Adei Dina, Agyemang-Duah Williams, Mensah Anthony Acquah
Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Res Notes. 2019 Nov 21;12(1):758. doi: 10.1186/s13104-019-4782-2.
Informal sector workers are exposed to occupational hazards which could escalate their healthcare expenditures. Thus, enrollment in a health protection scheme among informal sector workers is useful for reducing their catastrophic healthcare expenditures. However, there is scant information on factors predicting their enrollment in the National Health Insurance Scheme (NHIS) in Ghana, a gap this quantitative study aims to fill. A sample of 350 informal sector workers was involved in a cross-sectional survey.
Approximately 17% of the participants were enrolled in NHIS. Respondents who had worked between 5 and 7 years were significantly more likely to enroll in NHIS compared with those who had worked below 2 years (AOR = 13.159, CI 1.135-152.596, p = 0.039). The study further found that apprentices (AOR = 0.72, CI 0.353-1.056, p = 0.005) were less likely to enroll in NHIS compared with their masters. Participants who were exposed to electrical hazards (AOR = 2.93, CI 1.56-5.10, p = 0.013) and suffered from occupational diseases (AOR = 2.75, CI 1.743-5.17, p = 0.001) were significantly more likely to enroll in NHIS. Also, respondents who were non-Christians were significantly less likely to enroll in NHIS compared with their respective counterparts (AOR = 0.726, CI 0.067-2.503, p = 0.011). The findings are useful for increasing the NHIS enrollment rate among informal sector workers in Ghana.
非正规部门工人面临职业危害，这可能会增加他们的医疗保健支出。因此，非正规部门工人参加健康保护计划有助于减少他们的灾难性医疗保健支出。然而，关于预测加纳非正规部门工人参加国家健康保险计划（NHIS）的因素的信息很少，本定量研究旨在填补这一空白。350名非正规部门工人参与了一项横断面调查。
约17%的参与者参加了NHIS。工作5至7年的受访者参加NHIS的可能性明显高于工作不到2年的受访者（调整后比值比[AOR]=13.159，置信区间[CI]为1.135至152.596，p=0.039）。研究还发现，与师傅相比，学徒参加NHIS的可能性较小（AOR=0.72，CI为0.353至1.056，p=0.005）。接触电气危害（AOR=2.93，CI为1.56至5.10，p=0.013）和患有职业病（AOR=2.75，CI为1.743至5.17，p=0.001）的参与者参加NHIS的可能性明显更高。此外，与各自的基督教徒受访者相比，非基督教徒受访者参加NHIS的可能性明显较小（AOR=0.726，CI为0.067至2.503，p=0.011）。这些发现有助于提高加纳非正规部门工人的NHIS参保率。
