A report on Ghana’s health insurance that shows that only 18 per cent of Ghanaians benefit from the National Health Insurance Scheme (NHIS), has stirred controversy among some health players.
The report challenged the 65 per cent health insurance cover, which it said was hugely exaggerated by government. “Rather than two thirds of the population being included in the Scheme as government claims, in reality fewer than one in five Ghanaians benefit from it.
“The majority of the people continue to pay out of pocket for their health care in the parallel cash and carry health system, or resort to unqualified drug peddlers and home treatment due to lack of funds,” it said.
ISODEC, an NGO committed to the promotion of human rights; Alliance for Reproductive Health Rights, an NGO promoting rights based approaches to sexual and reproductive health and Essential Services Platform, an umbrella of coalition of in health, water and sanitation, launched the report on Wednesday with support from international agency Oxfam in Accra.
Dr Francis Asenso-Boadi of the National Health Insurance Authority, who was present at the launch of the report, challenged the rationale for the study and said the sponsors were ill-motivated given the fact that the NHIA had recently been praised for its impressive performance.
He said “the 18 per cent coverage can’t be true because the Ghana Health Service’s (GHS) records show that about 90 per cent of all patients, who visited public health institutions, have national health insurance cards.”
Professor Agyeman Badu Akofa, former Director General of the Ghana Health Service, who reviewed the report, said “it will stir up controversy necessary to open up a debate to address challenges in the Scheme.
He called on the Ministry of Health, the Ghana Health Service and other stakeholders to join the sponsors of study to discuss the issues dispassionately in the interest of the nation.
The study found also that whereas every citizen pays for health insurance scheme through Value Added Tax (VAT), the vast majority of people are excluded from the system and are forced to pay health care and treatment.
The report also raises serious concerns with poor transparency on NHIA, saying “NHIA financial reports are difficult if not impossible to obtain” and that in 2008, 45 per cent of NHIA funds went unaccounted for.
It said, however, that important progress had been made in Ghana’s health care system in recent years noting the introduction of free health care for all pregnant women in 2008 as a major step forward.
Other progress it mentioned were malaria deaths for children under five, which had been reduced by half and child and infant mortality that had also declined after years of stagnation.