30 research outputs found
The effects of National Health Insurance Scheme on healthcare utilisation, financial protection and health status in Ghana
No full textHealth insurance is predicted to increase healthcare utilisation, lower out-of-pocket health spending, and improve household health and productivity. This thesis aimed to assess the effects of Ghana’s National Health Insurance Scheme on healthcare utilisation, financial protection and health status of beneficiaries. The data for the study comes from the Ghana Socioeconomic Panel Survey (GSPS) wave 1, 2 and 3 datasets involving a total sample of 31,807 individuals. The study employed the logit model, negative binomial regression model, two-stage residual inclusion (2SRI), the two-part model (i.e., probit model and log-linear model), Heckman selection model, Copula-based Heckman selection model, endogenous switching regression for ordered outcomes and Conditional Mixed Process (CMP) model. The results revealed that NHIS membership improves healthcare utilisation by increasing visits to a health facility and formal care usage. The heterogeneous effects of NHIS on healthcare utilisation further show an increased probability of seeking formal care irrespective of residential status and income. Concerning health facilities visits, the study found increased visitations for the insured rural residents, whereas the probability of visiting a health facility increases for the NHIS members irrespective of income. The Copula-based Heckman sample-selection model was chosen as the preferred model for examining the determining factors of out-of-pocket health spending after a series of examinations of different models. Estimates from the superior Copula-based Heckman sample-selection model indicated that NHIS significantly reduces out-of-pocket health spending at the point of using healthcare services, thereby offering financial protection to its members. The study further found that NHIS membership was associated with decreasing probability of self-reporting lower health status, but rather increases the likelihood of self-reporting good health, suggesting that NHIS membership improves the health status of beneficiaries. The study recommends premiums subsidisation for the poor in the society by the government and other benevolent organisations as such targeted demand-side subsidy will help the country achieve universal health coverage.D. Phil. (Economics)Economic
Joint modelling of health insurance, healthcare utilisation, healthcare expenditure and health status: Evidence from Ghana
No full textAbstract: The purpose of this paper is to examine the determinants of health insurance, healthcare utilisation, healthcare expenditure, and health status simultaneously. The study used secondary data from the Ghana Socioeconomic Panel Survey. Health insurance, healthcare utilisation, healthcare expenditure, and health status were estimated simultaneously using the conditional mixed process (CMP) framework. The CMP corrects for likely heterogeneity and sample selection bias. The results revealed a significant association between insurance, healthcare utilisation, healthcare expenditure, and health status, implying that regressing these models apart would yield bias and inconsistent estimates making CMP estimates superior to single estimations. The results discovered that gender, age, education, obesity, physical activity, wealth index, household size, dependency ratio, formal-sector work, and savings significantly drive NHIS enrolment. Gender, age, education, obesity, chronic illness, physical activity, wealth index, risky behaviour, and type of illness influenced individuals’ visits to a health facility. The determinants of out-of-pocket payments were gender, chronic illness, wealth index, risky behaviour, distance to a health facility, and fever and diarrhoea sufferers. Finally, drivers of self-assessed health were gender, age, education, chronic illness, physical activity, wealth index, risky behaviour, fever, cold/cough and diarrhoea
Financial burden of risky behaviours
No full textThis paper examines the effect of alcohol and tobacco use on Ghanaian adults’ savings decisions. The dataset used for the study was obtained from the Ghana Socioeconomic Panel Survey. A recursive bivariate probit regression model was employed to address endogeneity between risky behaviours and savings decisions. The results revealed that participation indrinking and/or smoking significantly reduces the probability of household savings. The Average Treatment Effect shows that individuals who engage in risky behaviors are 34.2% less likely to save than those who do not. For persons who exclusively engage in these behaviours, as indicated by the Average Treatment Effect on the Treated, their average savings decrease by 64.5%. The heterogeneous analysis further reveals that drinking had a more severe financial impact than smoking; drinking reduced the likelihood of saving by 33.2% compared to 25.2% for tobacco. These findings reveal that smoking and alcohol consumption do more than harm health by making households less likely to save. Public health and fiscal policies that target risky behaviours can deliver double dividends: improve overall health outcomes while concurrently strengthening household financial resilience
Determinants of choice of credit source among clients of microfinance systems in the Upper West Region of Ghana
No full textMicrofinance institutions must understand what influences their clients’ choice of credit source in order to design and provide adequate and appropriate credit facilities to their clients. This paper explores the determinants of the choice of credit source among beneficiaries of microfinance systems in the Upper West Region of Ghana. An interview guide and a questionnaire were used to collect data. The study employed the multinomial probit model to analyse the data. The study revealed that gender, arable crop farming, household size, dependency ratio, access to microfinance information, repayment period, group size, interest rate, distance, loan amount, borrowing experience, household assets, and household members employed were the main determinants of the choice of credit source among beneficiaries. The study recommends that the Bank of Ghana, through the Apex Bank, standardise repayment periods and procedures such that banks compete on innovative methods of sourcing borrowers, which could result in efficiency in the lending industry
Monetary policy effectiveness in the advent of mobile money activity: Empirical evidence from Ghana
