Pdf national health insurance accreditation pattern among. Refusal to enrol in ghanas national health insurance scheme. Framework for governmentsponsored health insurance programmes published by the microinsurance network. Claim stores information concerning one claim data. June 2012 volume 46, number 2 ghana medical journal 76 the effect of ghanas national health insurance scheme on health care utilisation n. Nhias objective is to ensure access to basic healthcare services for all ghanaian residents through. The national health interview survey nhis has monitored the health of the nation since 1957. Since 2005, healthcare in ghana is free for all citizens under the national health insurance scheme nhis.
Downloadable documents national health insurance scheme. Ghanas national health insurance scheme nhis is an innovative attempt. Rural urban differences in the determinants of enrolment in health insurance in ghana stephen k. The effects of ghanas national health insurance scheme on. Plenary session 1 ghanas journey to universal health coverage.
Governing for quality improvement in the context of uhc background history. Summary of nhis microdata availability pdf icon pdf 18 kb nhis microdata files record lengths and counts pdf icon pdf 63 kb nhis microdata reference information. This paper describes the financing of and enrollment in the ghana national health insurance scheme nhis implemented in 2005. Since 2008, ppag has convened and mobilized civil society organizations to demand that the nhis package include family planning. Password if user forgets password, system administrator can reset the password. 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. Monitoring quality of care and accountability mechanisms. Jun 18, 2018 ghanas national health insurance scheme. It also identified various funding mechanisms available to finance health care in ghana. Citizens receive services when in need at no cost to the individual. Because the current cash and carry system, which makes it compulsory for everybody to. Pdf the ghana national health insurance scheme nhis was. Download to read our nhis english pdf icon pdf 330 kb or spanish pdf icon pdf 2 mb brochure.
In this case, the individual remains covered by the nhis but opts to buy and use private health insurance instead. 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 object of that policy was to recover 15% of the health sectors recurrent expenditure. All structured data from the file and property namespaces is available under the creative commons cc0 license. The idea for the national health insurance scheme nhis in ghana was conceived by former president john kufuor. Ghana national health insurance scheme open knowledge. Despite the fact that the national health insurance scheme nhis has increased. It is allowed to store more than one claim element within a shipment.
The model, however, could not be sustained for long and a token user fee was first introduced in 1972. Nhias objective is to ensure access to basic healthcare services for all ghanaian residents through the national health insurance scheme nhis. Nhis restricted variable information, restricted and public use variable lists. The effect of ghanas national health insurance scheme on. Claims processes in both districts were similar and predominantly manual. This page was last edited on 29 november 2016, at 07. Behind the card is the start date and end date of the nhis members eligibility period for the card holder.
The national health insurance scheme was implemented in 2004 to improve financial access, especially for the poorest and most vulnerable groups 10,11. Ghana began the implementation of a national health insurance scheme nhis in 2004 as a way to ensure equitable access to basic healthcare for all residents. The politicoeconomic challenges of ghanas national health insurance scheme implementation adam fusheini1,2 abstract background. It may be used as a standalone data file or linked to the nhis 2018 health data files. June 2012 volume 46, number 2 ghana medical journal the. However, stagnating active membership, reports of poor quality health care rendered to nhis insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. The paradata file description document gives an overview of the 2018 paradata file, including information about the sample design, weighting, and variables found on the file. The 2018 nhis paradata file contains data about the nhis data collection process. Challenges in provider payment under the ghana national health. A fullyfledged user fee scheme known as cash and carry came into effect in 1985.
While registration rates have increased, many of the registered individuals fail to reenroll each year. The 2017 nhis paradata file contains data about the nhis data collection process. 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. Evaluating the impact of the national health insurance scheme.
The politicoeconomic challenges of ghanas national. Addaekorankye management and public administration department central university college, accra, ghana abstract the study examined the challenges of financing health care in ghana. The paradata file description document gives an overview of the 2017 paradata file, including information about the sample design, weighting, and variables found on the file. 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. Governing for quality improvement in the context of uhc. Open access original research impact evaluation of a. Refusal to enrol in ghanas national health insurance. Nhis benefit package constitutes duplicate coverage. This situation analysis of ghanaian children and women provide the status of some of the progress made, acknowledging that children living in povert y face deprivations of many of their rights, namely the rights to survive, to develop, to participate and to be protected. For example, in 2010 the tolon nhis office, which serves a rural area near the city of tamale in northern ghana,8 estimated that about onehalf of.
However, stagnating active membership, reports of poor quality health care rendered. Learning from experience, conference paper 2 introduction ghana is a development success story for africa it has had steady economic growth over the past few years, good governance and it is. It may be used as a standalone data file or linked to the nhis 2017 health data files. Access to health insurance is expected to have positive effect in improving access to healthcare and offer financial risk protection to households.
