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Profitability, turnover, capital, costs, etc. Maximizing profit is an important goal of business, which in turn also indicates the long-term sustainability of the company and the return earned by the shareholders. Financial performance, usually measured by profitability, is determined by various factors which vary with the industry chosen.

Given the importance of analyzing financial performance, an understanding of the factors that contribute to the financial performance can highlight the areas where suitable action can be initiated. In the case of insurance sector, new business premiums, renewal premiums, control on expense ratios, new products focused on value creation, infusion of capital, margins, assets and investments, and macroeconomic conditions have been widely researched among the determinants of profitability. This paper attempts to study a selected set of firm-specific factors that determine the profitability of the life insurance sector in India.

Financial performance and its determinants have been extensively studied for banking sector across countries. To present a few from the vast literature, Berger and Neeley and Wheelock have studied the determinants of US bank's financial performance using different proxies. In developing countries, Barajas et al. An unknown error has occurred. Please click the button below to reload the page. These areas have been cited as important supply-side interventions that could help ensure active stakeholder participation in the NHIS and curtail unprofessional conduct of health providers [ 27 ].

Furthermore, to attain client-centered quality services at the levels of the NHIS and the health care providers, there is the need for strict monitoring and supervision by the national, regional and district NHIA offices. This will not only help identify genuine operational challenges but also detect illegal acts such as illegal charging of fees and other administrative lapses. In addition, even though many papers used triangulated methodologies, the emphasis was on quantitative data.

Albeit large sample sizes were used in many articles, one common weakness was the lack of nationally representative sample sizes. Moreover, none of the studies did a detailed analysis of databases that explored perspectives of the three key stakeholders of the NHIS: client, provider and insurer. Discussions on the roles of the provider, client and insurer towards sustaining the NHIS were largely done in isolation, thus creating a gap that needs to be bridged in future scientific endeavors. Even though many articles examined operational sustainability of the NHIS, not much was discussed on the role of clients and communities in sustaining health insurance operations.

This suggests the need to intensify efforts towards involving clients and community members in quality service monitoring and improvement. Existing platforms such as the Client Call Center instituted by the NHIA presents an opportunity to effectively involve clients in health insurance planning and implementation. Community engagement in NHIS activities is key to promoting client interest and compliance to health insurance policies. Moreover, community engagement in health has been found to enhance client adherence to medication regimen and honoring of clinic appointment dates [ 24 ].

These findings suggest, community involvement in NHIS activities will not only create awareness on new policies but also promote stakeholder support and goodwill for the insurance scheme. The current review is limited by the type of literature retrieved for review. First, the literature sources were all searched in the English language.

It is possible relevant literature published in other languages were left out to the detriment of quality results and discussions. Secondly, due to limited relevant information in the topic area, grey literature was reviewed to complement findings of the peer reviewed articles. This might have inadvertently introduced reporting bias by the authors. Even though quality checks were done through credible websites and validation of findings by expert reviewers, reported information on grey literature could still be bias.

Finally, the review is largely limited to the NHIS in Ghana and would be most appropriate in discussions pertaining to the Ghanaian context. Nonetheless, lessons could be drawn from the peculiar case of Ghana by other African countries which are at various stages of health insurance implementation. Future reviewers should extent their scope and do comparative reviews of health insurance sustainability in more than one African country. This paper reviewed relevant literature on sustainability challenges of the NHIS and suggested interventions to avert a collapse of the scheme.

Reviewed articles generally acknowledged some sustainability threats confronting the scheme. Discussions in this paper are not exhaustive, instead the debate has been initiated on the need to prioritize client-centered quality service approach i. It is expected that complementing existing efforts with these strategies will contribute towards increasing confidence in the NHIS to promote membership participation and retention.

Tobias Rinke de Wit, and Dr. Nicole Spieker. National Center for Biotechnology Information , U.

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PLoS One. Published online Nov Jonathan A Coles, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interests exist.

Article excerpt

Funding acquisition: DKA. Investigation: RKA. Methodology: RKA. Project administration: DKA. Resources: RKA. Software: RKA. Supervision: DKA. Writing — original draft: RKA. Received Apr 20; Accepted Oct 9. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

This article has been cited by other articles in PMC. Abstract Background The introduction of the national health insurance scheme NHIS in Ghana in significantly contributed to improved health services utilization and health outcomes.

Another Insurer to Cease Selling Life Insurance to Individuals - WSJ

Methods Electronic search was done for literature published between — on the NHIS and its sustainability in Ghana. Results Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement.

Conclusions The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Introduction Universal access to good quality health care remains a major concern of health systems globally. Table 1 Overview of Ghana and its health care system. Open in a separate window. Study selection process and exclusion criteria The search did not include literature on health insurance in developed countries.

Review process and literature selection The reviewers first assessed grey literature on the NHIS to inform the development of the review background. Extraction and analysis Data extraction was done using an Excel spreadsheet and analysis done in the narrative form since the retrieved literature is a mixture of peer reviewed articles and grey literature. Results Following the electronic search using relevant search engines, a total of 4, publications including grey literature were found on health insurance in Ghana and Africa.

Fig 1. Grey and peer reviewed articles date between and Fig 2.

Life insurance company efficiency: best method and proxies

Limitations The current review is limited by the type of literature retrieved for review. Conclusions This paper reviewed relevant literature on sustainability challenges of the NHIS and suggested interventions to avert a collapse of the scheme. DOC Click here for additional data file. Data Availability All data supporting our findings are contained in the manuscript and there are no restrictions to data sources. References 1. World Bank. ZS on 19th June, Ministry of Health MOH. Wholistic assessment of the health sector programme of work. Accra, Ghana. Health Systems Publications: Abuja Declaration.

Community health insurance in Sub-Saharan Africa: what operational difficulties hamper its successful development , Tropical Medicine and International Health , 14 5 — Arhinful D. The solidarity of self-interest: social and cultural feasibility of rural health insurance in Ghana. In Research report African Studies Center, Leiden, Netherlands. Agyepong IA, and Adjei S. Public social policy development and implementation: a case study of the Ghana National Health Insurance scheme , Health Policy and Planning , 23 2 — Providing free maternal health care: ten lessons from an evaluation of the national delivery exemption policy in Ghana , Global Health Action , 2 10 :1—13 [ PMC free article ] [ PubMed ] [ Google Scholar ].

Les B. Spencer L. About the seminar: The I. VW research seminar gives PhD students the opportunity to present and discuss their research with international guests and the I.

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