A Participatory Action Approach for Client-centered Health Insurance
Blog post by Christine Fenenga
Health insurance is a pivotal means to the development of an equitable care system. The field has attracted a lot of interest, not least to build more knowledge regarding the design, implementation and outcome of health insurance programs. The AR process I describe in this particular paper takes place in Ghana, one of the first countries in Africa to have introduced national health insurance in 2005. The National Health Insurance Authority, mandated with the implementation of the scheme, requested this study to further develop policy and practice and enhance broad participation in the scheme. The paper gives you a detailed and in-depth description of a participative action research approach (PAA) that we used to get a better understanding of clients’ perceptions regarding illness, health-seeking, healthcare and health insurance services. We explore clients’ motives as well as perceived barriers to use services. This understanding is important in order to contribute practical solutions to facilitate client-centered health care and health insurance services for all citizens in Ghana and increase participation in the scheme. Broad participation involving healthcare providers, health insurance staff and clients in a complex environment, with different power relations, was achieved using PAA together with a linked trajectory of qualitative and quantitative methods. The voices of the clients were brought forward for the future development and improvement of the services. We believe this paper contributes to PAA methodology knowledge. Lessons learned from the project should be very useful to action researchers embarking on similar initiatives in other contexts.
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