Ghana introduced a National Health Insurance Scheme in response to
financial access challenges posed by the "cash and carry" system.
Despite successes chalked, the scheme has been facing challenges
and government is committed to reviewing the policy to address
them. This study was therefore done to gather evidence on the
issues to support the policy review. The study confirmed the
delayed ID cards issuance and delayed re-imbursement of provider.
It also confirmed low coverage of indigents, inequity in premium
contributions in urban schemes and low performance of schemes in
rural locations. Schemes generate 8% to 16% of their inflows
internally while their administrative expenditures range between 3%
and 20% of their total incomes, with the highest burden being on
district schemes. Total expenditures exceeded incomes in all 6
schemes. Decentralization influenced performance of the scheme
positively and negatively. The schemes offer opportunity to protect
enrolees against catastrophic spending but could face
sustainability problems in the absence of tax funds.
General
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