Health Coverage in a Migration Hub: Comparing Insurance Access Among Immigrants and Ghanaians

As Ghana transitioned into a key destination for international migrants, understanding the health coverage landscape for this growing population is increasingly vital; Particularly in the context of global health crises. Using an explanatory sequential mixed method design, this study investigated disparities in health insurance coverage between 116 immigrants and 116 non-migrants in Ghana. The quantitative result revealed that, only 41.4% of all the respondents were registered with a health insurance scheme in Ghana with a stark gap by migration status: 75% of immigrants had never enrolled, compared to just 7.8% of non-migrants. Among the insured, the National Health Insurance Scheme (NHIS) was the dominant provider (88.5%). Qualitative insights further explain low enrolment among immigrants, citing limited knowledge of NHIS registration procedures, reliance on self-medication, and aversion to Ghana’s paper- and card-based insurance system particularly among digitally oriented migrants accustomed to electronic health platforms. The study identifies these factors as structural and informational barriers that function as disabling conditions within Andersen’s Behavioural Model of Health Services Use. We recommend that Ghana’s National Health Insurance Authority fully transition toward a digital, user-friendly enrolment and verification system and integrate pre-arrival health insurance orientation into visa processing for prospective immigrants. Such reforms could significantly improve equitable access to care in an increasingly mobile society.