NHIS capitation goes to Upper West in May

The National Health Insurance Authority (NHIA) is to roll out the health insurance capitation in the Upper West Region in May this year. According information released by Ghana news agency, capitation is one of the main payment systems under the National Health Insurance Scheme (NHIS) which seeks to replace the fee for service system.

Currently SEND-Ghana is collaborating with the NHIA to embark on a regional level sensitization with the ultimate aim of reaching out to majority of the populace.

Participants at the program were drawn from the health sector, civil society organizations, women groups, persons’ with disabilities, hair dressers, tailors and dressmakers associations and the Commission on Human Rights and Administrative Justice (CHRAJ), as well as the National Commission for Civic Education (NCCE) and the media among others.

Mr. Adamu Mukaila, Program Officer of SEND-Ghana addressing the participants noted that one of the most debated initiatives ever taken by the NHIA was its decision to pilot the capitation in the Ashanti Region.

He said people resisted the idea of piloting the capitation system in the Region and that it was clear beyond doubts that the late involvement of stakeholders in the implementation of the capitation fuelled the controversy and misunderstanding between service providers and the scheme.

“This definitely ought not to repeat itself as the authority aims at implementing the initiative throughout the country within a period of time,” he said.

Mr. Mukaila gave the assurance that SEND-Ghana would continue to collaborate with the NHIA to sensitize people of the Region for a successful implementation of the capitation payment system.

He charged the media to play its role in ensuring that the information was successfully disseminated to reach majority of the people including those at the hinterland.

Elyas Salifu, NHIA Monitoring and Evaluation Officer in a presentation explained that capitation was a payment method in which a predetermined fixed rate is paid in advance to providers to provide a defined set of services for each individual enrolled with the provider for a fixed period of time.

He said the objective was to introduce managed competition for providers and choice for providers to increase the responsiveness and quality of the health system and also improve efficiency and effectiveness through more rational resource use among others.

The Monitoring and Evaluation Officer mentioned simplified claims processing, improve cost containment, share financial risk, foster closer provider-patient relationship and address difficulties in forecasting and budgeting, as some of the merits of the implementation of the capitation.

Mr. Elyas also listed under-provided services leading to reduce quality of care, unnecessary referral to other providers, reduction in otherwise essential diagnostic tests and attempt to enroll healthier individuals as some of the potential challenges that were likely to affect the implementation of the capitation.

Mr. Issahaku Nuhu Putiaha, the Wa Municipal Chief Executive (MCE), said the implementation of the capitation would help prevent medical shopping leading to cost containment.

He called for proper monitoring of providers to prevent them from cheating clients and also for them not to register only healthier people at the detriment of people with chronic sicknesses.

The MCE welcomed the regional level sensitization and emphasized that the sensitization be replicated at the district and community levels to ensure proper public understanding of the capitation system.

Mr. Alasidongor Baluri, Chief Executive Officer of People’s Action to Win Life All-round (PAWLA) and Chairman of the Participatory Monitoring and Evaluation, pledged the support of the Coalition of non-governmental organizations in helping SEND-Ghana to implement its programs in the Region.

He said as a network, it was their duty to sensitize the public on policies before they were implemented and that they intended to adopt a trilateral approach including direct spread of information at the field, partner the NHIA at the district level to implement and monitor the program and try to raise support for the very poor in society to register with the NHIS.

Source Alhaji Alhasan Abdulai
Executive Director
P.O.BOX 17070AN 233244370345/23326370345/ 233208844791

[email protected] /[email protected]

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