Findings in Health Policy and Planning Reported from University of Kentucky (The Enrolment Paradox: Qualitative Evidence on Gendered Barriers to National Health Insurance for Ghana’s Poorest Households): Health and Medicine – Health Policy and Planning

2026 NOV 02 (NewsRx) -- By a News Reporter-Staff News Editor at Health & Medicine Business Daily -- A new study on Health and Medicine - Health Policy and Planning is now available. According to news originating from Lexington, Kentucky, by NewsRx correspondents, research stated, “Ghana’s National Health Insurance Scheme (NHIS) was established in 2004 to extend financial protection to all citizens and replace out-of-pocket payments at the point of care. Yet enrolment remains low among recipients of the Livelihood Empowerment Against Poverty (LEAP) cash transfer programme, Ghana’s primary social protection instrument for the poorest households, despite formal premium exemptions.”

Our news journalists obtained a quote from the research from the University of Kentucky, “This study examined the lived experiences and enrolment motivations of LEAP household heads in two Ghanaian districts (Shai Osudoku, Greater Accra Region; Amansie West, Ashanti Region). Data were collected between 2017 and 2018. Eight focus group discussions (n=56) and eight key informant interviews were conducted and analysed thematically using NVivo. Two motivators were identified: perceived illness vulnerability and perceived financial benefits. Both operated through pronounced gender structures. Female household heads, especially widows and single mothers, were motivated by guaranteed financial access to care, because economic precarity rendered even minor illness expenditure catastrophic. Male household heads demonstrated lower perceived illness vulnerability, a pattern reflecting culturally enforced norms of masculine resilience rather than genuine health status advantage. Critically, strong motivation to enrol did not guarantee enrolment as structural barriers including premium-adjacent costs, administrative complexity, and documentation requirements blocked motivated but uninsured women from acting on their intent. These findings point to identifiable policy failures. The NHIS categorical exemption structure does not adequately capture situational vulnerability among LEAP women. Enrolment outreach is gender blind. And implementation of the formal LEAP-NHIS linkage is operationally weak.”

According to the news editors, the research concluded: “The paper concludes with evidence-grounded policy directions for gender-responsive NHIS reform and stronger integration between social protection and health insurance programmes in Ghana and comparable low- and middle-income country settings.”

This research has been peer-reviewed.

For more information on this research see: The Enrolment Paradox: Qualitative Evidence on Gendered Barriers to National Health Insurance for Ghana’s Poorest Households. Health Policy and Planning, 2026. Health Policy and Planning can be contacted at: Oxford Univ Press, Great Clarendon St, Oxford OX2 6DP, England. (Oxford University Press - http://www.oup.com/; Health Policy and Planning - heapol.oxfordjournals.org)

The news correspondents report that additional information may be obtained from Abraham Tetteh Teye, College of Social Work, University of Kentucky, Lexington, KY, United States.

The publisher’s contact information for the journal Health Policy and Planning is: Oxford Univ Press, Great Clarendon St, Oxford OX2 6DP, England.

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