National Health Insurance Authority Research Articles

Economic cost of management of glaucoma in public and private health facilities in the Tema metropolis in Ghana

Objectives: This study sought to determine the economic cost of the management of glaucoma among patients seeking care in health facilities in Ghana.Design: A cross-sectional cost-of-illness (COI) study from the perspective of the patients was employed.Setting: The study was conducted in public and private eye care facilities in the Tema Metropolis of Ghana.Participants: About 180 randomly selected glaucoma patients seeking healthcare at two facilities participated in the study.Main outcome measure: Direct cost, including medical and non-medical costs, indirect cost, and intangible burden of management of glaucoma.Results: the cost per patient treated for glaucoma in both facilities was US$60.78 (95% CI: 18.66-107.80), with the cost in the public facilities being slightly higher (US$62.50) than the private facility (US$ 59.3). The largest cost burden in both facilities was from direct cost, which constituted about 94% of the overall cost. Medicines (42%) and laboratory and diagnostics (26%) were the major drivers of the direct cost. The overall cost within the study population was US$10,252.06. Patients paid out of pocket for the frequently used drug- Timolol, although expected to be covered under the National Health Insurance Scheme (NHIS). Patients, however, expressed moderate intangible burdens due to glaucoma.Conclusion: The cost of the management of glaucoma is high from the perspective of patients. The direct costs were high, with the main cost drivers being medicines, laboratory and diagnostics. It is recommended that the National Health Insurance Authority (NHIA) should consider payment for commonly used medications to minimize the burden on patients.

Estimating the Lifetime Cost of Managing Hypertension in Ghana: A Modelling Study.

Over the last decade, hypertension (HPT) is among the leading causes of death and morbidity in Ghana. In recent past, most health policy research in Ghana and Africa focussed on communicable diseases. In recent times, Ghana and other developing nations have shifted their attention to non-communicable diseases because most of these countries are going through an epidemiologic transition where there is a surge in the prevalence of HPT. This paper was therefore set out to estimate the cost of treating HPT in Ghana from the patients' and health system's perspectives. We used a cost of illness framework to simulate the cost of HPT management in Ghana taking into account 4 of the common target organ complications with the most mortality implication. A decision analytic model (DAM) was developed in Microsoft® Excel to simulate the progression of HPT patients and the Markov model was employed in simulating the lifetime cost of illness. The results show that by 10 years from diagnosis, the probability of death from any of the 4 complications (ie, stroke, myocardial infarction, heart failure, and chronic kidney disease) is roughly 41.03%. By 20 years (or 243 months) from diagnosis, the probability of death is estimated to be 69.61%. However, by the 30th anniversary, the probability of death among the cohort is 82.3%. Also, the lifetime discounted cost of treating HPT is about GHS 869 106 which could range between GHS 570 239 and GHS 1.202 million if wide uncertainty is taken into account. This is equivalent to USD 119 056 (range: USD 78 115-164 723). By highlighting the lifetime cost of treating HPT in Ghana, policies can be formulated regarding the cost of treating HPT by the non-communicable disease unit and National Health Insurance Authority (NHIA) of the Ministry of Health.

An assessment of primary health care costs and resource requirements in Kaduna and Kano, Nigeria.

