853
Views
0
CrossRef citations to date
0
Altmetric
HEALTH POLICY

A Systematic review of macro - and meso - determinants of national health insurance enrolment among older adults in Ghana

ORCID Icon, ORCID Icon, ORCID Icon, & ORCID Icon
Article: 2217546 | Received 22 Jun 2022, Accepted 18 May 2023, Published online: 08 Jun 2023

References

  • Aboderin, I. (2010). Understanding and advancing the health of older populations in sub-Saharan Africa: Policy perspectives and evidence needs. Public Health Reviews, 32(2), 357–20. https://doi.org/10.1007/BF03391607
  • Adei, D., Agyemang Duah, W., & Mensah, A. A. (2019). Predictors of enrollment in a health protection scheme among informal sector workers in Kumasi Metropolis of Ghana. BMC Research Notes, 12(1), 1–6. https://doi.org/10.1186/s13104-019-4782-2
  • Adjei-Mantey, K., & Horioka, C. Y. (2022). Determinants of health insurance enrollment and health expenditure in Ghana: An empirical analysis. Review of Economics of the Household, 1–20. https://doi.org/10.1007/s11150-022-09621-x
  • Adu, K. O. (2015). Determinants of household heads’ enrolment in national health insurance scheme in central region of Ghana: A case study. International Journal of Ecology & Development, 30(1), 24–35.
  • Agrigoroaei, S., Lee-Attardo, A., & Lachman, M. E. (2017). Stress and subjective age: Those with greater financial stress look older. Research on Ageing, 39(10), 1075–1099. https://doi.org/10.1177/0164027516658502
  • Aguila, E., Angrisani, M., & Blanco, L. R. (2016). Ownership of a bank account and health of older Hispanics. Economics Letters, 144, 41–44. https://doi.org/10.1016/j.econlet.2016.04.013
  • Agyemang Duah, W. (2018). Determinants of health care use among poor older persons: A case of the livelihood empowerment against poverty recipients in the Atwima Nwabiagya District [ M.Sc. Thesis, unpublished], KNUST,
  • Agyemang Duah, W., Peprah, C., & Peprah, P. (2019). Barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in the Atwima Nwabiagya District of Ghana. BMC Public Health, 19(1), 1–12. https://doi.org/10.1186/s12889-019-7437-2
  • Agyepong, I. A., Abankwah, D. N. Y., Abroso, A., Chun, C., Dodoo, J. N. O., Lee, S., Park, J., Twum, A., Oh, J., Park, J., Yang, D., Yoon, K., Otoo, N., Asenso-Boadi, F., & Mensah, S. A. (2016). The “Universal” in UHC and Ghana’s National Health insurance scheme: Policy and implementation challenges and dilemmas of a lower middle income country. BMC Health Services Research, 16(1), 1–14. https://doi.org/10.1186/s12913-016-1758-y
  • Akazili, J., Welaga, P., Bawah, A., Achana, F. S., Oduro, A., Awoonor-Williams, J. K., Williams, J. E., Aikins, M., & Phillips, J. F. (2014). Is Ghana’s pro-poor health insurance scheme really for the poor? Evidence from Northern Ghana. BMC Health Services Research, 14(1), 637–650. https://doi.org/10.1186/s12913-014-0637-7
  • Alam, N., Chowdhury, H. R., Bhuiyan, M. A., & Streatfield, P. K. (2010). Causes of death of adults and elderly and healthcare-seeking before death in rural Bangladesh. Journal of Health, Population, and Nutrition, 28(5), 520–534. https://doi.org/10.3329/jhpn.v28i5.6161
  • Alatinga, K. A., & Williams, J. J. (2015). Towards universal health coverage: Exploring the determinants of household enrolment into national health insurance in the Kassena Nankana District, Ghana. Ghana Journal of Development Studies, 12(1–2), 88–105. https://doi.org/10.4314/gjds.v12i1-2.6
  • Ansah, E. K., Narh-Bana, S., Asiamah, S., Dzordzordzi, V., Biantey, K., Dickson, K., Whitty, C. J. M., Greenwood, B. M., Mills, A., Whitty, C. J. M., & Gyapong, J. O. (2009). Effect of removing direct payment for health care on utilisation and health outcomes in Ghanaian children: A randomised controlled trial. PLoS Medicine, 6(1), e1000007. https://doi.org/10.1371/journal.pmed.1000007
  • Armstrong, R., Jackson, N., Doyle, J., Waters, E., & Howes, F. (2015). It’s in your hands: The value of hand searching in conducting systematic reviews of public health interventions. Journal of Public Health, 27(4), 388–391. https://doi.org/10.1093/pubmed/fdi056
  • Aryeetey, G. C., Jehu‐Appiah, C., Spaan, E., D’Exelle, B., Agyepong, I., & Baltussen, R. (2010). Identification of poor households for premium exemptions in Ghana’s National Health Insurance Scheme: Empirical analysis of three strategies. Tropical Medicine & International Health, 15(12), 1544–1552. https://doi.org/10.1111/j.1365-3156.2010.02663.x
  • Asante, F., & Aikins, M. (2008). Does the NHIS cover the poor? Ghana: Danida Health Sector Supports Office.
