5 results on '"Awoonor-Williams, John Koku"'
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2. Unawareness of health insurance expiration status among women of reproductive age in Northern Ghana: implications for achieving universal health coverage
- Author
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Kanmiki, Edmund Wedam, Bawah, Ayaga A., Akazili, James, Agorinyah, Isaiah, Awoonor-Williams, John Koku, Phillips, James F., and Kassak, Kassem M.
- Published
- 2019
- Full Text
- View/download PDF
3. Community perceptions of universal health coverage in eight districts of the Northern and Volta regions of Ghana
- Author
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Wright, Kalifa J., Biney, Adriana, Kushitor, Mawuli, Awoonor-Williams, John Koku, Bawah, Ayaga A., and Phillips, James F.
- Subjects
Adult ,Male ,qualitative appraisal ,Adolescent ,Maternal-Child Health Services ,media_common.quotation_subject ,Declaration ,Mothers ,universal health coverage ,Health Services Accessibility ,Fathers ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Universal Health Insurance ,quality of care ,Perception ,Political science ,Humans ,030212 general & internal medicine ,Quality of care ,Health planning ,Child ,Socioeconomics ,Quality of Health Care ,media_common ,ghana ,Health Equity ,Primary Health Care ,health systems research ,030503 health policy & services ,Health Policy ,Age Factors ,Public Health, Environmental and Occupational Health ,scaling-up ,Child, Preschool ,Original Article ,Female ,community-based primary health care ,Public aspects of medicine ,RA1-1270 ,0305 other medical science - Abstract
Background: Ever since Ghana embraced the 1978 Alma-Ata Declaration, it has consigned priority to achieving ‘Health for All.’ The Community-based Health Planning and Services (CHPS) Initiative was established to close gaps in geographic access to services and health equity. CHPS is Ghana’s flagship Universal Health Coverage (UHC) Initiative and will soon completely cover the country with community-located services. Objectives: This paper aims to identify community perceptions of gaps in CHPS maternal and child health services that detract from its UHC goals and to elicit advice on how the contribution of CHPS to UHC can be improved. Method: Three dimensions of access to CHPS care were investigated: geographic, social, and financial. Focus group data were collected in 40 sessions conducted in eight communities located in two districts each of the Northern and Volta Regions. Groups were comprised of 327 participants representing four types of potential clientele: mothers and fathers of children under 5, young men and young women ages 15–24. Results: Posting trained primary health-care nurses to community locations as a means of improving primary health-care access is emphatically supported by focus group participants, even in localities where CHPS is not yet functioning. Despite this consensus, comments on CHPS activities suggest that CHPS services are often compromised by cultural, financial, and familial constraints to women’s health-seeking autonomy and by programmatic lapses constrain implementation of key components of care. Respondents seek improvements in the quality of care, community engagement activities, expansion of the range of services to include emergency referral services, and enhancement of clinical health insurance coverage to include preventive health services. Conclusion: Improving geographic and financial access to CHPS facilities is essential to UHC, but responding to community need for improved outreach, and service quality is equivalently critical to achieving this goal.
- Published
- 2020
4. Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.
- Author
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Awoonor-Williams, John Koku, Tindana, Paulina, Dalinjong, Philip Ayizem, Nartey, Harry, and Akazili, James
- Subjects
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GOAL (Psychology) , *HEALTH care reform , *HEALTH facility administration , *HEALTH services accessibility , *HEALTH services administrators , *INSURANCE , *HEALTH insurance , *INTERVIEWING , *MEDICAL care , *MEDICAL care costs , *NATIONAL health services , *PREVENTIVE health services , *ADULT education workshops , *PRIMARY health care , *QUALITATIVE research , *HEALTH insurance reimbursement , *PILOT projects , *ECONOMICS - Abstract
Background: In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Methods: Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. Results: The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among stakeholders in PHC delivery; and inadequate funding for PHC, particularly on preventive and promotive services. Other areas are: the bypassing of PHC facilities due to lack of basic services at the PHC level such as laboratory services, as well as proximity to the district hospitals; and finally the lack of clear understanding of the national policy on PHC. Conclusion: This study suggests that despite the progress that has been made since the establishment of the NHIS in Ghana, there are still huge gaps that need urgent attention to ensure that the goals of UHC and PHC are met. The key areas of misalignment identified in this study, particularly on the delays in reimbursements need to be taken seriously. It is also important for more dialogue between the NHIA and service providers to address key concerns in the implementation of the NHIS which is key to achieving UHC. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
5. Is Ghana's pro-poor health insurance scheme really for the poor? Evidence from Northern Ghana.
- Author
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Akazili, James, Welaga, Paul, Bawah, Ayaga, Achana, Fabian S., Oduro, Abraham, Awoonor-Williams, John Koku, Williams, John E., Aikins, Moses, and Phillips, James F.
- Subjects
HEALTH insurance ,MEDICAL care ,MEDICAL care cost control ,MEDICAL care of poor people ,SOCIOECONOMIC factors - Abstract
Background Protecting the poor and vulnerable against the cost of unforeseen ill health has become a global concern culminating in the 2005 World Health Assembly resolution urging member states to ensure financial protection to all citizens, especially children and women of reproductive age. Ghana provides financial protection to its citizens through the National Health Insurance Scheme (NHIS). Launched in 2004, its proponents claim that the NHIS is a pro-poor financial commitment that implements the World Health Assembly resolution. Methods Using 2011 survey data collected in seven districts in northern Ghana from 5469 women aged 15 to 49 the paper explores the extent to which poor child-bearing age mothers are covered by the NHIS in Ghana's poorest and most remote region. Factors associated with enrolment into the NHIS are estimated with logistic regression models employing covariates for household relative socio-economic status (SES), location of residence and maternal educational attainment, marital status, age, religion and financial autonomy. Results Results from the analysis showed that 33.9 percent of women in the lowest SES quintile compared to 58.3 percent for those in the highest quintile were insured. About 60 percent of respondents were registered. However, only 40 percent had valid insurance cards indicating that over 20 percent of the registered respondents did not have insurance cards. Thus, a fifth of the respondents were women who were registered but unprotected from the burden of health care payments. Results show that the relatively well educated, prosperous, married and Christian respondents were more likely to be insured than other women. Conversely, women living in remote households that were relatively poor or where traditional religion was practised had lower odds of insurance coverage. Conclusion The results suggest that the NHIS is yet to achieve its goal of addressing the need of the poor for insurance against health related financial risks. To ultimately attain adequate equitable financial protection for its citizens, achieve universal health coverage in health care financing, and fully implement the World Health Assembly resolution, Ghana must reform enrolment policies in ways that guarantee pre-payment for the most poor and vulnerable households. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
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