The availability of quality primary health care (PHC) services in Nigeria is limited. The PHC system faces significant challenges and the improvement and expansion of PHC services is constrained by low government spending on health, especially on PHC. Out-of-pocket (OOP) expenditures dominate health spending in Nigeria and the reliance on OOP payments leads to financial burdens on the poorest and most vulnerable populations. To address these challenges, the Nigerian government has implemented several legislative and policy reforms, including the National Health Insurance Authority (NHIA) Act enacted in 2022 to make health insurance mandatory for all Nigerian citizens and residents. Our study aimed to determine the costs of providing PHC services at public health facilities in Kaduna and Kano, Nigeria. We compared the actual PHC service delivery costs to the normative costs of delivering the Minimum Service Package (MSP) in the two states. We collected primary data from 50 health facilities (25 per state), including PHC facilities-health posts, health clinics, health centers-and general hospitals. Data on facility-level recurrent costs were collected retrospectively for 2019 to estimate economic costs from the provider's perspective. Statewide actual costs were estimated by extrapolating the PHC cost estimates at sampled health facilities, while normative costs were derived using standard treatment protocols (STPs) and the populations requiring PHC services in each state. We found that average actual PHC costs per capita at PHC facilities-where most PHC services should be provided according to government guidelines-ranged from US$ 18.9 to US$ 28 in Kaduna and US$ 15.9 to US$ 20.4 in Kano, depending on the estimation methods used. When also considering the costs of PHC services provided at general hospitals-where approximately a third of PHC services are delivered in both states-the actual per capita costs of PHC services ranged from US$ 20 to US$ 30.6 in Kaduna and US$ 17.8 to US$ 22 in Kano. All estimates of actual PHC costs per capita were markedly lower than the normative per capita costs of delivering quality PHC services to all those who need them, projected at US$ 44.9 in Kaduna and US$ 49.5 in Kano. Bridging this resource gap would require significant increases in expenditures on PHC in both states. These results can provide useful information for ongoing discussions on the implementation of the NHIA Act including the refinement of provider payment strategies to ensure that PHC providers are remunerated fairly and that they are incentivized to provide quality PHC services.

Cost analysis of the management of end-stage renal disease patients in Abuja, Nigeria

BackgroundAlthough the treatment for end-stage renal disease (ESRD) under Nigeria’s National Health Insurance Authority is haemodialysis (HD), the cost of managing ESRD is understudied in Nigeria. Therefore, this study estimated the provider and patient direct costs of haemodialysis and managing ESRD in Abuja, Nigeria.MethodThe study was a cross-sectional survey from both healthcare provider and consumer perspectives. We collected data from public and private tertiary hospitals (n = 6) and ESRD patients (n = 230) receiving haemodialysis in the selected hospitals. We estimated the direct providers’ costs using fixed and variable costs. Patients’ direct costs included drugs, laboratory services, transportation, feeding, and comorbidities. Additionally, data on the sociodemographic and clinical characteristics of patients were collected. The costs were summarized in descriptive statistics using means and percentages. A generalized linear model (gamma with log link) was used to predict the patient characteristics associated with patients’ cost of haemodialysis.ResultsThe mean direct cost of haemodialysis was $152.20 per session (providers: $123.69; and patients: $28.51) and $23,742.96 annually (providers: $19,295.64; and patients: $4,447.32). Additionally, patients spent an average of $2,968.23 managing comorbidities. The drivers of providers’ haemodialysis costs were personnel and supplies. Residing in other towns (HD:β = 0.55, ρ = 0.001; ESRD:β = 0.59, ρ = 0.004), lacking health insurance (HD:β = 0.24, ρ = 0.038), attending private health facility (HD:β = 0.46, ρ < 0.001; ESRD: β = 0.75, ρ < 0.001), and greater than six haemodialysis sessions per month (HD:β = 0.79, ρ < 0.001; ESRD: β = 0.99, ρ < 0.001) significantly increased the patient’s out-of-pocket spending on haemodialysis and ESRD.ConclusionThe costs of haemodialysis and managing ESRD patients are high. Providing public subsidies for dialysis and expanding social health insurance coverage for ESRD patients might reduce the costs.

Does mobile renewal make health insurance more responsive to clients? A case study of the National Health Insurance Scheme in Ghana

BackgroundIn 2018, Ghana’s National Health Insurance Authority (NHIA) introduced a mobile strategy to enhance re-enrolment and improve client knowledge of their entitlements. This study investigated how Ghana’s mobile strategy has...

