Determinants of nonrenewal of National Health Insurance (NHI) membership cards among healthcare workers in the Kintampo North Municipality, Bono East Region of Ghana

Introduction: National Health Insurance Scheme (NHIS) was implemented in Ghana in 2004 to serve as the lifeline to realizing Universal Health Coverage (UHC). Available evidence suggests that, formal sector workers do not promptly renew their expired NHIS membership cards. This study was therefore conducted to unearth factors responsible for the failure of healthcare workers in the Kintampo North Municipality to promptly renew their health insurance membership whenever it expires. Methods: a descriptive cross-sectional design was used to conduct this study, where three hundred and ninety-seven (397) participants were recruited using a proportionate stratified sampling technique. All variables with a p-value <0.25 at the bivariate analysis level were selected and put into multiple logistic regression analysis models for statistical significance (p-value < 0.05). Odds ratios with their corresponding 95% Confidence Interval were reported. A p-value < 0.05 was set as level of significance. Results: almost all the respondents (94.0%) had NHIS membership cards; out of which 70.7% had valid membership cards. Fourty percent did not renew their expired NHIS membership cards for more than 7 months. From the study, reasons given for health workers´ inability to promptly renew NHIS membership included: 212 (19.8%) indicated forgetfulness, busy schedules 191 (17.9%), procrastination 167 (15.6%), self-medication 170 (15.9%) and utilization of spiritual homes (4.5%). All socio-economic factors were significantly associated at the bivariate level (p<0.05). However, in the multiple logistic regression model, employment status, the type of health staff and monthly salary lost their statistical significance. Conclusion: NHIS subscription and membership renewals are high among healthcare workers who participated in the study in Kintampo North District of the Bono East Region of Ghana. However, there is the need to encourage those who do not renew their expired cards by NHIA and its accredited facilities sensitizing the general populace on the utilization of mobile phones to renew NHIS membership cards in order to prevent long waiting time and bureaucracies in renewing NHIS cards. It will be prudent for NHIS to liaise with Government of Ghana (GoG) to put measures in place to facilitate automatic membership renewals for public sector workers who for some other reasons often fail to renew their cards.

Determinants of emergency contraceptive utilization among female tertiary students in the middle belt of Ghana, West Africa

Introduction: Emergency Contraceptives (ECs) are after-coital contraceptive methods used before implantation. These give females in the sexually active age group the opportunity to prevent unplanned pregnancies after refusing to patronize a contraceptive before unprotected sexual intercourse or when a regular contraceptive fails and or when raped. Higher education students fall under the sexually active age category and form a higher risk group for unplanned pregnancy because of inadequate utilization of ECs. The aim of this study was to identify the determinants of ECs utilization among female tertiary students in the Middle Belt of Ghana, West Africa. Methods: institutional-based descriptive cross-sectional study design was used with quantitative method in collecting the data from 28th March 2022 to 18th April 2022. A total of 535 female tertiary students were recruited using simple random proportionate sampling technique. Data were collected using structured questionnaires and entered into Stata version 15 and analyzed descriptively and inferentially using Chi-squared test. A conventional p<0.05 was considered statistically significant. Results: out of the 535 respondents that were interviewed, majority (426 (79.6%) were aware of ECs. However, only 44 (9.4%) had good knowledge of ECs utilization. All respondents who were affiliated to traditional religion had poor knowledge. About half of 279 (52.1%) indicated they ever utilized ECs and 200 (71.7%) of these said the efficacy of ECs was between 75-99%. Regarding barriers to ECs utilization, 333 (20.5%) indicated ECs cause infertility and 330 (20.4%) mentioned the fear of being seen by others. All Chi-square test of associations of demographic characteristics and knowledge on ECs were not statistically significant (p≥0.05). Conclusion: the study reported that ECs utilization among female tertiary students was quite low despite majority being aware of them. Most of them had poor knowledge on ECs utilization, even though majority had not experienced unplanned pregnancies. Further reproductive health and family planning education and promotion initiatives directed on the utilizations of ECs, their efficacies and typology are needed, especially among future health professionals who will later educate other young adults.