Effects of spatial and material affluence on health insurance subscription among women in Ghana

This study compares ownership of health insurance among Ghanaian women with respect to material affluence and spatial location. The paper draws on the 2008 Ghana Demographic and Health Survey. Bivariate descriptive analysis and binary logistic regression estimation technique were used. In the bivariate descriptive, it is observed that the proportion of women not registered decreases with increase in material affluence. Spatially, the proportion of respondents not registered during the data collection was highest (70%) in the Coastal areas followed by Savannah and Forest belts. However, inferential analysis at the bivariate stage showed that the likelihood of registration was significant among respondents from the Savannah areas. Interacting material affluence with wealth, we notice that the gaps between the poorest and the non-poor in the Savannah widens significantly but the differences between the poor and least poor in the Forest zone are virtually non-extant. Our findings underscore the point that targeting the poor to improve equity in social health insurance such as the one operating in Ghana requires particular attention to proxy means (material affluence) and spatial targeting since choosing one over the other can obscure and result in ineffective policy prescriptions.