Improving health insurance coverage in ghana research explorer. May 29, 2017 we explored the motivational factors as well as the barriers to health insurance subscription in the cape coast metropolis of ghana. The scheme therefore focuses heavily on meeting the needs of the poor and providing social health protection based on the principles. Ghana began the implementation of a national health insurance scheme nhis in 2004 as a way to ensure equitable access to basic healthcare for all residents. However, stagnating active membership, reports of poor quality health care rendered. Plenary session 2 towards innovative healthcare financing experiences from the world. Ismail osei, has declared zero tolerance for false entries as claims for reimbursement. Social capital and ghanas national health insurance. Highlighting the financial sustainability challenges in a policy brief produced by coprincipal investigators of the project, robert kaba alhassan, edward nketiahamponsah, stephen duku. A number of countries are currently experimenting with different approaches.
After a decade of its implementation, national coverage is just about 34% of the national. Field representatives interviewers manual, nhis 1985 pdf icon pdf 21. Ghana national health insurance scheme open knowledge. The nhis is a social intervention program intended to provide financial risk protection against out of pocket healthcare expenditure for residents in ghana. Act 852 to regulate private health insurance schemes phis in ghana. Ghanas national health insurance scheme nhis was passed into law in 2003 but fully. Making safe motherhood a reality, recommended among others that to successfully enrol majority of the core poor and vulnerable groups on the nhis, there is the need to strengthen institutional collaboration between the nhis and the department of. Sep 08, 2017 health financing systems are a major factor challenging the provision of equitable and quality health care in ghana. Ghanas national health insurance scheme nhis is an innovative attempt to. This study collected qualitative data from 30 purposively selected subscribers and nonsubscribers to the national health insurance scheme using an indepth interview guide. Aug 30, 2016 the ghana national health insurance scheme nhis in 2003, the government of ghana established the national health insurance scheme through an act of parliament act 650, revised to act 852 in 2012 to provide financial risk protection against the cost of basic health care for all residents in ghana.
So, a warm happy birthday to the ghana nhis is amply deserved. The national health insurance scheme in ghana is deemed as one of the legacies of the john kufuor administration. Plenary session 1 ghanas journey to universal health coverage. June 2012 volume 46, number 2 ghana medical journal 76 the effect of ghanas national health insurance scheme on health care utilisation n. Pdf does the operations of the national health insurance scheme. In december 2004, ghana established a national health insurance scheme nhis 1 to enhance the performance of its health system, paying particular attention to the poor. Despite universal population coverage and equity being a stated policy goal of its nhis, over a decade since passage of the first law in 2003, ghana continues to struggle with how to attain it. Refusal to enrol in ghanas national health insurance scheme.
Ghana national health insurance scheme nhis was established in 2003 as a major vehicle to achieve the countrys commitment of universal health coverage. There is considerable interest at present in exploring the potential of social health insurance to increase access to and affordability of health care in africa. Does the operations of the national health insurance scheme. The national health insurance scheme is a form of national health insurance established by the government of ghana, with a goal to provide equitable access and financial coverage for basic health care services to ghanaian citizens. Prescribed drugs, pharmaceutical care and diagnostic tests as contained in the nhis drugs list and nhis diagnostic test lists. The acting director of quality assurance qa at the national health insurance authority nhia, mr. After a decade of its implementation, national coverage is. Jan 17, 2015 access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households. The national health insurance scheme nhis in ghana was established by the national health insurance act, 2003 act 650 and national health insurance regulations, 2004 l.
Nhis ghana overview reforms achievements version 3 free download as powerpoint presentation. Aug 28, 2009 there is considerable interest at present in exploring the potential of social health insurance to increase access to and affordability of health care in africa. Tettey also told the press that any other nhis card registrant who is found apart from the list which was presented by the supreme court will also be deleted. June 2012 volume 46, number 2 ghana medical journal the. Ghana s national health insurance scheme nhis was passed into law in 2003 but fully implemented from late 2005. The state of enrollment on the national health insurance scheme in. In performing its regulatory functions the authority registers, licenses and supervises the operations of phis in ghana. The total number of inpatient and outpatient visits to health facilities rose. Ghanas health care system was founded on the basis of the free health. The predominantly about 70 % tax funded nhis currently has active enrolment hovering around 40 % of the population. The nhis is a social intervention program intended to provide financial risk protection against out of pocket healthcare expenditure for. Since the establishment of ghana national health insurance scheme nhis in 2003, the government of ghana has made substantial progress toward its goal of universal health care. Seeking the mandate of the people in the 2000 elections.
Until the nhis was introduced in 2003, the country had over time implemented a number of financing reforms. Nationalsocial health insurance schemes have increasingly been seen in many low and middleincome countries lmics as a vehicle to universal health coverage uhc and a viable alternative funding mechanism for. However, currently, majority of the schemes subscribers are individuals in the upper wealth quintile, as the poor in society rather have not subscribed. This study explored indepth enablers and barriers to. Maternity antenatal, delivery and postnatal care for four pregnancies ending in. Ghana is among the first countries in subsaharan africa to begin implementation of a national health insurance scheme nhis. The government is to replace the existing cash and carry health financing system with a national health insurance scheme.
