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Health Financing in Ghana (Paperback, New)
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Health Financing in Ghana (Paperback, New)
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Ghana is one of only several African countries to enact legislation
and earmark financing for universal health insurance coverage for
its entire population. Seven years into its implementation the
Ghana National Health Insurance Scheme (NHIS) has made significant
progress in transitioning to universal coverage, but faces
significant fiscal and coverage challenges. This study reviews
Ghana's health financing system with a special emphasis on its
National Health Insurance Scheme. Such an assessment is important
because Ghana is often considered a global 'good practice' in terms
of earmarking significant amounts of its general revenues for
health insurance coverage, providing formal coverage to its
vulnerable population groups, and extending coverage by
transitioning its existing community health insurance schemes into
a national health insurance program. In addition to the global
interest in the Ghana 'model', this review is timely in view of
recent critiques of the system and questions about its financial
sustainability. The study is also unique in terms of evaluating
Ghana's NHIS in terms of basic health system goals of health
outcomes, financial protection, consumer satisfaction, equity,
efficiency, and financial sustainability. The strengths and
weaknesses of Ghana's health financing system are assessed on the
basis of these performance goals to provide the current health
policy reform baseline. The assessment is also based on several new
and updated sources of information on: total health spending,
inputs, outcomes, household spending, and the macro economy. It
also undertakes for the first time an extensive international
benchmarking analysis; assesses the financial protection/equity of
the system at both macro and micro levels; and, contains an
extensive fiscal space analysis based on Ghana's new macroeconomic
realities (i.e., the revaluation of Ghana's Gross Domestic Product
(GDP) upward by some 60 percent in November 2010, making Ghana a
lower middle income country). The study concludes with an
assessment of potential structural and operational reform options
to assure NHISs long-term efficacy and sustainability in the
context of its future available fiscal space.
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