Top

Journal of Public Health

Published in:

01-04-2019 | Original Article

Facilitators of and barriers to the use of healthcare services from a user and provider perspective in Ejisu-Juaben municipality, Ghana

Authors: Williams Agyemang-Duah, Charlotte Monica Mensah, Prince Peprah, Francis Arthur, Emmanuel Mawuli Abalo

Published in: Journal of Public Health | Issue 2/2019

Abstract

Objective

Knowledge about the use of formal healthcare services is an important aspect of public health policy. However, there is a paucity of empirical studies on facilitators of and barriers to formal healthcare use in Ghana from the health user and provider points of view, a gap this qualitative study aims to fill.

Methods

In-depth interviews were conducted with 20 healthcare users and 15 formal healthcare providers in Ejisu-Juaben Municipality in the Ashanti Region of Ghana. A thematic analytical framework was used to analyse the data, which were then presented based on an a posteriori inductive reduction approach.

Results

Four major facilitators of healthcare use were identified: acceptance of the health insurance card, having a good relationship with the healthcare providers, quality of the service offered/professionalism and proximity to healthcare facilities. The barriers to formal healthcare use established in this study were of an economic, social, cultural and institutional nature.

Conclusion

The study findings highlight the need to address barriers to the utilisation of formal healthcare by reviewing the national health insurance scheme, recruiting language interpreters at health facilities and integrating the formal and traditional systems into the mainstream national health system in Ghana. This move would help make headway toward meeting UN Sustainable Development Goal 3 of ensuring healthy lives and promoting well-being for all at all ages by 2030.

Alhassan RK, Nketiah-Amponsah E, Arhinful DK (2016) A review of the national health insurance scheme in Ghana: what are the sustainability threats and prospects? PLoS One 11(11):121–132CrossRef

Barbour RS (2001) Checklists for improving rigour in qualitative research: a case of the tail wagging the dog? Br Med J 322(7294):1115–1117CrossRef

Barimah KB, Mensah J (2013) Ghana’s national health insurance scheme: insights form members, administrators and healthcare providers. J Health Care Poor Underserved 12(1):1–5

Beekman AT, Van der Feltz-Cornelis C, Van Marwijk HW (2013) Enhanced care for depression. Curr Opin Psychiatry 26(2):7–12CrossRefPubMed

Blanchet NJ, Fink G, Osei-Akoto I (2013) The effect of Ghana’s National Health Insurance Scheme on healthcare utilisation. Accessed at http://www.nhis.gov.gh on 28th February, 2017

Braun V, Clark V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101CrossRef

Bryman A, Bell B (2007) Business research methods, 2nd edn. Oxford University Press, Oxford

Buor D (2003) Analysing the primacy of distance in the utilization of health services in the Ahafo-Ano South District, Ghana. Int J Health Plann Manag 18:293–311CrossRef

Chadwick R, Boutle I, Martin G (2013) Doctors attitudes towards the use of herbal medicine in Lagos, Nigeria. J Herb Med 2(1):16–22

Cook RI, Render M, Woods D (2009) Gaps in the continuity of care and progress on patient safety. Br Med J 320(7237):791–794CrossRef

Creswell JW (2003) Research design: qualitative, quantitative and mixed method approaches (2^nd edition). London, New Delhi, International Educational and Professional Publisher, Thousand Oaks

Creswell JW (2009) Research design. Qualitative, quantitative, and mixed methods approaches (third edition). Sage, London

Creswell JW (2012) Educational research: planning, conducting, and evaluating quantitative and qualitative research (Fourth Edition). Boston: Pearson Education

Creswell JW (2014) Research design: Qualitative, quantitative, and mixed methods approach (fourth edition). Sage, London

Dawson C (2002) Practical research methods: a user-friendly guide to mastering research techniques and projects. How to Books Ltd, United Kingdom

Denscombe M (2010) The good research guide for small-scale social research projects(4th ed). Open University Press, England

DiClemente RJ, Salazar FL, Crosby RA (2011) Health behaviour theory for public health: principles, foundations and applications. Int Q Community Health Educ 20(4):347–368

Glaser B, Strauss A (1967) The dictionary of grounded theory: strategies for qualitative research. Aldine, Chicago, IL

Griffiths P, Stephenson R (2001) Understanding user’s perspective of barriers to maternal healthcare use in Maharashtra, India. J Biosoc Sci 33:339–359CrossRefPubMed

Hassali MA, Saleem F, Shafie AA, Al-Qazaz HK, Farooqui M, Aljadhey H, Atif M, Masood I (2012) Assessment of general public perceptions toward traditional medicines used for aphrodisiac purpose in state of Penang, Malaysia. Complement Ther Clin Pract 18(4):257–260CrossRefPubMed

