Social capital and financial access to healthcare in Ghana

Financial barriers have long been established as a serious impediment to achieving universal health coverage and equitable health outcomes in low income countries. Using a mixed methods approach, this research seeks to critically examine the dynamic nature of informal risk sharing networks and their mechanisms for dealing with health care expenses among poor households in northern Ghana. It will also evaluate how informal risk-sharing networks impact on the demand for voluntary health insurance in the Ghana National Health Insurance Scheme. And thirdly, it will examine how informal institutions can be harnessed to improve health insurance take up among poor households in the informal sector.

The significance of the research is manifold. Firstly, it emphasises looking beyond the role of individual and scheme factors in determining health insurance uptake to focusing on the role of socio-cultural factors in shape individual decision over the demand for health insurance. Empirical evidence on the influence of such socio-cultural factors is currently limited in the health literature, and this research will contribute to filling the literature gap. Secondly, the findings will enable for effective contribution to debate and understanding of the determinants of health insurance uptake among households in the informal sector. Health financing and social health insurance in the developing country context has gained much in health policy discourse and this research will provide useful evidence to contribute to such debate. Thirdly, the study will provide empirical knowledge on how to harness informal institutions to expand insurance coverage in developing countries. This will be shared with the National health insurance Authority in Ghana which will help improve coverage of the NHIS.