  • Ayitey, A., Nketiah-Amponsah, E., & Barimah, A. (2013). Determinants of insurance enrolment among Ghanaian Adults: The Case of the National Health Insurance Scheme (NHIS). Economics, Management & Financial Markets, 8(3), 37–57.
  • Badu, E., O’Brien, A. P., & Mitchell, R. (2019). An integrative review on methodological considerations in mental health research – design, sampling, data collection procedure and quality assurance. Archives of Public Health, 77(37), 1–15. https://doi.org/10.1186/s13690-019-0363-z
  • Bambra, C. (2011). Real world reviews: A beginner’s guide to undertaking systematic reviews of public health policy interventions. Journal of Epidemiology & Community Health, 65(1), 14–19. https://doi.org/10.1136/jech.2009.088740
  • Banerjee, A., Armstrong, P., Daly, T., Armstrong, H., & Braedley, S. (2015). “Careworkers don’t have a voice:” Epistemological violence in residential care for older people. Journal of Aging Studies, 33, 28–36. https://doi.org/10.1016/j.jaging.2015.02.005
  • Baozhen, D., Yaw, M. A., Bonsu, O. A. M., & Prempeh, A. F. S. (2019). Assessing factors affecting the patronage of health insurance schemes: An Evidence of Ghana. Journal of Public Administration and Governance, 9(1), 73–91. https://doi.org/10.5296/jpag.v9i1.14442
  • Basaza, R., Criel, B., & Van der Stuyft, P. (2007). Low enrolment in ugandan community health insurance schemes: Underlying causes and policy implications. BMC Health Services Research, 7(1), 105–122. https://doi.org/10.1186/1472-6963-7-105
  • Beard, J., Biggs, S., Bloom, D. E., Fried, L. P., Hogan, P. R., Kalache, A., & Olshansky, S. J. (2012). Global population ageing: Peril or promise? (No. 8912). Program on the Global Demography of Aging. PGDA Working Papers 8912.
  • Bennett, S., Creese, A. L., Monasch, R., & World Health Organization. (1998). Health insurance schemes for people outside formal sector employment (No. WHO/ARA/CC/98.1). https://apps.who.int/iris/bitstream/handle/10665/64161/WHO_ARA_CC_98.1.pdf?sequence=1
  • Bettany-Saltikov, J. (2012). How to do a systematic literature review in nursing: A step-by-step guide. McGraw-Hill/Open University Press.
  • Boakye, K. B. (2008). National health insurance in Ghana: Evaluation of the Nzema-east district mutual health insurance scheme. Royal tropical institute (KIT). http://bibalex.org/baifa/Attachment/Documents/185297.pdf
  • Boateng, D., & Awunyor-Vitor, D. (2013). Health insurance in Ghana: Evaluation of policyholders’ perceptions and factors influencing policy renewal in the Volta region. International Journal for Equity in Health, 12(1), 1–10. 50. https://doi.org/10.1186/1475-9276-12-50
  • Botma, Y., Greeff, M., Mulaudzi, F. M., & Wright, S. C. D. (2010). Research in health sciences. Cape Town.
