A community-based feasibility study of National Health Insurance Scheme in Ghana

In a community based study at Legon in 1997, a valuation method was used to assess the willingness of students on study leave to pay a percentage premium of their income towards a National Health Insurance Scheme (NHIS). Thirty-five percent of the respondents were aged 30-40 years, 97% were males, 45% were resident in Accra, 17% in Kumasi and 12% in Cape Coast. Respondents were 84% in formal public employment with 44% majority as teachers. Their monthly income was distributed as 33% earned below currency 200,000, 50% between currency 200,000-currency 400,000 and 7% above currency 400,000. More than 74% were willing to contribute to the scheme with 38% and 37% willing to pay 1% and 2 of their income as monthly premium respectively. Those willing to pay 2% premium, 14 (n=33) earned below currency 200,000, 18 (n=50) between currency 200,000-currency 400,000, and 5 (n=17) above currency 400,000. Malaria was the commonest disease with 86% incidence, however 30%of respondents revealed they did not spend money on hospital services except 39% who spent currency 20,000-currency 100,000 on hospital laboratory services. Over 65% of respondents indicated they self financed their health expenditure. The premium level was found to be influenced positively by financier, sex, age, income, and negatively by health expenditure, but not occupation. In an elite community with inadequate infrastructure and water supply problems but probably with better personal hygiene and sanitation, although respondents hardly spend on health services they were willing to contribute 2% of their incomes as premium towards an insurance scheme.