世界银行-加纳社会保障项目支出和家庭福利（英）-2023-139页_4mb

Summary of Social Protection Program Spending and Household Welfare in Ghana

Core Content

This study evaluates the performance of Ghana's main social protection programs in terms of spending, coverage, incidence, and effectiveness in reducing poverty and inequality. It is based on government administrative data and recent national household survey data (GLSS 2016–17).

Main Social Protection Programs

1. Livelihood Empowerment Against Poverty (LEAP) Program

• Target Group: Households with individuals in vulnerable groups (orphans, elderly, pregnant women, mothers of infants, and persons with disabilities) and low proxy means test (PMT) scores in high-poverty areas.
• Financing: Jointly funded by the government and donors.
• Coverage:
  • Covers 1.5% of Ghanaians and 6.7% of the extreme-poor population nationally.
  • Increases to 22.7% of the overall population and 27.8% of the extreme-poor population in LEAP areas.
  • When accounting for underreporting (LEAP+ households), coverage rises to 4.1% of all Ghanaians and 17.9% of the extreme-poor population.
• Effectiveness:
  • Benefits are concentrated among the poor (concentration coefficient = -0.53).
  • Has modest poverty-reducing effects, though overall impact is limited due to low spending.

2. Labor-Intensive Public Works (LIPW) Program

• Target Group: Rural areas during agricultural off-seasons, targeting the poorest individuals through geographic, self-selection, and community-based criteria.
• Financing: Fully funded by donors.
• Coverage:
  • Covers 3.5% of the population in LIPW areas.
  • In 2019, the program was inactive.
• Effectiveness:
  • Limited coverage and relatively low spending.
  • Benefits are more concentrated in poor areas than in general.

3. Ghana School Feeding Programme (GSFP)

• Target Group: Preprimary and primary school students in high-poverty areas.
• Financing: Funded through general government revenues.
• Coverage:
  • Covers 6% of the national population (administrative data), 10% of the extreme-poor population (survey data).
  • Among targeted students, coverage is 61% overall and 64% for the extreme-poor population.
• Effectiveness:
  • Has a moderate impact on reducing poverty and inequality.
  • Benefits are more concentrated in poor areas than in general.

4. National Health Insurance Scheme (NHIS)

• Target Group: Universal coverage, though in practice, coverage has ranged between 30% and 40% of the population over the past decade.
• Financing:
  • Funded primarily through a 2.5% National Health Insurance Levy on value-added tax (VAT).
  • Additional funding from SSNIT and other members' premia and fees.
• Coverage:
  • Covers 5.2% of those aged 60 or older (survey data).
  • Not targeted at the poor, and registration or renewal costs are a major barrier to participation.
• Effectiveness:
  • NHIS benefits are more concentrated among the poor (concentration coefficient = 0.19), though not as much as LEAP.
  • A major challenge is the slow payment of health care providers, which undermines the scheme's effectiveness.

5. Social Security and National Insurance Trust (SSNIT) Pension Scheme

• Target Group: Formal sector workers and their survivors, with limited coverage of the poor.
• Financing: Funded by contributions from members and their employers.
• Coverage:
  • Covers 0.4% to 0.7% of the national population (administrative data).
  • Covers 5.2% of those aged 60 or older (survey data).
• Effectiveness:
  • Benefits are highly concentrated among the poor (concentration coefficient = 0.53).
  • Despite low coverage of the poor, the average benefit level is high (60.3% of household consumption).
  • The program is not well-targeted to the poor, as it is limited to formal sector workers.

Key Findings

• Overall Spending:

  • Social protection spending in Ghana is relatively low, accounting for about 1.4% of GDP.
  • Social assistance spending is even lower, at 0.2% of GDP, far below international averages.
  • Total social protection spending in 2019 was GH$4.5 billion, with SSNIT pensions (65%), NHIS (22%), GSFP (10%), and LEAP (3%) being the largest contributors.

• Coverage and Targeting:

  • Most programs are well-targeted to the poor, with LEAP and GSFP being the most effective.
  • NHIS is intended to be universal but has limited coverage and is not well-targeted to the poor.
  • SSNIT pensions are not targeted at the poor, as they are limited to formal sector workers.

• Effectiveness in Reducing Poverty and Inequality:

  • The LEAP and GSFP programs have a significant impact on reducing poverty and inequality.
  • NHIS benefits are more concentrated among the poor than general household consumption, but its effectiveness is hampered by payment delays.
  • SSNIT pensions, while highly concentrated in terms of benefits, do not reach the poor due to limited access.

• Impact of Shocks:

  • Social assistance programs are more likely to be used by households exposed to adverse shocks, particularly weather-related shocks.
  • LEAP and LIPW programs are more responsive to drought and flood risks in certain districts.

• Program Performance and Recommendations:

  • The current level of social assistance spending is too low to have a substantial impact on poverty and inequality.
  • Expanding coverage and increasing benefit levels could improve program effectiveness.
  • However, the macroeconomic and fiscal situation makes such changes challenging.
  • The slow payment of health care providers under NHIS is a critical issue that needs to be addressed.

Conclusion

Ghana's social protection programs have made some progress in reducing poverty and inequality, but their overall impact is limited due to low spending and imperfect targeting. The LEAP and GSFP programs are the most effective in reaching the poor, while NHIS and SSNIT pensions face challenges in coverage and implementation. The study recommends increasing program spending and improving targeting mechanisms to enhance the effectiveness of social protection in Ghana.