  • Bougioukas, K. I., Liakos, A., Tsapas, A., Ntzani, E., & Haidich, A. B. (2018). Preferred reporting items for overviews of systematic reviews including harms checklist: A pilot tool to be used for balanced reporting of benefits and harms. Journal of Clinical Epidemiology, 93, 9–24. https://doi.org/10.1016/j.jclinepi.2017.10.002
  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
  • Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. The American Psychologist, 32(7), 513. https://doi.org/10.1037/0003-066X.32.7.513
  • Bronfenbrenner, U. (1994). Ecological models of human development. International Encyclopedia of Education, 3(2), 37–43.
  • Carrin, G., & James, C. (2004). Reaching Universal Coverage via Social Health Insurance: Key Design Features in the Transition Period. World Health Organization.
  • Carrin, G., & James, C. (2005). Social health insurance: Key factors affecting the transition towards universal coverage. International Social Security Review, 58(1), 45–64. https://doi.org/10.1111/j.1468-246X.2005.00209.x
  • Carrin, G., Waelkens, M. P., & Criel, B. (2005). Community‐based health insurance in developing countries: A study of its contribution to the performance of health financing systems. Tropical Medicine & International Health, 10(8), 799–811. https://doi.org/10.1111/j.1365-3156.2005.01455.x
  • Chankova, S., Sulzbach, S., & Diop, F. (2008). Impact of mutual health organizations: Evidence from West Africa. Health Policy and Planning, 23(4), 264–276. https://doi.org/10.1093/heapol/czn011
  • Crooks, V. A., & Andrews, G. J. (Eds.). (2009). Primary health care: People, practice, place. Ashgate Publishing, Ltd.
  • Dalaba, M. A. (2009). Impact of National Health Insurance on health seeking behavior in the Kassena-Nankana district of Northern Ghana (Master’s thesis, University of Cape Town).
  • Dalinjong, P. A., & Laar, A. S. (2012). The national health insurance scheme: Perceptions and experiences of health care providers and clients in two districts of Ghana. Health Economics Review, 2(1), 13–27. https://doi.org/10.1186/2191-1991-2-13
  • De Allegri, M., Sanon, M., & Sauerborn, R. (2006). “To enrol or not to enrol?”: A qualitative investigation of demand for health insurance in rural West Africa. Social Science & Medicine, 62(6), 1520–1527. https://doi.org/10.1016/j.socscimed.2005.07.036
  • De Allegri, M., Sauerborn, R., Kouyaté, B., & Flessa, S. (2009). Community health insurance in sub‐Saharan Africa: What operational difficulties hamper its successful development? Tropical Medicine & International Health, 14(5), 586–596. https://doi.org/10.1111/j.1365-3156.2009.02262.x
  • Denscombe, M. (2017). The Good Research Guide. McGraw-Hill Education.
  • Dickersin, K., Scherer, R., & Lefebvre, C. (1994). Systematic reviews: Identifying relevant studies for systematic reviews. BMJ, 309(6964), 1286–1291. https://doi.org/10.1136/bmj.309.6964.1286
  • Dong, H., De Allegri, M., Gnawali, D., Souares, A., & Sauerborn, R. (2009). Drop-out analysis of community-based health insurance membership at Nouna, Burkina Faso. Health Policy, 92(2–3), 174–179. https://doi.org/10.1016/j.healthpol.2009.03.013
  • Doody, O., & Bailey, M. E. (2016). Setting a research question, aim and objective. Nurse Researcher, 23(4), 34–44. https://doi.org/10.7748/nr.23.4.19.s5
  • Duku, S. K. O. (2018). Differences in the determinants of health insurance enrolment among working-age adults in two regions in Ghana. BMC Health Services Research, 18(1), 1–16. 384. https://doi.org/10.1186/s12913-018-3192-9
  • Duku, S. K. O., van Dullemen, C. E., & Fenenga, C. (2015). Does health insurance premium exemption policy for older people increase access to health care? Evidence from Ghana. Journal of Ageing & Social Policy, 27(4), 331–347. https://doi.org/10.1080/08959420.2015.1056650
