AN ASSESSMENT OF THE HEALTH REFORM POLICY PROCESS IN GHANA: THE CASE OF THE NATIONAL HEALTH INSURANCE POLICY PROCESS

Abstract

This study provides a critical assessment of the health reform policy process culminating in the implementation of the National Health Insurance Scheme (NHIS) in Ghana. It is opportune to examine the health reform policy process now because most policy makers and analysts have focused most of their attention on the technical design and content of the NHIS while inadequate attention has been paid to the process by which the technical design and content of the policy came into being. Using the generic and institutional policy process models as the main theoretical guide, the study provides a comprehensive, vivid and systematic understanding of the health reform policy process in Ghana bringing to light the historical and constitutional context of the policyThe study establishes that the NHIS was plagued by design flaws and questions of sustainability due to the fact that public participation in the policy decision-making process was very low. This led to many implementation problems including weak institutional capacities of the novel scheme. Nevertheless, 38 percent of the Ghanaian population was enrolled into the insurance programme within the first two years of implementation. In conclusion, the health reform policy process in Ghana provides broad lessons for public policy reform as it demonstrates the importance of politics in the formulation of public policy in general.