The role of NHIS and its effectiveness in achieving universal health coverage and adequate healthcare in Ghana: a systematic literature review

Os seguros de saúde tornaram-se um instrumento muito importante no fornecimento de acesso e utilização de serviços de saúde na maioria dos países em desenvolvimento como o Gana. O Sistema Nacional de Saúde do seguro do Gana (NHIS) é um instrumento promissor para os decisores políticos. No entanto, desde a sua criação em 2003, poucos estudos avaliaram o seu impacto. O estudo investiga o papel do Sistema Nacional de Saúde do Seguro do Gana (NHIS) na utilização dos cuidados de saúde e a sua eficácia na obtenção de uma cobertura de saúde universal. Assim, o principal objectivo era avaliar o papel do NHIS no Gana e a sua eficácia no fornecimento de saúde adequada aos ganeses. Este trabalho aborda o problema de 40% dos ganeses que não subscreveram o Sistema Nacional de Saúde de Seguro (NHIS) e cerca de 36% dos outros que alguma vez se registaram não renovaram os seus cartões após a expiração da sua filiação. A maioria dos ganeses afirma que o esquema não é eficaz, uma vez que os subscritores do NHIS estão autorizados a comprar alguns medicamentos prescritos e a pagar alguns testes laboratoriais. Assim, o papel do NHIS é-lhes invisível e não há necessidade de se inscreverem ou renovarem as suas subscrições no esquema. Com a introdução do NHIS em 2003, não é claro se todos os problemas inerentes ao anterior sistema "cash and carry" foram resolvidos. Ainda mais importante, parece não haver investigação disponível para avaliar o papel do NHIS e a sua eficácia no fornecimento de saúde adequada aos ganenses. O estudo foi analisado tematicamente, tal como "Investigação empírica analisou os cuidados de saúde e os sistemas de saúde", "Ministério da Saúde e a estrutura de saúde no Gana", "seguro de saúde, perspectiva global do seguro social de saúde", "evolução do seguro de saúde no Gana", "o Sistema Nacional de Seguro de Saúde" (NHIS) - "a estrutura do NHIS no Gana", "e o impacto do NHIS na utilização dos serviços de saúde no Gana". A pesquisa on-line foi efectuada para a literatura publicada entre 2003-2022 sobre o NHIS e a sua sustentabilidade no Gana. O investigador empregou três bases de dados: Science Direct, Web of Science Core Collection, e PubMed. Esta abordagem de pesquisa sistemática foi baseada na PEO, que significa População, Exposição, e Resultado na sua totalidade. Mais de 34 milhões de referências a literatura biomédica do MEDLINE, revistas de ciências da vida, e livros em linha estão incluídos na PubMed, 6 artigos da colecção Web of Science Core, 924 artigos da base de dados Science Direct, e 21 artigos da PubMed estavam entre os resultados da base de dados. Estudos sobre o impacto catastrófico das despesas médicas fora do bolso (OOP) no Gana, as consequências do NHIS, e o papel da literacia em saúde como método para garantir a cobertura universal da saúde foram encontrados através da pesquisa. A revisão sistemática está centrada na questão de como os ganeses estão a ser bem tratados. Muitas fontes variadas e técnicas foram utilizadas para localizar literatura académica para explorar o assunto em investigação. 11 artigos elegíveis revistos por pares foram seleccionados para revisão final com base na relevância específica para o contexto ganês e os objectivos do estudo, utilizando critérios de inclusão e exclusão, bem como o fluxograma do PRISMA e analisados utilizando a análise temática. A partir da análise temática, foram identificados e categorizados temas que foram apresentados no âmbito dos objectivos específicos. Os Resultados permitem caracterizar a proporção de ganenses actualmente inscritos e renovados no NHIS (a Cobertura Universal de Saúde), se os serviços do NHIS corresponderem às exigências dos ganenses (Adequado e eficaz), e aos desafios enfrentados pela implementação eficaz do Sistema Nacional de Seguro de Saúde (NHIS) no Gana. As conclusões alcançadas levaram à apresentação das conclusões. Apercebeu-se de que os pagamentos fora do bolso têm um impacto catastrófico nos ganeses e que as famílias em situação de pobreza têm mais probabilidades de sofrer um desastre financeiro. O Gana estava pior do que a África do Sul, Tanzânia, Sri Lanka, Malásia, Indonésia e Tailândia quando comparado com outros países africanos e asiáticos, tendo o efeito catastrófico dos pagamentos Fora do Objectivo (utilizando 10% de despesas globais e 40% de despesas de limiares não-alimentares). O Gana, contudo, está a fazer melhor do que o Bangladesh, a China e o Nepal. Os custos mais elevados dos cuidados de saúde catastróficos estão relacionados com pagamentos fora-do-bolso significativos nas nações que têm custos catastróficos mais elevados. Os resultados demonstram que a desigualdade horizontal prevalece sobre a desigualdade vertical. Embora o prémio seja regressivo, isto não altera tanto o desequilíbrio horizontal como a redistribuição da capacidade de pagamento. A investigação demonstrou que, após o ajustamento da capacidade de pagar, os prémios são mais elevados em Urbano do que em semiurbano e mais baixos para os membros que completaram o ensino superior do que para os que não o fizeram. O estudo revelou também que uma pequena percentagem dos pobres é susceptível de sofrer custos catastróficos devido ao pagamento de prémios. Os resultados mostraram que os níveis de literacia em saúde têm um papel significativo na determinação da forma como o acesso aos cuidados de saúde e aos seguros de saúde afectam. Os resultados implicam que mesmo as políticas de apoio à Cobertura Universal da Saúde são susceptíveis de ficar aquém dos objectivos em matéria de Qualidade de Vida relacionada com a Saúde, a face da baixa Literacia da Saúde. Assim, deve ser enfatizado que a Literacia da Saúde deve ser um plano primário para políticas destinadas a reduzir as desigualdades e disparidades na saúde, especialmente em outras nações emergentes e no Gana que são comparáveis. O NHIS continua a desempenhar um papel crucial no sentido de alcançar uma cobertura universal da saúde no Gana, ao mesmo tempo que se vê confrontado com desafios que podem potencialmente fazer ruir o esquema.The general purpose of the study is to understand the role of National Health Insurance Service (NHIS) and its effectiveness in achieving Universal Health Coverage. To address the objective, the study adopted systematic literature approach and uses qualitative research approach in data collection and analysis. Only secondary data from related studies found in scientific journals, were used. In all, 11 related studies were included in the review, using inclusion and exclusion criteria as well as the PRISMA flowchart and analyzed thematically. Identified themes were categorized into major and minor themes and presented under the specific objectives. The study revealed that Out-Of-Pocket payments have a catastrophic impact on Ghanaians and that households in poverty are more likely to experience financial disaster. The study also reveals that those living in the urban cities can pay higher premiums than their counterparts in the semi-urban areas. Also, workforce group with tertiary education certificates see the premiums paid to access the health care facilities very low. It was found that higher catastrophic health care costs relate to significant Out-of-Pocket payments in the nations that have higher catastrophic costs. We find that a small percentage of the poor are probable to suffer catastrophic costs because of the premium payments. The results showed that levels of health literacy have a significant role in determining access to healthcare and health insurance. In all, Ghana is gradually doing better than other African countrie