  • Durairaj, V., Kirigia, S. D. A., & Kirigia, J. (2010). Ghana’s approach to social health protection. World Health Report Background Paper No. 2. World Health Organization. https://www.who.int/publications/m/item/background-paper-2-ghana-s-approach-to-social-health-protection
  • Dzakpasu, S., Soremekun, S., Manu, A., Ten Asbroek, G., Tawiah, C., Hurt, L., Kirkwood, B. R., Hill, Z., Campbell, O. M. R., Kirkwood, B. R., & Fenty, J. (2012). Impact of free delivery care on health facility delivery and insurance coverage in Ghana’s Brong Ahafo Region. PLos One, 7(11), e49430. https://doi.org/10.1371/journal.pone.0049430
  • Fenny, A. P., Yates, R., & Thompson, R. (2021). Strategies for financing social health insurance schemes for providing universal health care: A comparative analysis of five countries. Global Health Action, 14(1), 1868054. https://doi.org/10.1080/16549716.2020.1868054
  • Foster, M. J., & Shurtz, S. (2013). Making the Critical Appraisal for Summaries of Evidence (CASE) for evidence-based medicine (EBM): Critical appraisal of summaries of evidence. Journal of the Medical Library Association: JMLA, 101(3), 192. https://doi.org/10.3163/1536-5050.101.3.008
  • Fuller, J. (1997). Multicultural health care: Reconciling universalism and particularism. Nursing Inquiry, 4(3), 153–159. https://doi.org/10.1111/j.1440-1800.1997.tb00093.x
  • George-Carey, R., Adeloye, D., Chan, K. Y., Paul, A., Kolčić, I., Campbell, H., & Rudan, I. (2012). An estimate of the prevalence of dementia in Africa: A systematic analysis. Journal of Global Health, 2(2), 1–13. https://doi.org/10.7189/jogh.02.020401
  • Ghana Statistical Service. (2013). The elderly in Ghana. 2010 population & housing census report. Author. https://www2.statsghana.gov.gh/docfiles/publications/2010phc_the_elderly_in_Gh.pdf
  • Gobah, F., & Zhang, L. (2011). The National Health Insurance Scheme in Ghana: Prospects and challenges: A cross-sectional evidence. Global Journal of Health Science, 3(2), 90. https://doi.org/10.5539/gjhs.v3n2p90
  • Gyasi, R. M., & Phillips, D. R. (2018). Gender, self-rated health and functional decline among community-dwelling older adults. Archives of Gerontology & Geriatrics, 77, 174–183. https://doi.org/10.1016/j.archger.2018.05.010
  • Gyasi, R. M., Phillips, D. R., & Meeks, S. (2020). Ageing and the rising burden of non-communicable diseases in Sub-Saharan Africa and other low-and middle-income countries: A call for holistic action. The Gerontologist, 60(5), 806–811. https://doi.org/10.1093/geront/gnz102
  • Hertler, S. C., Figueredo, A. J., Peñaherrera-Aguirre, M., Fernandes, H. B., Woodley of Menie, M. A., & Hertler, S. C. (2018). Urie Bronfenbrenner: Toward an evolutionary ecological systems theory. Life History Evolution: A Biological Meta-Theory for the Social Sciences, 323–339. https://doi.org/10.1007/978-3-319-90125-1_19
  • Higgins, J. P., Thomas, J., Chandler, J., Cumpston, M., & Li, T, Page, M. J. & Welch, V. A. (Eds.). (2019). Cochrane handbook for systematic reviews of interventions. John Wiley & Sons.
  • Holmes, W. R., & Joseph, J. (2011). Social participation and healthy ageing: A neglected, significant protective factor for chronic non-communicable conditions. Globalization and Health, 7(1), 1–8. https://doi.org/10.1186/1744-8603-7-43
  • Issahaku, P. A., & Neysmith, S. (2013). Policy implications of population ageing in West Africa. International Journal of Sociology & Social Policy, 33(3/4), 186–202. https://doi.org/10.1108/01443331311308230
  • Jakab, M., & Krishnan, C. (2004). Review of the strengths and weaknesses of community financing. Health financing for poor people: Resource mobilization and risk sharing. The World Bank.
