Modern or traditional health care? Understanding the role of insurance in health-seeking behaviours among older Ghanaians

Aim: This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana. Background: There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies. Methods: The study used data from the first wave of the World Health Organisation's Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors. Findings: Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile. Conclusion: The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.