Health-seeking behaviour during times of illness: a study among adults in a resource poor setting in Ghana

Abstract

The implementation of the National Health Insurance Scheme (NHIS) in Ghana aims to bridge the gap between the poor and rich in health-care access and utilization. Guided by Andersen's behavioural model of health services utilization, we examine the factors that influence health-care services utilization in a resource poor setting. Data for the study were obtained through randomly selected respondents in our study location (n = 1137). Logistic regression models were fitted to the data to examine the impact of enabling, predisposing and need factors on health-care-seeking behaviour during last illness. Individuals in the poor and poorest wealth quintiles who are enrolled in the NHIS were less likely to seek treatment in a health facility during their last illness compared with individuals in the richest wealth quintile who are enrolled in the NHIS (β = 0.41, ρ < 0.01 and β = 0.45, ρ < 0.05, respectively). Although health insurance is supposed to increase the likelihood of utilizing health services, poor people in our study who are enrolled in the NHIS are still less likely to utilize health services, suggesting that the NHIS has not succeeded in bridging inequalities in health services utilization between the poor and rich.