Features
Is the NHIS working effectively at the accredited health facilities at all?
For the number of times, this year, that I had sought medical attention at my health provider (Clinic), which has been duly registered under the National Health Insurance Scheme (NHIS), I did not receive my medications from the pharmacy even though the prescriptions by the doctors were covered by the scheme.My only benefits were the examination and compilation of my vital information, i.e. taken of temperature, blood pressure and checking of weight by the nurses and finally the medical treatment by the doctors. The prescriptions for my drugs were issued alright by the doctors, only to be told by the pharmacists on duty that the drugs were not available, therefore, I should go outside and buy them.
‘NO DRUG’ SYNDROME BY ACCREDITED NHIS HEALTH PROVIDERS
I have monitored and observed this situation critically in some of the NHIS health providers in Accra and arrived at the conclusion that I was not the only person suffering from this unfavourable practice but quite a number of people were also being denied their legitimate entitlement. The mantra has been, ‘please go to the doctor to write a fresh prescription for you to buy your drugs from pharmacies outside’. Such is the scenario in most of the health facilities covered by the NHIS in our dear country. I have contacted a number of people who have attested to that fact and told me they have been buying their drugs from pharmacies outside at exorbitant prices. I have come to realise that these health facilities covered by the NHIS, have the drugs alright but then, failure to reimburse them by the government has necessitated their reluctance to supply them to the beneficiaries of the scheme. The NHIS is indebted to them in huge amount which remains unpaid.
QUESTIONS FOR NHIS ADMINISTRATORS
The few questions we need to ask ourselves are; What is happening to the NHIS? Is the NHIS collapsing? Why is it that medical facilities that are operating under the scheme are not being reimbursed by the government? Are there no funds to run the scheme properly? Has the economic decline affected the scheme financially? Somebody must answer these questions to set the records straight.
Ghana was the first Sub-Saharan African country to introduce the National Health Insurance Scheme (NHIS) in 2003 through an Act of Parliament (Act 650 Amended Act 852) and its full implementation started in 2004. Under the NHIS Amended Act 852 (2012), every Ghanaian is required to enrol in the health insurance scheme. The scheme is regarded as one of the social intervention programmes the government introduced to provide financial access to quality health care in Ghana.
THE EMERGENCE OF NHIS AND HOW IT IS FUNDED
The scheme is largely funded by the National Health Insurance Levy (NHIL) which is 2.5 per cent levy on goods and services collected under the Value Added Tax (VAT), 2-5 percentage points of Social Security and National Insurance Trust (SSNIT) contributions per month.
The idea for the establishment of the NHIS in Ghana was conceived by former President John Agyekum Kufuor who used the scheme as a campaign promise in the 2000 general election and promised to abolish the ‘Cash and Carry’ system of health delivery when he gained power in the country.True to his campaign promise, President Kufuor, after winning the election introduced the scheme in 2003.
The major objective of the NHIS was to ensure that it covered all indigene Ghanaians across the country with the purpose of delivering a comprehensive and affordable health care nationwide. The scheme was designed to cover employers, unemployed both in the rural and the urban communities across the country.
ACHIEVEMENT OF NHIS UNDER VARIOUS GOVERNMENTS
Since its introduction in the country, the scheme had witnessed remarkable progress in various regimes after the Kufuor led government. Former Presidents John Evans Atta Mills, John Mahama and the current President Akufo-Addo, readily embraced the scheme because of its immense benefits to the people and the country in general. They, therefore, adopted it as one of the social interventions in the health sector and gave it the needed push. The scope of the scheme was widened to rope in more beneficiaries. Currently, the active membership of the NHIS has risen from 10.8 million in 2018 to over 12 million in 2019. The Ashanti Region, according to statistics, recorded the highest active membership of 2.2 million followed by the Greater Accra Region in the year under review. Latest figures on the entire membership as of the end of 2021 is not yet available.
The scheme has been made compulsory by government based on past experiences which showed that most of the citizens could not engage in it and the fact that the government has the duty to protect the general welfare of all the citizens in our dear country. The flexible nature of the scheme and its lower payment of registration, made it quite easy for people to register and enrol as members. It has been designed to exempt certain category of people including the older persons from the payments of certain charges.
