Modes of using health insurance policies: Lessons from Daakye District, Ghana
Donnish Publishing House
School of Arts and Humanities
Health insurance policies are regarded as enhancing people’s access to healthcare, particularly in developing countries, where poverty remains a barrier to healthcare access and utilisation. As most health insurance policies operate within so-called ‘scientific’ hospital-based medical systems, it is expected that those who purchase them – particularly the poor – would use them when they are ill. However, drawing on an ethnographic study of Ghana’s National Health Insurance Scheme (NHIS) in the Daakye District of the Central Region, this paper argues that joining health insurance schemes does not mean that people necessarily access hospital-based medical care exclusively. In the Ghanaian context, there exists a pluralistic healthcare system consisting of hospital-based treatment, pharmacy/drugstores, traditional medicines and faith healing. Socio-economic factors such as local perceptions of illness, the quality of healthcare provided, distance to healthcare centres and local partisan politics were found to influence people’s decisions and modes of NHIS use in the Daakye District. The findings indicate that it is not sufficient to make health insurance policies affordable; rather they also must be accompanied by more medical facilities, with service delivery, that are functionally and qualitatively available, accessible and acceptable.