Skip to main content

Contextual Issues in Health Care Financing in Africa: Drawing on the Ghanaian Experience

  • Chapter
  • First Online:
Selected Themes in African Development Studies

Abstract

The search for appropriate policy of financing healthcare in Africa in general is far from over. However, Ghana, unlike many of the emerging economies in sub-Sahara Africa, has made great strides in this area of policy formulation and development with the introduction of a National Health Insurance Scheme (NHIS). Ghana’s search for an acceptable policy on healthcare financing dates back to the colonial era and the immediate post-independence period through the ‘cash and carry’ system to the present health insurance regime, which is still seeking refinement to meet the hopes and aspirations of many Ghanaians. The main objective of the NHIS is to provide equitable and universal access to essential healthcare for all citizens. This paper examines the tortuous path of health care financing policies in Ghana by outlining its historical antecedents and current perspectives.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Africa Union (2009) Fourth session of the African union conference of Ministers of Health Addis Ababa, Ethiopia, 4–8 May 2009

    Google Scholar 

  • Agyepong IA, Adjei S (2008) Public social policy development and implementation: a case study of the Ghana National Health Insurance scheme. Health Policy Plan 23(2):150–160

    Article  Google Scholar 

  • Allotey J (2012) Financing health care in Ghana: is one-time insurance premium the answer? http://www.myjoyonline.com. Accessed 27 May 2007

  • Arah OA, Klazinga NS, Custers T (2003) Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement. Int J Qual Health Care 15(5):377–398

    Article  Google Scholar 

  • Arhinful DK (2003) The solidarity of self-interest: social and cultural feasibility of rural health insurance in Ghana. In: Research report 71. African Studies Centre, Leiden

    Google Scholar 

  • Arhin-Tenkorang D (2001) Health Insurance for the informal sector in Africa: design features, risk protection, and resource mobilization. Health, Nutrition, and Population Discussion Paper No. 3. The World Bank, Washington, DC

    Google Scholar 

  • Aryeetey E, Codjoe E (2005) Income distribution and poverty. In: Aryeetey E (ed) Globalization, employment, and poverty reduction: a case study of Ghana. Woeli Publishing Services, Accra, pp 26–43

    Google Scholar 

  • Atim CB, Diop FP, Ette J, Evrard D, Marcaden P, Massiot N (2000) The contribution of mutual health organizations to financing, delivery, and access in health care in west and central Africa: summaries of synthesis and case studies in six countries. Technical report 19. Partnerships for health reform project, 1998, Abt Associates, Inc., Bethesda, MD

    Google Scholar 

  • Baltussen R, Niessen L (2006) Priority setting of health interventions: the need for multi-criteria decision analysis. Cost Eff Resour Alloc 4:14. doi:10.1186/1478-7547-4-4

    Article  Google Scholar 

  • Centre for Health and Social Services (2011) Ghana’s National Health Insurance Scheme: views on progress, observations and commentary. Rockefeller Foundation, Accra

    Google Scholar 

  • Deeble JS (1982) Unscrumbling the omelet: public and private health care financing in Australia. In: McLachhlan G, Maynard A (eds) The public/private mix for health: the relevence and effects of change. Nuffield Provincial Hospital Trust, London, pp 89–123

    Google Scholar 

  • Dimovska D, Sealy S, Bergkvist S, Pernefeldt H (2009) Innovative pro-poor healthcare financing and delivery models. Results for Development Institute, Washington, DC

    Google Scholar 

  • Economist Intelligent Unit (2012) The future of healthcare in Africa. A report from the Economist Intelligence Unit sponsored by Janssen

    Google Scholar 

  • Eurostat and WHO (2009) Classifications of health financing. First IHAT draft, units 9 and 10. http://www.oecd.org/dataoecd/39/21/43893740.pdf. Accessed 9 Nov 2009

  • Ghana Statistical Service (2003) Ghana 2003 Core Welfare Indicators Questionnaire (QWIC II) survey report: statistical abstract. Ghana Statistical Service, Accra

    Google Scholar 

  • Gilson L, Raphaely N (2008) The terrain of health policy analysis in low and middle income countries: a review of published literature 1994–2007. Health Policy Plan 23:294–307

    Article  Google Scholar 

  • Hanson K (2004) Public and private roles in malaria control: the contributions of economic analysis. Am J Trop Med Hyg 71:168–173

    Google Scholar 

  • Hsiao WC (2003) A descriptive framework for country level analysis of health care financing arrangements. Health Policy 56:171–204

    Google Scholar 

  • Institute of Statistical, Social and Economic Research (2012) Ghana social development outlook, 2012. Ghana Universities Press, Accra

    Google Scholar 

  • James CD, Hanson K, McPake B, Balabanova D, Gwatkin D, Hopwood I et al (2006) To retain or remove user fees? Reflections on the current debate in low and middle-income countries. Appl Health Econ Health Policy 5:124–137

    Article  Google Scholar 

  • Loevinsohn B (2006) Contracting for health services with the private sector: the evidence and experience from developing countries. In: Presentation to the Global Health Council annual conference, May–June, The World Bank, Washington, DC

    Google Scholar 

  • McPake B, Mills A (2000) What can we learn from international comparisons of health systems and health system reform? Bull World Health Organ 78:811–820

    Google Scholar 

  • Ministry of Health, Ghana (2004) Guideline for designing and implementing district-wide MHOs in Ghana. Ministry of Health, Accra

    Google Scholar 

  • Mossialos E, Allin S, Figueras J (2007) Health systems in transition: template for analysis. World Health Organization, on Behalf of European Observatory on Health Systems and Policies, Copenhagen

    Google Scholar 

  • Murray CJL, Evans DB (2003) Chapter 1: Health system performance assessment: goals, framework and overview. In: Murray CJL, Evans DB (eds) Health system performance assessment: debates, methods and empiricism. WHO, Geneva

    Google Scholar 

  • National Health Insurance Authority (2003) National Health Insurance Act (Act 650). National Parliament of Ghana Press, Accra

    Google Scholar 

  • National Health Insurance Authority, Ghana (2011) Annual report, 2010. National Health Insurance Authority, Ghana, Accra

    Google Scholar 

  • Schieber G, Maeda A (1999) Healthcare financing and delivery in developing countries. Health Aff (Millwood) 18(3):193–205

    Article  Google Scholar 

  • The World Health Report (2000) Health systems: improving performance. World Health Organization, Geneva

    Google Scholar 

  • WHO (2009) Health financing strategy for the Asia Pacific Region (2010-2015). World Health Organization South-East Asia Region and Western Pacific Region, Philippines

    Google Scholar 

  • Willis K, Daly J, Kealy M, Small R, Koutrolis G (2007) The essential role of social theory in qualitative public health research. Aust N Z J Public Health 31:438–443

    Article  Google Scholar 

  • World Bank (1987) Financing health services in developing countries: an agenda for reform. World Bank, Washington, DC

    Book  Google Scholar 

  • World Bank (2010) World development indicators, 2010. The World Bank, Washinton, DC

    Book  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ebenezer Owusu-Sekyere .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Owusu-Sekyere, E., Osumanu, I.K. (2014). Contextual Issues in Health Care Financing in Africa: Drawing on the Ghanaian Experience. In: Asuelime, L., Yaro, J., Francis, S. (eds) Selected Themes in African Development Studies. Advances in African Economic, Social and Political Development. Springer, Cham. https://doi.org/10.1007/978-3-319-06022-4_9

Download citation

Publish with us

Policies and ethics