In recent years the number of formal risk-sharing schemes for health care services in Ghana has risen rapidly. At present about 42 out of 110 districts are operating some form of formal community-based health insurance, which are voluntary and to a greater extent integrated to health care facilities. The success of these schemes depend largely on the extent to which they directly or indirectly lessen the financial burden of people who have suffered most since the inception of economic reforms in the health sector.
The paper looked at the social inclusion aspects of the schemes by studying demand for the two oldest schemes by the poor and exploring design features that could enhance better coverage and improve financial protection for health care services. The findings portray a remarkable exclusion of the poorest of the poor, even from other forms of risk-sharing arrangements in the informal sector. The paper also identifies limitation on plan choice as a constraining factor and highlights re-direction of subsidies from urban areas to favour rural health infrastructure.
Demand for voluntary health insurance by the poor in developing countries: evidence from rural Ghana, presented at Staying Poor: Chronic Poverty and Development Policy, Institute for Development Policy and Management, University of Manchester, 7-9 April 2003. Chronic Poverty Research Centre (CPRC), Manchester, UK, i + 24 pp.