Despite calls for governments to provide universal health coverage for all, social health insurance programmes (SHI) that specifically target older adults continue to be largely absent in many African countries. Only a few African countries have implemented SHI programmes that include specific provisions for older adults. Ghana’s National Health Insurance Scheme (NHIS) is one of the few programmes in Africa that exempts older adults from paying premiums for health insurance. This study examined socio-demographic factors associated with old-age premium exemption under Ghana’s NHIS. The study used data from the seventh round of the Ghana Living Standards Survey (GLSS 7) conducted in 2017. Descriptive statistics and binary logistic regression were used in analysing data from a sample of 1532 older adults aged 70 years and older. The results reveal that only about 43% of older adults who were enrolled on the NHIS at the time of the survey acquired their membership through the old-age exemption policy. Additionally, increasing age was associated with higher odds of reporting exemption from paying premiums for health insurance. Also, older adults who are living in rural areas were more likely to pay premiums rather than being exempt as compared to their counterparts living in urban areas. These findings indicate that the old-age exemption policy is not achieving the intended goal of providing financial risk protection for some older adults. Additionally, the policy is not reaching those who need it most, particularly those living in rural areas. Specific targeting is required for older adults living in rural areas who are less likely to benefit from the old-age exemption policy in spite of being eligible.

中文翻译：

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迈向老年人普及医疗服务：根据加纳国家健康保险计划对老年人免税政策的评估。

尽管呼吁政府为所有人提供全民医疗保险，但在许多非洲国家仍然没有针对老年人的社会医疗保险计划（SHI）。只有少数非洲国家实施了SHI计划，其中包括针对老年人的特定规定。加纳的国家健康保险计划（NHIS）是非洲为数不多的豁免老年人支付健康保险费的计划之一。这项研究调查了与加纳国家NHIS规定的免除养老金有关的社会人口统计学因素。该研究使用了2017年加纳生活水平调查（GLSS 7）的第七轮数据。描述性统计数据和二元Logistic回归用于分析来自1532名70岁以上老年人的数据。结果显示，在调查之时，只有大约43％的参加NHIS的老年人通过老年免税政策获得了会员资格。此外，年龄增长与报告免除缴纳健康保险保费的几率更高有关。此外，与居住在城市地区的老年人相比，居住在农村地区的老年人更有可能支付保费而不是免税。这些发现表明，老年豁免政策没有达到为某些老年人提供财务风险保护的预期目标。此外，该政策还没有覆盖最需要的人，特别是那些生活在农村地区的人。