Factors influencing the use of public and private health care facilities among poor older people in rural Ghana
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The choice of a particular health care facility is premised on certain factors which remain largely unknown in rural settings in Ghana. The purpose of this study was to explore issues influencing public and private health care facilities use among poor older people in rural Ghana.
In-depth interviews and focus group discussions were conducted with 30 poor older persons, 15 caregivers, and 15 formal health care providers in the Atwima Nwabiagya District of the Ashanti Region of Ghana. A thematic analytical framework was used to analyze the data, which was then presented based on an a posteriori inductive reduction approach.
Three key public health care facility use factors were identified: health insurance acceptance, perceived service affordability, and availability of well-trained professionals. For private health care facilities, five main use factors were found: distance and proximity, good interpersonal relationships, good quality health services, service responsiveness, and logistics availability.
The findings of this study have implications for addressing attitudinal problems existing mainly in public health care facilities in Ghana. It also calls for policy intervention toward equitable access to public and private health facilities, especially for poor older persons.
KeywordsPublic health facility Private health facility Poor older people Rural Ghana Qualitative
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Furthermore, the Committee on Human Research Publication and Ethics (CHRPE), School of Medical Sciences, Kwame Nkrumah University of Science and Technology and Komfo Anokye Teaching Hospital, Kumasi, Ghana provided approval for this study (ref.: CHRPE/AP/311/18).
Informed consent was obtained from the study respondents before data collection began. They were assured that their participation in the study was voluntary and that they were free to opt out at any time.
- Agyemang-Duah W, Mensah CM, Peprah P, Arthur F, Abalo EM (2018) Facilitators of and barriers to the use of healthcare services from a user and provider perspective in Ejisu-Juaben municipality, Ghana. J Public Health. https://doi.org/10.1007/s10389-018-0946-0
- Bitran RA (2011) Private health sector assessment in Ghana. World Bank Publications, Washington, DCGoogle Scholar
- Blanchet NJ, Fink G, Osei-Akoto I (2012) The effect of Ghana’s national health insurance scheme on health care utilisation. Ghana Med J 46:76–84Google Scholar
- Creswell JW (2014) Research design: qualitative, quantitative, and mixed methods approaches, 4th edn. Sage, LondonGoogle Scholar
- Denscombe M (2010) The good research guide for small-scale social research projects, 4th edn. Open University Press, EnglandGoogle Scholar
- DiClemente RJ, Salazar FL, Crosby RA (2011) Health behavior theory for public health: principles, foundations, and applications. Jones & Bartlett Learning, Burlington, MAGoogle Scholar
- Ghana National Health Insurance Authority (NHIA) (2013) Annual report of the National Health Insurance Scheme of Ghana, 2012. NHIA, GhanaGoogle Scholar
- Glaser BG, Strauss AL (1967) The discovery of grounded theory: strategies for qualitative research. Aldine, ChicagoGoogle Scholar
- Government of Ghana (2012) Medium-term National Development Policy Framework: Ghana Shared Growth and Development Agenda (GSGDA), 2010–2013. National Development Planning Commission (NDPC), AccraGoogle Scholar
- Guba EG, Lincoln YS (1994) Competing paradigms in qualitative research. In: Denzin NK, Lincoln YS (eds) The SAGE handbook of qualitative research. Sage, Thousand Oaks, CA, pp 105–117Google Scholar
- He W, Goodkind D, Kowal P (2016) An aging world: 2015. International Population Reports, P95/16-1. U.S. Census Bureau, Washington, DCGoogle Scholar
- Onwuegbuzie AJ, Leech NL, Collins KMT (2010) Innovative data collection strategies in qualitative research. Qual Rep 15:696–726Google Scholar
- Papadimitriou DB (2007) Economic perspectives on aging. The Levy Economics Institute of Bard College, Working Paper No. 500Google Scholar
- Peltzer K, Phaswana-Mafuya N (2012) Patient experiences and health system responsiveness among older adults in South Africa. Glob Health Action 5:1–11Google Scholar
- UNICEF and World Bank Group (2016) Ending extreme poverty: A focus on children. Briefing Note. New York, Geneva, Washington, DCGoogle Scholar
- United Nations, Department of Economic and Social Affairs, Population Division (2013) World population ageing 2013.. United Nations, New York, pp 9–11Google Scholar
- United Nations, Department of Economic and Social Affairs, Population Division (2015) World population prospects. The 2015 revision. United Nations, New YorkGoogle Scholar
- World Health Organization (WHO) (2009) World health statistics. WHO, GenevaGoogle Scholar
- World Health Organization (WHO) (2011) Global health and ageing. National Institute on Aging; National Institutes of Health; U.S. Department of Health and Human Services; WHO, GenevaGoogle Scholar
- Yawson AE, Nimo KP, Biritwum RB (2013) Challenges of health care delivery at a municipal health facility under Ghana’s National Health Insurance Scheme. Postgrad Med J Ghana 2(2):56–64Google Scholar