Preferences of healthcare workers for provider payment systems in The Gambia’s National Health Insurance Scheme

BackgroundThe Government of The Gambia introduced a national health insurance scheme (NHIS) in 2021 to promote universal health coverage (UHC). Provider payment systems (PPS) are strategic purchasing arrangements that can enhance provider performance, accountability, and efficiency in the NHIS. This study assessed healthcare workers’ (HCWs’) preferences for PPS across major service areas in the NHIS.MethodsA facility-based cross-sectional study was conducted using a probability proportionate to size sampling technique to select an appropriate sample size. Health care workers were presented with options for PPS to choose from across major service areas. Descriptive statistics explored HCW socio-demographic and health service characteristics. Multinomial logistic regressions were used to assess the association between these characteristics and choices of PPS.ResultsThe majority of HCW did not have insurance coverage, but more than 60% of them were willing to join and pay for the NHIS. Gender, professional cadre, facility level, and region influenced HCW’s preference for PPS across the major service areas. The preferred PPS varied among HCW depending on the service area, with capitation being the least preferred PPS across all service areas.ConclusionThe National Health Insurance Authority (NHIA) needs to consider HCW’s preference for PPS and factors that influence their preferences when choosing various payment systems. Strategic purchasing decisions should consider the incentives these payment systems may create to align incentives to guide provider behaviour towards UHC. The findings of this study can inform policy and decision-makers on the right mix of PPS to spur provider performance and value for money in The Gambia’s NHIS.

Premium exemptions and active health insurance membership among teenage migrant head porters in Ghana: a cross-sectional study

Ghana’s national health insurance scheme (NHIS) aims to provide financial risk protection to vulnerable populations by making provisions for premium  exemptions for all people below 18 years. This study assessed the factors associated with active insurance membership and access to premium  exemptions among teenage migrant head porters in Ghana. Data collected from 257 migrant female head porters (10-17 years old) in Accra and Kumasi  in a cross-sectional survey were analysed using descriptive statistics and regression models. Only 25% of participants had active membership cards  although about 54% had ever registered with the NHIS. Among registered members, only 40% benefited from NHIS premium exemptions as per the insurance policy. Respondents who benefited from premium exemptions were more likely to maintain active membership (OR=3.58, p-value&lt;0.01).  Relatively higher income earners (OR=2.72, p-value&lt;0.05) and those who migrated to Kumasi (OR=5.17, p-value&lt;0.01) were more likely to maintain active  membership. Although benefiting from premium exemptions improves active enrolment, many migrant teenage head porters were unable to benefit  from exemptions. We recommend that the National Health Insurance Authority takes pragmatic steps to identify and enrol all female head porters below  18 years to improve their access to healthcare. 

Assessment of the Impact of Health Maintenance Organizations on Access, Utilization, and Quality of Service among National Health Insurance Authority Enrollees in Kano, Kano State Nigeria

Effort by government in Nigeria to provide effective ways of accessing quality and affordable healthcare service has been contentious with high cost of health care service delivery. The ineffective management of health care funds over the years was observed as key contributor to the rising cost of healthcare services. The need for the establishment of health maintenance organizations (HMOs) whose responsibility as purchasers, was to manage health care services with health facilities providers under the National Health Insurance Authority Scheme (NHIA). However, this research seeks to assess the impact of healthcare purchasers in Kano state Nigeria, as regards knowledge, utilization, and satisfaction of enrollees whose healthcare services they manage. The study utilized analysis of enrollees, HMOs and desk officers under the scheme. Quantitative and qualitative methods using interviewer administered questionnaire and Key stakeholders’ interview was used. Data were recorded in Microsoft Excel 2010 and analyzed using SPSS version 23.0. NVIVO version 12 with verbatim transcription was used for thematic analysis of qualitative data. Chi-square used to test degree of association and Logistic regression utilized to predict factors for the determinants. Results were presented as tables and charts. Statistical significance p-value &lt;0.05 at confidence level of 95% was considered significant. Thus, analysis of the general demographic outcomes showed a significant association between HMOs and enrollees’ level of knowledge, utilization and satisfaction (p&lt;0.05). Conversely, analysis of federal, state and private run facilities separately, revealed varying outcome as regards the three determinants, with the state-run hospitals mostly affected in terms of enrollee’s outcome. Keywords: Desk officers, Health Maintenance Organizations, Knowledge, National Health Insurance Authority, Satisfaction, Utilization.

