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Health insurance has been identified as an effective tool for removing barriers to healthcare utilisation, especially in developing countries. However, many factors such as education,

Health insurance has been identified as an effective tool for removing barriers to healthcare utilisation, especially in developing countries. However, many factors such as education, wealth or income, age, religion, health status and sex can influence individuals decision to enrol or not to enrol onto health insurance. The National Insurance Commission (NIC) of Ghana aims to evaluate health insurance policy subscription among individuals in a typical rural district of the country (Biakoye). The distributions of individuals in all the five communities of the district are as follows: Ahenkro 12,800; Bumbula 3,200; Wurupong 6,400; Appiakrom 3,200 and Ntumda 6,400. You have been contracted to work on this project. The aim of this project is to ascertain the association between religious denominations and health insurance enrolment decisions. a. Choose and describe appropriate sampling technique(s) to be adopted in selecting a representative sample of 24,000 individuals for the study? [5 marks] b. By analyzing the data using Chi Square Test, you obtained the results in the four tables below. Study the results carefully and answer the questions that follow. Table 1: Case Processing Summary Cases Valid Missing Total N Percent N Percent N Percent Health insurance status * religion 23110 100.0% 8 0.0% 23118 100.0% Table 2: Crosstabulation of health insurance status and Religious denomination Religious denomination Health insurance status Insured Uninsured Total No religion Count 561 495 1056 % 53.1% 46.9% 100.0% Orthodox Christians Count 3738 1682 5420 % 69.0% 31.0% 100.0% Pentecostal/charismatic Christians Count 6667 4297 10964 % 60.8% 39.2% 100.0% Islam Count 3493 1164 4657 % 75.0% 25.0% 100.0% African Traditionalist Count 577 436 1013 % 57.0% 43.0% 100.0% Total Count 15036 8074 23110 % 65.1% 34.9% 100.0% Table 3: Chi-Square Tests Value df Asymptotic Significance (2-sided) Pearson Chi-Square 421.649a 4 .000 Likelihood Ratio 428.636 4 .000 Linear-by-Linear Association 27.655 1 .000 N of Valid Cases 23110 a. 0 cells (0.0%) have expected count less than 5. The minimum expected count is 353.91. Table 4: Symmetric Measures Value Approximate Significance Nominal by Nominal Phi .135 .000 Cramer's V .135 .000 N of Valid Cases 23110 i. Determine the total sample size used for the test and calculate the response rate [2 marks] ii. Determine the proportion of Orthodox Christians that got insured. [2 marks] iii. State any two requirements for using chi-square test [2 marks] iv. State appropriate hypotheses for the study. [3 marks] v. What is the value of the chi-square test statistic? [1 mark] vi. From the chi-square test performed, what decision and conclusion can you make regarding religious denominations and health insurance status (using a level of significance of 5%)? [5 marks]

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