The Integration of Intercultural Competence in Innovative Pedagogical Methodology in Nursing Education.

The global population is continuously emigrating and progressing due to the increased abilityto travel. This has resulted in upsurge escalation of cultural diversity in every country.Immigration expansion, increasing globalization and the growth of minorities have resulted incultural diversity of students in the nursing education. This, therefore, calls for the need toenhance the teaching strategies of nursing educators to meet the demands of diverse students.This correlational study aims to measure the relationship between the integration ofintercultural competence on the use of innovative pedagogical methodology. Also, it aims tomeasure the significant difference of years of teaching experience on the use of innovativepedagogical methodology. Thirty (30) nurse educators were conveniently sampled from threeuniversities in Trinidad and Tobago. The study adopted and modified Cultural DiversityQuestionnaire for Nurse Educators (CDQN) to assess the intercultural competence of nurseeducators and a self-constructed questionnaire was used for the pedagogical methodology ofnurse educators. The statistical treatment used was Pearson Correlation and ANOVA. Therelationship between intercultural competence and the use of innovative pedagogicalmethodology yielded a moderate significant positive relationship (r=0.387, p=0.008) at a95% confidence interval. In examining the differences between years of teaching experiencethe use of innovative pedagogical methodology, the study showed a non-significantdifference (p=1.35) on equal variance assumed, Therefore, this study concludes that in orderto enhance the quality of nursing education, nurse educators should pose interculturalcompetence in order to provide innovative pedagogical methods that would enhance teachingquality and facilitate cultural diversity in the classrooms. It is therefore critical for continuousprofessional development for nursing educators to include the development of interculturalcompetence and the use of innovative pedagogical methodology. Further research shouldinvestigate using qualitative research design on the challenges that nurse educators face withthe increase of cultural diversity in nursing education

Capital Structure and Firm’s Performance in Ghana. Do Macroeconomic Factors Matter?

