valentineghanem-bit/ghana-health-insurance-analysis

NHIS Uninsurance and Health Equity - Spatial ML Analysis Ghana 261 Districts # NHIS Uninsurance & Health Equity — Ghana 261 Districts **Author:** Valentine Golden Ghanem | Ghana COCOBOD Cocoa Clinic, Accra, Ghana **ORCID:** 0009-0002-8332-0220 **Affiliation:** Ghana COCOBOD Cocoa Clinic, Accra, Ghana **Reporting standard:** STROBE · RECORD-Spatial · TRIPOD+AI **Date:** 2026 **Status:** Manuscript in preparation ## 1. Abstract Ghana's National Health Insurance Scheme (NHIS), established in 2003, aims for universal health coverage but faces a persistent "subscription paradox" driven by poverty, geographic remoteness, and low literacy. This ecological study analyses all 261 districts using 2021 Population and Housing Census data integrated with NHIS administrative registers. Spatial econometrics (Global Moran's I = 0.54, p **Tip:** The dashboard works fully offline once downloaded. The poster is print-ready at A0 (841 × 1189 mm). ## 9. Reporting Standard This study follows the **STROBE** reporting guideline for observational ecological studies. Machine learning components follow **TRIPOD+AI**; spatial statistical components follow **RECORD-Spatial**. ## 10. Ethical Statement All data are publicly available secondary administrative and census sources. No individual-level data were collected or processed. All analyses operate at district-level aggregates. Standard institutional research ethics principles for secondary data analysis apply. ## 11. Citation **APA:** Ghanem, V. G. (2026). *NHIS Uninsurance & Health Equity — Ghana 261 Districts.* GitHub. github.com **BibTeX:** ```bibtex @misc{ghanem2026nhis, author = {Ghanem, Valentine Golden}, title = {NHIS Uninsurance \& Health Equity --- Ghana 261 Districts}, year = {2026}, url = {github.com } ``` A machine-readable citation is provided in `CITATION.cff`. ## 12. License Code is released under the **MIT License** — see LICENSE for details. Outputs and figure …