EMERGING CHALLENGES OF THE NHIS
Like all human institutions across the globe, the scheme despite its successful implementation over the years in the country, is challenged with a number of problems such as poor coverage, poor quality care, corruption, poor stakeholder participation, lack of clarity on concepts in the policy, intense political influence and poor financing. These administrative lapses are, indeed, affecting the effective operation of this laudable scheme.
It is worthy of note that National Health Insurance Authority (NHIA), the administrative body of the scheme in collaboration with the National Identification Authority (NIA), is determined to ensure that all residents in Ghana use one card which will be the Ghana Card to access health care. Consequently, steps are in progress to synchronise the NHIS card with the Ghana Card. That will be a positive development and a step in the right direction.
THE SUCCESSFUL STORY OF THE NHIS
Suffice it to say, the NHIS unlike the ‘Cash and Carry’ system which requires up-front payment of medical care and imposes a financial stress on Ghanaians in terms of health care delivery, is a laudable social intervention which needs to be supported adequately by government if we are to achieve health for all by the year 2024 and beyond. The scheme has come to serve and continues to serve a useful purpose in our dear country and we need to nurture it to flourish. It has been a source of hope for the majority of people in the rural areas who depend on it to access their health care needs. It is, therefore, necessary for the government to clear the outstanding arrears of the service providers and invest heavily in the programme to enable the scheme to cater for the millions of patients under the scheme.
A healthy nation, they say, is a wealthy nation. Health care is important to society because people get ill, accidents and emergencies do arise and the hospitals are needed to diagnose, treat and manage different types of ailments and diseases. Many of our people’s aspirations and desires cannot be met without longer, healthier and happy lives.
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By Charles Neequaye
All over the world, it has been recognised that nations who have developed, paid attention to education and continue to do so. If we pay lip service to the development of our educational system, we might as well forget about our development in the foreseeable future.
In order for effective teaching and learning to happen, the teacher who is the centre of it all, must be well motivated. Every person working in an office, every parliamentarian, every minister or deputy minister, all the way up to the first gentleman of the land, owes his or her status to a teacher.
Unfortunately, for some strange reason, our leaders who are the decision makers, do not seem to care very much about the welfare of teachers. The leadership of the various teacher unions, also appear not to be doing their job as is expected of them, leaving the teacher who had worked for over a year without being paid, frustrated.
The lack of seriousness that is attached to teachers’ issues is very worrying. My parents were teachers so I am very passionate about teachers’ issues. Gone are the days that we used to say that teachers will get their reward in Heaven.
Now those in the teaching profession are mostly youthful and they have a different mindset from that of our parents. They do not want their reward in Heaven, they want it here on this very earth.
A teacher sees his colleague who he was academically better than in school, from the same background socially, becomes a Municipal Chief Executive (MCE), an Member of Parliament (MP) or a Government Appointee and overnight, this guy becomes wealthy and you say he the teacher, should wait for his reward in Heaven?
His going there is not guaranteed anyway, so if he or she does not make it to Heaven, then what? Promises of government after government to teachers, remain unfulfilled and so they become disillusioned and demotivated to ensure effective teaching and learning.
I read a story of a lady, who as a child was suffering from Dyslexia but her teacher gave her the needed attention to help her and this even led her teacher to run into problems with the school authorities, resulting in the loss of her job. This lady grew up and became a famous actress and won an Oscar.
She then gave the prize money attached to the award, which was three million dollars, to her teacher who put her career on the line to help her out of her dyslexia challenge as a child.
There are many such teachers in our educational system because teaching is a calling, like medicine, like nursing etc. and therefore teachers who are the first point of call before we can climb the ladder to become the engineers, the lawyers, accountants and the rest, deserve special attention.
What is even important is the crucial role they play in shaping the moral character of future leaders which is invaluable.
Let us all, especially our leaders, place a high premium on the teacher who is at the centre of our educational system and who can make or unmake our future as a nation. How do you ask a teacher to go to a place, far removed from his or her parents and for a year and above not pay any salary to him or her?
