By: Godfried Yormesor
The welfare of the citizenry involving their safety, livelihood, security and health status always attract priority attention of the rulers to ensure that life is devoid of drudgery to enable people function effectively in their daily socio-economic activities to lead meaningful and well-deserving lifes. In all these endeavours, the concern for the vulnerable, especially children, become paramount. In the educational sector, reforms aimed at improving school enrolment as well as quality of teaching and learning culminated in the institution of the capitation grant, school feeding programme, construction new classroom blocks and free busing services for basic school children in the urban centres.
Incorporated in the Social Protection Strategy of the Ministry of Manpower, Youth and Employment is the Livelihood Empowerment Against Poverty [LEAP]in which financial benefits ranging from GH¢8.00 to GH¢15.00 are donated to selected poor households across the country for a period of three years to aid poverty reduction activities.
Reforms in the national health care delivery sector led to the establishment of the Ghana Health Service by virtue of a Legislature Instrument in 1996 which also gave birth to the National Health Insurance Scheme (Parliamentary Act 650 of 2003). The management objective of the NHIS is to provide Ghanaians and foreign residents decent, affordable and quality health care services on sustainable basis to stand the test of time. The communication objective is to influence potential service providers and beneficiaries to fully comprehend the virtues of the Scheme and to ensure its sustainability.
During its teething stages in the years 2005/2006, 129 Mutual Health Schemes were instituted with registered card-holders representing 15% to 40% of the nation’s population of 22 million. This contrasted with tremendous improvements in contemporary times of 145 Schemes registering 11,279,678 equivalent to 55% of the nation’s population. Funding sources which included 2.5% workers contributions of the Social Security and National Insurance Trust (SSNIT) with some donor supplements filliped with another 2.5% levy imposed by the Value Added Tax [VAT] Service on general consumption expenditure patterns. Allocations from the consolidated fund to each Scheme depended on the number of people registered and returned to the NHIS – Authority as card-holders. This constitutes the pool for each Scheme to manage itself especially purchase of drugs.
With a benefit package of approximately 95% coverage of diseases and ailments that commonly afflict the ordinary Ghanaian, it is astonishing that within a short period of two years, the NHIS Authority has creaditably chalked immense successes as an implementor of a viable social insurance policy for the nation. The accreditation of about 1,135 private health care service providers to augment the well-equipped initial public sector structures of the Teaching Hospitals, Regional and District Hospitals as well as the Polyclinics, are testimonies to achievable targets of accessing affordable healthcare services enveloping the whole country.
Challenges:
v The time-honoured challenges of the brain-drain, notably, the exodus of able health professionals to the advanced world hunting for greener pastures, are at the fore of all hindrances in the unblemished health care delivery service. This has inevitably culminated in inadequate human resources to facilitate all round health service delivery activities.
v The synchronization of the Ghana Health Service Standard Drug List and the NHIS approved medicines list would increase the scope of drug accessibility to registered card- holders of this laudable social insurance scheme.
v The infiltration of unpatented drug and fake medicines into the scheme as well as high tariffs on drugs are challenges that the implementors should exercise vigilance to countenance.
v The tendency for Scheme implementors to inflate the number of registered beneficiaries to attract fraudulent allocations of funds from the consolidated fund as well as corruption on the part of some Scheme Managers/ Directors are constraints that honest citizens frown upon. This emanated from non-standardization of scheme operations.
v Protracted time lapse between period of registration and issuance of membership ID card.
v Reluctance of some private providers to accept NHIS card-holders.
v Increase in the number of beneficiaries contrasted with limited number of service providers especially at the OPDs.
Way Forward: The National Health Insurance Scheme, like any other laudable poverty reduction and social protection strategy, has come to stay as a permanent feature of the nation’s social insurance programme to salvage the people during the hour of ill-health. It will also greatly prop-up health related issues encapsulated in the attainment of the millennium development goals of achieving a middle income status of $1,000 per capital income within the next seven and half years.
v It is crystal clear that the Scheme has attained its communication objective of influencing potential service providers and beneficiaries to fully embrace the benefits of the scheme and hence ensure its sustainability as reflected in the statistics provided.
v However, frequent media encounters to update developmental implementations of the NHIS, human-interest stories, documentaries and success stories should be available for public consumption; use of community radio stations to attract rural audiences, drama, posters and outreach programmes are necessary channels to propagate the message.
v Drastic change in attitude of service providers towards cardholders at the service provide points is paramount.
v Perfection in service delivery is unachievable but excellence is the morn as attendance of card-holders have consistently increased over the four years period of implementation.
v The introduction of a logo for ease of identification of accredited providers as well as a uniform ID card for beneficiaries to last for five years, are magnificent strides in the direction of perfection in health-care delivery services.
Source: ISD
Posted: 09/05/08