Public Social Policy Efficacy Assessment: Operational Challenges of the Health Insurance Scheme in Ghana
Journal of Public Policy and Administration
Volume 2, Issue 4, December 2018, Pages: 71-83
Received: Nov. 7, 2018;
Accepted: Nov. 26, 2018;
Published: Dec. 25, 2018
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Vincent Ekow Arkorful, School of Public Affairs, University of Science and Technology of China, Hefei, China
Ibrahim Basiru, School of Public Affairs, University of Science and Technology of China, Hefei, China
Latif Amadu, School of Public Affairs, University of Science and Technology of China, Hefei, China
Anastasia Hammond, Department of Psychology and Home Science, University of Ghana, Accra, Ghana
Sarah Pokuaah, Department of Nursing, Stark State Community College, Stark County, USA
Eric Kwadwo Agyei, Agricultural Extension Department, University of Ghana, Accra, Ghana
Nurudeen Abdul-Rahaman, School of Public Affairs, University of Science and Technology of China, Hefei, China
Edward Arthur, Department of Economics and Entrepreneurial Studies, University for Development Studies, Wa, Ghana
Maintaining the health and wealth of a nation largely depends on the state of health care and policies guaranteeing citizens access to health care. It is the policy that creates the enabling operational environment for the health institutions. The purpose of this paper is to examine the current state of the public social policy program delivery, as well as challenges and prospects in three (3) purposefully selected districts each in the selected case study areas of the three (3) Northern regions of Ghana; The Northern Region, Upper East Region and the Upper West Region. The study employed the case study method. Interviews were conducted in communities in the selected districts in the regions using a semi-structured interview guide. The study relied on primary sources of data. Primary data were obtained through interview schedule and interview guide. The study identified reimbursement delays, widespread poverty among denizens of the study area, human resource constraints, infrastructural challenges and unethical conduct of health professionals. Others include: limited drug coverage under the scheme, logistical constraints, fraud and abuse, and delays in documents processing. The study therefore recommended among others things that, stakeholders, as part of concerted efforts to sustain the policy in the Northern, Upper East and the Upper West Region should integrate social justice, and vulnerability considerations into the policy to favour the poor and the socially marginalized.
Vincent Ekow Arkorful,
Eric Kwadwo Agyei,
Public Social Policy Efficacy Assessment: Operational Challenges of the Health Insurance Scheme in Ghana, Journal of Public Policy and Administration.
Vol. 2, No. 4,
2018, pp. 71-83.
WHO, “The World Health Report: Health Systems Financing: the Path to Universal Coverage.,” Geneva, 2010.
P. A. Dalinjong and A. S. Laar, “The national health insurance scheme : perceptions and experiences of health care providers and clients in two districts of Ghana,” Health Econ. Rev., vol. 2, no. 13, pp. 1–13, 2012.
D. G. M. and D. A. M. G. Adam Fusheini, “The Implementation of the National Health Insurance Programme in Ghana – an Institutional Approach,” in 62nd Political Studies Association Annual International Conference In Defence of Politics 3, 2016, no. April 2012.
Osei-Akoto and Adamba, “Health Insurance and Vulnerability to Health Shocks in Ghana.,” in 4th European Conference on African Studies, Uppsala, Sweden., 2011.
Aryeetey, “Targeting the poor in Ghana’s National Health Insurance Scheme and benefits of enrolment.,” 2012.
D. K. Arhinful, “The solidarity of self-interest,” The African studies centre, Leiden, 2003.
Derbile et al, “Repackaging exemptions under National Health Insurance in Ghana: how can access to care for the poor be improved?,” Health Policy Plan., pp. 1–10, 2012.
Kunfaa, “Sustainable rural health services through community-based organisation: women’s groups in Ghana,” Spring Res., 1996.
Jehu-Appiah et al., “Household perceptions and their implications for enrolment in the National Health Insurance Scheme in Ghana,” Heal. Policy Planning., vol. 27, no. 3, pp. 222–233, 2012.
Chris Atim and Madjiguene, “An External Evaluation of the Nkoranza Community Financing Health Insurance Scheme , Ghana,” Bethesda, Maryland, 2000.
S. et al. Atim, C., Grey, A survey of health financing schemes in Ghana. Bethesda, Maryland: Partners for health Reform plus, Abt Associate Inc., 2001.
Arhin D. C, Rural health insurance : a viable alternative to user fees? A review and evidence from three countries., 19th ed. PHP Departmental publication no 19, 1995.
