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Free primary healthcare for all -NHIS review committee recommends

April 20, 2016, 7:47 a.m.

The technical committee set up by President John Mahama last year to review the National Health Insurance Scheme (NHIS)

has tabled a proposal that the scheme be restricted to compulsory primary healthcare, as well as maternal and child healthcare provision.

Even though the review process has not been completed, the committee appears to be convinced that compulsory primary healthcare, as well as maternal and child healthcare provision must cover all Ghanaians under the scheme.

Primary healthcare is the first level of contact individuals, families and communities have with the healthcare system.

With this proposal, the NHIS will provide a core Primary Healthcare benefit package guaranteed for all citizens of the country free of charge, whether they are members of the scheme or not.

This, according to the committee, will make the NHIS more focused as a major vehicle for Universal Health Coverage. 

Currently, the NHIS runs a benefit package which experts have described as bloated, inefficient and exclusionary, and one which is not sustainable into the future.

 The Finder can report that at a recently held meeting between the review committee and the advisory committee, consensus on the way forward for the scheme, given the work done so far, appeared to have tilted towards redesigning the scheme to provide a compulsory free primary healthcare package for Ghanaians, irrespective of whether they are members of the scheme or not, and also help address the current challenges of the NHIS system. 

Speaking at the meeting, Chairman of the review committee, Dr Chris Atim said: “[The] redesign will seize the opportunity offered by the government’s ongoing focus on Community Health Planning Services (CHPS) zone expansion and reinforcement to redirect public resources and efforts principally towards primary healthcare and maternal and child health with the limited public resources.” 

According to him, the NHIS benefits policy should be better aligned with Ghana’s most pressing public health problems and available resources. 

“It (NHIS) should be re-prioritised toward universal access to primary healthcare in the medium term and progressive realisation of universal access to higher levels of care in the long term,” he stated.

The review committee was of the view that to address the top health priorities of the country, consistent with Ghana’s income category, public resources should be focused on high impact, cost-effective interventions to address the health conditions that are responsible for the country’s underperformance in its key health indicators, such as unacceptably high maternal and child deaths, which resulted in Ghana missing out on the health-related MDG targets. 

The review process is also appearing to suggest that preventive health and actions to slow or arrest the rising burden of Non-Communicable Diseases need to be tackled as public health priorities.

Prof Agyeman Badu Akosa, a member of the advisory committee, averred that the country must take advantage of the opportunity of the NHIS review to position the scheme as one that would address the current burden of disease of the country. 

According to him, it is a good idea to suggest that a core Primary Healthcare benefit package should be guaranteed for all residents of the country.

While supporting the view that prioritising primary healthcare and maternal and child health for all Ghanaians is the way to go, Professor Kwabena Frimpong Boateng, also a member of the advisory committee, mentioned that the process must include measures to step up efficiency in the running of the scheme.

Another member of the advisory committee, Professor Plange-Rhule, rector of the Ghana College of Physicians and Surgeons, opined that a reviewed NHIS must guarantee that the basic healthcare needs of the populace are addressed and at an affordable cost.

The scheme is undergoing its first-ever comprehensive review since its establishment, and it is expected that the process will spawn a system that will be able to address the present difficulties of the scheme and be robust enough to take on challenges of the future.

The NHIS has been running a funding gap since 2009, a situation which, according to the NHIA, arose because of design and structural weaknesses of the scheme. 

NHIA officials have said cost of providing medical care has increased exponentially since the scheme started full operation in 2005, resulting in financing deficit. 

A seven-member committee, chaired by Dr Chris Atim, a renowned health economist, is leading the review process with an advisory committee made up of both local and international experts in health, academia, legislature and civil society. 

These include Prof Agyemang Badu Akosa, former Director-General of the Ghana Health Service; Prof Frimpong Boateng, formerly of the Korle Bu Teaching Hospital; Prof Plange-Rhule of the College of Physicians and Surgeons; Nuamah Donkor, a past Health Minister; Joseph Yieleh Chireh, MP; Dr Richard Anane, MP; Mohammed Muntaka, MP; Dr Matthew Opoku Prempeh, MP; and 11 others.  


Disclaimer: The views expressed in this news report do not necessarily reflect the position of the National Development Planning Commission (NDPC)