Oxfam dismisses NHIA’s reaction to report
Oxfam, an international charity, on Thursday declared support for Ghanaian civil society organisations in their dispute with the National Health Insurance Authority (NHIA) on the operation of the National Health Insurance Scheme (NHIS).
The report had indicated among other things that official figures put out on the NHIS coverage were exaggerated and could be as low as 18 per cent.
But NHIA dismissed the report with the Chief Executive Officer, Mr Sylvester Mensah, saying as of December 2010 the insurance coverage stood at 16.8 million with 12.2 million people on active insurance.
The figures represent 65 per cent coverage as against the 18 per cent given by the report.
Now, Oxfam, which was involved in the compilation of the report, has said in a statement, received in Accra, that it supports Ghanaian civil society organisations, which have refuted “the negative claims” by the NHIA.
“Oxfam stands by the quality of the research and the accuracy of the conclusions made, which were based on the best available data from the NHIA itself,” it said in the statement.
It said the report “Achieving a Shared Goal” argued that universal access free at the point of use was within reach in Ghana but only if the government overhauled the expensive and fragmented insurance bureaucracy and scaled up progressive taxation to pay for health workers, medicines and facilities for all.
It also welcomed the strong political commitment of the Government of Ghana to health but called for bolder steps to now implement their own promise of free universal health care.
Ghanaian NGOs, Integrated Social Development Centre (ISODEC), the Alliance for Reproductive Health Rights and the Essential Services Platform produced the paper with support from Oxfam.
It quoted Oxfam Ghana Country Director, Mr Sebastian Tiah, as saying: “We are disappointed by the NHIA’s reaction. The NHIA seems set on avoiding the central issue raised in the paper, which is that every Ghanaian pays for the NHIA through tax, whilst only those with membership benefit.
“Ghana needs a health system that is free for all citizens,” he stated. “The current system is inefficient and excludes many.” The paper welcomes government ideas like a nominal one time premium for every Ghanaian instead as a potential clear step towards a health service based on need and not ability to pay.”
Mr Tiah said: “The paper raised legitimate concerns over the fairness, efficiency, cost, transparency and overall performance of the NHIA and health financing in Ghana. We look forward to continuing constructive dialogue to achieve the shared goal of health care for all.”
On the NHIA claim that the report was inaccurate and methodologically flawed, Oxfam said the civil society paper was very transparent about the methodology and sources used to arrive at an estimated coverage of 18 per cent.
“This is a best estimate using the data available. The primary source is the NHIA’s own annual report.”
It said the NHIA had not responded to the main challenge, that their own estimate involved counting many people more than once, leading to much higher figures than an accurate picture of who actually accesses healthcare.
“The NHIA is counting every registration since 2005 as new, despite many of these being repeat registrations by the same Ghanaians, leading to this inaccurate and inflated figure.”
Mr Tiah refuted claims that the research was “haphazard” and that “this is Oxfam’s stock in trade”.
He said: “We would suggest the NHIA provide specific examples as we assume they would not make such an allegation without having specific, reliable evidence to substantiate. Oxfam has an extensive body of published work on health, including health financing.
On the NHIA claim that the report was a malicious effort to tarnish a home-grown African initiative, Mr Tiah said it was a civil society paper by Ghanaians for Ghanaians.
“This report is home grown and produced by Ghanaian civil society with Oxfam’s support,” he said. This report is driven by a concern for the fairness and efficiency of the current health financing model and its ability to improve access to health care for all Ghanaians.”