Heaman IM, Sword W, Elliot L, Moffatt M, Helewa EM, Morris H, Gregory P, Tjaden L, Cook C (2015) Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of healthcare providers. BMC Pregnancy Childbirth 15(2):121–130

Kaseje D (2006) Healthcare in Africa: challenges, opportunities and an emerging model for improvement. Presented at the Woodrow Wilson International Centre for Scholars

Kasil O (2003) Enhancing Traditional medicine researcher and development in the African Region. African Health Monitor, World Health Organization Africa Region (WHO-AFRO)

Kirby A (2007) Early detection of breast cancer in Ghana, West Africa. J Investig Med 53(2):580–582

Kirigia MJ, Barry PS (2008) Health challenges in Africa and the way forward. Int Arch Med 27(1):256–323

Kusi A, Enemark U, Hansen SK, Asante AF (2015) Refusal to enrol in Ghana’s National Health Insurance Scheme: is affordability the problem? Int J Equity Health 14(2):132–152

Mason M (2010) Sample size and saturation in PhD studies using qualitative interviews [63 paragraphs]. Forum Qualitative Sozialforschung / Forum: Qual Soc Res 11(3) Art 8. http://nbn-resolving.de/urn:nbn:de:0114-fqs100387, on 18 Feb 2018

Mayo H (2009) Fatalism towards breast cancer among the women of Ghana. Healthcare Women Int 24(7):608–615CrossRef

Morse JM (1994) Designing funded qualitative research. In: NK Denzin, YS Lincoln (eds) Handbook of qualitative inquiry. Sage Publications Ltd., Thousand Oaks, pp 220–235

National Cancer Institute (2014) Division of extramural activities: annual report 2014. California

Ratnasingham S, Caimey J, Manson H, Lin E, Kurdyak P (2013) The burden of mental illness and addiction in Ontario. Can J Psychiatr 85(3):135–142

Ross LE, Vigod S, Wishart J, Waese M, Spence JD, Oliver J, Chambers J, Anderson S, Shields R (2015) Barriers and facilitators to primary care for people with mental health and/or substance use issues: a qualitative study. BMC Fam Pract 16(135):191–203

Scheppers E, Dongen VE, Dekker J, Geertzen J, Dekker J (2006) Potential barriers to the use of health services among ethnic minorities: a review. Oxford University Press, OxfordCrossRef

Stanfield S (2009) Structuring information and incentives to improve health. Bull World Health Organ 83(3):562–563

Sword E (2003) The concept of access: definition and relationship to consumer satisfaction. J Med Care 19(1):127–140

Tidermalm D, Waern M, Stefansson CG, Elofsson S, Runeson B (2008) Excess mortality in prisons with severe mental disorder in Sweden: a cohort study of 12 103 individuals with and without contact with psychiatric services. Clin Pract Epidemiol Ment Health 4(1):23–25

UNICEF (2011) UNICEF annual report 2011. Accessed at http://www.unicef.org, on 17^th February, 2016

Vickers KA, Jolly KB, Greenfield SM (2006) Herbal medicine: Women’s views, knowledge and interaction with doctors: a qualitative study. BMC Complement Altern Med 6(40):1054–1123

Waiswa P, Kallander K, Peterson S, Tomson G, Pariyo WG (2010) Using the three delays model to understand why new-born babies die in eastern Uganda. Tropical Med Int Health 15(8):964–972CrossRef

World Health Organization (2007) World Health Report 2000- health systems: Improving performance. Geneva, WHO. Accessed at: http://www.who.int, on 13/03/2017

World Health Organization (2016) World Health Statistics 2016: Monitoring health for the SDGs. Geneva

Title: Facilitators of and barriers to the use of healthcare services from a user and provider perspective in Ejisu-Juaben municipality, Ghana
Authors: Williams Agyemang-Duah
Charlotte Monica Mensah
Prince Peprah
Francis Arthur
Emmanuel Mawuli Abalo
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Journal of Public Health / Issue 2/2019
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-018-0946-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Facilitators of and barriers to the use of healthcare services from a user and provider perspective in Ejisu-Juaben municipality, Ghana

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2019

Magnitude of occupational exposure to bagasse dust and associated factors among Metehara Sugarcane Factory workers, east Shoa, Ethiopia

Grazing, motives to eat palatable foods, and fat and sugar consumption: an exploratory investigation

Male gender, age and low income are risk factors for road traffic injuries among adolescents: an umbrella review of systematic reviews and meta-analyses

Dispositional mindfulness promotes public health of the obesity population by reducing perceived discrimination and weight stigma concerns

Disease mapping of tuberculosis prevalence in Eastern Cape Province, South Africa

Reference growth curves for Greek infants and preschool children, aged 0–6.7 years