diskussionspapiere, Volkswirtschaftliche Reihe V-66-12, University of Passau, Faculty of Business and Economics.
    3. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    4. A. Smith, Jeffrey & E. Todd, Petra, 2005. "Does matching overcome LaLonde's critique of nonexperimental estimators?," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 305-353.
    5. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    6. James J. Heckman & Hidehiko Ichimura & Petra E. Todd, 1997. "Matching As An Econometric Evaluation Estimator: Evidence from Evaluating a Job Training Programme," Review of Economic Studies, Oxford University Press, vol. 64(4), pages 605-654.
    7. Xiaobo Peng & Dalton Conley, 2016. "The implication of health insurance for child development and maternal nutrition: evidence from China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(5), pages 521-534, June.
    8. Rodrigo Barros, 2008. "Wealthier But Not Much Healthier: Effects of a Health Insurance Program for the Poor in Mexico," Discussion Papers 09-002, Stanford Institute for Economic Policy Research.
    9. Stella A. Quimbo & John W. Peabody & Riti Shimkhada & Jhiedon Florentino & Orville Solon, 2011. "Evidence of a causal link between health outcomes, insurance coverage, and a policy to expand access: experimental data from children in the Philippines," Health Economics, John Wiley & Sons, Ltd., vol. 20(5), pages 620-630, May.
    10. Alberto Abadie & Guido W. Imbens, 2008. "On the Failure of the Bootstrap for Matching Estimators," Econometrica, Econometric Society, vol. 76(6), pages 1537-1557, November.
    11. Yilma, Zelalem & van Kempen, Luuk & de Hoop, Thomas, 2012. "A perverse ‘net’ effect? Health insurance and ex-ante moral hazard in Ghana," Social Science & Medicine, Elsevier, vol. 75(1), pages 138-147.
    12. Marco Caliendo & Sabine Kopeinig, 2008. "Some Practical Guidance For The Implementation Of Propensity Score Matching," Journal of Economic Surveys, Wiley Blackwell, vol. 22(1), pages 31-72, February.
    13. Hong Wang & Winnie Yip & Licheng Zhang & William C. Hsiao, 2009. "The impact of rural mutual health care on health status: evaluation of a social experiment in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 65-82, July.
    14. Joseph Mensah & Joseph R. Oppong & Christoph M. Schmidt, 2010. "Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 95-106, September.
    15. Rajeev H. Dehejia & Sadek Wahba, 2002. "Propensity Score-Matching Methods For Nonexperimental Causal Studies," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 151-161, February.
    16. Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
    17. Mawuli Gaddah & Alistair Munro, 2011. "The Progressivity Of Health Care Services In Ghana," GRIPS Discussion Papers 11-14, National Graduate Institute for Policy Studies.
    18. Agar Brugiavini & Noemi Pace, 2011. "Extending Health Insurance: Effects of the National Health Insurance Scheme in Ghana," RSCAS Working Papers 2011/27, European University Institute.
    19. Gajate-Garrido, Gissele & Ahiadeke, Clement, 2015. "The effect of insurance enrollment on maternal and child health care utilization: The case of Ghana," IFPRI discussion papers 1495, International Food Policy Research Institute (IFPRI).
    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. Bagnoli, Lisa, 2019. "Does health insurance improve health for all? Heterogeneous effects on children in Ghana," World Development, Elsevier, vol. 124(C), pages 1-1.
    2. Sarah Alkenbrack & Magnus Lindelow, 2015. "The Impact of Community‐Based Health Insurance on Utilization and Out‐of‐Pocket Expenditures in Lao People's Democratic Republic," Health Economics, John Wiley & Sons, Ltd., vol. 24(4), pages 379-399, April.
    3. Abebaw, Degnet & Fentie, Yibeltal & Kassa, Belay, 2010. "The impact of a food security program on household food consumption in Northwestern Ethiopia: A matching estimator approach," Food Policy, Elsevier, vol. 35(4), pages 286-293, August.
    4. Johar, Meliyanni, 2009. "The impact of the Indonesian health card program: A matching estimator approach," Journal of Health Economics, Elsevier, vol. 28(1), pages 35-53, January.
    5. Schilling, Brian J. & Attavanich, Witsanu & Sullivan, Kevin P. & Marxen, Lucas J., 2014. "Measuring the effect of farmland preservation on farm profitability," MPRA Paper 100122, University Library of Munich, Germany, revised Jun 2014.
