Ghana’s Health Insurance, financial backbone to health delivery

patience Gbeze, GNA

Accra, Sept. 6, GNA – Mr Kwaku Agyemang-Manu,
the Minister of Health, says the National Health Insurance Scheme (NHIS) is the
financial backbone of the country’s health delivery system, which engages more
than 4000 public and private healthcare providers.

He said the NHIS accounted for about 85 per
cent of the Internally Generated Funds (IGF) of the Scheme and Ghana recognised
health financing as the third arm of Universal Health Coverage beyond access
and quality care.

He said it was not surprising that Ghana was
often considered an example of global “good practice” and was amongst only a
handful of emerging countries in Africa to actively start implementing
universal health insurance coverage by providing formal coverage to its
vulnerable population.

Mr Agyemang-Manu said this at the 68th Session
of the World Health Organisation Regional Committee for Africa, held in Dakar,
Senegal from August 27 to 31, 2018.

He spoke on the topic: “Sustainability
Financing for Universal Health Coverage in Africa in the Midst of Changing
Global and Local Economic Factors,” a statement issued to the Ghana News Agency

“In the past 15 years, Ghana has made
substantial progress in its quest to attain Universal Health Coverage. Active
membership of the Scheme has increased form 1.3 million in 2005 to almost 11
million in 2018, representing 38 per cent of Ghana’s population.

“Over the years, many countries in Africa and
beyond continue to visit the National Health Insurance Authority to understudy
its operations for possible replications in their respective countries,” he

The Minister said despite the progress made
over the years, the Scheme was confronted with sustainability challenges, which
Ghana believed Member States could learn from.

Key among the challenges, he said, were high
utilization rate by members; fraud and abuse of the system by some credentialed
service providers resulting in high claim costs; premiums not actuarially
determined; administrative and operational inefficiencies, and clearly defined
benefit packages.

Mr Agyemang-Manu said year-on-year the Scheme
had been confronted with funding gaps leading to about five per cent of claims
payments running into arrears.

He said to address the aforementioned
sustainability challenges, measures were being implemented including the
financing model to secure additional inflows; operational efficiency; re-structuring
of the entire NHIA; reviewing of NHIS benefit package, and full automation of
claims processing to minimise fraud and abuse.

The rests are strengthening of Quality
Assurance and Internal Audit functions; amendment of the NHIA Law to make crime
against it more punitive and obtaining of prosecutorial powers from the
Attorney-General to prosecute service providers who abuse the system.

The Minister said Ghana believed that the
health insurance reform should be accompanied with a comprehensive health
systems reform.

“In this regard, my delegation particularly
endorses the Framework of actions for Strengthening Health Systems for
Universal Health Coverage and SDGs in Africa, which encourages innovative means
to raise funds.

“We welcome all the actions proposed by the
team. Additionally, we encourage the setting up of health technology assessment
agencies in Member States. They would conduct cost effective analysis and
Budget Impact Analysis before interventions are accepted in the areas of
medical devices, vaccines, pharmaceuticals,” he added.

The debate around Universal Health Coverage
dates from a World Health Assembly Resolution of 2005 that stated that
“everyone should be able to have access to health services and not be subjected
to financial hardship in doing so”.

Since then the influential 2010 World Health
Report was dedicated to Universal Health Coverage and several conferences
around the globe were organised around this theme.


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