  • Jakab, M., Preker, A., Krishnan, C., Schneider, P., Diop, F., Jütting, J., Supakankunt, S. (2001). Social inclusion and financial protection through community financing: Initial results from five household surveys. In World Health Organisation, Commission on Macroeconomics and Health.
  • Jehu-Appiah, C., Aryeetey, G., Spaan, E., Agyepong, I., & Baltussen, R. (2010). Efficiency, equity and feasibility of strategies to identify the poor: An application to premium exemptions under National Health Insurance in Ghana. Health Policy, 95(2–3), 166–173. https://doi.org/10.1016/j.healthpol.2009.11.017
  • Jehu-Appiah, C., Aryeetey, G., Spaan, E., De Hoop, T., Agyepong, I., & Baltussen, R. (2011). Equity aspects of the national health insurance scheme in Ghana: Who is enrolling, who is not and why? Social Science & Medicine, 72(2), 157–165. https://doi.org/10.1016/j.socscimed.2010.10.025
  • Kilanowski, J. F. (2017). Breadth of the socio-ecological model. Journal of Agromedicine, 22(4), 295–297.
  • Kipo-Sunyehzi, D. D., Ayanore, M. A., Dzidzonu, D. K., & AyalsumaYakubu, Y. (2019). Ghana’s Journey towards universal health coverage: The role of the national health insurance scheme. European Journal of Investigation in Health, Psychology and Education, 10(1), 94–109.
  • Kotoh, A. M., Aryeetey, G. C., & Van Der Geest, S. (2018). Factors that influence enrolment and retention in Ghana’ national health insurance scheme. International Journal of Health Policy and Management, 7(5), 443–454.
  • Kotoh, A. M., & Van der Geest, S. (2016). Why are the poor less covered in Ghana’s national health insurance? A critical analysis of policy and practice. International Journal for Equity in Health, 15(1), 1–11.
  • Kowal, P., Kahn, K., Ng, N., Naidoo, N., Abdullah, S., Bawah, A., Xavier Gómez-Olivé, F. (2010). Ageing and adult health status in eight lower-income countries: The IN-DEPTH WHO-SAGE collaboration. Global Health Action, 3(1), 5302.
  • Kusi, A., Enemark, U., Hansen, K. S., & Asante, F. A. (2015). Refusal to enrol in Ghana’s national health insurance scheme: Is affordability the problem. International Journal for Equity in Health, 14(2), 22–35.
  • Kwarteng, A., Akazili, J., Welaga, P., Dalinjong, P. A., Asante, K. P., Sarpong, D., Sankoh, O. (2020). The state of enrollment on the national health insurance scheme in rural Ghana after eight years of implementation. International Journal for Equity in Health, 19(1), 1–14.
  • Kyomugisha, E. L., Buregyeya, E., Ekirapa, E., Mugisha, J. F., & Bazeyo, W. (2009). Strategies for sustainability and equity of prepayment health schemes in Uganda. African Health Sciences, 9(2), 25–34.
  • MacAuley, D. (1998). Randomised controlled trial of the READER method of critical appraisal in general practice. BMJ, 316(7138), 1134–1137.
  • Mba, C. (2004). Population ageing and poverty in rural Ghana. Paper presented at the Union for African Population Science African Conference on Ageing (pp. 1–21), 18–20 August 2004, Johannesburg, South Africa. Accessed on August 18–20, 2020, from https://wikieducator.org/images/2/26/AGRIC_chuksmba.pdf
  • McCracken, K., & Phillips, D. R. (2017). Global health: An introduction to current and future trends. Routledge.
  • Mcintyre, D. (2004). Health policy and older people in Africa. Living longer: Ageing, development and social protection. Zed Books.
  • Mensah, J., Oppong, J. R., & Schmidt, C. M. (2010). Ghana’s national health insurance scheme in the context of the health MDGs: An empirical evaluation using propensity score matching. Health Economics, 19(S1), 95–106.
  • Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & Group, P. (2010). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. International Journal of Surgery (London, England), 8(5), 336–341.
