External Evaluation of the Nkoranza Community Financing Health Insurance Scheme, Ghana. Technical Report No. 50

摘要

The Nkoranza Community Health Insurance Scheme in Ghana, considered the pioneer of its kind in that country, was evaluated after eight years of operation. The scheme has proved successful in terms of sustainability and making quality care affordable to a high percentage of vulnerable households in the district. In this sense, it is a model for other schemes. Despite these achievements, certain problems need to be resolved: coverage is still low (30 percent of the population) due to an inappropriate registration period, community misconceptions about the scheme, and massive adverse selection; the benefits package lacks coverage for health center services, in particular, maternal-child care; and the scheme also lacks adequate operational transparency and management skills. This evaluation report recommends ways for the scheme to resolve these problems, including rescheduling the registration period; introducing incentives to enroll entire families; expanding services; and offering training in management and outreach skills to better inform and involve the community.