Sep 21, 2016 the ghana nhis law act 852 and the preceding act 650 all define out of pocket premium exempt categories. A case study of claims management in two districts article pdf available in ghana medical journal 464. The scheme, which guarantees health care that is free for most. Challenges to the scaleup of the nigerian national health. A simple pdf merger were you can add pdf s, sort them and merge them into one file. The universal in uhc and ghanas national health insurance. Barriers and motivations for health insurance subscription in. The law established two 2 types of private health insurance schemes. Is the propoor premium exemption policy of ghanas nhis. Pdf client power and access to quality health care. Health financing systems are a major factor challenging the provision of equitable and quality health care in ghana. Ghanas national health insurance scheme nhis was passed into law in 2003 but fully implemented from late 2005.
The government has earmarked valueadded tax to finance nhis in addition to deduction from social security trust ssnit and premium payment. If youre new to stata we highly recommend reading the articles in order. To analysethe effect of the introduction of national health insurance scheme on funding in ghana. Challenges in provider payment under the ghana national health insurance scheme. Under the act that established the national health insurance scheme nhis, persons 70 years of age or above are automatically enrolled in the scheme and therefore can access health services free at the point of use. Nimo1 1department of community health, university of ghana medical school, college of health sciences, korle. This study examined the challenges in the implementation and scaleup of the national health insurance scheme nhis in nigeria. Full list of deleted nhis registrants modern ghana. Towards a sustainable health care financing in ghana. As part of rejuvenated efforts at pursuing sustainable health care financing options that promote universal coverage, ghana has adopted a national health insurance scheme nhis to provide financial access and universal coverage for health care, which is key in promotive, preventive, curative and rehabilitative health interventions for all at an affordable cost. Get detailed views of sql server performance, anomaly detection powered by machine learning, historic information that lets you go back in time, regardless if its a physical server, virtualized, or in the cloud. The effect of the national health insurance scheme nhis on. Executive summary the national health insurance scheme nhis, initially introduced in ghana as an alternative to direct outofpocket oop financing to improve access, faces considerable challenges, not least its financial sustainability. The national health interview survey nhis is the principal source of information on the health of the civilian noninstitutionalized population of the united states and is one of the major data collection programs of the national center for health statistics nchs which is part of the centers for disease control and prevention cdc.
The ghana national health insurance scheme nhis in 2003, the government of ghana established the national health insurance scheme through an act of parliament act 650, revised to act 852 in 2012 to provide financial risk protection against the cost of basic health care for all residents in ghana. Acheampong worked for leading health insurance and. Notice to data users having problems downloading datasets. Barriers and motivations for health insurance subscription. The politicoeconomic challenges of ghanas national.
Pdf ghanas social health insurance scheme, introduced in 2003, aims to. Does the operations of the national health insurance scheme nhis in ghana align with the goals of primary health care. Pdf challenges in provider payment under the ghana. The commission has also promised to delete names of other nhis registrants whose names were not captured on the list of 56,000 presented to the supreme court. Addaekorankye management and public administration department central university college, accra, ghana abstract the study examined the challenges of financing health care in ghana.
Downloadable documents national health insurance scheme. The effect of ghanas national health insurance scheme on. Ghanas national health insurance scheme nhis was created by the national health insurance act of august 2003, and is one of very few attempts by a subsaharan african country to implement a nationallevel, universal health insurance program. Nhis membership on the increase send ghana ghana business. These include children under 18, the elderly defined as those over 70, persons with mental disorders, pregnant women and the indigent too poor to pay. Provide estimates to inform the development of the health care financing strategy and the hsmtdp ii 20142016. The introduction of the national health insurance scheme nhis in ghana in 2003 significantly contributed to improved health services utilization and health outcomes. Pdf the implementation of the national health insurance.
When it comes to social insurance provision in ghana, the national health insurance scheme nhis is the jewel in the crown. The politicoeconomic challenges of ghanas national health. June 2012 volume 46, number 2 ghana medical journal. Nhis data, questionnaires and related documentation.
Maternity antenatal, delivery and postnatal care for four pregnancies ending in live births under the nhis. Prior to implementation of the nhis in ghana, the health financing. Access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households. Pdf challenges in provider payment under the ghana national. While a good share of problems and challenges exist, ghanas experience has a lot to offer to other countries still struggling to find a path towards universal health coverage. We designed this descriptive crosssectional study to investigate the knowledge and opinions of 150 randomly selected adults in urban kano regarding the nhis. Refusal to enrol in ghanas national health insurance. Given the immutable benefits of social health insurance in this pursuit. Download free pdf merger and splitter simple for free. Pursuing universal health care in a developing economy like ghana is a bold, laudable idea. Because the current cash and carry system, which makes it compulsory for everybody to. For a list of topics covered by this series, see the introduction. Seven years into its implementation the ghana national health insurance scheme nhis has made significant progress in transitioning to universal coverage, but faces significant fiscal and coverage challenges.
Mar 02, 2016 the study, initiated by send ghana social enterprise development foundation on the theme. The national health insurance scheme nhis is a body corporate established under act 35 of 1999 constitution by the federal government of nigeria to improve the health of all nigerians at an affordable cost. Electronic search was done for literature published between 20032016 on the nhis and its sustainability in ghana. Nhis ghana overview reforms achievements version 3. The effect of the national health insurance scheme nhis.
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