How is the teacher to survive? If the same thing was done to any of our leaders, especially the leaders of the various teacher unions, will they be happy? How do they expect the teachers to survive and also be motivated to deliver quality teaching? Funds must be found to immediately resolve their unpaid salaries do they can be in the right frame of mind to do their very precious job. The teaching profession, in my view, is number one, when ranking professions because as an advert displays “If you can read this, thank a teacher”. Let us give our teachers their due. God bless.
By Laud Kissi-Mensah
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GREETINGS from Korkorti and from Kofi Owuo, alias Death-By-Poverty. When this column took a short break, the two friends summoned me. They wanted to know whether the column had gone on pension or was just on strike. I explained that the column was not on retirement and neither was it on a hunger strike. Rather, the column was of the habit of falling into coma for four weeks or thereabout every year.
Kwame Korkorti and Kofi Owuo (who is addicted to poverty and has sworn not to prosper) are two of my former classmates I cherish so much. And it was great fun to be a Nino in those days. In fact, on the first day on campus, Korkorti was bold enough to bully his own mates who tragically mistook him for a senior.
In fact, when the first-years arrived, Korkorti was one of them but quickly pretended he was in Form 2. So he began pulling the noses of his mates and brushing their faces when the real seniors were not quite in sight. It was when classes began that his victims realised the so-called nose-pulling senior was in fact their own classmate.
So Korkorti got famous for that gimmick. But his English was poor.
The English master was a tall, bombastic young man who claimed he was a former soccer star. In fact, he swore he had a magical left foot that was comparable to that of the legendary Pele. And his grandiloquence par excellence clearly distinguished him from other members of staff.
He did not quite like Korkorti because although the boy was stubborn and his head did not have a nice shape, the girls adored him. Moreover he never did his English Language assignments.
Stand up, you tall fool, the English master often ordered. Korkorti wouldn’t stand up but would just smile broadly.
“I say stand up” the teacher would bark now like a dog suffering from rabies “Get up and let me measure your stupidity.”
Korkorti would stand up this time round and yawn.
Certainly, lunchtime has been long in coming and a good yawn often relieved the young student’s stomach of gastronomic stress.
Invariably, the English guru did not like it when Korkorti yawned. For one thing, the boy opened his mouth too widely. For another, he yawned a bit too audibly and that caused laughter among his mates.
Certainly, the master must have figured out that the boy’s height was proportional to his stupidity. But there were no school rules against yawning
Merari Alomele’s
• A female student walking away from some male students
or wide mouth. In fact, there was freedom of yawning and snoring and Korkorti exercised both freedoms judiciously and democratically.
“Do you know when you yawn you look like a hungry crocodile,” the master once asked him.
“Yes sir, I am aware sir,” Korkorti confirmed and yawned again. This time he nearly swallowed the whole class. There was an uproar and the whole class reverberated in good laughter.
The English master shook his head and then nodded it like an agama lizard. This Korkorti boy was a real character, a phenomenon, a one-man thousand. Meanwhile lessons had to continue.
It was in those days when school was exciting and we often gathered and talked about girls. I had often dreamt of having a girl from Holy Child School because I had heard very saintly and curious things about them, I had learnt from a guy from Saint Augustine’s College that Holy Child girls were of a special breed, in fact a hybrid between the cultured home-bred variety and those of inner holiness. They were born of the Holy Spirit. The only thing was that they didn’t suffer under Pontius Pilate.
In short, they were angels in human form, spoke in a special way, walked with a unique and danced with heavenly steps. They were taught by Holy Nuns and so were quite different from us who had no hope of making any spirito-culturo-scholastic progress.
I confessed to Korkorti that I wanted a girl from Holy Child, not for immoral purposes but to partake of their saintly ways so that when it was time for going to heaven, Kwame Alomele could also be considered.
During vacations we met girls from Mawuli, Ola, Accra Girls, St. Roses, Wesley Girls but none from Holy Child. Then one day, Kwame Korkorti whispered into my ear that a Holy Child babe was in town and that he was sure my dreams had come true.
Korkorti organised it and we positioned at a spot, knowing the girl would traverse en route to the library or the market. After a boring period of waiting, Korkorti suddenly espied the child coming. I looked at her face and saw of an angel. What! This was the kind I always wanted. God bless my soul! This was really my chance and Korkorti had prophesied it.
