Agar Brugiavini|Noemi Pace
Extending health insurance in Ghana: effects of the National Health Insurance Scheme on maternity care
Ca' Foscari University of Venice|Ca' Foscari University of Venice
considerable interest exploring potential social health insurance africa number countries currently experimenting different approaches since schemes introduced recently continuously evolving important evaluate effectiveness enhancement health care utilization reduction outofpocket expenses potential policy suggestions investigate national health insurance schemes nhis ghana affects utilization maternal health care services medical outofpocket expenses used nationallyrepresentative household data ghana demographic health survey gdhs analyzed 2014 gdhs focusing four outcome variables ie antenatal check delivery health facility delivery assisted trained person outofpocket expenditure estimated probit bivariate probit models take account issue self selection health insurance schemes results suggest also taking account issue self selection health insurance schemes nhis enrollment positively affects probability formal antenatal checkups delivery probability delivery institution probability assisted delivery trained person contrary find issue selfselection taken account nhis enrollment significant effect outofpocket expenditure extensive margin since greater utilization healthcare services strong positive effect current future health status women children healthcare authorities ghana make every effort extend coverage particular since results first step bivariate probit regressions suggest educational attainment women strong determinant enrollment low education unable read less likely enroll information nhis disseminated ways reach little education moreover availability government health facilities region associated higher likelihood enrollment nhis accordingly extending geographical access important strategy expanding nhis membership improving access healthcare