THE ROLE OF NATIONAL HEALTH INSURANCE SCHEME IN THE SUSTAINABLE PROVISION OF AFFORDABLE AND ACCESSBLE HEALTHCARE DELIVERY IN AMANSIE WEST DISTRICT

Abstract

National Health Insurance Scheme, as it has now become a means for health care financing in Ghana,. needs some level of assessment in order to improve upon it for effective health care delivery for all especially, the poor. This thesis, seeks to find out the opportunities, challenges and obstacles that have effects on the scheme in playing an effective role in a sustainable provision of affordable and accessible healthcare delivery for all, especially the poor in Amansie West District in particular and Ghana as a whole and recommend how the NHIS can be sustainable. The analysis was made based on the data collected from field survey and other secondary data from Amansie West Mutual Health Insurance Scheme, and the respondent facilities which clients normally access. As in client interview 100% responding rate was achieved, 53% of the facilities selected responded. The findings were that as the Scheme faces the problem of handling the waste from the service . . providers and clients, the service providers are also fmding it difficult to deal with the huge sum of the debt accumulated at the various insurance offices. The clients on the other hand, cry for poor service delivery at some hospitals and clinics which results in cash and carry health care in some services which the scheme even covers. Access to health care under NHIS is limited to the services and drugs which are only covered by the scheme. The mode of paying the facilities as service providers even though creates loopholes for both the facilities and the clients to cheat on the scheme, yet it does not limit the clients in searching for quality healthcare as the new mode of payment, capitation, will do. Hence, as a new policy, if the facilities are able to manipulate and cheat on the system as it is going on in the current free for service mode of payment, then access to health care under NHIS will be more limited under capitation especially in Amansie West District, than as it is now. It is recommended that there should be a policy direction to integrate the NHIS into the mainstream of health care delivery to avoid the sharp gap between NHIS operations and that of the health facilities which has given way to a wide gap between the NHIS clients health needs and the benefits NHIS offers the clients. In all, any effort to make scheme sustainable at the expense of free access to quality health care will deepen the people loss of interest in the scheme thereby reversing the system back to full cash and carry.