Socioeconomic and demographic correlates of nonenrolment onto the national health insurance scheme among children in Ghana: Insight from the 2017/18 Multiple Indicator Cluster Survey

The goal of Ghana's health insurance scheme is to achieve universal coverage. Despite NHIS’ benefits to children, not all children in Ghana are covered. This study investigates the sociodemographic covariates of nonenrolment onto the national health insurance scheme among children in Ghana. We used the child dataset of the 2017/18 Ghana Multiple Indicator Cluster Survey (G-MICS). We used STATA version 14 for the data analyses. We described each study variable using frequency and percentages. We used Poisson regression to estimate crude and adjusted prevalence ratios of the relationship between the covariates and the outcome variable. Approximately 57% of children were covered with health insurance in Ghana. In the adjusted multivariable model, male children, children within the ages of 10–14 or 15–17 years, and children who have some form of functional disability and those with no information on their functional disability status, children of mothers with lower than post-secondary education, and children residing in households of less than the fifth quantile on the household wealth index were associated with a higher likelihood of nonenrolment onto the national health insurance scheme. Finally, compared to the children in greater Accra, children in the other nine regions were associated with a lower likelihood of nonenrolment onto the national health insurance scheme. Given the results, improvement in health insurance coverage should be done, taking into consideration variations across the socio-demographic characteristics of the child, mother, and households.