The paper seeks to investigate how macroeconomic factors affect the relationship between capital structure and bank performance from 2004 to 2014. In this context we try to condition the postulated relations between capital structure and firm performance on the dynamics of the macroeconomic environment of Ghana. We considered the impact of some macroeconomic variables such as inflation and GDP growth. Panel data methodology is adopted in this study. This combines simultaneous cross-section and time series data. The paper employs samples of banks in Ghana. Using fixed effect regression estimation model, a relationship was established between performance (proxied by return on asset and return on equity) and the firms capital structure over a period of ten years. Hausman chi-square test was conducted in each equation.The macroeconomic variables, GDP growth were registered to be significant in both models. This signifies that macroeconomics matter in the bank’s capital structure and performance. Inflation however were found to be insignificant. We therefore recommend that macroeconomic policies should provide a conducive environment for banks operations, in addition the government should develop the bond market

Conceptual Exploration of the Rites of Passage With The Kumasi Central Market

As a concept, the Rites of Passage –a phrase which was coined by the French anthropologist and folklorist Arnold van Gennep, is represented with paintings to depict the stages of life from the time of birth to death. This write-up, conceptually represents the behavioural tendencies at each stage of life with scenes captured from the Kumasi Central Market at the four major periods of the day which are morning, afternoon, evening and night. The captured scenes were selected based on the effect of light on the particular scene, specifically, the brightness of the hues, and its capability of portraying the specific period of the day. To achieve the exact optical effect, the selected scenes were photographically painted on canvasses. Descriptions were made of the scenes and were finally analysed. Thus Observatory, Participatory, Descriptive and Analytical methodologies were utilized to observe and capture snapshots of the scenes from the Kumasi Central Market, then painted the scenes, described them and finally analysed them respectively. The analyses resulted in conceptually portraying the Rites of Passage theory with the paintings. The statement or morals is that in nature, everything passes through the four stages of life and eventually dies. It is therefore concluded that nothing is permanent in life as it goes through several challenges and changes before finally deteriorating and dying or annihilating. Keywords: Conceptual, Exploration, Rites of passage, Kumasi Central Market. DOI: 10.7176/JCSD/66-03 Publication date:August 31st 2021

Kayayo: An e-commerce site with recommendations and text messaging

Applied project submitted to the Department of Computer Science, Ashesi University College, in partial fulfillment of Bachelor of Science degree in Computer Science, April 2013E-commerce, as a means of transacting business, is increasingly providing Ghanaians abroad and at home with a new and more convenient way to do their shopping. Sites such as makola.com and myebayghana.com are providing retailers with a means to exhibit their products to enable them expand their reach. However, many e-commerce sites do not fully address the shopping needs of the average Ghanaian shopper, which are, a quick, easy, reliable and more contextual way to shop for products and have them delivered to their doorsteps. This project therefore proposes a convenient, intuitive and contextually relevant e-shopping system. The system uses recommendation algorithms and SMS messaging as a major means of interaction.Ashesi University Colleg

CHROMOBIOTICS: The Silent Neglect of a Salient Need

Colour has been one of the multi-faceted means of human development interwoven in the social structure and institutions which practically, psychologically and physiologically reveal the beauty and benefits of nature. This paper focuses on the subject of colour with particular emphasis on its often nuanced involvement in human well-being as regards health, and the vital edification of social life. It looks at the roles colour play in the life of humanity, dwelling on its functionalities. The study combines historical and discourse analysis methods based upon the qualitative research approach. How does colour draw on human inbuilt capacities to rejuvenate and restore the entire system to enliven and delight the senses? This inquiry is to incline human-kind to identify more with colour and be responsible and respectful in its application, to appreciate the intrinsic importance of the power of colour to life and to understand its contingent potential for maximum employment. The study provides exciting opportunity and inspiration to advance the reader’s knowledge and experience of colour in an overarching manner. Keywords: hue, chromatics, physio-psychological, colour sensibilities, holistic, chromo-therapy

