Journal of Public Health

, Volume 27, Issue 6, pp 713–721 | Cite as

Knowledge and satisfaction of health insurance clients: a cross-sectional study in a tertiary hospital in Ghana

  • Eric Nsiah-BoatengEmail author
  • Francis Asenso-Boadi
  • Francis-Xavier Andoh-Adjei
  • Moses Aikins
Original Article



This study assesses client knowledge of, and satisfaction with services under the National Health Insurance Scheme (NHIS) in a tertiary healthcare facility.

Subject and methods

A cross-sectional exit interview was conducted at the Korle-Bu Teaching Hospital in the Greater Accra region of Ghana. Respondents were classified into various groups based on the number of positive responses obtained for knowledge and satisfaction measures on a 5-point Likert scale. Descriptive statistics and multivariate logistic regression analyses were conducted to test and measure associations between client characteristics, their knowledge of the NHIS, and satisfaction with services.


Two hundred and four clients participated in the study, representing a 97% response rate. Seventy-nine clients (39%) had more knowledge of the NHIS, 115 (56%) were more satisfied with NHIS services, and 200 (98%) were more satisfied with healthcare services. Factors including education and years of enrolment were significantly associated with more knowledge of the NHIS. Similarly, knowledge of the NHIS, number of living children, and years of enrolment strongly correlated with more satisfaction with NHIS services. However, being a returning patient was strongly related with less knowledge of the NHIS and less satisfaction with NHIS services.


Clients have less knowledge of the NHIS and are fairly satisfied with its services overall. However, they are more satisfied with healthcare provider services. More education and sensitization are necessary to increase knowledge and improve satisfaction and enrolment.


Client knowledge Client satisfaction National Health Insurance Scheme Korle-Bu Teaching Hospital Ghana 



We would like to thank the management of Korle-Bu Teaching Hospital for giving us approval for the study. We are also grateful to the respondents for their participation in the survey, and appreciate the contributions and insightful comments made by the field workers and reviewers.

Compliance with ethical standards

Disclosure of potential conflicts of interest

Eric Nsiah-Boateng, Francis Asenso-Boadi, and Francis-Xavier Andoh-Adjei are employees of the National Health Insurance Authority; however, their affiliations did not in any way, influence findings of the study. Moses Aikins has no conflict of interest.

Ethical approval

All procedures performed in studies 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.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10389_2018_1000_MOESM1_ESM.docx (21 kb)
ESM 1 (DOCX 20 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Public Health, College of Health SciencesUniversity of GhanaAccraGhana
  2. 2.National Health Insurance AuthorityAccraGhana

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