TY - JOUR
T1 - Community concepts of poverty
T2 - An application to premium exemptions in Ghana's National Health Insurance Scheme
AU - Aryeetey, Genevieve C.
AU - Jehu-Appiah, Caroline
AU - Kotoh, Agnes M.
AU - Spaan, Ernst
AU - Arhinful, Daniel K.
AU - Baltussen, Rob
AU - van der Geest, Sjaak
AU - Agyepong, Irene A.
PY - 2013/3/14
Y1 - 2013/3/14
N2 - Background: Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana's National Health Insurance Scheme.Methods: We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty.Results: Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community.Conclusion: The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care.
AB - Background: Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana's National Health Insurance Scheme.Methods: We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty.Results: Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community.Conclusion: The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care.
KW - Community participation
KW - Exemptions
KW - Ghana
KW - Health insurance
KW - Poor households
KW - Targeting
KW - Wealth ranking
UR - http://www.scopus.com/inward/record.url?scp=84874933129&partnerID=8YFLogxK
U2 - 10.1186/1744-8603-9-12
DO - 10.1186/1744-8603-9-12
M3 - Article
C2 - 23497484
AN - SCOPUS:84874933129
SN - 1744-8603
VL - 9
JO - Globalization and Health
JF - Globalization and Health
IS - 1
M1 - 12
ER -