Dr Emmanuel Odame, the Director of Policy Planning Monitoring and Evaluation (PPME), Ministry of Health, who officially launched the annual Health Sector Policy Dialogue series on Thursday, expressed his gratitude to all the stakeholders for their sustained contributions over the years.

He said the Ministry recognises the importance of policy dialogue as an effective mechanism for engaging and taking decisions with key stakeholders on critical health systems issues.

The Policy dialogue, which was a collaborative project between the academia from the University of Technology in Belin, Germany, and the Kwame Nkrumah University of Science and Technology (KNUST), would therefore facilitate an exchange of information, and build consensus between the public, private and Civil Society Organisations (CSOs) through leaders who could forge alliances, make decisions, or strongly influence the trajectory of a possible solution to a challenging issue such as healthcare financing.

It would further ensure their examination of opportunities and constraints of topical issues concerning the health sector, saying, the timing was ideal considering the fact that the National Health Insurance Scheme (NHIS) was currently undergoing review to make it much better.

Dr Odame said although the health sector had seen some remarkable improvement in terms of performance such as increase in government allocation, improved performance in child health and increased coverage of Health Insurance, the holistic assessment for the past three years (2014, 2015 and 2016) had shown stagnating performance of the sector which included NHIS.

He therefore called for a more integrated approach to the development of healthcare financing systems, to immediately rectify the current challenges being faced under the NHIS, if Ghana was to make strides in the Sustainable Development Goal-3, which aimed to “ensure healthy lives and promote well-being for all at all ages”.  

He said the NHIS, was currently faced with challenges including increased coverage without a corresponding increase in resources or premiums, which had created a significant financial burden on the scheme.

Review reports, showed that the Scheme was threatened by inadequate fund, which had resulted in indebtedness to service providers, and “as a result, some service providers are asking patients to pay out-of-pocket and in some cases, NHIS car holders who are unable to pay are denied health care services”, he said.

He noted that as policy makers focused attention towards achieving health policy goals of quality, efficiency and access, they were faced with increasing cost of healthcare partly due to inefficiencies in the financing arrangements.   

He said globally 400 million people did not have access to essential health services, and six per cent of these, living in low and middle income countries were being pushed further into extreme poverty because of weaknesses in health financing system, hence, they did not have access to effective and affordable drugs, surgeries and other interventions.

He however warned that while reforms in provider payment systems may help address such inefficiencies, it could also affect quality of care and patients’ trust in health care providers, citing the introduction of the capitation payment of primary care in 2012, with the view of containing escalating claims expenditure.

He encouraged CSOs, the academia and all relevant stakeholders to continue engaging the Ministry through such dialogues to address some of the challenges facing the health sector. Prof. Anthony Kwaku Edusei, the Vice Dean, School of Public Health (KNUST) and the Coordinator of the collaborative project, said going forward, it was important that health purchasing be based on needs, sustainability, as well as who should be the agents to be engaged so as to minimise the challenges.

Prof. Reinard Busse, the Project Leader, Capacity Building in Health Systems Research and Management and Head of the Department of Health Care Management, University of Technology Berlin, said a good purchasing strategy could among other things bridge the gap between planning and budgetary allocation, and improve information systems so that they are mandated to collect and make available meaningful information for effective use by all stakeholders.