scholarly journals Sustaining the National Health Insurance Scheme in Ghana: Perceptions and Experiences of Health Care Providers and Subscribers

2017 ◽  
Vol 6 (1) ◽  
pp. 29
Author(s):  
Amangbey Emmanuel ◽  
Gandiibu A. Julius ◽  
Gbaran Gbolo
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Providers ◽  
National Health Insurance ◽  
Universal Health Coverage ◽  
National Health Insurance Scheme ◽  
Health Coverage ◽  
Care Providers ◽  
Insurance Scheme ◽  
Universal Health

The establishment of the National Health Insurance Scheme was as a consequence of government effort at adopting a sustainable health care financing system with the aim of achieving universal health coverage. This study therefore explored the perceptions and experiences of health care providers and subscribers regarding the sustenance of the NHIS in Ghana. The study employed a mixed method design using survey questionnaires and in-depth face-to-face interviews. The study revealed that NHIS had contributed to the revenue base of service providers and increased healthcare utilisation at provider centres. The inability of health care providers to provide essential medicines and perceived poor quality of health care were identified as challenges to subscribers. The study concludes that the NHIS has the potential of ensuring universal health coverage provided stakeholders make deliberate efforts at addressing the obvious sustainable threats identified.

scholarly journals Ghana’s Journey towards Universal Health Coverage: The Role of the National Health Insurance Scheme

2019 ◽  
Vol 10 (1) ◽  
pp. 94-109 ◽  
Author(s):  
Kipo-Sunyehzi ◽  
Amogre Ayanore ◽  
Dzidzonu ◽  
Ayalsuma Yakubu
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Universal Health Coverage ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Universal Health

: Background: the main aim of the study is to find if the National Health Insurance Scheme (NHIS) in Ghana is achieving universal health coverage (UHC) or not. The study gives the trajectories of health policies in Ghana and their implications on long term health financing. NHIS in Ghana was implemented in 2004, with the aim of increasing subscribers’ access to health care services and reduce financial barriers to health care. On equity access to healthcare, it addresses two core concerns: (1) enrolling particular groups (persons exempted from annual premium payments) and (2) achieving UHC for all citizens and persons with legal residence. It utilizes a multifactor approach to the conceptualization of UHC. The research question: is Ghana’s NHIS on course to deliver or achieve universal health coverage? Methods: we used qualitative methods. In doing so, the study engaged participants in in-depth interviews, focus group discussions and direct observations of participants in their natural settings, like hospitals, clinics, offices and homes, with purposive and snowball techniques. This data triangulation approach aims to increase the reliability and validity of findings. Results: the empirical evidence shows NHIS performed relatively well in enrolling more exempt groups (particular groups) than enrolling all persons in Ghana (UHC). The biggest challenge for the implementation of NHIS from the perspectives of health insurance officials is inadequate funding. The health insurance beneficiaries complained of delays during registrations and renewals. They also complained of poor attitude of some health insurance officials and health workers at facilities. Conclusions: both health insurance officials and beneficiaries emphasized the need for increased public education and for implementers to adopt a friendly attitude towards clients. To move towards achieving UHC, there is a need to redesign the policy, to move it from current voluntary contributions, to adopt a broad tax-based approach to cover all citizens and persons with legal residence in Ghana. Also, to adopt a flexible premium payment system (specifically ‘payments by installation’ or ‘part payments’) and widen the scope of exempt groups as a way of enrolling more into the NHIS.

scholarly journals Narrowing the Gap of Inequity in the Indonesia’s National Social Health Insurance Scheme, 2014-2018

2021 ◽  
Author(s):  
Hasbullah Thabrany ◽  
Ryan R. Nugraha ◽  
Ery Setiawan ◽  
Farah Purwaningrum
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
Universal Health Coverage ◽  
Low Income ◽  
National Health Insurance Scheme ◽  
Income Group ◽  
Health Insurance Scheme ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Universal Health

Abstract Background. Indonesia is nearing its 7-year implementation of its national health insurance scheme, or the Jaminan Kesehatan Nasional (JKN), as a facilitator for achieving universal health coverage (UHC). Despite its long-running system, it is contentious as to whether JKN has been narrowing the gap of inequity in its delivery. This paper aims to explore on whether the national health insurance scheme in Indonesia have been promoting equity of access towards health services.Methods. This study analyzes findings from JKN statistic data of 2014-2018 published by Government of Indonesia. Using a retrospective design, this study identified membership and utilization of health services within JKN, based on different membership enrollment groups as proxy for income.Results. JKN has been expanding its enrollment significantly within 5 years, during year 2014 to 2018. Moreover, the study concludes that there was increased access for outpatient in all membership groups. Inpatient care was increased in low-income group, but not in high-income group. Result also showed inpatient access was correlated with adequate supply side intervention, particularly hospital beds.Conclusion. JKN has been successful in narrowing the inequity gap, particularly by serving the low-income group better in terms of access. Going forward, equity needs to be incorporated into JKN achievement indicator, particularly to accelerate Indonesia’s effort to realize universal health coverage.

