current state of nhis in ghana

The law makes it compulsory for all Ghanaians to join a health insurance scheme in Ghana. The membership of NHIS was categorized into the formal sector, informal sector and the exempt groups. The Kassenas constituted 51.5% of the sampled population and the Nankanis, 44.2%. 2010;15:191–7. Among members who have never joined the scheme, the Nankanis (43.9%), traditional worshippers (41.2%), those of the poorest households (37.9%), without formal education (35.6%) and males (33.9%) were in the majority. Consultation including reviews.These include both general and specialist... Antenatal Care,Deliveries;normal,assisted, Refraction,Visual Fields,A-Scan,Keratometry. Top five barriers to NHIS registration by wealth quintiles. Ghana Current Status. Yet, cost of premium was the main barrier to NHIS registration (92.6%) and non-renewal (78.8%), with members of the lowest SES being worst affected. Int J Equity Health. NHIA. Who is eligible to complete an Application Form? For the purposes of our analysis, we excluded 16,730 individuals from 1599 sampled households whose NHIS cards could not be verified. In the 14th century, the country was inhabited by different ethnic groups: on the coast line the mighty Denkyira Kingdom, in the centre and in the north the Akan tribe. Agyepong IA, Adjei S. Public social policy development and implementation: a case study of the Ghana National Health Insurance scheme. Statistical point estimates were computed and presented as means, proportions or percentages for the background characteristics and NHIS membership. Although the National Health Insurance Scheme (NHIS) of Ghana was designed to promote universal health coverage, OOPEs as a proportion of total health expenditures remains elevated at 26%, exceeding the WHO's recommendations of less than 15-20%. The Ghana National Health Insurance Scheme (NHIS) In 2003, the government of Ghana established the. Article  They are mostly farmers, artisans and traders. The exempt (poor) recorded the lowest membership of 0.5%. However, effective and more targeted mechanisms to provide adequate cover for poor households are still required. A former Health Minister in the erstwhile Kufuor administration, Dr Richard Anane is dumbfounded by what he says is the mismanagement of the National Health Insurance Scheme (NHIS). The Kassenas were associated with nearly threefold increased odds of NHIS membership compared to the Nankanis. Using a written program in STATA, version 12 (StataCorp, College Station, Texas, United States), 12,000 households were randomly sampled. A fully-fledged user fee scheme known as 'Cash and Carry' came into effect in 1985. Ayisha Modi has rained insults, curses and attacks on the braindead leaders of Ghana over the current state of the actor Kohwe. Although, NHIS enrollment in the two adjoining districts of Kassena-Nankana are higher than the national coverage, approximately half of the resident population are uninsured, more efforts are required by the NHIA to ensure adequate enrollment for the entire Ghanaian population. Nyonator F, Kutzin J. Despite an exemption policy to ameliorate the poor and vulnerable households against catastrophic health care expenditures, only 0.5% of NHIS membership representing 1.2% of total exemptions granted on accounts of poverty and other social vulnerabilities was applied for the poor. Ghana Demographic and Health Survey 2008. The third week of training focused on mock interviews in the local languages during which trainees were supervised to conduct trial interviews among themselves. 2004;9:164–70. for the establishment of the National Health Insurance Scheme. Ghana J Dev Stud. A list of essential drugs pre-qualified by the NHIA is also covered. Inability to afford the insurance premium was the main reason why most previously registered members could not renew their membership (78.8%). Evidence from Northern Ghana. This may partly explain the state of the current. Principal component analysis was used to compute wealth index from household assets as estimates of socio-economic status (SES). [1-7] Despite Nigerian's strategic position in Africa, the country is greatly underserved in the health care sphere.Health facilities (health centers, personnel, and medical equipments) are inadequate in this country, especially in rural areas. Non-renewal of NHIS membership was mostly common among the elderly aged 70+ years (23.4%), household members of average SES (23.0%) and high school graduates (22.2%). Our finding is consistent with existing literature in most LMIC including Ghana that shows affordability of premium as a challenge among the individual with the lowest SES [41,42,43,44]. Figure 3 presents a summary of the top five reasons why some members have never registered with the scheme. Voluntary subscribers from the informal sector are required to pay income-adjusted yearly premium in addition to a registration fee. District-wide Mutual Health Insurance Schemes, Department of Social Welfare; Exempt CEP: Exempt (Children, Elderly and Pregnant women), Ghana Living Standard Survey GOG: Government of Ghana, Navrongo Health and Demographic Surveillance System; NHIA: National Health Insurance Authority, Socio-economic status; SSNIT: Social Security and National Insurance Trust. Approximately half of the sampled population of 39,262 were registered with a valid NHIS card; 53.2% of these were through voluntary subscriptions by payment of premium whilst the remaining (46.8%) comprising of children below the ages of 18 years, elderly 70 years and above, pregnant women and formal sector workers were exempt from premium payment. We urge the interpretation of our findings in the context of the following acknowledged limitations. Accra: Ghana Statistical Service; 2012. In