No full textFinancial development impacts a country's economic growth and development. Due to this, many nations have sought new ways to bring about financial sector development. For developing economies, innovations in the financial sector are a sure bet for the development of financial inclusion. Mobile money is one of them. However, as the financial sector innovate, the Central Bank may lose control, rendering monetary policy ineffective. Therefore, this study examines one such innovation's effect on monetary policy effectiveness. Using SVAR and monthly data spanning from January 2012 to December 2018, the study found that monetary policy becomes less effective under mobile money growth. The study further revealed that policy rates respond to mobile money growth in Ghana. In conducting monetary policy in Ghana, the study recommends that the monetary policy authority includes mobile money activity
Poverty and malaria morbidity in the Jirapa District of Ghana: A count regression approach
No full textMalaria potentially affects everyone in the tropics and sub-tropics, however, the poor and vulnerable are worse affected mainly due to the socio-economic constraints that confront them. In Ghana, the Upper West Region, which is the poorest, is one of the worse affected in terms of malaria burden. Given social and economic factors directly relate to malaria morbidity, global malaria control strategy unfortunately has not particularly targeted the effects of socio-economic deprivation on the disease morbidity and control. This study investigates the linkages between poverty and malaria morbidity using count data models, with Jirapa District in the Upper West Region of Ghana as the study area. Empirical results confirm the presence of poverty in the study area as more than half of households depend on heads whose incomes are below the poverty line of US$1 per day and that significant relationships exist between poverty and education on the one hand and malaria morbidity on the other, since gender and level of education of household head, and household poverty situation are significant determinants of malaria morbidity. The study thus recommends that policies aimed at reducing and/or eradicating malaria should include measures to increase income earning capacity of households in the study area
Health insurance and hospitalisation duration: empirical evidence from Ghana’s national health insurance scheme
No full textThe study aims to explore the causal effect of Ghana’s National Health Insurance Scheme (NHIS) on hospitalisation duration. The analysis was based on the Ghana Socioeconomic Panel Survey datasets, comprising the second wave (2014/2015) and the third wave (2018/2019). The study employed the endogenous switching regression model for count data (ESRC) to control selection bias and unobserved heterogeneity. The ESRC estimates reveal that NHIS membership significantly reduces the length of stay in the hospital, indicating that health insurance has a negative association with hospitalisation. On average, insured people spend nearly five fewer days in the hospital than their uninsured counterparts. The findings further revealed common and heterogeneous determinants of hospitalisation care for both insured and uninsured individuals. Age, household expenditure, and self-assessed health were the main predictors of hospitalisation duration for insured and uninsured persons. Heterogeneously, gender, education, and physical inactivity are significant determinants of NHIS members’ hospitalisation care, while chronic illness affects the length of stay in the hospital of the uninsured. The paper concludes with a discussion of the policy options for increasing NHIS enrolment to reduce the length of stay in the hospital and improve individuals’ well-being
Urban agriculture and farmers’ willingness to pay for treated wastewater: Insights from vegetable producers in the greater Accra metropolis of Ghana
No full textAbstractUrbanisation and water scarcity pose a challenge to urban vegetable production and livelihoods in major cities across the world. At the same time, increasing demand for fresh vegetables coupled with the high profitability of vegetable production enterprises has made it attractive and indispensable as it creates jobs along the entire crop value chain. This study analysed the efficiency performance of urban vegetable producers and their willingness to pay (WTP) for treated wastewater using data collected from 214 farmers. By applying the data envelopment analysis (DEA) and logistic regression models, the results show that the current production system is technically inefficient as 33% more output could have been produced using the existing resources. The mean amount that farmers are willing to pay for treated wastewater to be delivered to their farms is GH¢66.7 per month. Technical efficiency influences farmers’ WTP for treated waste water. Other drivers of WTP for treated wastewater include experience in vegetable production, type of irrigation practised, source of water used for irrigation, the volume of water applied per day, extension access, association membership, market demand for products, and access to market information. Strengthening public–private partnerships in the treatment and utilization of water resources and providing technical training to urban producers could enhance the efficient use of treated wastewater in agriculture
Farm credit access, credit constraint and productivity in Ghana
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Purpose
The purpose of this paper is to examine farmers’ access to credit, credit constraint, and productivity in the Northern Savannah ecological zone of Ghana.
Design/methodology/approach
Secondary data from the Ghana Feed the Future baseline survey involving a total sample of 2,968 farm households were used. The conditional mixed process (CMP) framework was applied to estimate access to credit, credit constraint, and productivity simultaneously. As a system estimator the CMP corrects for possible heterogeneity and sample selection bias.
Findings
The results from the estimations revealed that age, literacy, farm non-mechanized equipment, and group membership were the variables influencing farmers’ access to credit. Credit constraint conditions were determined by household size, locality, group membership, and household durable assets. Finally, the results showed that productivity of farmers was dependent on marital status, household size, locality, farm size, commercialization, farm mechanized equipment, group membership, and household durable assets.
Originality/value
This paper is the first, to the best of the authors’ knowledge, to use the CMP framework to jointly estimate access to credit, credit constraint, and productivity. The results indicate that estimating credit access and constraint models separately would have yielded biased estimates. Thus, this paper informs future research on farmers’ credit access, credit constraint, and productivity for informed policymaking.
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Effects of farm credit access on agricultural commercialization in Ghana: Empirical evidence from the northern Savannah ecological zone
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