가나 농촌가족의 건강자원 재분배와 정책적 함의 = Health Resource Redistribution among Ghanaian Family Members and its Policy Implication

다국어 초록 (Multilingual Abstract)

Purpose: This article explores and classifies patterns and standards of health resource redistribution in Ghanaian poor rural families through analysis of their enrollment and renewal of national health insurance.
Originality: In many developing countries, in the case of formal sector employees, office workers and their family members can be the beneficiaries of the national health insurance, due to the dependent eligibility policy. On the other hand, informal sector members hardly have the same benefit because the government adopts and manages individual health insurance system in the case of informal sector subscribers. Unlike Korea adopting compulsory subscription system not only to the formal sector, but also to the informal sector, the Ghanaian government adopts voluntary subscription system to the informal sector. Therefore, many informal sector workers such as farmers and their family members can choose national health insurance enrollment.
Methodology: In the article, it is operationally defined the enrollment of health insurance among family members as ’health resource redistribution’ in the family. It was conducted qualitative interviews to 18 regional residents for the research.
Result: The limited health resource in the Ghanaian poor rural families is redistributed by the patterns of need, contribution/productivity and equality. The redistribution by needs is that health resource is allocated to the unhealthy members in the family first and foremost. The redistribution by equity means that health resource is allocated first to the ‘productive’ family members now and in the future. Lastly, the redistribution by equality is that health resource is redistributed to all the family members equally. It can be analysed that poor families redistribute their limited health resource to the family members who are and will be ’bread-winner’ now and in the future, or, who take responsibility for ’reproduction’ by care, pregnancy, and birth in the family by priority.
5. Conclusion and Implication: If these patterns are maintained, old men and women will be alienated from the health insurance benefit, even though medial care and service is very important and inevitable for them at the moment. To prevent the exemption and marginalization of the vulnerable old groups from healthcare service, and to promote the integration of all the population, it should be considered the adoption of compulsory subscription system and the expansion of governmental health insurance subsidy system.

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