The two sides of free National Health Insurance policies : lessons from Daakye District, Ghana

The impact of free health insurance policies on healthcare access and utilisation in developing countries, where poverty is endemic, is well documented. However, previous research on the topic seems to have focused on the generic correlation between health insurance policies and increased patronage of hospital-based treatment where most health insurance schemes operate. We seek to contribute to the topic by showing the dynamics of healthcare utilisation in free health insurance contexts and associated unintended impacts. The study draws on an ethnographic study of Ghana's National Health Insurance Scheme in the Daakye district of the Central Region of Ghana. While the findings confirm the theory that free health insurance policies do induce people's health-seeking behaviours, they also unearth issues that result when public policies do not match local infrastructural and human resource capacities.