Abstract
BackgroundIn 2004, Ghana started experimenting a National Health Insurance Scheme (NHIS) to reduce out-of-pocket payment for healthcare. Like many other social health insurance schemes in Africa, the NHIS is striving for universal health coverage (UHC). This paper examines trends and characteristics of enrolment in the scheme to inform policy decisions on attainment of UHC.MethodsWe conducted trend analysis of longitudinal enrolment data of the NHIS for the period, 2010–2017. Descriptive statistics were used to examine trends and characteristics of enrolment by geographical region and member groups.ResultsOver the 8-year period, the population enrolled in the scheme increased from 33% (8.2 million) to 41% (11.3 million) between 2010 and 2015 and dropped to 35% (10.3 million) in 2017. Members who renewed their membership increased from 44% to 75.4% between 2010 and 2013 and then dropped to 73% in 2017. On average, the urban regions had significantly higher number of new enrolments than the rural ones. Similarly, the urban and peri-urban regions recorded significantly higher number of renewals than the other regions. In addition, persons below the age of 18 years and the informal sector workers had significantly higher number of enrolment than any other member group.ConclusionsEnrolment in the NHIS is declining and there are significant differences among geographical regions and member groups. Managers of the NHIS need to enforce the mandatory enrolment provision in the Act governing the scheme, employ innovative strategies such as mobile phone application for registration and renewals and address delays in healthcare provider claims to improve enrolment.
Highlights
In 2004, Ghana started experimenting a National Health Insurance Scheme (NHIS) to reduce out-ofpocket payment for healthcare
The NHIS is managed by the National Health Insurance Authority (NHIA), a regulatory body mandated by law to oversee operations of public and private health insurance schemes in the country [21]
It shows that persons below the age of 18 years were the most registered in each year of the study period, 48% in 2010 to 45.4% in 2017; followed by workers in the informal sector of the economy, about 32% to 30% over the same period
Summary
In 2004, Ghana started experimenting a National Health Insurance Scheme (NHIS) to reduce out-ofpocket payment for healthcare. Like many other social health insurance schemes in Africa, the NHIS is striving for universal health coverage (UHC). It is a general belief that UHC is a panacea for reducing out-of-pocket payment and inequity in access to and utilization of healthcare services [6, 9]. A lower middle-income country in SSA, implemented a National Health Insurance Scheme (NHIS) in 2004 to provide financial risk protection for all residents [13,14,15,16,17]. The NHIS has made gains in population coverage, increased access to healthcare services by reducing out-of-pocket payment and contributed to raising revenue of healthcare providers [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
