Background: Over the preceding few years, the rate of individuals that have been living without health insurance has continued to increase exponentially. This paper the aim was on investigating the factors determining the demand for health insurance among migrants Botswana. Methods: A cross sectional study conducted between August 2013 to January 2014 in Gaborone and Francistown. Descriptive statistics and multivariate logistic regression analysis were used to describe the characteristics of the sample and to identify factors associated with participation in the health insurance. Results: The likelihood ratio chi-square of 42.09 with a p-value of 0.0000 indicated model as a whole fits significantly better than an empty model. We can say that for a one unit increase in employment category level, the odds in favour of owning insurance increases by a factor of 0.31. Conclusions: The results from the study revealed that gender of an individual was significant in determining the health insurance ownership among tuberculosis patients. A possible policy solution that would make health insurance compulsory would help to increase the demand for medical aid scheme.

Background: Ghana's pursuance of extensive reforms of her health care system to improve access, increase efficiency and ensure quality dates back to the colonial era. The recent attempt made to achieve this is the introduction of National Health Insurance Scheme (NHIS) which has resulted in the increase of health care utilization. The aim of this study is to find out how this increase has affected client's perception of quality of health care delivery in Ghana under the NHIS.
Method: A cross-sectional survey was used to assess client perception of quality under the NHIS. In a bid to gather information on fresh client experience at the hospital, exit interview was conducted using structured questionnaire. Moreover, at the point of service delivery, observation was utilized to collect data on customer and service provider interaction.
Results: Albeit the service delivery fall short of the Ministry of Health (MoH) quality standards, most of the patients were satisfied. Regarding health facilities, clients need to be educated on their entitlement especially by health insurance schemes, on what they are entitled to whenever they visit health facilities.
Conclusion: Generally, the introduction of the NHIS has resulted in increased level of utilization of health services utilization, however this has not been reflected in the quality of service delivery. Since the patients are not aware of their entitlements, they are unable to harvest the maximal benefits of the services.