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Background: Enrolment of informal sector workers in Ghana's National Health Insurance Scheme (NHIS) is critical to achieving increased risk-pooling and attainment of Universal Health Coverage. However, the NHIS has struggled over the years to improve enrolment of this subpopulation. This study analysed effect of social capital on enrolment of informal sector workers in the NHIS. Methods: A cross-sectional survey was conducted among 528 members of hairdressers and beauticians, farmers, and commercial road transport drivers' groups. Descriptive statistics, principal component analysis, and multinomial logit regression model were used to analyse the data. Results: Social capital including membership in occupational group, trust, and collective action were significantly associated with enrolment in the NHIS, overall. Other factors such as household size, education, ethnicity, and usual source of health care were, however, correlated with both enrolment and dropout. Notwithstanding these factors, the chance of enrolling in the NHIS and staying active was 44.6% higher for the hairdressers and beauticians; the probability of dropping out of the scheme was 62.9% higher for the farmers; and the chance of never enrolling in the scheme was 22.3% higher for the commercial road transport drivers. Conclusions: Social capital particularly collective action and predominantly female occupational groups are key determinants of informal sector workers' participation in the NHIS. Policy interventions to improve enrolment of this subpopulation should consider group enrolment, targeting female dominated informal sector occupational groups. Further studies should consider inclusion of mediating and moderating variables to provide a clearer picture of the relationship between occupational group social capital and enrolment in health insurance schemes. [ABSTRACT FROM AUTHOR]

Background: Ghana introduced a mobile phone-based contribution payment system in its national health insurance scheme (NHIS) in December 2018 to improve the process of enrolment. We evaluated the effect of this digital health intervention on retention of coverage in the Scheme, one year after its implementation. Methods: We used NHIS enrolment data for the period, 1 December 2018–31 December 2019. Descriptive statistics and propensity-score matching method were performed to examine a sample of 57,993 members' data. Results: Proportion of members who renewed their membership in the NHIS via the mobile phone-based contribution payment system increased from 0% to 8.5% whilst those who did so through the office-based system only grew from 4.7% to 6.4% over the study period. The chance of renewing membership was higher by 17.4 percentage points for users of the mobile phone-based contribution payment system, compared to those who used the office-based contribution payment system. The effect was greater for the informal sector workers, males and the unmarried. Conclusions: The mobile phone-based health insurance renewal system is improving coverage in the NHIS particularly for members who hitherto were less likely to renew their membership. Policy makers need to devise an innovative way for new members and all member categories to enrol using this payment system to accelerate progress towards attainment of universal health coverage. Further study needs to be conducted using mixed-method design with inclusion of more variables. [ABSTRACT FROM AUTHOR]

The question of how much of the potential tax revenue is actually obtained remains very critical in Ghana's efforts to improve domestic revenue mobilization. This paper computes and examines tax gap and compliance burden among micro and small businesses which constitute more than 90% of Ghana's informal economy. Using data on 485 businesses in Ghana, the study finds that while some businesses underpay their taxes, surprisingly others actually pay more than expected. The average tax gap is computed to be about GHC 109.2 (US$19.2). Small businesses are associated with a higher tax gap of 24.9% compared to their micro counterparts. Moreover, we find that as compliance burden increases, the tax gap also increases, albeit significant variation in the effect of compliance burden on tax gap across regions and different tax handles. JEL Classification: H25, H26, H27, H32 [ABSTRACT FROM AUTHOR]

Background: Maternity leave policies are designed to protect gender equality and the health of mothers in the workforce and their children. However, maternity leave schemes are often linked to jobs in the formal sector economy. In low- and middle-income countries a large share of women work in the informal sector, and are not eligible to such benefit. This is worrisome from a social justice and a policy perspective and suggests the need for intervening. Costing the implementation of potential interventions is needed for facilitating informed decisions by policy makers. Methods: We developed and applied a costing methodology to assess the cost of a maternity leave cash transfer to be operated in the informal sector of the economy in Brazil and Ghana, two countries with very different employment structures and socioeconomic contexts. We conducted sensitivity analysis by modeling different numbers of weeks covered. Results: In Brazil, the cost of the maternity cash transfer would be between 0.004% and 0.02% of the GDP, while in Ghana it would range between 0.076% and 0.28% of the GDP. The relative cost of rolling out a maternity intervention in Brazil is between 2.2 to 3.2 times the cost in Ghana depending on the benchmark used to assess the welfare measure. The differences in costs between countries was related to differences in labor market structure as well as demographic characteristics. Conclusions: Findings show how a standard methodology that relies on routinely available information is feasible and could assist policymakers in estimating the costs of supporting a maternity cash transfer for women employed in the informal sector, such intervention is expected to contribute to social justice, gender equity, and health trajectories. [ABSTRACT FROM AUTHOR]

Informal electronic waste (e-waste) recycling plays a significant role in e-waste management in developing countries, such as Ghana, where over 90% is handled by the informal sector. However, the informal treatment of e-waste poses a risk to human health and the environment due to the release of toxic pollutants. There is a lack of data on e-waste management and informal processing, and the material flows of output fractions and the fate of hazardous fractions are largely unknown. This hinders the development of appropriate management strategies. Herein, Material Flow Analysis (MFA) was used to investigate five important informal e-waste recycling processes, and risk analysis was used to evaluate environmental, economic, and health safety. On average of all assessed processes, 40.3% of the emerging fractions are landfilled or burned whereof the processing of ICT appliances (desktop PC, laptops and phones) (P1) contributes with 19.4%, CRT appliances (P2) with 11.7%, compressors from cooling appliances (P3) with 0.1%, microwaves (P4) with 1.3% and printers (P5) with 7.7 % to the landfilled or burned fractions. The risk assessment showed that there are considerable risks in environmental, economic and health safety for all processes. When considering the overall risk assessment across all categories, the priority for action to have the most substantial impact is as follows: P2>P5>P3>P1>P4. The key findings of this research focus on the assessment of the so far not known informal e-waste process workflows, the identification of emerging fractions, the remain of potentially hazardous fractions and the identification of the primary economic drivers in informal e-waste dismantling. Recommended action areas involve the incorporation of the informal sector, guided by the insights derived from the MFA and risk assessment. The results of this study are of importance for addressing the challenges faced by the informal sector and for making well-informed decisions when strategizing e-waste management infrastructure. [Display omitted] • Material flow analysis of important informal e-waste recycling processes in Ghana. • Mapping of the remain of valuable and hazardous fractions. • Process evaluation and risk analysis for environmental, economic and health safety. • Technical and socio-economic potentials for improvement suggestions derived. • Identification of urgent fields of actions for political decision makers. [ABSTRACT FROM AUTHOR]

This paper examines the determinants of the decision of owners of small enterprises in Ghana to participate in the informal sector at start-up. For enterprises participating in the informal sector, the paper evaluates whether there are linkages with formal sector enterprises, and the determinants of the linkage. Data for the analysis is from the 2013 World Bank Enterprise survey. Using binary choice models, it is evident from the analysis that the informal sector in Ghana is dominated by people who have low levels of education, and hence, do not have otherwise employable skills. Undertaking economic activities in the informal sector becomes a means to survival, and not necessarily an attempt to evade compliance with formal sector regulations. The challenge to policy makers in Ghana is to find the right balance between policies that reduces the costs to enterprises of participating in the informal sector, whiles increasing the benefits for participating in the formal economy. [ABSTRACT FROM AUTHOR]