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1.
Trop Med Int Health ; 20(3): 312-21, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25418283

ABSTRACT

OBJECTIVE: To identify the factors influencing dropout from Ghana's health insurance scheme among populations living in slum communities. METHODS: Cross-sectional data were collected from residents of 22 slums in the Accra Metropolitan Assembly. Cluster and systematic random sampling techniques were used to select and interview 600 individuals who had dropped out from the scheme 6 months prior to the study. Descriptive statistics and multivariate logistic regression models were computed to account for sample characteristics and reasons associated with the decision to dropout. RESULTS: The proportion of dropouts in the sample increased from the range of 6.8% in 2008 to 34.8% in 2012. Non-affordability of premium was the predominant reason followed by rare illness episodes, limited benefits of the scheme and poor service quality. Low-income earners and those with low education were significantly more likely to report premium non-affordability. Rare illness was a common reason among younger respondents, informal sector workers and respondents with higher education. All subgroups of age, education, occupation and income reported nominal benefits of the scheme as a reason for dropout. CONCLUSION: Interventions targeted at removing bottlenecks to health insurance enrolment are salient to maximising the size of the insurance pool. Strengthening service quality and extending the premium exemption to cover low-income families in slum communities is a valuable strategy to achieve universal health coverage.


Subject(s)
Insurance, Health/statistics & numerical data , Medically Uninsured/statistics & numerical data , Urban Health/statistics & numerical data , Urban Population/statistics & numerical data , Adult , Aged , Cross-Sectional Studies , Female , Ghana , Humans , Male , Middle Aged , Poverty Areas , Principal Component Analysis , Risk Factors , Socioeconomic Factors , Urban Health/economics , Young Adult
2.
Article in English | AIM (Africa) | ID: biblio-1258656

ABSTRACT

Introduction :Quality of acute care has attracted attention in recent years with policy initiatives in Ghana. Such initiatives need to be complemented with patient feedback systems for strengthening quality. Therefore the goal of this study is to examine factors associated with quality of acute care and to propose a range of options for improving the existing model of healthcare delivery. Methods: Cross-sectional data were collected from 379 patients presenting to emergency centres in five public health facilities. A structured questionnaire developed based on the literature and expert advice by physicians and nurses was used to collect data. Principal component analysis (PCA) was used to extract the factors salient to patients' perspective of quality of care. Logistic regression was then used to examine association between these factors and overall quality of acute care. Results :The majority of the patients (17.2) presented with obstetrical related conditions; 15 with Road Traffic Accidents (RTAs); 11.3 with diarrhoea related problems and the least number (8.4) with bronchial asthma. The average days of admission was high for patients with bronchial asthma (mean = 9); RTA (mean = 8) and burns (means = 7). The PCA produced four factors of quality (interpersonal care; prompt care; physical environment and privacy; drugs and equipment) all of which had a positive statistically significant association with overall quality of acute care after controlling for patient's socio-demographic characteristics.Conclusion Study findings provide important feedback not only for optimising clinical operations but also for improving in-hospital quality of acute care with short-term and long-term approaches


Subject(s)
Acute Pain , Emergencies , Ghana , Hospitals , Inpatients , Quality of Health Care
3.
Health policy dev. (Online) ; 9(1): 6-15, 2011.
Article in English | AIM (Africa) | ID: biblio-1262636

ABSTRACT

Competitive forces coupled with new and continuing demands require public sector organisations to be increasingly careful in thinking about their strategies. This is complicated especially for the health sector because it must do so in a multi-sectoral environment where system complicate decision making. This paper examines the evidence of Human Resource Management Strategies and practices in a public sector organization; the Ministry of Health of Ghana. The paper examines strategies of the Human Resources of the Ministry of Health of Ghana to achieve the objectives of reforms which are largely to make quality health care accessible and affordable to the people of Ghana with the right staff doing the right job at the right place. It is an established fact that the success of every organization depends greatly on its human resource. However having the right quantity and quality of employees at the right place is the problem. HRM strategy is about providing the right numbers and calibre of staff; as well as retaining and motivating staff to enhance productivity. There are difficulties in developing appropriate HRM strategies to enable especially public sector organisations achieve their objectives. There is no perfect solution as to how to evolve an effective HRM strategy. Nonetheless there are some general principles of best practice that policy makers should keep in mind. Where these principles are not considered and a balance is not achieved; a policy may be impotent at birth and not facilitate organisational success


Subject(s)
Health Care Reform , Health Workforce , Organizational Policy , Practice Management , Public Sector
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