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Critical evaluation of the national health insurance scheme in Ghana: the perspective of the stakeholders [Abstract]

Salek, Mir-saeed and Seglah, Sabrina Elikem 2013. Critical evaluation of the national health insurance scheme in Ghana: the perspective of the stakeholders [Abstract]. International Journal of Clinical Pharmacy 35 (5) , p. 976. 10.1007/s11096-013-9801-0

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Abstract

Background and objectives: User fees, also termed ‘cash and carry’, is the preferred approach used in the delivery of healthcare in many third world countries who have limited funds allocated to health services. The WHO has advised that this inequitable method creates many barriers for the poor to access healthcare services, where there are often many competing day-to-day necessities and therefore choices are made based on intuitive trades-offs. However, some of the third world nations have taken a stance against the use of user fees, by introducing social healthcare to the masses. Ghana is one of many to implement this system in 2005 by setting up the National Health Insurance Scheme (NHIS) run by the National Health Insurance Agency (NHIA). The NHIS is aimed at the pro-poor, the most vulnerable group to access primary healthcare. The aim of the study was therefore to evaluate the progress of the scheme from the perspectives of the main stakeholders. Setting and methods: A semi structured interview was conducted to evaluate service providers and decision makers with regards to their daily involvement and management of the scheme. In addition the HUI2 questionnaire was distributed to patients aged 18–70 in the greater Accra region to measure their current health states. Main outcome measure: The interview demonstrated that the scheme was a good initiative in providing coverage to all, in particular the poor and those in rural areas, Results: Despite the scheme being a good initiative all responders mentioned that there were many discrepancies with regards to the repayment system of the scheme and further improvements were needed, as well as more responsibility to the service providers. The HUI2 demonstrated that the mean utility scores of the patients HRQoL showed the NHIS members had a higher utility score of 0.96 versus 0.95 of the non members, with an overall mean of 0.94 for all respondents suggesting very good health. Conclusion: The findings indicate that further improvements are needed in the scheme, NHIA have made recommendations of improvement to the current structure and the financing of the scheme to curb fraud on claims and expenditure. Disclosure of interest: None declared.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Pharmacy
Subjects: H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine
Additional Information: 41st ESCP symposium on clinical pharmacy: personalised and safe therapy
Publisher: Springer Verlag
ISSN: 2210-7703
Last Modified: 11 Feb 2022 10:15
URI: https://orca.cardiff.ac.uk/id/eprint/56563

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