NHIS membership on the increase – SEND Ghana
A study on Maternal Health and National Health Insurance (NHIS) in 20 poor districts and 120 communities indicates that active membership stands at 10,145 representing 38 per cent of the Ghanaian population.
One hundred and twenty communities selected from Greater Accra and the three Northern Regions show a growth rate of 14.2 per cent in 2012 while all four targeted regions reported increased membership of between 13 and 32 per cent between 2012 and 2013.
Majority of the membership of the NHIS in 2013 were females representing 57.8 per cent.
The study, initiated by SEND Ghana (Social Enterprise Development Foundation) on the theme: “Making Safe Motherhood a reality”, recommended among others that to successfully enrol majority of the core poor and vulnerable groups on the NHIS, there is the need to strengthen institutional collaboration between the NHIS and the Department of Social Welfare (DSW).
Among the 18 districts schemes which provided data on NHIS coverage, Adenta in the Greater Accra municipality reported the highest coverage of 15 per cent of its population while Wa municipality in the Upper West reported the highest coverage of 90 per cent of its population.
The study revealed that increase in subscription to the schemes were largely due to public education and sensitization of communities through radio and community durbars by NHIS in collaboration with Civil Society Organisations (CSOs), improved customer service delivery and reduction in registration fees among others.
With regards to the Free Maternal Care Programme, the study observed that a number of unapproved charges collected at health facilities including those for a flask of mashed kenkey or tea, chamber pots to contain urine and vomit, six old cloths and three strong ones to wrap babies, prevent pregnant women from enjoying the full benefits of the scheme as prescribed by the policy.
The study also noted strong collaboration between the NHIS and the DSW in some districts in the Northern Region which resulted in enrolment of Livelihood Empowerment Against Poverty (LEAP) beneficiaries onto the NHIS.
Mr John Nkaw and Mr Mukuila Adamu, SEND Ghana Programme Managers in the Northern and Upper West regions respectfully, who disseminated the report, were of the view that the mere transfer of the mandate of identifying indigenes for registration to the DSW was not sufficient to widen the safety net for many poor people in Ghana.
They noted that pro-poor programme like the NHIS should reach not only the extreme poor but the poor in general meaning all persons who fall below the upper poverty of GHȼ 1,314 per a year.
Mr Siapha Kamara, Chief Executive Officer of SEND West Africa, noted that though Ghana has made strides towards its health delivery system, the strategies to an extent have not been equity centred, comprehensive and effective enough to guarantee all poor and vulnerable people in Ghana access to healthcare.
Mr Daniel Dogbetse, Head of Monitoring and Evaluation of the Ministry of Heath, noted that if society will take responsibility for all their health needs and make effort to seek timely intervention, more than half of all health needs would be solved.
He said the current trend in institutional Maternal Mortality ratio continues to improve though not at the rate that meets expectation.
Maternal Mortality ratio improved from 155 per 100,000 live births (LB) in 2013 to 14 per 100,000 LB in 2014.
Institutional Maternal Mortality Ratio was a high 174 deaths per 100,000 in 2011 but has since then dropped to 144 per 100,000 in 2014, a drop of about 21 per cent.
Mr Dogbetse was of the view that the magnitude and persistent high rates was an indicator of the level of development and raises issues policy makers need to confront.
Despite the strides made, the Ministry he said would continue to implement plans that place priority on maternal and infant mortality reduction.