Nhis in ghana is achieving universal health coverage uhc or not. Challenges and prospects of social protection in ghana 11 4. The ghana national health insurance scheme nhis was created by an act of parliament in 2003 act 650, subsequently revised by act 852 in 2012, and implemented as a national program in 2005 18. The distributional consequences of ghana s national. Ghana shared growth and development agenda gsgda, 201020, that opd utilisation indicated that opd per capita continued to increase to 1. The national health interview survey nhis is the principal source of information on the health of the civilian noninstitutionalized population of the united states and is one of the major data collection programs of the national center for. After a decade of its implementation, national coverage is just about 34% of the national. Plenary session 2 towards innovative healthcare financing experiences from the world. Under the nhis, citizens get access to free consultations and prescriptions for emergency.
Seeking the mandate of the people in the 2000 elections. The government has yet to provide the policy directive and implementation guidelines necessary to make these methods part of the nhis package in practice. Ghanas nhis needs to reform its provider payment and claims submission and. A situation analysis of ghanaian children and women. Learning from experience, conference paper 2 introduction ghana is a development success story for africa it has had steady economic growth over the past few years, good governance and it is on track to halve poverty by 2015. National health insurance accreditation pattern among private healthcare providers in ghana article pdf available in archives of public health 7536. Pdf does the operations of the national health insurance. The country profiles, overview of their governmentsponsored health insurance programmes, and performance evaluation frameworks presently used in these programmes are discussed in detail in the discussion paper. Social protection in ghana friedrich ebert foundation. This period is the active membership of the subscriber to access health care from nhis accredited health providers. Census bureau has been the data collection agent for the national health interview survey. Nhis questionnaires, datasets, and related documentation.
Ethiopia, nigeria, benin and senegal visited ghana to understudy the operations of the nhis. The law established two 2 types of private health insurance schemes. It will also offer recommendations on effective policy interventions specifically targeting rural and urban populations to address low enrolment coverage in health insurance in developing countries. Open access original research impact evaluation of a social. Background the introduction of the national health insurance scheme nhis in ghana in 2003 significantly contributed to improved health services utilization and health outcomes. Evaluating the impact of the national health insurance. As it turned out, this system was neither a social nor financial success. Nhis ghana overview reforms achievements version 3 free download as powerpoint presentation.
Monitoring quality of care and accountability mechanisms at. The ghana national health insurance scheme nhis is operated and managed by the ghana national health insurance authority nhia. Census bureau has been the data collection agent for the national health. National health insurance scheme nhis benefits package.
Claims data are recorded in excel files and submitted to nhia along with paper. Approximately 150 million people suffer from financial catastrophe annually because of outofpocket expenditures oopes on health. Pdf national health insurance accreditation pattern. Governing body of the national health insurance authority 1 the governing body of the authority is a council consisting of a the chairperson, b one representative of i the ministry of health not below the rank of a director. The increase in health care utilisation has largely been attributed to increase in the proportion of insured patients under the national health insurance scheme. Nhis data on a broad range of health topics are collected through personal household interviews.
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 effect of nhia debt on accounts payables management in public hospitals julius aidoobuameh central university college, accra, ghana julius aidoobuameh abstract nhis has become a key means of ensuring accessibility to improved health care delivery in many countries. The national health insurance authority nhia of ghana is a public sector body established under the national health insurance act in 2003. In performing its regulatory functions the authority registers, licenses and supervises the operations of phis in ghana.
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 politicoeconomic challenges of ghanas national health. May 06, 2019 nhis microdata files record lengths and counts. The nhis has an overall goal of ensuring equitable access to quality basic healthcare for all residents, without having to make outofpocket payments at the point of service. The government is to replace the existing cash and carry health financing system with a national health insurance scheme. Files are available under licenses specified on their description page. National health insurance is one means to provide health care. In 2004, ghana began the implementation of a national health insurance scheme nhis following the passage of the national health insurance act act 650 in 2003. Standardized eclaims interface for health providers. Nationalsocial 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. June 2012 volume 46, number 2 ghana medical journal.
Ghana s nhis in brief ghana s health care system was founded on the basis of the free health care model. Nhis ghana overview reforms achievements version 3. The national health insurance scheme in ghana is deemed as one of the legacies of the john kufuor administration. The nhis is a social intervention program intended to provide financial risk protection against out of pocket healthcare expenditure for residents in ghana. Membership of the nhis is legally mandatory, but in practice membership is voluntary. Ghanas national health insurance scheme nhis was established by an act of parliament in 2003 act 650 to provide financial risk protection against the cost of health care services for all residents of ghana. New earmarked funding sources for the nhisparticularly the national health insurance levyas well as a portion of social. However, if the individual uses the services of the phis, the cost of healthcare shall be fully borne by the phis. Ghanas national health insurance scheme nhis was established by an act of parliament in 2003 act 650 to provide financial risk protection. The distributional consequences of ghana s national health insurance scheme.
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. Nhis microdata files record lengths and counts pdf icon pdf 63 kb nhis microdata reference information. Act 852 to regulate private health insurance schemes phis in ghana. Nhis offices report that reenrollment is a particular challenge. 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. The visits created the platforms for information and knowledge sharing between ghana and the visiting.
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