Impact of digital health technology on health insurance claims rejection rate in Ghana: a quasi-experimental study

IntroductionAn efficient medical claims billing system is critical to mitigating the challenges associated with claim denials and ensuring the sustainability of providing healthcare services. This study assessed the impact of Digital Health Technology (DHT) in reducing the claim rejection rate of health insurance claims submitted by health facilities to the National Health Insurance Authority in Ghana.MethodsThe study used longitudinal data on monthly claims adjustments due to errors from both paper-based and claims submitted using different DHT systems from 2010 to 2019. The claim rejection rate was estimated for each month. Prais-Winsten Segmented Interrupted Time-Series analysis was used to estimate the impact of DHT systems by comparing claims data before and after the system implementation for each facility. We employed meta-analysis techniques to generate a pooled impact estimate of DHT systems on the claim rejection rate of health insurance claims.ResultsThe total cost of deductions due to errors from the DHT system was significantly lower than the paper-based system (DHT = 8.15%, paper-based system = 10.13%). DHT contributed to an immediate impact of 1.31 percentage point reduction in the claim rejection rate of health insurance claims compared to the paper-based system.ConclusionThe DHT recorded lower denied claims costs than the paper-based claims system. Scaling up the use of DHT for claims submission will reduce the rate of claim denials and ensure the sustainability of providing healthcare services.

Healthcare Providers and Access to Quality Services Under the National Health Insurance Authority in Kano State, Nigeria

Lack of effective operational facilities and manpower among healthcare facilities has also been attributed to poor operational practices, mismanagement of the government’s health care funds, increased health care spending, and a negative impact on patient health outcomes. Like health maintenance organizations (HMOs), healthcare facilities are providers of National Health Insurance Authority (NHIA) for enrollees in the states. However, the roles of these facilities in implementation of social health insurance under the national health insurance Authority of Nigeria are not very well defined in terms of providing health care services as either providers or as well as purchasers. This qualitative, single case study was to explore the roles of these healthcare facilities as regards their impacts in contributing to implementation of the national social health insurance scheme in Kano state, Nigeria. A dominant qualitative design was employed in the study of health maintenance organizations officers using Key stakeholders’ interview. Copious notes and transcribed interviews were analyzed. NVIVO version 12 with verbatim transcription was used for thematic analysis of qualitative data. Thus, analysis of the general outcomes showed a significant association between health facilities and quality of services provided. Conversely, findings support that, NHIA providers who attain accreditations and appropriate approvals were short of providing efficient and effective services and maximize their performances in terms of patient’s outcome in ensuring achieving universal health coverage.

Medication adherence and blood pressure control: A preliminary assessment of the role of health insurance in Nigeria and Ghana.

This study sought to assess the current impact of health insurance coverage on medication adherence and blood pressure control of patients being managed for hypertension in Ghana and Nigeria. The study was a prospective study among 109 patients with hypertension in two health facilities with similar population dynamics in Ghana and Nigeria. Patients were systematically selected, categorized as having health insurance coverage or not, and followed up monthly for 6 months. The outcome variables (medication adherence and blood pressure control) were then measured and compared at 6 months. Analysis was done using Stata with level of significance set at p ⩽ 0.05. There was a 90% insurance coverage among participants from Ghana compared to 15% from Nigeria. National Health Insurance Authority enrolees in both countries had better blood pressure control and medication adherence compared to non-enrolees (adjusted odds ratio = 2.6 and 4.5, respectively). National Health Insurance Authority enrolment was found to be poor among respondents in Nigeria compared to Ghana. Enrolment into the National health financing schemes in both countries led to better blood pressure control and medication adherence among patients with hypertension at primary health facilities. There is therefore the need for system strengthening to improve their sustainability.

