Open Access Open Badges Research article

Effects of spatial location and household wealth on health insurance subscription among women in Ghana

Akwasi Kumi-Kyereme and Joshua Amo-Adjei*

Author affiliations

Department of Population and Health, Faculty of Social Sciences, University of Cape Coast, Cape Coast, Ghana

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Citation and License

BMC Health Services Research 2013, 13:221  doi:10.1186/1472-6963-13-221

Published: 17 June 2013



This study compares ownership of health insurance among Ghanaian women with respect to wealth status and spatial location. We explore the overarching research question by employing geographic and proxy means targeting through interactive analysis of wealth status and spatial issues.


The paper draws on the 2008 Ghana Demographic and Health Survey. Bivariate descriptive analysis coupled with binary logistic regression estimation technique was used to analyse the data.


By wealth status, the likelihood of purchasing insurance was significantly higher among respondents from the middle, richer and richest households compared to the poorest (reference category) and these differences widened more profoundly in the Northern areas after interacting wealth with zone of residence. Among women at the bottom of household wealth (poorest and poorer), there were no statistically significant differences in insurance subscription in all the areas.


The results underscore the relevance of geographic and proxy means targeting in identifying populations who may be need of special interventions as part of the efforts to increase enrolment as well as means of social protection against the vulnerable.

Health insurance; Ecological zones; Wealth quintile; Ghana