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ABSTRACT. This paper investigates the factors influencing the decision to enroll in Ghana’s National Health Insurance Scheme (NHIS) with emphasis on individuals’ socio-economic factors. The paper uses the fifth round of the Ghana Living Standards Survey (GLSS 5) for the econometric estimation. Our findings indicate that education and economic status (being non-poor and being employed) are significant and positive predictors of the decision to enroll in the NHIS. Further, age, area of residence (urban) and geographical area of residence per Ghana’s ten administrative regions were found to be significantly correlated with the decision to enroll in the NHIS. In addition, the study found that individuals who use the services of modern healthcare providers (consult health practitioner) are also more likely to enroll relative to those who seek care from traditional practitioners. Our findings thus indicate that Ghana’s NHIS is not yet pro-poor as envisaged. The study recommends that policymakers should introduce more innovative communication channels that are more appealing to many Ghanaians who are not literate or do not have formal education. In addition, policies geared towards universal basic education should be strengthened to encourage more people to become more health conscious through education. Finally, targeting the poor for enrolment through consistent and transparent inclusion criteria will improve the pro-poorness of the scheme. pp. 37–57
JEL Codes: G22, I11, I18

Keywords: insurance, enrolment, NHIS, adults, Ghana

ARYEE MAKARIOUS AYITEY
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University of Ghana, Legon, Accra
EDWARD NKETIAH-AMPONSAH*
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University of Ghana, Legon, Accra
ALFRED BARIMAH
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University of Ghana, Legon, Accra

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