Migrant female head porters’ enrolment in and utilisation and renewal of the National Health Insurance Scheme in Kumasi, Ghana

Simon BOATENG, Prince AMOAKO, Adjoa Afriyie POKU, Anthony BAABEREYIR, Razak Mohammed GYASI

Research output: Journal PublicationsJournal Article (refereed)


Purpose: As a social protection policy, Ghana’s National Health Insurance Scheme (NHIS) aims to improve access to healthcare, especially for the vulnerable. Migrant female head porters (kayayoo), who are part of the informal economic workforce, are underscored as an ethnic minority and vulnerable group in Ghana. This study aimed to analyse the factors associated with enrolment in and renewal and utilisation of the NHIS among migrant female head porters in the Kumasi Metropolis. Method: We purposively sampled 392 migrant female head porters in the Kejetia, Asafo and Bantama markets. We used a binary logit regression model to estimate associations among baseline characteristics, convenience and benefit factors and enrolment in and renewal and utilisation of the NHIS. Result: Age and income significantly increased the probability of NHIS enrolment, renewal and utilisation. Long waiting times at NHIS offices significantly reduced the likelihood of renewal, while provision of drugs highly significantly increased the tendency for migrant female head porters to enrol in, renew and use the NHIS. Consulting and surgery also significantly increased renewal and utilisation of the NHIS. Conclusion: Political commitment is imperative for effective implementation of the decentralisation policy of the NHIS through the National Health Insurance Authority in Kumasi. We argue that retail offices should be well equipped with logistic facilities to ensure convenience in NHIS initial enrolment and renewal processes by citizenry, and by vulnerable groups in particular.
Original languageEnglish
Pages (from-to)625-634
Number of pages10
JournalJournal of Public Health
Issue number6
Publication statusPublished - 1 Dec 2017


Bibliographical note

The study was approved by the Committee on Human Research, Publication and Ethics of the School of Medical Sciences/Komfo Anokye Teaching Hospital with reference no. CHRPE/AP/361/14. All participants gave verbal consent for their participation in the study.

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