The idea for the national health insurance scheme nhis in ghana was conceived by former president john kufuor who when seeking the mandate of the people in the 2000 elections, promised to abolish the cash and carry system of health delivery. The 2014 ghana demographic health survey datasets with information for 9396 women and 3855. In 2004, ghana began implementation of a national health insurance scheme nhis to minimize out of pocket expenditure at the point of use of service. In 2004, ghana began implementation of a national health insurance scheme nhis to minimize outofpocket expenditure at the point of use of service. National health insurance schemes national health portal of. The national health insurance scheme is a form of national health insurance established by the government of ghana, with a goal to provide equitable access and financial coverage for basic health care services to ghanaian citizens. The national health insurance scheme nhis is a social intervention program.
Understanding nigerias health insurance scheme punch. Ghana national health insurance scheme open knowledge. Seven years into its implementation the ghana national health insurance scheme nhis has made significant progress in transitioning to universal coverage, but faces significant fiscal and. The effect of the national health insurance scheme nhis. National health insurance nhi, sometimes called statutory health insurance shi, is a system of health insurance that insures a national population against the costs of health care. Ghana national health insurance scheme pdf also because you are paying out an important more significant tax deductible, it is actually estimated that youre going to give decrease in the event that you will be hospitalized as opposed to any other overall healthiness high grade. Download the implementation of national health insurance. The national health insurance scheme nhis is a body corporate established under act 35 of 1999 constitution by the federal government of nigeria to improve the health of all nigerians at an affordable cost. National health insurance authority ministry of health. Results ability of the nhis to continue its operations in ghana is.
Pdf health insurance coverage, type of payment for. However, stagnating active membership, reports of poor quality health care rendered to nhisinsured clients and cost escalations have raised concerns on the operational and. South africa is in the process of introducing an innovative system of healthcare financing with far reaching consequences on the health of south africans. National health insurance into the national health insurance scheme monitor and ensure compliance with this act and any regulations, guidelines, policies, processes and manuals made under this act perform any other function conferred on it by this act or that are ancillary to the obj. Seeking the mandate of the people in the 2000 elections. They include the formal sector social health insurance programmes a public sector federal, states and local governments. Comments on the planned national health insurance system in ghana, discussion paper no. Pdf the ghana national health insurance scheme nhis was.
Ghana s national health insurance scheme nhis was passed into law in 2003 but fully implemented from late 2005. Jun 18, 2018 ghanas national health insurance scheme. Private mutual health insurance scheme pmhis private commercial health insurance scheme pchis functions. An evaluation of the ghana national health insurance. Methods this is a crosssectional study in two southern regions in ghana involving 64 primary health facilities. The scheme therefore focuses heavily on meeting the needs of the poor and providing social health protection based on the principles. Healthcare financing through social health insurance has become a very important tool in providing access to and utilization of health services in most developing countries such as ghana. In performing its regulatory functions the authority registers, licenses and supervises the. Ghana s national health insurance scheme nhis has achieved considerable success, but is beset by challenges that have become important election issues ahead of the december parliamentary and presidential polls. Health insurance scheme of the ghana federation of employers and the ghana trades union congress, discussion paper no.
Operational guideline of national health insurance scheme. A contract of insurance for the provision of healthcare services entered into between a person and a private health insurance scheme is a private contract governed by the laws of contract of the country. Nov 10, 2016 the introduction of the national health insurance scheme nhis in ghana in 2003 significantly contributed to improved health services utilization and health outcomes. Act 650 identi es three major types of health insurance in the country. Background the introduction of the national health insurance scheme nhis in ghana in 2003 significantly contributed to improved health services utilization and health outcomes. The national health insurance scheme nhis in ghana was established by the national health insurance act, 2003 act 650 and national health insurance regulations, 2004 l.
Ghanas national health insurance scheme nhis is an innovative attempt to extend social protection to. The national health insurance scheme in ghana is deemed as one of the legacies of the john kufuor administration. May 18, 2018 the national health insurance scheme is a form of national health insurance established by the government of ghana, with a goal to provide equitable access and financial coverage for basic health care services to ghanaian citizens. Comparison of perceived and technical healthcare quality. Ghana is the first country in africa to implement a national health insurance scheme nhis to meet the needs of its population with the aim of achieving uhc. The politicoeconomic challenges of ghanas national. The national health insurance scheme is a form of national health insurance established by.
