Implications of Measuring the Progress towards Financial Risk Protection Using Varied Survey Instruments: A Case Study of Ghana

Given the urgency for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey instruments, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey (HBS) conducted in Ghana between 2017 and 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The HBS compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in HBS), Version II (new questions developed to measure OOPHP in HBS) and Version III (existing questions used to measure OOPHP in health surveys integrated into HBS). Version I, II and III contained 11, 44 and 56 health items respectively. The sample size for Version I, II and III were 930, 1032 and 1068 households respectively. Financial risk protection will be calculated across these three versions using STATA 15. It is expected that findings from this study will present valuable contributions on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Author(s): Dr.Jemima Sumboh

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