RESUMEN
The impact of COVID-19 vaccination programmes on disease transmission, morbidity and mortality relies heavily on the population's willingness to accept the vaccine. We explore Ghanaian adult citizens' vaccine hesitancy attitudes and identify the likelihood of participation or non-participation in the government's effort to get citizens vaccinated. A fully anonymised cross-sectional online survey of 2345 adult Ghanaians was conducted from 23 to 28 February 2021. Differences in intentions regarding COVID-19 vaccination were explored using Pearson Chi-square tests. Additionally, multinomial logistic regression was used to analyse the factors associated with willingness to receive vaccines. Responses were weighted using the iterative proportional fitting technique to generate a representative sample. About half (51%) of mostly urban adult Ghanaians over 15 years are likely to take the COVID-19 vaccine if made generally available. Almost a fifth (21%) of the respondents were unlikely to take the vaccine, while another 28% were undecided. Additionally, we find differences in vaccine hesitancy among some socio-demographic characteristics such as age, gender, and primary sources of information. Attaining the proverbial 63% to 70% herd immunity threshold in Ghana is only possible if the preventive vaccination programmes are combined with an enhanced and coordinated public education campaign. Such a campaign should focus on promoting the individual and population-level benefits of vaccination and pre-emptive efforts towards addressing misinformation about vaccines.
RESUMEN
Ghana introduced a social health insurance scheme in 2003. One of its motivations was to protect consumers against adverse health shocks. Financing for the programme comes from a 2.5% goods and service tax, contributions by formal sector workers directly transferred from their social security savings and individual premiums from informal members. This arrangement makes formal workers compulsory members of the scheme while informal members voluntarily enroll. We view this as a natural experiment in which one section of the population automatically acquires insurance (with formal sector employment), and the remainder choose to obtain the same coverage (or not). Using data from the 2009/2010 Ghana Socioeconomic Panel Survey, we explore the determinants of the uptake of health insurance by informal members and test whether this voluntary health insurance uptake impacts the frequency of use of health care resources. We find robust evidence that older, wealthier and more educated individuals are more likely to buy (voluntary) health insurance. Moreover, using the method of propensity score matching, we find that voluntary health insurance uptake is strongly associated with higher health care utilization-implying that, with respect to the frequency of use, the mode of insurance acquisition matters.