Does membership in mutual health insurance guarantee quality health care? Some evidence from Ghana

Abstract

Access to health care and quality of health care are inextricably linked. Not merely is access to health care important, but also its quality: hence the apparent increasing demands for health care services where they are perceived by citizens to be offering quality services. The inverse situation also seems to exist, that is, when health systems are perceived to deliver health services that are of 'poor' quality, attendances at such facilities tend to be low. In light of this, this study seeks to examine the nascent National Health Insurance Scheme in Ghana (NHIS) and how the NHIS addresses the issue of quality health care delivery for its patients. Using mixed methods research; focus group discussions and household surveys, the study compares two groups (insured and non-insured) with respect to the quality of health each group receives in attempt to providing reliable information to policy and decision-makers about the areas that need attention for improvement in quality of healthcare in the Kassena-Nankana District in Northern Ghana. While the household survey results do not establish any difference in the quality of health received by either the insured or uninsured, findings from the FGDs strongly suggest that the uninsured received better quality care than the insured. These findings provide a fertile ground for policy action. It is thus, recommended amongst other things, that health authorities investigate further alleged illegal extortions of monies by some nurses from uninsured patients.