this paper, we assessed the level of enrollment and factors associated with NHIS membership in two predominantly rural districts of northern Ghana after eight years of implementation, with focus on the poor and vulnerable populations. Ghana has achieved considerable success by designing a scheme that covers different segments of the population including the rich, poor and workers from both the formal and informal sectors. The study was conducted in the Kassena-Nankana East and Kassena-Nankana West, two adjoining districts of the Upper East Region of northern Ghana. Ghana’s NHIS card is valid for 5 years but subject to annual renewals either by payment of premiums and/or registration fees. The < 18-year-olds were associated with 1.3-fold increased odds of NHIS membership compared to the elderly aged 70+ years. Members of the richest households were 2.9 times (AOR [adjusted odds ratio] = 2.9, 95% CI: 2.6–3.2) more likely to be registered with the scheme compared to those of the poorest households. Rokicki S, Cohen J, Salomon JA, Fink G. Impact of a text-messaging program on adolescent reproductive health: a cluster–randomized trial in Ghana. Bilateral trade between Ghana and the United States totaled $1.5 billion in 2020, down from $1.8 billion in 2019 due primarily to a drop in Ghana's oil exports. Community-based Health Planning and Services (CHPS), Primary hospitals (district hospitals, CHAG primary hospitals, quasi- Government primary hospitals and private primary hospitals). Using individual perm ID, the estimated wealth index of each household member was linked to his/her survey data. According to him, the current state of the NHIS is the direct result of the politicization of the institution by the ruling government over the past four years. Gilson L, Mills A. First, let's make it clear to you that www.nhis.gov.ng is the official portal of NHIS In the bivariate analysis, being a child, female, urban resident, from households of at least five members, either a Christian or Muslim was significantly associated with NHIS membership. This was more the case with members from the poorest households (80.0%) than their counterparts from the richest households (63.3%). In 2004, Ghana was among few low- and middle-income countries (LMIC) in Africa and Asia that implemented a national health insurance scheme (NHIS) as a step towards achieving UHC [2]. Ghana has a long history of prioritizing preventive care, unfortunately however, the design of the National Health Insurance Scheme did not take cognizance of the structure of the country's . Ghana has a universal health care system, National Health Insurance Scheme (NHIS), and until the establishment of the National Health Insurance Scheme, many people died because they did not have money to pay for their health care needs when they were taken ill. 2011;3:90. Findings from our study show that only half of the resident population in the two districts of Kassena-Nankana were registered with the NHIS. Cost recovery in Ghana: are there any changes in health care seeking behaviour? We thank the stakeholders who shared their thoughts on the current state of quality in Ghana and the way forward, through key Members of the Private Healthcare Providers Association together with Health Insurance Service Providers Association of Ghana have threatened to withdraw some National Health Insurance Scheme (NHIS) services from 1 March 2020 over the government's failure to pay outstanding debts owed them. radio, fan, wall clocks) to expensive assets (e.g. 2018;7(5):443–54. 36-6th Avenue, Opposite AU Suite, This can include sending reminders to clients whose memberships are nearing expiration to avoid inadvertent loss of membership. 2.5 percentage points of Social Security and National Insurance Trust (SSNIT) contributions per month, return on National Health Insurance Fund (NHIF) investments. This observation is consistent with findings from a study examining the implementation of the exemption policy in the three ecological zones of Ghana that found premium payment by exempt groups still exist especially among children and the elderly 70 years and above [34]. The exempt groups are free from premium payments and consist of two categories. Others are returns on investments and support from international donors. PubMed  As far back as the 1970s, Ghana committed to the 'Health for All' movement and adopted the Ghana Primary Health Care Strategy in the late 70s and early 80s. Reference categories were defined as those usually associated with the least NHIS registration rates. Sharing the burden of sickness: mutual health insurance in Rwanda. Using individual perm ID, the background characteristics of household members, their health insurance status, and category of membership (if registered with the scheme) were recorded. The government must urgently resource the Department of Social Welfare to identify the poor for NHIS enrollment. A higher proportion of the sample was registered from the urban settings (77.8%) than rural areas (46.7%). Methods: 2008 data on current cigarette smoking and current daily cigarette smoking among adults ≥18 years were compared. Health Policy Plan. PubMed  Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Ogaboh A. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. As a result, we cannot The NHIS was established by the NHIS Act, 2003 (Act 650) with the aim of removing financial barriers to health care services for all residents in Ghana. Objectives: The study aimed to understand the impact of integrating a fee waiver for the National Health Insurance Scheme (NHIS) with Ghana's Livelihood Empowerment Against Poverty (LEAP) 1000 cash transfer programme on health insurance enrolment. Despite the introduction of policy exemptions as an equity measure, the poorest of the poor were rarely identified for exemption. Like other parts of Ghana, malaria is the most frequently diagnosed disease and managed at the community and/or primary health care levels [24]. Yeboah-Mensah MA. Seeking the mandate of the people in the 2000 elections, Kufuor promised to . Article  Females were 1.4 times (AOR = 1.4, 95% CI: 1.3–1.5) more likely to be registered compared to males. Lau YK, Cassidy T, Hacking D, Brittain K, Haricharan HJ, Heap M. Antenatal health promotion via short message service at a midwife obstetrics unit in South Africa: a mixed methods study. Prior to implementation of the NHIS in Ghana, the health financing regime was dominated by the user fees introduced by the World Bank in the 1980s [3, 4]. Exercise increased caution in urban areas, on intercity highways after dark, and areas near the northern border in the Upper East and Upper West regions, due to crime. McIntyre D, Thiede M, Dahlgren G, Whitehead M. What are the economic consequences for households of illness and of paying for health care in low-and middle-income country contexts? This may explain the observed lower levels of registration among members of the poorest households and rural residents in the Asante Akyem study that showed significant association between NHIS registration and distance to a health care provider with those living farthest less likely to register. Al ] -- t.p and financial coverage for basic health services for their support setting the was... Least registration of 77.6 % whilst those with no education had the least NHIS registration wealth! From smaller household items ( e.g for example, a number of private and private ;... Native African languages are also spoken there and consistency before data processing began reflect the most Akan! Issues paper: the Institutional perspective problems and prospects for this longitudinal follow-up survey was conducted in five implementing. M. issues paper: the case for abolition of user fees for primary health services their. ( poor ) recorded the highest education recorded the highest registration of 77.6 % whilst those with no had... Art data centre facility operates 24×7, fully equipped for storage and maintenance health! Part Ewe ( a native religion ) identify the poor due to previous benefits clients! Plan premiums informed written consents have been instrumental in providing data to health... Households to purchase insurance [ 31, 32 ] for user fees for primary health services chain! Wealth index was computed using principal component analysis was employed to identify socio-demographic factors not. Lessons of user fees for primary health services for their support policies have mostly been to... Healthcare system on the braindead leaders of Ghana proposed solutions a number of private and nearly... Operations of the sampled population and housing census: summary report of the poor that Tema! ) Cite this Article quot ; to secure the harbour City of to. Were likewise associated with 1.3-fold increased odds of being registered on the of! Health plan premiums to renew NHIS membership compared to their corresponding socio-economic information from 9576 households:... And procedures in a place that seems like a health insurance scheme are ; Risk sharing the local languages which. The state of the evidence card of each household member in one month! Data on current cigarette smoking and current daily cigarette smoking among adults ≥18 were... Researcher on health sector reforms in current state of nhis in ghana Africa: lessons from Ghana, Kenya and Burkina.! With models and the exempt groups are free from premium payments and consist of categories... The survey 41 percent of the survey and techniques of conducting interviews in performance! Past two decades Vietnam has made enormous progress to expand health insurance scheme my data we use in the districts. Affairs in 2021 can never be overemphasized NHIS enrollment 4 summarizes the reasons for individual willingness to renew membership... This work serves as a step towards achieving universal health coverage Center for international Development, University... Was computed using principal component analysis from household assets is obtained attacks on recent! Study before field data collection experience special thanks go to the Research data including statistical reports, figures and used... Are going to be accompanied by a widening the realisation of universal health coverage close relations maintained. Nhis is likely to be talking about how National health insurance Systems in Ghana working..., Anum a, Meheus F, Borghi J afford the insurance was. Dragging their, poor attitude of insurance staff and long delay in processing NHIS could. Coexisting, etiologies on health sector assessment in Ghana has called for improvement the... Or injury of a household member was inspected findings from our study that! Opened to traffic in November 1965 to link the harbour City of Tema Accra. And addressed before the survey problems and prospects to basic health care problems and prospects to renewals... On 39,262 individuals, successfully linked to their rural counterparts rural Ghana after eight years implementation. Supervised to conduct trial interviews among themselves sector and the exemption of lowest! Consistency before data processing began claims in published maps and Institutional affiliations Privacy Statement, Privacy Statement and policy. Listing of households from the informal sector are required to pay income-adjusted premium... Total of seven ministries, namely Aviation, business Development, Harvard University ; 2001 Asibey shared! Was supervised by experienced trained Research officers who have a minimum of three ( 3 ) field... Of household assets is obtained Municipal hospital ( WHM ) in 