I. A. Agyepong and S. Adjei, “Public social policy development and implementation : a case study of the Ghana National Health Insurance scheme,” Health Policy Plan., vol. 23, no. February 2008, pp. 150–160, 2008.
“DWHIS: Annual Report of the first Insurance Year (1st October 2000-30 th September, 2001),” Dodowa-Ghana, 2002.
“DWHIS: Annual Report of the 2nd AInsurance Year (1 st October, 2001-30 th September, 2002),” Dodowa-Ghana, 2003.
R. Baltussen, E. Bruce, G. Rhodes, and I. Agyepong, “Management of mutual health organizations in Ghana,” Trop. Med. Int. Heal., vol. 11, no. 5, pp. 654–659, 2006.
Y. Owusu, A., “National/Mutual Health Insurance in Ghana; Introduction, Access, Framework. Workshop on Micro Health Insurance,” 2010.
“Annual Report,” Accra, Ghana, 2011.
Z. L. Freeman F. K. Gobah, “The National Health Insurance Scheme in Ghana : Prospects and Challenges : a Cross-Sectional Evidence,” Glob. J. Health Sci., vol. 3, no. 2, pp. 90–101, 2011.
I. O.-A. A. A. W. k Asenso-Okyere, Adote Anum, “13-2-181.pdf,” Health Policy Plan., vol. 13, no. 2, pp. 181–188, 1998.
I. A. Agyepong, “Reforming health service delivery at district level in Ghana : the perspective of a district medical officer,” Health Policy Plan., vol. 14, no. 1, pp. 59–69, 1999.
Joseph M. et al, “Ghana’s National Health Insurance Scheme in the Context of the Health MDGs: An Empirical Evaluation Using Propensity Score Matching,” RUHR Econ. Pap. #157, 2009.
I. Osei-akoto, “Demand for voluntary health insurance by the poor in developing countries : Evidence from rural Ghana,” Cent. Dev. Resaerch, Univ. og Bonn, Germany, 2004.
L. Adomah-Yeboah, “Financing health Care in Ghana since Independence,” Daily Graphic, 16258, Accra, p. 10, 2005.
P. Boni, O., “The economic impact of national health insurance scheme on health on health care delivery in Ghana: case study of the Donkorkrom District,” Presbyterian University College, Ghana, 2011.
E. Owusu-sekyere and A. Chiaraah, “Demand for Health Insurance in Ghana : What Factors Influence Enrollment ?,” Am. J. Public Heal. Res., vol. 2, no. 1, pp. 27–35, 2014.
National Health Insurance Authority, “Annual Report,” Accra, Ghana, 2013.
Ghana Statistical Service, “Ghana poverty mapping report,” Accra, Ghana, 2015.
D. Adogla, “The national health Insurance and its Challenges,” 2013. [Online]. Available: https://www.ghanaweb.com/GhanaHomePage/health/The-NHIS-and-its-challenges-282620. [Accessed: 05-Jul-2018].
A. Brugiavini and N. Pace, “Extending health insurance in Ghana : effects of the National Health Insurance Scheme on maternity care,” Health Econ. Rev., vol. 6, no. 7, pp. 1–10, 2016.
S. O. D. et al. Robert Kaba Alhassan, “Comparison of Perceived and Technical Healthcare Quality in Primary Health Facilities : Implications for a Sustainable National Health Insurance Scheme in Ghana,” PLoS One, vol. 10, no. 10, pp. 1–19, 2015.
N. et Alhassan, Robert Kaba, “Assessing the Impact of Community Engagement Interventions on Health Worker Motivation and Experiences with Clients in Primary Health Facilities in Ghana : A Randomized Cluster Trial,” PLoS One, vol. 11, no. 7, pp. 1–19, 2016.
J. Akazili et al., “Is Ghana ’ s pro-poor health insurance scheme really for the poor ? Evidence from Northern Ghana,” pp. 1–9, 2015.
G. audit Service, “Auditor General Report: Performance audit report of the auditor General on the Magement of Claims OF Claims by the National Health Insurance Authority,” Accra, 2012.
“World Health Organization (WHO)/Global Health Workforce Alliance (GHWA). Global messages.,” 2014.
S. Witter and B. Garshong, “BMC International Health and Something old or something new ? Social health insurance in Ghana,” BMC Int. Health Hum. Rights, vol. 13, 2009.