OP51 Improving Childhood Cancer Management And Financing In Ghana: Results From Stakeholder Mapping and Analysis

IntroductionCoverage of childhood cancer treatment under the Ghanaian National Health Insurance Scheme (NHIS) has been a policy discussion recently. To improve priority setting, Ghana introduced and used health technology assessment (HTA) processes to guide the resource allocation. To understand the role of stakeholders throughout the HTA lifecycle and for this decision, a stakeholder mapping and engagement was undertaken. We share our results of this mapping and analysis for improving management and financing of childhood cancers in Ghana.MethodsWe used two main approaches; first, we undertook a systematic policy documents and literature review of stakeholders relevant in childhood cancer management and financing in Ghana. This was followed by a stakeholder engagement workshop of key stakeholders from the Ministry of Health, Ghana Health Service (GHS), National Health Insurance Authority (NHIA), academia, non-governmental organizations (NGOs), private sector, teaching hospitals, patient groups, and civil society organizations. Participation was done in-person and virtual. Questions were moderated using a focus group discussion approach where responses were recorded. Data were analysed using synthesis and development of themes. Mapping of stakeholders was done using Mendelow’s power-interest grid.ResultsThe mapping identified eight key stakeholders in different roles: policy makers (Ministry of Health), payer (NHIA), healthcare providers (teaching hospitals, GHS, private hospitals), pharmaceutical companies, patient group (Ghana Parents Association for Childhood Cancers), and advocacy group (NGOs). Analysis showed that power and interest are concentrated with Ministry of Health and NHIA primarily because of control over resources. Also, while healthcare providers, patient groups, and advocacy groups have high interest, their power ranges from low to moderate. Further analysis of data from the workshop revealed that inability to pay for high cost of treatment leads to treatment abandonment. Payment for treatment was mainly out-of-pocket and by donation from philanthropist.ConclusionsThere was a strong will from stakeholders to extend coverage of the NHIS to childhood cancers in Ghana. Stakeholder engagement is a powerful tool and should be an integral part of every HTA process.

Nigeria's mandatory health insurance and the march towards universal health coverage

The 2022 Lancet Nigeria Commission highlights the value of adequate investments in health as Nigeria undergoes key transitions.1 It provides compelling evidence on the need for a “new social contract”1 between the people and the state. This contract is crucial for the implementation of the National Health Act (NHA), the National Health Insurance Authority (NHIA) Act, and national strategies and plans for health.

Perceptions and attitudes about antibiotic resistance in the general public and general practitioners in France

BackgroundDuring the last 20 years, France has taken important steps to tackle antibiotic resistance. These include national awareness campaigns for the general public, and supporting changes in terms of antibiotic prescription for healthcare practitioners. To prepare the upcoming 2022/2023 campaign, we conducted two surveys to assess (1) the general public’s knowledge, attitudes and behaviours regarding antibiotics and (2) the perceptions and practices of general practitioners (GPs).MethodsTwo quantitative telephone surveys were conducted using the same methodology as that used in 2010 by the National Health Insurance Authority. The first was conducted in 2019 in a national representative quota sample of 1204 persons aged over 15 years living in metropolitan France, including an over-sample of 332 parents of children aged six years or under. The second was conducted in 2020 in a national representative sample of 388 GPs.ResultsTwenty-seven percent of respondents reported taking antibiotics during the previous year. Sixty-five percent of GPs declared prescribing fewer antibiotics during the previous five years. However, 33% of GPs reported they often had patients who put high pressure to get antibiotics. The pressure from elderly patients, especially those with comorbidities was notable. Three percent of respondent patients reported putting often pressure on their GP. All respondents expressed total trust in their GP irrespective of whether s/he had prescribed them antibiotics. Half knew that antibiotics act only on bacteria, and 38% said they understood precisely what antibiotic resistance is.ConclusionAlthough antibiotic use is decreasing in France, patient pressure on GPs to prescribe antibiotics is very high. GPs are key ambassadors in reducing antibiotic use. Awareness campaigns must target elderly patients in particular.

