The National Health Insurance Scheme (NHIS) is improving health financing and good health among Ghanaians, findings of a research titled, “Making the National Health Insurance Scheme (NHIS) work for the people” has revealed.
It also showed that NHIS has reduced out-of-pocket expenditure and poverty among patients.
The research, conducted by the CUTS International with support from Open Society Initiatives for West Africa (OSIWA), further stated that the impact of the NHIS could be better felt if the challenges preventing the NHIS from delivering on its mandate to subscribers were addressed.
Some challenges hindering the effectiveness of the Scheme identified in the research include fraud, limited funding, information asymmetries, delay in payments of claims, and poor service quality.
The report also showed that the National Health Insurance Authority did not have established customer complaints or resource policies written down for customers to follow.
It recommended that the NHIS developed a clear cut strategy and procedure for redress monitoring and conduct regular need-assessment to ensure that the diverse healthcare needs of subscribers were met.
Mr Adomako Kusi Appiah, West African Regional Director for CUTS International, said at the dissemination of the report in Accra on Wednesday, that the research was necessitated by the need to advocate and influence policy makers and stakeholders to strengthen health outcomes and welfare of subscribers.
That, he said would ensure that the NHIS and its accredited healthcare providers provided utmost care to insurance subscribers by reducing out of –pocket expenses when using the Scheme.
Mr William Omane – Adjekum, Deputy Director of Claims, NHIA, said the NHIS, despite the challenges, had successfully enrolled 16 million active members, representing 52 per cent of the population.
He said presently, the Scheme provided benefit packages for 95 diseases with about 4,200 healthcare service providers under it across the country.
Mr Bright Amissah-Nyarko, President of the Coalition of NGO’s in Health, said it was about time the Scheme paid more attention to preventive care rather than curative care.
He said the Scheme also needed to recruit claim managers to assess claims from health providers and block leakages.
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