The National Health Insurance Scheme (NHIS) in Ghana was introduced to alleviate the problem of citizens having to pay for healthcare at the point of delivery, given that many did not have the financial resources needed to do so, and as such were unable to adequately access healthcare services. The scheme is managed from the national headquarters in the capital Accra, through satellite offices located in districts right across the length and breadth of the country. It is the job of these offices to oversee the operations of the scheme within that particular district. Current literature however shows us that there is a digital divide that exists between the rural and urban areas of the country which has led to differences in the management of information within urban-based and rural-based districts. This thesis reviews the variables affecting the management of information within the scheme, and proposes an information management model to eliminate identified bottlenecks in the current information management model.
The thesis begins by reviewing the theory of health insurance, information management and then finally the rural-urban digital divide. In addition to semi-structured interviews with key personnel within the scheme and observation, a survey questionnaire was also handed out to staff in nine different district schemes to obtain the raw data for this study. In identifying any issues with the current information management system, a comparative analysis was made between the current information management model and the real-world system in place to determine the changes needed to improve the current information management system in the NHIS. The changes discovered formed an input into developing the proposed information management system with the assistance of Natural Conceptual Modelling Language (NCML).
The use of a mixed methodology in conducting the study, in addition to the employment of NCML was an innovation, and is the first of its kind in studying the NHIS in Ghana. This study is also the first to look at the differences in information management within the NHIS given the rural-urban digital divide.
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.