scholarly journals Towards Universal Health Coverage: An Analysis of the Health Insurance Coverage in Nigeria

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Yusuff Olanrewaju Azeez ◽  
Yusuf Olalekan Babatunde ◽  
Damilola Babatunde ◽  
Joseph Olasupo ◽  
Elizabeth Alabi ◽  
...  
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
National Health Insurance ◽  
Informal Sector ◽  
Universal Health Coverage ◽  
National Health Insurance Scheme ◽  
Health Insurance Scheme ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Universal Health

Context: Achieving universal health coverage requires a Health Insurance Scheme that minimizes out-of-pocket expenditure, guarantees the provision of essential health services, and covers majority of the population. This study examines the NHIS, it's success, failures, efforts so far towards achieving UHC and overall, examines if Nigeria is progressing towards the achievement of universal health coverage. Evidence Acquisition: We conducted a narrative review of published articles on National Health Insurance Scheme (NHIS) coverage in Nigeria. Pubmed and Google Scholar were searched with the following keywords: National Health Insurance Scheme (NHIS), Success, Failure, Universal Health Coverage (UHC). Results: NHIS has failed in its inclusiveness and covers only about 5% of the general population, mainly from the formal sector while most from the informal sector are excluded. Certain factors such as the inadequate legal framework for a successful scheme, optional enrollment policy, poor funding and lack of political will are responsible for the failure of the NHIS. Conclusions: Revising the NHIS to cover all segments of the society including remote areas and ensuring the insured have access to health services at all hospitals and health centers across the country is essential in attaining the third sustainable development goal in Nigeria. Also, there is need for intensify public awareness programs to enlighten the people and relevant groups on the positive values of the scheme. The attributes of the scheme should be well publicized in a way that both the formal and informal sector would understand clearly. This might involve the use of all local languages spoken in different parts of the country.

scholarly journals Insured clients out-of-pocket payments for health care under the national health insurance scheme in Ghana

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Akweongo ◽  
Moses Aikins ◽  
Kaspar Wyss ◽  
Paola Salari ◽  
Fabrizio Tediosi
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Facility ◽  
National Health Insurance ◽  
National Health Insurance Scheme ◽  
Health Facilities ◽  
Health Coverage ◽  
Insurance Scheme ◽  
Out Of Pocket Payments ◽  
Universal Health

Abstract Background In 2003, Ghana implemented a National Health Insurance Scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments (OOP) by insured clients is one of such challenges of the scheme. This study sought to examine the types of services OOP charges are made for by insured clients and how much insured clients pay out-of-pocket. Methods This was a descriptive cross-sectional health facility survey. A total of 2066 respondents were interviewed using structured questionnaires at the point of health care exit in the Ashanti, Northern and Central regions of Ghana. Health facilities of different levels were selected from 3 districts in each of the three regions. Data were collected between April and June 2018. Using Epidata and STATA Version 13.1 data analyses were done using multiple logistic regression and simple descriptive statistics and the results presented as proportions and means. Results Of all the survey respondents 49.7% reported paying out-of-pocket for out-patient care while 46.9% of the insured clients paid out-of-pocket. Forty-two percent of the insured poorest quintile also paid out-of-pocket. Insured clients paid for consultation (75%) and drugs (63.2%) while 34.9% purchased drugs outside the health facility they visited. The unavailability of drugs (67.9%) and drugs not covered by the NHIS (20.8%) at the health facility led to out-of-pocket payments. On average, patients paid GHS33.00 (USD6.6) out-of-pocket. Compared to the Ashanti region, patients living in the Northern region were 74% less at odds to pay out-of-pocket for health care. Conclusion and recommendation Insured clients of Ghana’s NHIS seeking health care in accredited health facilities make out-of-pocket payments for consultation and drugs that are covered by the scheme. The out-of-pocket payments are largely attributed to unavailability of drugs at the facilities while the consultation fees are charged to meet the administrative costs of services. These charges occur in disadvantaged regions and in all health facilities. The high reliance on out-of-pocket payments can impede Ghana’s progress towards achieving Universal Health Coverage and the Sustainable Development Goal 3, seeking to end poverty and reduce inequalities. In order to build trust and confidence in the NHIS there is the need to eliminate out-of-pocket payments for consultation and medicines by insured clients.

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