  • Moher, D., Shamseer, L., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., Stewart, L. A. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews, 4(1), 1–9.
  • Morgan, A. K., Adei, D., Agyemang Duah, W., & Mensah, A. A. (2022). An integrative review on individual determinants of enrolment in national health insurance scheme among older adults in Ghana. BMC Primary Care, 23(1), 1–13. https://doi.org/10.1186/s12875-022-01797-6
  • Musau, S. N. (1999). Community-based health insurance: Experiences and lessons learned from East and Southern Africa. Partnerships for Health Reform, Abt Associates.
  • National Health Insurance Authority [NHIA]. (2022). NHIS @20 clock is ticking. Retrieved May 13, 2023: from https://www.nhis.gov.gh/News/nhis-%4020-clock-is-ticking—–5399
  • Nsiah-Boateng, E., & Aikins, M. (2018). Trends and characteristics of enrolment in the National Health Insurance Scheme in Ghana: A quantitative analysis of longitudinal data. Global Health Research and Policy, 3(1), 1–10. https://doi.org/10.1186/s41256-018-0087-6
  • Nsiah-Boateng, E., Musah, M., Jung, H., Danso Akuamoah, C., Yang, D., Kim, Y., Dsane-Selby, L., Asenso-Boadi, F., Kim, W. -H., Dsane-Selby, L., Andoh-Adjei, F. -X., & Kim, B. (2020). The impact of community outreach intervention on national health insurance enrolment, knowledge and health services utilisation: Evidence from two districts in Ghana. Journal of Global Health Science, 2(1), 1–12. https://doi.org/10.35500/jghs.2020.2.e8
  • Oduro Appiah, J., Agyemang Duah, W., Fordjour, A. A., & Adei, D. (2020). Predicting financial barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in Ghana. GeoJournal, 20(1), 1–15. https://doi.org/10.1186/s12877-020-1473-8
  • Osei Afriyie, D., Krasniq, B., Hooley, B., Tediosi, F., & Fink, G. (2022). Equity in health insurance schemes enrollment in low and middle-income countries: A systematic review and meta-analysis. International Journal for Equity in Health, 21(1), 21. https://doi.org/10.1186/s12939-021-01608-x
  • Osei-Akoto, I., & Adamba, C. (2011). Ethnic and religious diversity as determinants of health insurance uptake in Ghana. Proceedings of the Fourth European Conference for African Studies (ECAS 4), Uppsala.
  • Parmar, D., Williams, G., Dkhimi, F., Ndiaye, A., Asante, F. A., Arhinful, D. K., & Mladovsky, P. (2014). Enrolment of older people in social health protection programs in West Africa–Does social exclusion play a part? Social Science & Medicine, 119, 36–44. https://doi.org/10.1016/j.socscimed.2014.08.011
  • Pearson, A., White, H., Bath-Hextall, F., Apostolo, J., Salmond, S., & Kirkpatrick, P. (2014). Methodology for JBI mixed-methods systematic reviews. The Joanna Briggs Institute Reviewers Manual, 1, 5–34.
  • Prah, S. (2006). Factors Contributing to the Low Registration of National Health Insurance Scheme (NHIS) in Kassena-Nankana District (KND) in Upper East Region, Ghana (Doctoral dissertation, University of Ghana). https://ugspace.ug.edu.gh/handle/123456789/6415?show=full
  • Quartey, T., Peprah, C., & Morgan, A. K. (2023). Determinants of national health insurance enrolment among people at risk of statelessness in the Awutu Senya East Municipality and Gomoa East District of Ghana. BMC Health Services Research, 23(1), 1–11. https://doi.org/10.1186/s12913-022-08738-0
  • Rajkotia, Y. (2009). National Health Insurance in Ghana: Politics, adverse selection, and the use of child health services. The Johns Hopkins University.
  • Saeed, B. I., Oduro, S. D., Ebenezer, A. M. F., & Zhao, X. (2012). Determinants of healthcare utilization among the ageing population in Ghana. International Journal of Business & Social Science, 3(24), 66–77.
