scholarly journals Challenges of medicines management in the public and private sector under Ghana’s National Health Insurance Scheme – A qualitative study

Author(s):  
Paul G. Ashigbie ◽  
Devine Azameti ◽  
Veronika J. Wirtz
2019 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 220s-220s
Author(s):  
D. Moye Holz ◽  
M. Ewen ◽  
A. Dreser ◽  
S. Bautista ◽  
R. Soria ◽  
...  

Background: More alternatives are becoming available for the diagnosis and treatment of cancer in low- and middle-income countries. Yet, because of increasing demands, many governments are now facing the dilemma of making essential cancer medicines available to all while keeping them affordable. Precise information about current access to these medicines is limited, and there's no systematic methodology in place to do so. Aim: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices (public sector procurement and patient prices) against those in other countries of the region. Methods: We adapted the WHO/HAI methodology. We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines (each strength and dose-form specific). Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People's Health Insurance” (SPS) were slightly more available. Only 7 (public sector) and 5 (private sector) out of 49 medicines were deemed affordable. Overall, public sector procurement prices were 41% lower than in other countries of the region. Conclusion: The availability of essential cancer medicines, in the public and private sector, falls below WHO's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.


2020 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.


2018 ◽  
Author(s):  
Sataru Fuseini ◽  
Seddoh Anthony

Background Ghana’s National Health Insurance Scheme is a demand side programme where the governing authority registers clients and purchases health care services for them from public and private providers. Access of services is high across a broad Benefits Package with no parallel enrolment necessary for any type of service at the point of access. Nonetheless, there is evidence of difficulty in acquiring and use of the NHIS card to access health care services. Objective While studies had been conducted into general awareness, there was no linkage between awareness, uptake and experiences with registration and use of the card. This study fills this gap. Methods This is a descriptive study. A mix of qualitative (39 Focus Group Discussions) and quantitative (625 household interviews) methods were used to collect the data. Qualitative data was analysed manually using a thematic approach while a frequency analysis was done for the quantitative data. Results Knowledge about the Scheme was near universal. Enrolment was lower among FGD discussants, 38.7% had valid cards, than for household respondents, 62.9% valid cards. While mixed experiences with the registration process was observed among FGD discussants, 74% of the households’ ranked attitudes of Scheme staff as positive. The study found the NHIS card facilitates access to facility based health care. Satisfaction levels with use of the card were mixed and contextual among discussants. However, 90% of households reported their cards were readily accepted at health facilities. Expired card (51.4%) and health facility had stopped accepting NHIS cards (14.3%) were mentioned as reasons for non-acceptance. Conclusion People’s experience during registration and use of the NHIS card to access health care has lasting effect on their perceptions of the Scheme. This can be harnessed to manage the high expectations, grow membership, discourage frivolous use and address artificial barriers of access.


Author(s):  
Obelebra Adebiyi ◽  
Foluke Olukemi Adeniji

The National Health Insurance Scheme (NHIS) of Nigeria was established in 2005. This study assessed the utilization of health care and associated factors amongst the federal civil servants using the NHIS in Rivers state. This was a descriptive cross-sectional study using self-administered questionnaires. Data were collated and analyzed using SPSS version 21.0. A Chi-square test was carried out. The level of Confidence was set at 95%, and the P-value ≤ .05. Out of a total of 334 respondents, 280 (83.8%) were enrolled for NHIS, 203 (72.5%) utilized the services of the scheme. Most 181 (82.1%) of the respondents who utilized visited the facility at least once in the preceding year. Although, 123 (43.9%) of the respondents made payments at a point of access to health care services, overall there was a reduction in out of pocket payment. Possession of NHIS card, the attitude of health workers, and patients’ satisfaction were found to significantly affect utilization P ≤ .05. Regression analysis shows age and income to be a predictor of utilization of the NHIS. Though utilization is high, effort should be made to remove payment at the point of access and improving the harsh attitude of some of the health workers.


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