    6. Amorn Pochanasomboon & Witsanu Attavanich & Akaranant Kidsom, 2020. "Impacts of Land Ownership on the Economic Performance and Viability of Rice Farming in Thailand," Land, MDPI, Open Access Journal, vol. 9(3), pages 1-18, March.
    7. Dettmann, E. & Becker, C. & Schmeißer, C., 2011. "Distance functions for matching in small samples," Computational Statistics & Data Analysis, Elsevier, vol. 55(5), pages 1942-1960, May.
    8. Jan Fałkowski & Maciej Jakubowski & Paweł Strawiński, 2014. "Returns from income strategies in rural Poland," The Economics of Transition, The European Bank for Reconstruction and Development, vol. 22(1), pages 139-178, January.
    9. Cadot, Olivier & Fernandes, Ana M. & Gourdon, Julien & Mattoo, Aaditya, 2015. "Are the benefits of export support durable? Evidence from Tunisia," Journal of International Economics, Elsevier, vol. 97(2), pages 310-324.
    10. Anne Stevenot & Loris Guery & Geoffrey Wood & Chris Brewster, 2018. "Country of Origin Effects and New Financial Actors: Private Equity Investment and Work and Employment Practices of French Firms," British Journal of Industrial Relations, London School of Economics, vol. 56(4), pages 859-881, December.
    11. Hohendanner Christian, 2011. "Ein-Euro-Jobs und reguläre Beschäftigung / One-Euro-Jobs and Regular Employment: Eine Analyse potenzieller Substitutionseffekte mit Daten des IAB-Betriebspanels / An Analysis of Potential Substitution," Journal of Economics and Statistics (Jahrbuecher fuer Nationaloekonomie und Statistik), De Gruyter, vol. 231(2), pages 210-246, April.
    12. Anupam Nanda, 2005. "Property Condition Disclosure Law: Does 'Seller Tell All' Matter in Property Values?," Working papers 2005-47, University of Connecticut, Department of Economics, revised Jul 2006.
    13. Jasmin Kantarevic & Boris Kralj, 2013. "Link Between Pay For Performance Incentives And Physician Payment Mechanisms: Evidence From The Diabetes Management Incentive In Ontario," Health Economics, John Wiley & Sons, Ltd., vol. 22(12), pages 1417-1439, December.
    14. Dan Pan, 2014. "The Impact of Agricultural Extension on Farmer Nutrient Management Behavior in Chinese Rice Production: A Household-Level Analysis," Sustainability, MDPI, Open Access Journal, vol. 6(10), pages 1-22, September.
    15. Kazushi TAKAHASHI & Takayuki HIGASHIKATA & Kazunari TSUKADA, 2010. "The Short‐Term Poverty Impact Of Small‐Scale, Collateral‐Free Microcredit In Indonesia: A Matching Estimator Approach," The Developing Economies, Institute of Developing Economies, vol. 48(1), pages 128-155, March.
    16. Heinrich, Carolyn J. & Mueser, Peter R. & Troske, Kenneth & Jeon, Kyung-Seong & Kahvecioglu, Daver C., 2009. "New Estimates of Public Employment and Training Program Net Impacts: A Nonexperimental Evaluation of the Workforce Investment Act Program," IZA Discussion Papers 4569, Institute of Labor Economics (IZA).
    17. Andrea Ichino & Fabrizia Mealli & Tommaso Nannicini, 2008. "From temporary help jobs to permanent employment: what can we learn from matching estimators and their sensitivity?," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 23(3), pages 305-327.
    18. Eliasson, Kent, 2006. "How Robust is the Evidence on the Returns to College Choice? Results Using Swedish Administrative Data," Umeå Economic Studies 692, Umeå University, Department of Economics.
    19. Jens Ruhose & Stephan L. Thomsen & Insa Weilage, 2018. "The Wider Benefits of Adult Learning: Work-Related Training and Social Capital," CESifo Working Paper Series 7268, CESifo.
    20. Peter R. Mueser & Kenneth R. Troske & Alexey Gorislavsky, 2007. "Using State Administrative Data to Measure Program Performance," The Review of Economics and Statistics, MIT Press, vol. 89(4), pages 761-783, November.

    More about this item

    Keywords

    health insurance; health; health care utilization; children; Ghana; propensity score matching;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs
    • I10 - Health, Education, and Welfare - - Health - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:eca:wpaper:2013/246227. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Benoit Pauwels). General contact details of provider: https://edirc.repec.org/data/arulbbe.html .

    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 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.