Author:
Odjidja Emmanuel Nene,Ansah-Akrofi Ruth,Iradukunda Arnaud,Kwanin Charles,Saha Manika
Abstract
Abstract
Introduction
In 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. This study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea.
Methods
Nigeria was used as the control country with pre-intervention period of 1990 and 2003 and 1993 and 1998 in Ghana. Post-intervention period was 2008 and 2014 in Ghana and 2008 and 2018 in Nigeria. Data was acquired from demographic health surveys in both countries and propensity score matching was calculated based on background socioeconomic covariates. Following matching, difference in difference analysis was conducted to estimate average treatment on the treated effects. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05.
Results
After matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and fever (40 percentage points). Also for those receiving care specifically in government managed facilities for diarrhoea (14 percentage points) and fever (24 percentage points).
Conclusions
Introduction of health financing reforms in Ghana had positive effects on childhood infections (malaria and diarrhoea).
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference25 articles.
1. World Health Organisation. Universal health coverage (UHC). 2017. [online] www.who.int. Available at: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc). Accessed 12 Aug 2020.
2. Holmes D. Margaret Chan: committed to universal health coverage. The Lancet. 2012;380(9845):879. https://doi.org/10.1016/s0140-6736(12)61493-7.
3. Fenny A, Yates R, Thompson R. Social health insurance schemes in Africa leave out the poor. Int Health. 2018;10(1):1–3. https://doi.org/10.1093/inthealth/ihx046.
4. Acharya A, Vellakkal S, Taylor F, Masset E, Satija A, Burke M, Ebrahim S. The impact of health insurance schemes for the informal sector in low- and middle-income countries: a systematic review. The World Bank Research Observer. 2012;28(2):236–66. https://doi.org/10.1093/wbro/lks009.
5. Makaka A, Breen S, Binagwaho A. Universal health coverage in Rwanda: a report of innovations to increase enrolment in community-based health insurance. Lancet. 2012;380:S7. https://doi.org/10.1016/S0140-6736(13)60293-7.
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献