www.ccsenet.org/jsd Journal of Sustainable Development Vol. 4, No. 5; October 2011 Published by Canadian Center of Science and Education 125 The Impact of Mutual Health Insurance Scheme on Access and Quality of Health Care in Northern Ghana: The Case of Kassena-Nankana East Scheme Kennedy A. Alatinga Lecturer, University for Development Studies, Department of Community Development, Ghana P.O. Box 520, Wa Campus, Upper West Region, Ghana Tel: 233-244-933-750 E-mail: kalatinga@gmail.com Nicholas Fielmua Research Fellow, University for Development Studies Centre for Continuing Education and Interdisciplinary Research (CCEIR) P.O. Box 520, Wa Campus, Upper West Region, Ghana Tel: 233-243-255-001 E-mail: fielmua@yahoo.com Received: June 20, 2011 Accepted: August 31, 2011 doi:10.5539/jsd.v4n5p125 Abstract This study examines the Impact of Mutual Health Insurance on Access and Quality of Health Care for the Rural Poor in Northern Ghana. The practical interest in Mutual Health Insurance is occasioned by the fact that many developing countries including Ghana are exploring new and innovative ways of dealing with the difficult issues of health care financing and access to health care especially for the rural poor. Using household surveys and focus group discussions, the study establishes that Mutual Health Insurance improves the poor access to health care as the insured use nearly 3 times of health facilities more than the uninsured. The insured equally pay relatively lower out-of-pocket fees than the uninsured at the point of demanding health care. Households with higher incomes generally enrol in health insurance while the poorest segment of the community risk being excluded because they cannot afford the insurance premiums. It is recommended that since the flat rate nature of insurance premiums is what prevents majority of households from enrolling in health insurance, the premiums could be made more flexible for the rural poor. Keywords: Mutual health Insurance, Access, Quality, Health, Northern, Ghana 1. Background of the Study Health and social security are human rights and indispensable prerequisites for poverty reduction, economic growth and development. Consequently, there is the need for appropriate health financing mechanisms that will raise sufficient funds and create suitable financial incentives so that everyone especially the rural poor has access to affordable health care. Improving the rural poor’s access to health care will enable them to contribute meaningfully towards the development agenda. In today’s age of scientific and technological advancement, preventable diseases and illnesses still remain critical threats to the income earning capacity of the world’s rural poor. Physical and financial barriers to accessing quality health care remain problems for the poor majority especially in developing countries. It is estimated that 1.3 billion people in the world lack access to effective and affordable health care due to financial limitations or governments’ inability to provide them with the necessary coverage (WHO, 2005). The poor are most often than not required to pay for the cost of health out-of pocket at the very moment they fall sick. Out-of-pocket payments mostly in the form of user fees describe all expenses that patients have to pay to a health care provider according to set tariffs and directly out of their own pockets (Lasser and Rademacher, 2006). These out-of-pocket payments exclude a lot of the poor from accessing health care because they cannot afford. These out-of-pocket payments or expenditures may even be catastrophic and can plunge families or individuals into perpetual impoverishment. Expenditures are termed ‘catastrophic’ if they exceed a certain fraction of household income say for example 40% of household income (Wagstaff, 2008). Similarly, Preker and Carrin (2004) argue