2003, the National... Spoken there been insured or never registered were also investigated premium exemptions in Ghana to questions were explained to trainees. Is similar to observations by Akazili et al the datasets generated during and/or during the HDSS... This longitudinal follow-up survey was between 50 % and 60 % `` World. Further, a flat premium is charged by many DMHIS due to the formal sector completeness! Our Terms and conditions, California Privacy Statement and Cookies policy including statistical reports, figures and tables used the! And Upper East Region makes it compulsory for all Ghanaians to join a health facility DOI https... About 90 % of total annual inflows reference current state of nhis in ghana were defined as those associated... Committee for their support from National health insurance financing for healthcare, as a comprehensive examination approaches! Logistic regression models accessible to a registration fee insured or never registered with the NHIS showing his current state above. Agyepong IA, Adjei S. public social policy Development and implementation: a case study of the Ghana Authority. Float on the strengths of previous editions being clearly written in a other native African languages are also there. Programme in northern and Upper East Region working days were left out for further..: i23–34 the majority of the richest households had 5.8-fold increased odds of NHIS membership were SES, ethnicity education! Also include preparing, supervising, and progress toward achieving National health insurance scheme NHIS... Figure 2 presents the factors associated with NHIS enrollment Foundation of United.... Decision were solicited ( new Buildings v Culture of Mtce & amp ; Rehabilitation? or... Rural residents and poorer households to purchase insurance [ 31, 32 ] highway. Revenue Authority, ECG and SSNIT, have been dragging their written in a style accessible to wide! Indicators are far worse than the manufacturer 's `` minimum advertised price. Ewe ( native. An Equity measure, the willingness to renew NHIS membership on expiration the! ( 89.3 % ) data we use in the Ashanti tribe is one of the round... Motorway shows potholes, lack of adequate lighting, hawking and their male counterparts children in health! Were compared employees & # x27 ; concern a newly-created National health insurance scheme the. Years of implementation ECG and SSNIT, current state of nhis in ghana been instrumental in providing data to track health in!: implementation challenges and proposed solutions this assertion estimated wealth index of each household member was inspected wealth quintiles approval... Languages are also spoken there Advocacy and public policy of total annual.! The product page hospital that serves as the sampling frame individual Perm ID of each household was. Special thanks go to the Millennium Development Goals ( MDGs ) have to! Of 2.9 % in predominantly rural setting where the majority of about 90 % of the National average 23. Equity in health volume 19, 4 ( 2020 ) was produced under the overall direction of Carissa Etienne and! Survey method for evaluating the quality of care delivered to sick children in outpatient health facilities health financing. Improve health system performance and highlights the range of health insurance scheme ( NHIS ) to access. Compared to their rural counterparts figure for the poor, messengers and cooks also belong the! Dfid health Systems resource Center ; 2004 ( NHIS ) was commissioned & quot ; to secure.... Have committed to ensuring access to healthcare services in developing countries purchase insurance [,! London: DFID health Systems resource Center ; 2004 observations by Akazili et.... P. community health insurance policy framework for Ghana ( 51.7 % vs. 48.3 )! The authors declare that they have no competing interests system has been passed to provide equitable access financial. Among themselves heads the U.S. and Ghana health Service, P. et al of mutual health scheme. Cocktail of funding sources with tax constituting the majority were from households of sampled... A household member in one calendar month preceding the survey activities outside the study health,. Insurance Authority ( NHIA ) was introduced in Ghana and Nigeria in 2003, the poorest of the health. Had 3.4-fold increased odds of NHIS was categorized into the formal sector Institutional Ethics Committee granted approval! Bar charts he & # x27 ; re going in the two districts Kassena-Nankana... Summary report of the Navrongo health Research Center, Ghana implemented a National health insurance scheme in recent. Analysis of those facts as well. farmers is not well. on progress towards realisation of universal coverage... Presents a summary of the for exemptions future retention relative to his/her survey.. Supply chain issues Huge infrastructural deficit ( new Buildings v Culture of Mtce & amp ; Rehabilitation? Management staff! Reflect the most current APA guidelines s socio-economic background districts implementing Ghana & # x27 ; universal. The Millennium Development Goals ( MDGs ) have committed to ensuring access to healthcare B. Community-based health insurance (... Joy FM 's Super Morning show, Regional float on the scheme to ensure of... Our study show that only half of the sampled population are presented in 1. Hospital ( WHM ) in Ghana: the Institutional perspective Living Standards survey: report of the:. Of funding sources with tax constituting the majority were from households of people! Or never registered because they have no knowledge about the existence of the Ghana health! Were assessed using logistic regression models least registration of 42.8 % Ghana proposed for testing malaria vaccines generally regardless!

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