NHIS under pressure

Tuesday, April 21, 2009 (Daily Graphic - Front page)

Story: Lucy Adoma Yeboah
A HIGH intrusion rate by Fulani nomads and other nationals from some neighbouring West African countries into the National Health Insurance Scheme (NHIS) has brought intense pressure on the operations of the scheme.
Officials of the scheme say the influx of other nationals with no clear resident status, but who cross the borders in pursuit of cheaper, as well as free services under the NHIS, is difficult to prevent, since the law allows every resident of Ghana to enjoy services under the scheme.
A Ministry of Health (MoH) document on the scheme titled National Health Policy Framework for Ghana (August 2004), stated that “it is compulsory for every person living in Ghana to belong to a health insurance scheme type”.
It continued that “Every person living in Ghana shall contribute according to the principle of ability to pay in order to enjoy a package of health services covering over 95 per cent of diseases afflicting Ghanaians.”
In a reaction to a Ghana News Agency (GNA) story from the Builsa District that stated that Fulani herdsmen were insisting on registering under the scheme, the Media Relations Officer of the National Health Insurance Authority (NHIA), Mr Kwasi Acquah, said the authority had field reports that indicated that pregnant Togolese women allegedly came to Ghana to have access to the free maternal care being enjoyed by Ghanaian women.
Mr Acquah pointed out that the issue was a delicate one, since it was difficult to distinguish a Ghanaian from other nationals who did not reside in the country but only came to have free services.
According to the GNA, Fulani herdsmen and their families, insisting on registering with the NHIS in the Builsa District of the Upper East Region, were hindering the progress of the scheme in the area.
The Fulani families, nomads from neighbouring Burkina Faso, according to the report, were being aided by some opinion leaders in the various communities to harass the NHIS workers to register them.
Mr James Abakesi, Builsa District Manager of the scheme, made the allegation in Bolgatanga when the NHIS managers called on the Regional Minister, Mr Mark Woyongo, to brief him on the operations of the scheme in the region.
Mr Roger Ayine, Regional Manager, NHIS, said other challenges the scheme encountered were high tariffs by health service providers, low incentives for the staff of the scheme, inadequate staff and over centralisation of the issuance of identity cards.
He said a newly registered client had to wait between three months and one year to have his or her card issued from Accra.
He noted that money allocated for pregnant women was inadequate as one attendance to hospital by a pregnant woman cost the scheme GH¢10.88 and they were expected to visit the hospital at least six times before they deliver.
Mr Ayine complained that the new districts that were still depending on their mother districts were posing operational difficulties and called on the minister to help get them their own offices.
The districts are Garu-Tempane, Talensi-Nabdam and Kassena-Nankana East.
  Mr Woyongo said the government would review the NHIS to make it more efficient and urged the workers to be dedicated to their work.