Utilization of Colour for Visual Representation of Nature, Form, Space and Time

In nature, everything has a form, occupies a space, and is susceptible to change in a matter of time. Nature, form, space and time could well be classified as theoretical and the problem of intangibility of the said terms is addressed with the application of colour to visually represent them through paintings. Through application of colour, this article pulls the said incorporeities from their abstract realm for visual perception. Methodology of Observation was applied to observe some scenes at the same time, but a particular scene or spot was studied at four different periods of the day namely; morning, afternoon, evening and night. Participatory methodology was utilized to capture the scenes with a camera and, through the application of colour, painted the captured scenes on canvasses. Analyses of the painted scenes were finally made to result in conceptually representing nature, form and space with painted objects. Four of the scenes visually present the four periods or time of the day which are morning, afternoon, evening and night. The analyses have subsequently resulted in visually bringing about the concept of nature, form, space and time. In conclusion, if the intangibilities of nature, form, space and time could be concretized for visual conception, then any theory could be practically materialized. Keywords: colour, visual representation, nature, form, space, time DOI: 10.7176/ADS/94-01 Publication date:July 31st 202

Analytical Solution of Dufour and Soret Effects on Hydromagnetic Flow Past a Vertical Plate Embedded in a Porous Medium

This study investigated among others, the effect of thermal diffusion and diffusion thermo on heat and mass transfer over a vertical porous surface with convective heat transfer. A similarity analysis was used to transform the system of partial differential equations describing the problem into ordinary differential equations. The reduced system was solved using the Forth-order Runge - Kutta algorithm alongside the Newton Raphson shooting method. The results are presented graphically and in tabular form for various controlling parameters. Keywords: Permeability; Soret and Dufour; Brinkmann number; heat and mass transfer; vertical plate, Buoyancy

Evaluation of postoperative refractive error correction after cataract surgery

Suboptimal cataract surgery outcomes remain a challenge in most developing countries. In Ghana, about 2 million people have been reported to be blind due to cataract with about 20% new cases being recorded yearly. The aim of this study was to evaluate postoperative correction of refractive errors after cataract surgery in a selected eye hospital in Ashanti Region, Ghana. This was a retrospective study where medical records of patients (aged 40–100) who reported to an eye hospital in Ghana from 2013–2018 were reviewed. Included in the study were patients aged ≥40 years and patients with complete records. Data on patient demographics, type of surgery, intra-ocular lens (PCIOL) power, availability of biometry, postoperative refraction outcomes, pre- and postoperative visual acuity were analyzed. Data of two hundred and thirteen eyes of 190 patients who met the inclusion criteria were analyzed. Descriptive analysis and Chi-square test were carried out to determine the mean, median, standard deviation and relevant associations. The mean ± SD age was 67.21±12.2 years (51.2% were females). Small Incision Cataract Surgery (99.5%) with 100% IOL implants was the main cataract surgery procedure in this stud

A Discourse Pragma-Stylistic Analysis of Invective Expressions in Ghanaian Politics

Decent use of language has been a common trademark in communication. It is such an aspect of human development that has been an important part in our societies since time immemorial. In recent times, this practice has contemptuously gone amiss due to our demanding need for democratic development. Recent development in politics in Ghana has witnessed a total change in the use of decent language to achieve the intended purposes in political communication. It is in this regard that the present study sought to examine the use of invectives in political communications in Ghana. The study adopted Fairclough’s (1995) Critical Discourse Analysis theory to analyse the data gathered, which spanned from 2011 to 2016 and were taken from statements made by politicians that had been covered as major news items in the print media and online networks. In all, one hundred and fifty (150) bulletins of such invectives were identified and further categorised into descriptive, attributive and symbolic forms. Our findings showed that many of the noted politicians in Ghana made frequent use of invectives to seek political recognition that will prepare them for better political fortunes should the party they represent come to power in the future. It was further identified that all of these invectives were meant to cause emotional and psychological pains and also to lower the social status of the affected individuals so as to make them politically ‘dirty’ and irrelevant