Healthcare consumers in developing countries are usually faced with inadequate choices when it comes to access to quality care. These choices are further limited by social and economic factors in such a way that policies intended to provide adequate access such as health insurance must be critical about them. Researchers and policy makers, especially those in developing countries will find this book useful as it brings out how some of the forgotten factors (indirect costs) affects healthcare consumption, especially in a rural setting. The book will also help organizations interested in providing health interventions in rural areas.
There is considerable interest at present in achieving the MDG-5 by implementation of the Free Maternal Health Policy embedded in the social health insurance to increase access to and affordability of health care in Ghana. Ghana's National Free Maternal Health Policy was passed into operation in July, 2007. This book aims to provide assessment of the explicit costs of maternal healthcare services rendered to NHIS clients in Ghana. The book revealed that there is increase utilization of the free maternal health service. The NHIS offers the entire maternal health package to their clients free of charge. There is a cost gap between the tariffs paid by the NHIA which uses the G-DRG compared to the cost of services rendered by the health providers if they use the itemized billing system. The challenges were the NHIA paying less to the service rendered by the health providers and payment of the claims on late. The free maternal health care in the Health insurance has become the alternative option of the health care financing in achieving the MDG-5 in Ghana.
This research examined how private healthcare providers in Ghana supplement the government in enhancing access and affordable healthcare. It was a comparative study involving two private and two public healthcare facilities in two districts in the Northern Region. The sample size was made up of 92 respondents and the study made use of both quantitative and qualitative data including direct observation. The four health facilities showed steady increases of OPD attendance for seven years. However, the public health facilities recorded large number of total OPD attendance compared with the private. The cost of healthcare was equal in both health facilities, and even the private providers were relatively less costly compared to the public. Also, both providers lack adequate doctors and specialists which impact negatively on access and quality especially in private health facilities. It recommended for an increase in investment into the training of more doctors, professional staff, and nurses as well as increase in the provision of infrastructure and the supply of equipment to help health facilities function well.
Generally, private security providers provide military and police services. This study focuses on those who provide police services. In this study, they are called household security providers and constitute the private security companies and neighbourhood watch committees. Using Accra as the study area, this study argues that the high crime rate and the inability of the Ghana Police Service to provide adequate security for Ghanaians is the main reason behind the growth of household security providers in Ghana. In the midst of this growth, different households have engaged different providers to ensure their security. The rich have resorted to private security companies and the poor have created neighbourhood watch committees. But despite the growth of private household security providers in Accra, this study argues that they have not ‘replaced’ the Ghana Police Service. Rather, there has been an integration of the police and the household security providers to ensure a safe and a disciplined Accra. In the light of the high crime rate in Accra, this study recommends the creation more neighbourhood watch committees to meet the needs of the poor majority.
Over 60 percent of the population in Ghana depends on agriculture which is largely subsistent for their livelihoods. Crops grown are mainly staple food crops with relatively low output, making food crop farmers the most vulnerable to food insecurity in society. Ejura Sekyedumasi district, one of the nation’s food baskets, is characterised largely by a food crop farming population.The study therefore examines the food security situation in the Ejura Sekyedumasi district. Specifically, periods in which farm households are vulnerable to food insecurity were found using descriptive statistics; the level of food security among farm households was determined by measuring the calories/person/day of each household and comparing it with the minimum dietary energy requirement (MDER) of 1800 kcal/person/day based on FAO (2004-2008) recommendations; and the coping strategies adopted by farm households when they are food insecure were identified by using frequency of responses.
This book discusses the dynamics of poverty and their effects on children in Ghana. Using the Northern Region of Ghana as a case study, the causes of poverty among households, how poverty impedes child development, and the available interventions to mitigate the negative effects of poverty on children in the Region were examined. From the research, poverty levels manifested as low income levels, low educational attainment and illiteracy, and low healthcare of parents. Poverty levels were also high among informal workers particularly farmers. The research revealed dire effects of poverty on children-- particularly on their education, healthcare and risks of becoming street children. These factors made it difficult for poor households to truncate the vicious cycle of poverty as children were not provided with the needed environment to develop to their full potentials. We recommended an increase emphasis on child development issues through participatory design of national and local interventions for children, capacity building, and research on child development issues in Ghana.
Revision with unchanged content. For both political and practical reasons, healthcare reforms are more about doing-what-has-been-done-elsewhere rather than learning-by-doing. In this regard, developments in the German Social Health Insurance (SHI) system are of international importance not least because SHI is one of the primary models of financing healthcare both in the North and in the South. This research aims to complement the literature on SHI systems and healthcare reforms by evaluating post-reunification reforms in the German SHI system and how they have impacted the lot of the patient - the raison d'etre of healthcare systems. How have the reforms in German SHI since reunification affected the system? What does engagement in medical tourism by the German patient imply for the SHI system? What role does personal responsibility in the German SHI system play in terms of healthcare financing? The author, Percivil M. Carrera presents a comprehensive overview of the German SHI system and highlights the unique role of the patient in the general sense and particular to the German SHI system. Two conceptual models are presented upon which the bulk of the discussion is anchored. The book should prove valuable to health economists, health managers, health policy makers and decision-makers as well as the general public with keen interest on the German SHI system and contemporary issues faced by healthcare systems.
Improving the health status of the population is one of the major pillars of the Millenium Development Goal (MDG) that has been signed by 147 heads of state. To achieve the health target included in MDG document, each country has to know the current coverage and quality of its health service, utilization level of the existing facilities and how effectively and efficiently the service is provided. In developing countries like Ethiopia,although modern (public and private) as well as traditional health care institutions are functioning side by side, only limited empirical studies exist on the demand of each health care institutions. Using household data collected from East Abaya District of Gamo Gofa Zone (SNNPR, Ethiopia), this study analyzes the nature of health care demand in rural Ethiopia, with special reference to the first stage of patient initiated contacts. An extended version of a discrete choice model (multinomial logit model) is used to analyze factors that determine the choice of a given health care provider.
