Insured clients out-of-pocket payments for health care under the national health insurance scheme in Ghana

Abstract Background In 2003, Ghana implemented a National Health Insurance Scheme (NHIS) designed to promote universal health coverage and equitable access care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments (OOP) by insured clients one of such the scheme. This study sought examine types services OOP charges are made for how much pay out-of-pocket. Methods was descriptive cross-sectional facility survey. A total 2066 respondents were interviewed using structured questionnaires at point care exit in Ashanti, Northern Central regions Ghana. facilities different levels selected from 3 districts each three regions. Data collected between April June 2018. Using Epidata STATA Version 13.1 data analyses done multiple logistic regression simple statistics results presented as proportions means. Results Of all survey 49.7% reported paying out-of-pocket out-patient while 46.9% paid Forty-two percent poorest quintile also Insured consultation (75%) drugs (63.2%) 34.9% purchased outside they visited. unavailability (67.9%) not covered NHIS (20.8%) led payments. On average, patients GHS33.00 (USD6.6) Compared Ashanti region, living region 74% less odds Conclusion recommendation Ghana’s seeking accredited make that attributed fees charged meet administrative costs services. These occur disadvantaged facilities. high reliance on can impede progress towards achieving Universal Coverage Sustainable Development Goal 3, end poverty reduce inequalities. order build trust confidence there need eliminate medicines clients.