A highly subsidized health care program for a privileged few find, read and cite all the. An evaluation of the ghana national health insurance scheme. Ghana s national health insurance scheme nhis has been operational since 2003. Ghana national health insurance scheme pdf at this time there are plenty of types of privately owned wellbeing covers on the market to satisfy an array. Health insurance coverage, type of payment for health insurance, and reasons for not being insured under the national health insurance scheme in ghana article pdf available december 2019 with. Evaluating the impact of the national health insurance scheme of.
National health insurance scheme national health insurance. The study was a crosssectional comparative assessment of paper and electronicbased. The national health insurance scheme nhis took off in the year 2005 and is a corporate body established under act 35 of 1999 constitution by the federal government of nigeria to improve the health of all nigerians at an affordable cost through various prepayment systems. Jun 22, 2012 the ghana health insurance policy agenda emerged from different factors and sources. In december 2004, ghana established a national health insurance scheme nhis1 to enhance the performance of its health system, paying particular attention to the poor. There are both private and public health insurance plans, with different plans offering different benefits. The national health policy and strategy to achieve health for all. Aug 28, 2009 there is considerable interest at present in exploring the potential of social health insurance to increase access to and affordability of health care in africa.
However, stagnating active membership, reports of poor quality health care rendered to nhisinsured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. J page 2 national health insurance policy hence the two main types of health insurance regimes shall be operational in ghana. Health insurance for the poor determinants of participation in community based health insurance scheme in rural areas, elsevier ltd paris ibiwoye a, adeleke aa 2007. The health insurance section of the nhis family core fhi has a full range of data items addressing health insurance. The national health insurance scheme nhis is a body corporate established under act 35 of 1999 by the federal government of nigeria to improve the health of all nigerians at an affordable cost3.
Subsequently, a number of initiatives have been put in place to simultaneously address sustainability challenges, reach universal access to health care and improve efficiency and transparency of the. Under the cash and carry system, the health need of an individual was only attended to after initial payment for the service was made. Pdf on jan 10, 2016, david adewole and others published nigeria national health insurance scheme. In 2004, ghana began implementation of a national health insurance scheme nhis to. The study was a crosssectional comparative assessment of paper and electronicbased claims. The first section focuses on the history of health financing in ghana, followed by an examination of the challenges facing the challenges with the national health insurance scheme.
National health insurance in south africa policy paper. Though feeforservice was introduced in 1971 nothing was done for insurance. Under this policy, three types of health insurance schemes were set up. The politicoeconomic challenges of ghanas national health. Distribution of claims expenditures, by facility type, volta, 2014 31. Lower enrolment was reported among the poor categories. The study investigates the effect of ghanas national health insurance scheme nhis on health care utilisation. Granting of credentials to healthcare providers and health facilities. Introduction, theoretical framework, research methods, overview of nhis, findings and discussions, conclusion pdf. These are the social type health insurance scheme made up of. Ghana national health insurance scheme pdf liability insurance is definitely an insurance policy that will buy from you to the damaged dance in case your doggie immediately insect bite a person. National social health insurance schemes have increasingly been seen in many low and middleincome countries lmics as a vehicle to universal health coverage uhc and a viable alternative funding mechanism for. The national health insurance scheme is form of the national health insurance established by the government of ghana with the aim of providing equitable access and financial coverage for the basic health care services to ghanaian citizens.
Approximately 150 million people suffer from financial catastrophe annually because of outofpocket expenditures oopes on health. May 28, 2018 in the formal sector social health insurance programme, specific responsibilities are expected from the healthcare facility, health maintenance organisation and the national health insurance scheme. Ghana s national health insurance scheme nhis was created by the national health insurance act of august 2003, and is one of very few attempts by a subsaharan african country to implement a national level, universal health insurance program. The first and most popular category is the district mutual health insurance scheme, which is operational in every district in ghana. The politicoeconomic challenges of ghana s national health insurance scheme implementation adam fusheini1,2 abstract background. Boosting membership of the scheme will need to be accompanied by a widening the payment net if the scheme is to remain financially. Evaluating the impact of the national health insurance. These are the socialtype health insurance scheme made up of. Please use the link provided below to generate a unique link valid for 24hrs.
An evaluation of the national health insurance scheme in ghana. It may be administered by the public sector, the private sector, or a combination of both. Learning from case studies of india, colombia, and thailand. This study uses propensity score matching to evaluate the outcomes of the ghanaian national health insurance scheme nhis on maternal and child health in ghana. Ghana government of ghana is the major funding source for most of the social protection programmes with additional support from our development partners, thus there are different sources which include. Several countries, including ghana, have thus introduced and implemented mandatory national health insurance schemes nhis as part of reform efforts towards increasing access to health services. Why is it important to know about health insurance. Challenges facing the national health insurance scheme. How to download the implementation of national health insurance scheme in ghana. Programmes in order to ensure that every nigerian has access to good healthcare services, the national health insurance scheme has developed various programmes to cover different segments of the society.
