“trust as insurance”: The use of traditional risk management schemes to address financial barriers to the utilization of emergency referral services in rural communities of northern Ghana
A community-based emergency referral programme is being introduced in 3 northern districts, as part of the Ghana Essential Health Intervention Programme (GEHIP). Presently, Ghana's National Health Insurance Scheme (NHIS) does not cover the transport costs of emergency referral. With many people unable to afford these expenses, GEHIP seeks to explore the use of traditional community financing schemes to support the sustainability and utilization of the referral system. An exploratory assessment was conducted with community members and health workers examining community financing operations, perceptions of its efficacy, and attitudes on both the feasibility and likelihood for community participation with a new emergency-specific community fund. This paper reports on the results of qualitative formative research indicating that such concepts are readily understood, feasible to introduce and plausibly sustainable with minimal start-up external revenue. In response, a project is being launched where a revolving account is established for each community, public gatherings known as durbars are used to build consensus for the scheme, and emergency transport providers are guaranteed immediate compensation due to the mobilization of the revolving fund.
Learning Areas:Administer health education strategies, interventions and programs
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences
Assess community financing schemes operating in rural Northern Ghana, including perceptions of their efficacy in addressing needs, and attitudes on both the feasibility and likelihood for community participation with the introduction of a emergency transport specific community fund.
Keyword(s): Community-Based Partnership, Community Health Planning
Qualified on the content I am responsible for because: I have been a research officer and manager for several health systems research projects at Columbia University for over the past two years. I have a Masters in Public Health from Columbia University.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.