Academic journal article Journal of Social Sciences

Perceptions of Care, Socio-Demographic Characteristics and Health Care Utilisation among Health Insurance Users in Ghana

Academic journal article Journal of Social Sciences

Perceptions of Care, Socio-Demographic Characteristics and Health Care Utilisation among Health Insurance Users in Ghana

Article excerpt

Abstract: The socio-demographic characteristics of clients and their perception of quality of care play a major part in people's decision making process especially in service utilization. This study assesses the relationship between clients' socio-economic features as well as their perceived quality on health care utilization. The study adopted a non-experimental cross sectional design in eliciting information from health clients who accessed health services in ten selected hospitals in the Kumasi Metropolis with a cluster sampling design to select 400 clients from the ten health facilities purposely selected. The researcher used interviews and semi structured questionnaires to collect data and used SPSS version 20 for processing whiles descriptive and inferential statistics was supported with STATA 11. Perception about the quality of health provision influenced access of healthcare with NHIS cards. Clients who viewed the overall quality of health provision as good or very good were more likely to access healthcare with NHIS card as compared to those who rated the overall health provision as poor or very poor (OR = 2.1; p<0.01). Socio-demographic factors continuously play a strong role in influencing clients to access health care under the National Health Insurance Scheme (NHIS) as the high income groups still dominate in utilizing health care services under the scheme than the deprived and the poor. Increased enrolment in the scheme should be supported with provision of quality services to enhance clients' satisfaction. Also, socio-demographic characteristics influence the utilization of health care.

Keywords: Ghana, Health Insurance, Perception, Health Care, Utilization, Socio-Demographic


In 2003, the National Health Insurance Scheme (NHIS) was established under Act 650 of 2003 by the Government of Ghana with the objective of providing basic healthcare services to Ghanaians through mutual and private health insurance schemes (Boateng and Awunyor-Vitor, 2013). The National Health Insurance Scheme (NHIS) came into effect in 2004 at a time when out of 80% of patients who required health care at any given time, only twenty percent had access to health care (Assensoh and Wahab, 2008) aimed at offering affordable and quality health care services to Ghanaians.

In Agyei-Baffour et al. (2013) study, despite the improvements in quality health care that the National Health insurance Scheme is facilitating in Ghana, there still continue to exist implementation challenges necessitating for proper reforms. Several factors aid in defining and understanding the drivers of health service utilization especially among health insured clients.

The Socio-Demographic characteristics consider the location of the people, their income levels, religion, educational levels, ethnicity and other social and cultural factors.

Several studies have documented on the influence of socio-demographic factors on membership renewal and subscription into NHIS (Basaza et al., 2008; Dalinjong and Laar, 2012; Dong et al., 2009; Nketiah-Amponsah, 2009; Sarpong et al., 2010). Buor (2004) in his study report that closeness to the scheme office was preferred to than when it was farther. This is further supported by Boateng and Awunyor-Vitor (2013) in their study in the Volta region of Ghana with their findings showing 72% disapproving of the convenience of the scheme office location. It was noted in all the studies by De Allegri et al. (2006a; 2006b; Sinha et al., 2006; Kamuzora and Gilson, 2007; Ndiayec et al., 2007; Asante and Aikins, 2008) the relationship different demographic factors has with NHIS enrollment and subsequent renewal of membership.

The findings from Aryeetey et al. (2010) cross sectional study of a sample population of 13, 867 individuals, with an average of 25 years and children under 18 years representing 49% of the sample, show that despite the fact that 67% of all individuals were in some form of employment, education which was measured by total years of schooling was low at a mean of 7 years whiles the mean monthly individual income was GHc43. …

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