Ghana is one of only several african countries to enact legislation and earmark financing for universal health insurance coverage for its entire population. The law established two 2 types of private health insurance schemes. The effect of ghanas national health insurance scheme on health. Comparison of perceived and technical healthcare quality in. A family respondent answers these questions about all family members. Health insurance scheme refers to a programme that covers or shares the expenses associated with healthcare of individuals. Yet since its inception in 2003, few studies have assessed the scheme.
The effect of the national health insurance scheme nhis on health service delivery in mission facilities in ghana. This study determines consumer and provider factors which most influence the nhis at a. Before joining the world bank, she was a researcher on health sector reform initiatives in china and the united states. The effect of the national health insurance scheme nhis on. However, individual members present can also respond to the questions as well. In performing its regulatory functions the authority registers, licenses and supervises the operations of phis in ghana. The law makes it compulsory for all ghanaians to join a health insurance scheme in ghana. A resident of ghana shall belong to the national health insurance scheme and may belong to a private health insurance scheme. Mhis mutual health insurance scheme ghana moh ministry of health mtef mediumterm expenditure framework ngo nongovernmental organization nhi national health insurance nhif national health insurance fund ghana oecd organisation for economic cooperation and development oop out of pocket phc primary health care ppp purchasing power parity shi. That is why choosing a health insurance plan that is right for you, and understanding how it works, may seem confusing. Ghanas national health insurance scheme nhis was created by the national health insurance act of august 2003, and is one of very few attempts by a subsaharan african country to implement a nationallevel, universal health insurance program.
The scheme provides equitable access and financial coverage for basic health care services to residents in ghana. The survey was carried out in dar es salaam were the majority of health insurance program offices are found. Policy initiation and political levers in health policy. The national health insurance scheme is a form of social intervention established by the government of ghana in the year 2003. The universal health insurance scheme uhis has been redesigned targeting only the bpl families. This paper focuses on the experience of ghana, where a national health insurance scheme nhis was fully implemented by the end of 2004 710.
Evaluating the impact of the national health insurance scheme. The introduction of the national health insurance scheme nhis in ghana in 2003 significantly contributed to improved health services utilization and health outcomes. Evidence suggests most health facilities are faced with management challenges in the delivery of services. Statutory payments taxations national health insurance scheme schools capitation grants o multi donor budget support.
Ghana s national health insurance scheme has improved access to care, although equity and sustainability issues remain. Wiego working paper no 30 1 abstract ghana s national health insurance scheme nhis is an innovative attempt to extend social protection to informal workers, and, as such, it may hold important policy lessons for other countries where the informal. Her responsibilities in the world bank also include preparing, supervising, and evaluating lending operations at the country level. Ghana s national health insurance scheme nhis is a promising tool for policymakers. Implications of the findings for a sustainable national health insurance scheme nhis in ghana are also discussed. This type of spending goes against the nhis core mission to. The table below depicts the different categories of subscribers, payments they have to. Reducing medical claims cost to ghanas national health. Although the national health insurance scheme nhis of ghana was designed to promote universal health coverage, oopes as a proportion of total health expenditures remains elevated at 26%, exceeding the whos recommendations of less than 1520%. The paper concludes with some suggested reforms to improve health financing in ghana. This is followed by a look at the prospects for private health insurance schemes.
The effect of ghanas national health insurance scheme on. The ghana national health insurance scheme social protection. Health insurance coverage, type of payment for health. Downloadable documents national health insurance scheme. The aim of the nhis is to ensure access for all and equity in the use of health care services by removing financial barriers to access at the point of use. The first proposal for a national health insurance scheme was made in 1970 as part of a comprehensive plan to introduce cost recovery and protect the poor. The national health insurance scheme nhis is a body corporate established under act 35 of 1999 constitution by the federal government of nigeria to improve.
The implementation of the scheme was accompanied by increased access and use of health care services. Factors that influence enrolment and retention in ghana national. The politics of public policy and problems of implementation. Funding mechanisms vary with the particular program and country. Although the national health insurance scheme nhis of ghana was designed to. Dec 24, 2014 the national health insurance authority which is mandated by law to manage and provide social health insurance scheme to the people of ghana also fulfills its promise by paying medical claims to. Ministry of health august 2004 ghana health service. A law has been passed to provide the legal framework necessary to facilitate the establishment of the national health insurance scheme. A number of countries are currently experimenting with different approaches. In 2003, ghana introduced the national health insurance scheme nhis to promote access to healthcare.
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