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Table 3 Summary of survey methodology and participant characteristics in the included studies

From: Evaluating the impact of the national health insurance scheme of Ghana on out of pocket expenditures: a systematic review

  General Information Study Characteristics Participant Characteristics
First Author Publication Year Citation/Title Study Objectives/Aims Study Design Data Source Sampling Technique Recall Period Settinga Study Population SESb Population Size
Chankova 2008 Chankova S, Sulzbach S, Diop F. Impact of mutual health organizations: evidence from West Africa. Health Policy and Planning. 2008;23(4):264–276. To answer the following questions: (1) Do MHOs include vulnerable populations. (2) Do they have an impact on the utilization of curative services. (3) On out-of-pocket expenditures Cross-sectional NRc Twelve months Household Three country comparisons; Ghana, Mali, Senegal. (Nkoranza and Offinso districts in Ghana) SES wealth quintiles, household head, education, occupation, residence(urban-rural), house-hold size 1806 households (34% NHIS, 66% uninsured)
Nguyen 2011 Nguyen HT, Rajkotia Y, Wang H. The financial protection effect of Ghana National Health Insurance Scheme: evidence from a study in two rural districts. International Journal for Equity in Health. 2011, 10: 4– Not clearly stated but evaluated the impact of NHIS on health service utilization and OOPE(s) Cross-sectional Two-stage cluster & random sampling Two weeks (injury recall period) to twelve months Household Households in two districts (Offinso and Nkoranza) in Ghana SES wealth quintiles, household head, employment status, house-hold size, ethnicity, residence(urban-rural) 11,617 individuals (35% NHIS, 65% uninsured)
Dalaba 2014 Dalaba M, Akweongo P, Aborigo R, Awine T, Azongo D, Asaana P et al. Does the national health insurance scheme in Ghana reduce household cost of treating malaria in the Kassena-Nankana districts? Global Health Action. 2014;7(1):23848. To examine the effect of NHIS in reducing household cost of treating malaria Cross-sectional Convenience random sampling NRc Household Households in the Kassena-Nankana district SES wealth quintiles, age, occupation 4226 households (49.1% NHIS, 50.9% uninsured)
Abrokwah 2014 Abrokwah SO, Moser CM, Norton EC. The effect of social health insurance on prenatal care: the case of Ghana. Int J Health Care Finance Econ. 2014;14(4):385–406. To describe how Ghana’s health insurance scheme affects prenatal care and out-of-pocket expenditures Cross-sectional 2° GLS5 2005–2006 Random stratified sampling Twelve months Household Women of child bearing age (15–49 years) SES wealth quintiles, age, education, region, marital status, occupation, employment status, house-hold size 1032 women from the GLS5 (36% NHIS, 64% uninsured)
Abuosi 2015 Abuosi A, Adzei F, Anarfi J, Badasu D, Atobrah D, Yawson A. Investigating parents/caregivers financial burden of care for children with non-communicable diseases in Ghana. BMC Pediatrics. 2015;15(1). To assess the extent to which parents/caregivers of children with NCDs experience financial burden in caring for them Cross-sectional Convenience random sampling NRc Inpatient Parents/caregivers of children hospitalized with NCDs at hospitals in Greater Accra, Ashanti, and the Volta region Parents’ age, education, income, marital status, religion, residence (urban-rural) 225 parents/caregivers (87% NHIS 13% uninsured)
Kusi 2015 Kusi A, Hansen K, Asante F, Enemark U. Does the National Health Insurance Scheme provide financial protection to households in Ghana? BMC Health Services Research. 2015;15(1). To assess the effect of NHIS on household OOPE(s) and CHE(s) Cross-sectional Random stratified Sampling Four weeks Household Households in three districts in the three ecological zones of Southern (Kwaebibrirem), Middle (Asutifi), and Northern (Savelugu-Nanton) SES wealth quintiles household size, household head, marital status, residence (urban-rural), education, distance to the nearest facility, mode of transportation 2430 households (28% NHIS, 46% uninsured, & 26% partially insured)
Aryeetey 2016 Aryeetey G, Westeneng J, Spaan E, Jehu-Appiah C, Agyepong I, Baltussen R. Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana’s National Health Insurance Scheme. International Journal for Equity in Health. 2016;15(1). To examine whether Ghana’s health insurance scheme reduces OOPE(s), CHE(s) and poverty at the household level Cross-sectional Random stratified sampling Four weeks Household Households in the Eastern and Central Region. Baseline study conducted in 2009 and follow-up in 2011 Household size, marital status, religion, education, residence (urban-rural), occupation, household income, household expenditures In 2009, 3300 households (31% NHIS 69% uninsured); 2011 3152 households (38% NHIS 62% uninsured)
  1. 1° denotes primary data collection by the authors. 2° is secondary analysis of previously collected data. a Study setting denotes where participants were interviewed
  2. bSES wealth quintile refers to the reporting of wealth-specific results using a principal component analysis of dwelling characteristics, access to utilities and ownership of house-hold items. Further description is available at
  3. cNR not reported by the studies