Social capital, social health insurance, and health-related quality of life among people living with chronic diseases : Cultural and ideational perspectives

This study extends debates on implications of informal welfare for population health and well-being. It examines whether cultural and ideational precepts such as social capital, affect enrolment in National Health Insurance Scheme (NHIS) among people living with chronic disease(s) in Ghana. It also explores how NHIS enrolment explains the association between social capital and health-related quality of life (HRQoL) using empirical data from five regions in Ghana. Results indicate that bonding social capital was associated with HRQoL. Bridging and linking social capital were positively and negatively associated with enrolment in NHIS, respectively. Enrolment in the NHIS explained the relationships of trust in neighbours, bridging and linking social capital with HRQoL. Thus, while social capital can improve HRQoL of people living with chronic disease(s), it does so by, among others, influencing their participation in formal health protective services. Culturally driven informal welfare resources are critical to making formal programmes meaningful to people.