Exploring for-profit healthcare providers' perceptions of inclusion in the Zambia National Health Insurance Scheme: A qualitative content analysis.

In 2019, Zambia introduced the national health insurance (NHI) as a healthcare financing strategy to increase universal access to health care services. The private health sector can complement public sector providers as service providers under the NHI. As such, the NHI Management Authority seeks to accredit for-profit private healthcare facilities in the NHI. Ascertaining factors that influence private-for-profit health providers to participate in the NHI is essential, but the evidence is lacking. In this study, we aimed to explore and characterize perceptions and experiences of for-profit private hospitals, dental clinics, eye clinics, diagnostic centres, and pharmacies regarding their inclusion in the NHI. We conducted in-depth interviews with owners or management officers of purposively sampled private health care providers in Lusaka, Zambia (n = 22) between May and June 2020. Qualitative content analysis was used to analyse data. The findings highlight low awareness of the NHI among providers and a need to understand the NHI. Providers revealed their positions and views on the accreditation process and payment arrangements and stated that their participation would complement the NHI. They also cited conditions to participate in the NHI, highlighted opportunities and challenges of engaging in the NHI, and expressed a need for sustainable ways of governing the scheme. The assessment of health providers' inclusion in the NHI scheme is multifaceted. The results of this study surfaced factors such as raising awareness on the NHI among providers and how their concerns on aspects such as payments can be considered as inputs to enlighten consensual agreements between the NHI authority and health providers in leveraging the private health sector. Private providers' concerns must be further understood and considered as the NHI strives to include this group as health care providers in the scheme.

Clinical and Cost-Saving Effects of the Drug Utilization Review Modernization Project in Inpatient and Outpatient Settings in Korea.

Korea's national health insurance authority introduced a drug utilization review modernization pilot project in which health professionals provided follow-up services to monitor adverse drug events. We aimed to evaluate the effects of the project on clinical and economic outcomes. We conducted difference-in-differences analysis using National Health Insurance claims data from the Health Insurance Review and Assessment Service. We calculated the number of adverse drug events and allergic reactions as a clinical indicator and medical costs incurred to manage these events as an economic indicator. Absolute difference in each outcome measure was defined as the value after the project minus the value before the project. Difference-in-differences was defined as a difference in absolute differences between the intervention group and the control group. Overall, difference-in-differences were -43 and -826 for the number of drug-related adverse events and allergic reactions and -$198,700 and $53,318 for medical costs in the inpatient and outpatient settings, respectively. For outpatients, the monthly number of adverse drug events and allergic reactions has grown higher for the control group than for the intervention group after implementation of the pilot project. Implementation of the pilot project lowered the number of adverse drug events and allergic reactions in the inpatient and outpatient setting. The project also lowered medical costs incurred to manage these events in the inpatient setting only. Based on our findings, we recommend that the pilot project be expanded on a nationwide level at least in the inpatient setting.

ASSESSING THE ANTECEDENTS OF NATIONAL HEALTH INSURANCE SCHEME (NHIS) ENROLLMENT IN GHANA: THE PERSPECTIVE OF RURAL DWELLERS

The purpose of this research is to assess the factors that affect National Health Insurance Scheme (NHIS) enrollment in Ghana. Using convenience sampling method, 200 completed data were analyzed. The Statistical Package for Social Sciences (SPSS 25) was used in analyzing the relationships between the Independent variables and the dependent variable. Findings from the study indicated that there is a reasonable positive linear relationship between Enrollment Drive Features (Independent variables) and NHIS Enrollment (Dependent). Based on the findings, it is concluded that, a comprehensive package and awareness of a health insurance guarantee higher enrollment. The study recommends that the National Health Insurance Authority (NHIA) and its affiliate offices intensify the education and sensitization program about the scheme, its role and the feedback from the public. KEYWORDS: National Health Insurance Scheme; Enrollment; Rural dwellers; Enrollment Drive Features

