CHALLENGES AND PROSPECTS OF WA MUTUAL HEALTH INSURANCE SCHEME

Abstract

Quality health is an important catalyst for development. However, the global quest for heath for all remains a mirage due to varying challenges. In developing countries including Ghana, it has become evident that the central govemment alone can not finance healthcare, neither could the burden of ever increasing cost of health care be left on the poor masses. Recognizing the role of good health care in attaining a middle income status on one hand, and sustainable development on another hand, Ghana opted for a nation wide implementation of health Insurance Scheme to improve access to quality health care. However, in Ghana where close to 70% of the economy is dominated by informal economies, and being the first ever nationwide implementation of the scheme, funding the health of the exemption group, attractiveness of the benefit package and the quality of health service delivery remain threats to the sustainability of the scheme. Hence, research was developed to identify the challenges and prospects of the Wa Municipal Health Insurance Scheme to improve sustainability. The study focused on a case study and descriptive cross - sectional in design aimed at eliciting information about perceptions of community members, the health facility, and the scheme about premium levels, benefit package, quality of service, funding, dependency of exempted registrants on the scheme. The study employed questionnaires administered to households, health facilities and scheme managers. A simple size of 200 respondents comprising registered and non registered members from the Wa municipality were randomly selected and given the questionnaire. The study revealed that, the Wa Municipal Health Insurance Scheme has tremendous prospects given the availability of technical support, quality of care at some facilities, solidarity that exists in communities, development partners and govemment commitment to this scheme as well as increasing community recognition that the scheme is a convenient means to increasing access to health care. However, the scheme is faced with some challenges. For instance, its limited benefit coverage, design weakness such as the "fee- for-service" system of payment and the scheme's potential for adverse selection which is a treat and can hamper sustainability.