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KMID : 1235020180120040011
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Health Service Management Review
2018 Volume.12 No. 4 p.11 ~ p.22
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Outcomes and Policy Implications of Health Insurance ODA in Ghana
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Chun Chang-Bae
Jung Kee-Taig
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Abstract
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Since Ghana introduced social health insurance in 2003, Government had tried to increase enrollment rate, which has been stagnated over the last ten years. National Health Insurance Authority in Ghana has requested KOFIH to start UHC project to learn Korea’s UHC experience, which was completed in twelve years. KOFIH started conducting various levels of training for NHIA staffs, while preparing a pilot project in Volta region to increase enrollment rate. Two Districts were selected to the pilot project places: Kadjebi and Ketu North districts. Different intervention methods were implemented in two districts. Group enrolment for Kadjebi and Information and education for Ketu North were implemented respectively for ten months from October 2016 to July 2017. The results of pilot project show that Kadjebi district has higher enrollment rate compared to Ketu North and North Tongu, control group. However, in terms of renewal enrollment rate, Ketu North shows the highest rate among three districts, which can be the result of effect of the education and public advertisement. In the pre-and-post-pilot comparison, Kadjebi with household unit enrollment shows 14.6 % increase in enrollment rate, while Ketu North with education and advertisement has marginal increase of 1.8 %. In revenue from premium, Kadjebi district brings about 5.5% of increase, but Ketu North decreased revenue of 9.2 %. Analysis on pilot study can contribute to understand the reasons of why enrollment rate is stagnated for long period in Ghana. This analysis can help understand the phenomena of adverse selection, risk pool, and moral hazard in social health insurance system. Outcomes through this analysis can give lesson to KOFIH and NHIA on how to handle and overcome the problems that appear during the first phrase. This study will contribute to find approaches to develop health insurance ODA effectively in the future.
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KEYWORD
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Ghana, Health Insurance ODA, Enrollment increase, Pilot increase, Pilot project, Intervention methods
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