The Mediating Effect of Healthcare Utilization on Livelihood Empowerment against Poverty (LEAP) and Health Security of Older Adults in Ghana: A Case Study on the Ga-West Municipality in Accra, Ghana

The concept of health security has aroused several interpretations because of theoretical technique indifferences or academic methodology. The focus has been on human security, old age health security (OAHS), whereas there remain issues of low healthcare utilization by older people from rural Ghana while there are social assistance programs. The study aimed at investigating the mediating effect of healthcare utilization on Livelihood Empowerment against Poverty (LEAP) and old age health security OAHS. With purposive sampling technique, participants were selected to participate in the study with standardized quantitative questionnaire to measure the variables involved in the study and a regression technique to analyze the data. The result of the mediation analysis showed a partial mediation between LEAP and Healthcare Utilization (HU) was found to have bridged the gap between the LEAP and OAHS. The LEAP policy also caused an increase in Health Utilization and, subsequently, an increase in old age health security (OAHS). The study is essential to help the National Health Insurance Authority NHIA in restructuring health care premiums to incite utilization of health facilities by the aged.

The Nigeria national health insurance authority act and its implications towards achieving universal health coverage.

The National Health Insurance Scheme (NHIS) faced several inherent and systemic drawbacks towards achieving universal health coverage for all Nigerians, and this has led to the signing of the new National Health Insurance Authority Act (NHIA), 2022. This article highlights the benefits of NHIA, discusses the possible challenges and the way forward in its implementation. A narrative review of past literature searched in PubMed, MEDLINE, African Journal Online, and Goggle was conducted. A total of 76 publications were initially retrieved and following data triangulation, 55 were finally used. The authors also included their experiences. The NHIA addressed some of the shortcomings of the previous NHIS, however, it would still face several challenges in its implementation such as low government funding priority to health, shortage of healthcare workers and poor healthcare coverage, as well as problems with enforcement as it mandates all Nigerians to enroll. These and other impending constraints must be surmounted and all stakeholders must be involved to ensure the Act accomplishes its aim.

Effect of Human Resource Development (HRD) Initiatives on Organizational Performance. A Case Study of the National Health Insurance Authority, Ghana

The paper investigates the practices of Human Resource Development (HRD) and its effect on organizational performance. The study employs a case-study strategy. A comprehensive study is done at the National Health Insurance Authority (NHIA) Human Resources to evaluate the variables of study. The study addresses the challenges faced by HRD professional, suggests remedies through HRD initiatives to achieve superior performance. Nonetheless, there is no empirical evidence as to whether the adoption of these initiatives led to employee retention and enhanced organizational performance at the NHIA. The study employs the mixed method approach: quantitative and qualitative research approaches. A total of 72 respondents were selected to participated in the research from a population of 90 employees at the Human Resources and Administrative Unit of the study organization. The study adopted questionnaires and interview guides to gather primary data. The study employs the use of descriptive analyses, and regression test to examine the relationship between the independent variable and the dependent variable. The study found that all the seven scales of the independent variable, HRD initiatives: career development, employee guidance and counseling, training and development, skills and technical training, organizational development, management and supervisory development, and coaching and mentoring had significant relationship with the dependent variable, organizational performance. The study concluded that the adoption of these practices would thus improve organizational performance. Keywords: Human Resource Development (HRD), Organizational Performance, Career Development, Employee Guidance and Counseling, Training and Development, Skills and Technical Training, Organizational Development, Management and Supervisory Development, Coaching and Mentoring DOI: 10.7176/JRDM/81-04 Publication date: December 31 st 2021