Healthcare waste has been managed anyhow in the past mainly to avoid its stockpile, nuisance and public reaction without much concern to public health and the environment. Two waste categories are considered: general and hazardous. The former is not infectious. The latter contains infectious, chemical or radioactive properties and needs to be managed properly. This study within 5 healthcare facilities within the Accra and Tema Metropolitan areas in Ghana focused on the practice from generation to disposal, a review of the draft national guidelines on Healthcare waste, roles of other government agencies and the adoption of appropriate management options. HCW was not well managed. The system lacked the necessary safety measures. Treatment and disposal methods within and outside the healthcare premises were not satisfactory. A national law to promote, monitor standards and address issues of non-compliance was lacking. An integrated management system is required. The analysis has highlighted gaps and the way forward for handling healthcare waste in developing countries and should also benefit academicians and professionals in waste management, public health and environmental science.
All countries share a common interest in the health and well-being of its citizens. The approach that countries take to achieve the goal of a healthy population is varied. Most countries utilize some form of universal health coverage (insurance) or universal health care. Since independence Ghana has had several health insurance systems. In 2006 the government implemented the National Health Insurance Scheme which provided for universal health care for all citizens funded by a combination of taxes. To date there has been no analysis of the effect of this program. The current analysis evaluated the health services utilization by residents of Mampong Municipality. This analysis used a time series (ARIMA)approach. Results indicated that discharges for diabetes increased for males. Diarrhea and malaria discharges increased in females but not in males. Diabetes discharges increased in males but not females. Typhoid discharges increased in males and females. These results should be followed by qualitative research to elucidate the mechanisms of the healthcare seeking decision processes of males and females in Ghana.
Using the first 17 years of data from the National Practitioner Data Bank, contained herein is the first comprehensive examination of physician assistant medical malpractice and other markers of medical practice safety. The(PA)profession has become a significant factor in the United States health care delivery system. PAs and Advanced Practice Nurses (APN) play an increasing role in the cost effective delivery of health care in the United States. Quality of care stakeholders are increasingly concerned about the medical care being delivered by these non-physician providers. Stakeholders include local and national government, health care delivery organizations, education programs, the health insurance industry and the general public. Dr. Nicholson's research answers the question of whether or not PAs and APNs are safe providers of medical care when compared with physicians. Often viewed as less trained and poorly qualified, Dr. Nicholson's scholarly examination puts to rest the notion that non-physician providers of medical care pose a quality or safety risk to the public when compared head to head with the rates of medical malpractice and disciplinary actions against physicians.
This study has considered migration from rural areas of Upper East Region to rural areas of Brong Ahafo Region of Ghana. In assessing the impact in the region of destination, short-term effects have been distinguished from long-term effects. The former is initial felling of trees and more intensive land use, and application of techniques so that the migrant households could earn from on-farm work. In the longer term, migrants are expected to follow the examples set by the indigenous population and adjust their techniques. Land acquisition is crucial to destination rural migrant farm households. A model on tenancy contracts has been formulated and empirical results show the importance of liquidity constraints in the acreage decisions of migrant households. Moreover, the farm households could generate income from other non-farm activities necessary for reducing liquidity constraints and assisting in financing farm activities and also benefit the origin households of the outmigrants through remittances. The study thus extends the debates on demographic changes, migration and its environmental implications at the migrant place of destination.
Evidence abounds in the livelihoods literature that rural households have a diversified portfolio of income sources, and that the share of income from non-farm sources is increasing overtime. Using data from national level household survey, this study investigates the determinants of non-farm income diversification among rural households in Ghana, as well as its income distribution and welfare implications. The findings of the study provide additional insight into diversification behaviors of rural households across the developing world, and highlight the need to promote and enhance the capacities of rural households, especially poorer households, to participate effectively in non-farm activities as a complement to agriculture to help reduce rural poverty. This book therefore is a useful reference material for policy makers, researchers and students of development economics.
Financing health-care has gone through a chequered history in Ghana. Like other developing nations in modern times, the Government of Ghana has no choice but to establish a sustainable health-care financing policy for all Ghanaians. The aim of this book is to examine whether the introduction of a National Health Insurance Scheme (NHIS) will provide and deliver and improved health-care service in Ghana. The introduction of the NHIS is to help reduce the financial barriers which have denied ordinary people access to healthcare for decades. While the health system appears to be making progress in meeting the basic needs of the people of Ghana, the continuing exodus of trained health workers, lack of leadership, corruption and weak institutional capacity remains a major obstacle. There are also many persuasive reasons why the NHIS should be a success. Some of the laudable points are the philosophy of the NHIS, the popularity of the policy, the institutional components which are in place and the overall State commitment to the scheme.
Community participation has become a buzz word in decentralized healthcare service delivery today than ever before. In Uganda, various efforts and initiatives have been put in place to build, enable, empower and promote, as well as supporting private initiatives. Some of these initiatives are voluntary and have evolved to secure resource mobilization for healthcare financing and delivery, and to ensure that the rights of healthcare service users are observed. Community participation should used for the benefit of the entire community. The central and local governments in Uganda should adequately play their “new” role of providing a more conducive political, economic, social and legal environment, favourable for community participation to mobilise resources for healthcare financing, delivery and utilisation. Alternative healthcare financing mechanisms, such as CHF, should be supported by the Government, since they play a great role in providing healthcare services to poor people in rural areas. While ensuring access to healthcare, the rights of healthcare users and providers should be respected by all actors in healthcare delivery and utilisation chain.