  • Saka, S., Oosthuizen, F., & Nlooto, M. (2019). National policies and older people’s healthcare in Sub-Saharan Africa: A scoping review. Annals of Global Health, 85(1), 1–7. https://doi.org/10.5334/aogh.2401
  • Salari, P., Akweongo, P., Aikins, M., & Tediosi, F. (2019). Determinants of health insurance enrolment in Ghana: Evidence from three national household surveys. Health Policy and Planning, 34(8), 582–594. https://doi.org/10.1093/heapol/czz079
  • Schmidt, J. O., Mayindo, J. K., & Kalk, A. (2006). Thresholds for health insurance in Rwanda: Who should pay how much? Tropical Medicine & International Health, 11(8), 1327–1333. https://doi.org/10.1111/j.1365-3156.2006.01661.x
  • Sekyi, S. (2009). The effects of National Health Insurance Scheme on outpatient utilization and expenditure in Ghana: A case study of Mfantseman Municipality (Doctoral dissertation, University of Cape Coast).
  • Suchman, L., Hashim, C. V., Adu, J., & Mwachandi, R. (2020). Seeking care in the context of social health insurance in Kenya and Ghana. BMC Public Health, 20(1), 1–13. https://doi.org/10.1186/s12889-020-08742-1
  • Trego, L. L., & Wilson, C. (2021). A social ecological model for military women’s health. Women’s Health Issues, 31, S11–21. https://doi.org/10.1016/j.whi.2020.12.006
  • Tudge, J. R., Merçon-Vargas, E. A., & Payir, A. (2022). Urie Bronfenbrenner’s bioecological theory: Its development, core concepts, and critical issues. In Adamsons, K., Few-Demo, A.L., Proulx, C., Roy, K. (Eds.), Sourcebook of family theories and methodologies: A dynamic approach (pp. 235–254). Springer International Publishing.
  • United Nations. (2013) . World Population Prospects. The 2012 revision. United Nations Department of Economic and Social Affair, Population division.
  • United Nations. (2015). World population ageing report 2015. Department of economic and social affairs, population division. United Nations, New York. https://www.un.org/en/development/desa/population/publications/pdf/ageing/WPA2015_Highlights.pdf
  • United Nations. (2020). World Population Ageing 2019. United Nations, Department of Economic and Social Affairs. Population Division.
  • Van der Wielen, N., Channon, A. A., & Falkingham, J. (2018a). Does insurance enrolment increase healthcare utilisation among rural dwelling older adults? evidence from the national health insurance scheme in Ghana. BMJ Global Health, 3(e000590), 1–9. https://doi.org/10.1136/bmjgh-2017-000590
  • Van der Wielen, N., Channon, A. A., & Falkingham, J. (2018b). Universal health coverage in the context of population ageing: What determines health insurance enrolment in rural Ghana? BMC Public Health, 18(1), 657. https://doi.org/10.1186/s12889-018-5534-2
  • Van Der Wielen, N., Falkingham, J., & Channon, A. A. (2018). Determinants of National Health Insurance enrolment in Ghana across the life course: Are the results consistent between surveys? International Journal for Equity in Health, 17(1), 1–14. 49. https://doi.org/10.1186/s12939-018-0760-x
  • Welty, E., Hofstetter, S., & Schulte, S. J. (2012). Time to re-evaluate how we teach information literacy. Applying PICO in library instruction. College & Research Libraries News, 73(8), 476–477. https://doi.org/10.5860/crln.73.8.8814
  • World Health Organization. (2011) . Global Ageing and Adult Health (SAGE). Geneva.
  • World Health Organization. (‎2015)‎. World report on ageing and health. World Health Organization. Accessed on August; from https://apps.who.int/iris/handle/10665/186463
  • Xu, K., Evans, D., Carrin, G., & Aguilar-Rivera, A. M. (2005). Designing health financing systems to reduce catastrophic health expenditure. Technical Briefs for Policy-Makers, 2(4), 1–5 https://hdl.handle.net/10067/558230151162165141.
  • Young, J. M., & Solomon, J. (2009). How to critically appraise an article. Nature Clinical Practice Gastroenterology & Hepatology, 6(2), 82–91. https://doi.org/10.1038/ncpgasthep1331