The Effect of Parent’s Insurance Enrollment on Health Care Utilization: Evidence from Ghana

Gissele Gajate Garrido, International Food Policy Research Institute (IFPRI)

Access to and utilization of health services are concerns in poor countries. If implemented correctly, health insurance systems may help solve this challenge. However it is difficult to determine whether joining an insurance scheme improves medical care-seeking behaviors because of selection and omitted variable bias. This paper examines how parental participation in the National Health Insurance Scheme (NHIS) affects health care utilization in Ghana, using an instrumental variable approach. The exogenous variation in enrollment comes from membership rules variations in the District Mutual Health Insurance Schemes (DMHIS). The data sets employed are the 2008 Demographic and Health Survey and a census of DMHIS in existence in 2008. We find insurance membership increases the probability of: i) seeking higher quality prenatal services and ii) parents becoming more active users of child curative and preventive care. IV estimates are larger than OLS ones indicating underlying heterogeneity in returns to NHIS participation.