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Extending Health Insurance: Effects of the National Health Insurance Scheme in Ghana

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  • Agar Brugiavini
  • Noemi Pace

Abstract

There is considerable interest in exploring the potential of health insurance to increase the access to, and the affordability of, health care in Africa. We focus on the recent experience of Ghana, where a National Health Insurance Scheme (NHIS) became law in 2003 and fully implemented from late 2005. Even though there is some evidence of large coverage levels, the effect of the NHIS on health care demand and out-of-pocket expenditures has still not been fully examined. This paper is an attempt to close this gap. Using nationally-representative household data from the Ghana Demographic and Health Survey, we find that the introduction of the NHIS has a positive and significant effect on the utilisation of health care services, although it does have only a weak effect on out-of-pocket expenditure.

Suggested Citation

  • 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.
  • Handle: RePEc:rsc:rsceui:2011/27
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    References listed on IDEAS

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    1. Paul Gertler & Jonathan Gruber, 2002. "Insuring Consumption Against Illness," American Economic Review, American Economic Association, vol. 92(1), pages 51-70, March.
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    3. Chetty, Raj & Looney, Adam, 2006. "Consumption smoothing and the welfare consequences of social insurance in developing economies," Journal of Public Economics, Elsevier, pages 2351-2356.
    4. Grossman, Michael, 1972. "On the Concept of Health Capital and the Demand for Health," Journal of Political Economy, University of Chicago Press, vol. 80(2), pages 223-255, March-Apr.
    5. Liu, Tsai-Ching & Chen, Chin-Shyan, 2002. "An analysis of private health insurance purchasing decisions with national health insurance in Taiwan," Social Science & Medicine, Elsevier, vol. 55(5), pages 755-774, September.
    6. Grant Miller & Diana Pinto & Marcos Vera-Hernández, 2013. "Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor," American Economic Journal: Applied Economics, American Economic Association, vol. 5(4), pages 61-91, October.
    7. Manning, Willard G. & Marquis, M. Susan, 1996. "Health insurance: The tradeoff between risk pooling and moral hazard," Journal of Health Economics, Elsevier, vol. 15(5), pages 609-639, October.
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    Citations

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    Cited by:

    1. Monica Lambon-Quayefio & Nkechi Owoo, 2014. "Examining the Influence of Antenatal Care Visits and Skilled Delivery on Neonatal Deaths in Ghana," Applied Health Economics and Health Policy, Springer, vol. 12(5), pages 511-522, October.
    2. Heath, Rachel, 2017. "Fertility at work: Children and women's labor market outcomes in urban Ghana," Journal of Development Economics, Elsevier, vol. 126(C), pages 190-214.
    3. 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.
    4. Mawuli Gaddah & Alistair Munro, 2011. "The Progressivity Of Health Care Services In Ghana," GRIPS Discussion Papers 11-14, National Graduate Institute for Policy Studies.
    5. repec:spr:hecrev:v:7:y:2017:i:1:d:10.1186_s13561-017-0169-z is not listed on IDEAS
    6. Nkechi Owoo & Monica Lambon-Quayefio, 2013. "National health insurance, social influence and antenatal care use in Ghana," Health Economics Review, Springer, vol. 3(1), pages 1-12, December.
    7. 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).

    More about this item

    Keywords

    Health insurance; out-of-pocket expenses; maternity care demand;

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