Promising Start, but bleak future? Progress of Ghana's National Health Insurance Schemes towards Universal Health Coverage

摘要

In 2003 the Government of Ghana, West Africa began implementing a National Health Insurance Scheme (NHIS) to improve health care access for Ghanaians and eventually as a cardinal strategy towards meeting the ideals of universal health coverage. After nearly a decade of implementation, this article attempts to examine the progress made in meeting the policy objective of ensuring that all residents of the country get an acceptable quality package of essential healthcare. The major finding from this study suggests that although the NHIS cover a wide range of services as well as absorption of remarkable proportion of healthcare cost , coverage of the scheme could best be described as low after nearly a decade of implementation as over 60% of the population are uninsured, and hence financially unprotected. In progressing faster towards UHC, the paper proposes some strategies for widening NHIS finance and recommends different strategies of expanding membership enrolment including a consideration of commission-based remuneration for NHIS registration staff. Keywords: Ghana, National Health Insurance, Universal Health Coverage, health financing