ArticleBMJ global health2023
Does mobile renewal make health insurance more responsive to clients? A case study of the National Health Insurance Scheme in Ghana.
Article in BMJ global health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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6 citing papers in PubMed.
- Article
- No shortcuts to universal health coverage: lessons from accountability initiatives.BMJ global health · 2025Article
- Making health insurance responsive to citizens: learning from six low-income and middle-income countries.BMJ global health · 2025Review
- Is mobile renewal enough? A qualitative study exploring stakeholders' perspectives on mobile phone-based add-ons for national health insurance uptake in Ghana.BMC public health · 2025Article
- Impact of Ghana's fee exemption policy on maternal health service utilisation: an inverse probability of treatment weighting analysis of pooled national data.Journal of global health · 2025Article
- 'We are the bridge': an implementation research study of SEWA Shakti Kendras to improve community engagement in publicly funded health insurance in Gujarat, India.BMJ global health · 2022Article
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7 authors.
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Abstract
backgroundIn 2018, Ghana's National Health Insurance Authority (NHIA) introduced a mobile strategy to enhance re-enrolment and improve client knowledge of their entitlements. This study investigated how Ghana's mobile strategy has influenced the NHIA's responsiveness to clients in terms of patient rights and entitlements, equity and satisfaction with health services.
methodsWe surveyed people (n=1700) in 6 districts who had renewed their insurance in the previous 12 months, using any strategy (mobile or manual). Multiple regression analysis examined correlation between individual characteristics and renewal modality. Policy documents on the mobile programme's design and focus group discussions (n=12) on people's experiences renewing their insurance were analysed thematically.
resultsWhile the mobile platform was designed for mobile National Health Insurance Scheme (NHIS) renewal and to provide information about insurance entitlements, few people surveyed (20%) knew about these informational features. Among those who renewed their NHIS coverage, 58% did so on the mobile renewal platform. Mobile renewal was high among those with tertiary education and those in the higher wealth quintiles. Mobile renewal was considered convenient, but required literacy in English, a phone and a mobile money wallet. For those who lacked some or all of these prerequisites but wanted to use mobile renewal, mobile vendors emerged as valued facilitators.
conclusionThe mobile platform has increased the responsiveness of Ghana's NHIS through offering clients a more convenient mechanism to renew their insurance policies. It does not, however, eliminate the one month waiting period for activating the card, does not provide prompts to reassure clients of their renewal and does not empower most clients with information on entitlements. To improve the adoption and use of the mobile renewal strategy, the NHIA should publicise the platform's information-sharing functions and explore formally engaging mobile vendors.
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