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National Health Insurance does not promote quality health care delivery – Research

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Findings of a research commissioned by SEND-Ghana, a civil society organisation and World Bank, Ghana office have revealed that a National Health Insurance Scheme (NHIS) does not promote quality health care delivery to subscribers.

In 44 selected districts from four regions, Greater Accra, Northern, Upper West and East Regions where the research was conducted, more than three-quarters of the accredited NHIS health care facilities, representing 76 per cent, said the scheme had negative effects on quality health care delivery.

It said accredited health care providers stated that implementation of the NHIS had negatively affected their ability to acquire medicines both in terms of quality and quantity to cope with the increasing attendance.

The research was conducted in the last quarter of last year and launched by Professor Fred Binka, Dean, College of Health Sciences of the University of Ghana, in Accra on Tuesday.

It was to assess the rate of subscription to the NHIS in the selected districts, and quality of health care provided to clients of the scheme.

The findings revealed that implementation of the scheme had led to significant increase in facility attendance by clients without a corresponding improvement in health infrastructure and equipment as well as human resource resulting in extra workload; over-stressed staff, excessive pressure on existing amenities and reduced attention to patients.

It said in Northern Region for instance, the number of medical doctors reduced from 32 to 26 between 2006 and 2008 while membership subscription between the same period increased to 828,805 from 281,775.

The findings said in the three Northern Regions, the average NHIS clients to a medical doctor ratio rose from 5,845 in 2006 to 21,663 in 2008 while the average NHIS clients to a nurse ratio also swelled from 208 to 743 during the same period.

It revealed delays in the issuance of NHIS identity cards to clients resulting in some not accessing health care services adding 27 per cent clients in Northern, 34 per cent in Upper West and 13 per cent in Greater Accra Regions could not access health care services because of the delays in issuing identity cards.

The findings said contrary to views of managers of health care facilities, District Mutual Health Insurance Schemes considered the NHIS to be inappropriate for the promotion of scheme sustainability because of the high tariffs service providers charged.

It recommended that the National Health Insurance Authority (NHIA) developed innovative ways of re-imbursing claims of service providers timely to facilitate acquisition of medicines and medical equipment for improved service delivery.

The findings suggested that the Ministry of Health (MOH) and Ghana Health Service (GHS) should pay serious attention to the development of existing health facilities, improve on human resource situation and re-distribute health personnel to underserved and overburdened areas.

It recommended that NHIA in collaboration with MOH, GHS and the Teaching Hospitals should institutionalise a regular stakeholder forum to discuss implementation issues that were of common interest.

Mr. Osei Acheampong, Director of Research at NHIA, said the report was eye-opener for the authority as it would take lessons from the research to improve upon its services.

He said NHIA would endeavour to expand registration, access as well as ensure improvement in operations of the scheme.

Source: GNA

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