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Open Access 01-12-2016 | Research article

Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions

Authors: Robert Kaba Alhassan, Edward Nketiah-Amponsah, Nicole Spieker, Daniel Kojo Arhinful, Tobias F. Rinke de Wit

Published in: BMC Health Services Research | Issue 1/2016

Abstract

Background

Barely a decade after introduction of Ghana’s National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services. However, sustainability of the scheme is increasingly threatened by concerns on quality of health service delivery in NHIS-accredited health facilities coupled with stakeholders’ discontentment with the operational and administrative challenges confronting the NHIS. The study sought to ascertain whether or not Systematic Community Engagement (SCE) interventions have a significant effect on frontline health workers’ perspectives on the NHIS and its impact on quality health service delivery.

Methods

The study is a randomized cluster trial involving clinical and non-clinical frontline health workers (n = 234) interviewed at baseline and follow-up in the Greater Accra and Western regions of Ghana. Individual respondents were chosen from within each intervention and control groupings. Difference-in-difference estimations and propensity score matching were performed to determine impact of SCE on staff perceptions of the NHIS. The main outcome measure of interest was staff perception of the NHIS based on eight (8) factor-analyzed quality service parameters.

Results

Staff interviewed in intervention facilities appeared to perceive the NHIS more positively in terms of its impact on “availability and quality of drugs (p < 0.05)” and “workload on health staff/infrastructure” than those interviewed in control facilities (p < 0.1). Delayed reimbursement of service providers remained a key concern to over 70 % of respondents in control and intervention health facilities.

Conclusion

Community engagement in quality service assessment is a potential useful strategy towards empowering communities while promoting frontline health workers’ interest, goodwill and active participation in Ghana’s NHIS.

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Title: Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions
Authors: Robert Kaba Alhassan
Edward Nketiah-Amponsah
Nicole Spieker
Daniel Kojo Arhinful
Tobias F. Rinke de Wit
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-016-1438-y

At a glance: The STEP trials

Springer Medicine

Perspectives of frontline health workers on Ghana’s National Health Insurance Scheme before and after community engagement interventions

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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