Access to health services by ethnic minorities in the Kumasi metropolis, Ghana: Does insurance cardholding matter?

Abstract Background: Ethnic minorities find difficulty in accessing healthcare and other services due to their vulnerable socio-economic conditions. The study explores the effectiveness of access to healthcare by insurance cardholding ethnic minorities in the Kumasi Metropolis, Ghana. Methods It was a qualitative study that used convenience and snowballing approaches in data collection. The study objects were ethnic minorities. Both primary and secondary data were used to explore access to health services in the Kumasi Metropolis of Ghana with data collected within a six-week time frame. The outcome variable was access to and use of health services and the key independent variable was insurance cardholding. The Andersen access and utilisation framework and WHO (2018) quality standards guidelines guided the study. Data were collected using unstructured focus group and interview guides from the community participants, both male and female, who were not below age 18, the legal age of adulthood. Appropriate variables were exhausted until theoretical saturation was reached. Data were analysed manually by coding and categorising the responses to derive the themes. Results It was observed that ethnic minority cardholders who bear insurance cards have better access to health services than none cardholders. The constraints to their effective use are inadequate and sometimes lack of medicine supply by the health facilities, low coverage of services given the low premiums they pay, poor communication by medical staff, stigmatisation and poor attitude of medical staff, among others. The conceptual framework has largely been justified. Conclusions Ethnic minorities generally face problems in accessing healthcare. Efforts must be made to facilitate their accessing national health insurance facility to improve their access. Besides, medical staff must improve their relationship with patients whilst services covered by low premium cardholders should improve.