Abstract

The establishment of the National Health Insurance Scheme was as a consequence of government effort at adopting a sustainable health care financing system with the aim of achieving universal health coverage. This study therefore explored the perceptions and experiences of health care providers and subscribers regarding the sustenance of the NHIS in Ghana. The study employed a mixed method design using survey questionnaires and in-depth face-to-face interviews. The study revealed that NHIS had contributed to the revenue base of service providers and increased healthcare utilisation at provider centres. The inability of health care providers to provide essential medicines and perceived poor quality of health care were identified as challenges to subscribers. The study concludes that the NHIS has the potential of ensuring universal health coverage provided stakeholders make deliberate efforts at addressing the obvious sustainable threats identified.

Highlights

  • Universal health coverage (UHC) has become a major goal for health reform in many countries

  • This paper discussed the perceptions and experiences of health care providers and how these affects the sustainability of the National Health Insurance Scheme (NHIS) in the Jirapa and Lambussie Districts of the Upper West Region of Ghana

  • The success of the NHIS does not depend solely on the National Health Insurance Authority (NHIA) and on the health service providers contracted to the scheme

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Summary

Introduction

Universal health coverage (UHC) has become a major goal for health reform in many countries. Post-independence in Ghana witnessed the establishment of a National Health Service (NHS) that was mainly financed from state revenue (Owusu-Sekyere and Bagah, 2014). This system of health delivery ensured that the citizenry received health services without any costs and as such insulated the poor and marginalised from financial distress (Frimpong, 2013). Limited resources engulfed the health sector and led to widespread shortages of essential medicines, supplies and equipment which adversely affected the quality of care in public health facilities (Dalinjong & Laar, 2012)

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