“Hello Sister,” Korkorti called her when about to leave us.
The girl slowed down and looked at us. My heartbeat increased in tempo. What really was I going to tell this angel? Wouldn’t she think Korkorti was Satan and me a common red-eyed demon? I gathered courage.
“What do you want?” she asked in a sweet voice. My heart melted instantly. Spotless beauty with voice that did something to me. Good gracious!
“Eh-h, my friend says he likes you,” Korkorti to her bluntly.
At that very moment I felt as if a sledge-hammer had hit my chest with the force of a dynamite. What a blunder! What a shock! I felt dizzy instantly. My bosom friend had balked the whole agenda. Before I could recover from the shock, the girl had walked away. From that day. I never met another holy child.
In January, this year, I miraculously received a letter from an 18-year old Holy Child student who said she was my fan.
It was a nicely written letter and I enjoyed reading it. I then relived the Korkorti incident and laughed aloud to myself.
So when Korkorti and Kofi Owuo summoned me, I reminded them of the day my heart melted at the sight of the angel; that angel which disappeared before my eyes and made me go back home not crying and yet not laughing.
Proofread
Searching for the Holy Child
GREETINGS from Korkorti and from Kofi Owuo, alias Death-By-Poverty. When this column took a short break, the two friends summoned me. They wanted to know whether the column had gone on pension or was just on strike.
I explained that the column was not on retirement and neither was it on a hunger strike. Rather, the column was of the habit of falling into coma for four weeks or thereabout every year.
Kwame Korkorti and Kofi Owuo (who is addicted to poverty and has sworn not to prosper) are two of my former classmates I cherish so much. And it was great fun to be a Nino in those days. In fact, on the first day on campus, Korkorti was bold enough to bully his own mates who tragically mistook him for a senior.
In fact, when the first-years arrived, Korkorti was one of them but quickly pretended he was in Form 2. So he began pulling the noses of his mates and brushing their faces when the real seniors were not quite in sight. It was when classes began that his victims realised the so-called nose-pulling senior was in fact their own classmate
So Korkorti got famous for that gimmick. But his English was poor.
The English master was a tall, bombastic young man who claimed he was a former soccer star. In fact, he swore he had a magical left foot that was comparable to that of the legendary Pele. And his grandiloquence par excellence clearly distinguished him from other members of staff.
He did not quite like Korkorti because although the boy was stubborn and his head did not have a nice shape, the girls adored him. Moreover he never did his English Language assignments.
Stand up, you tall fool, the English master often ordered. Korkorti wouldn’t stand up but would just smile broadly.
“I say stand up” the teacher would bark now like a dog suffering from rabies “Get up and let me measure your stupidity.”
Korkorti would stand up this time round and yawn.
Certainly, lunchtime has been long in coming and a good yawn often relieved the young student’s stomach of gastronomic stress.
Invariably, the English guru did not like it when Korkorti yawned. For one thing, the boy opened his mouth too widely. For another, he yawned a bit too audibly and that caused laughter among his mates.
Certainly, the master must have figured out that the boy’s height was proportional to his stupidity. But there were no school rules against yawning or wide mouth. In fact, there was freedom of yawning and snoring and Korkorti exercised both freedoms judiciously and democratically.
“Do you know when you yawn you look like a hungry crocodile,” the master once asked him.
“Yes sir, I am aware sir,” Korkorti confirmed and yawned again. This time he nearly swallowed the whole class. There was an uproar and the whole class reverberated in good laughter.
The English master shook his head and then nodded it like an agama lizard. This Korkorti boy was a real character, a phenomenon, a one-man-thousand. Meanwhile lessons had to continue.
It was in those days when school was exciting and we often gathered and talked about girls. I had often dreamt of having a girl from Holy Child School because I had heard very saintly and curious things about them,
I had learnt from a guy from Saint Augustine’s College that Holy Child girls were of a special breed, in fact a hybrid between the cultured home-bred variety and those of inner holiness. They were born of the Holy Spirit. The only thing was that they didn’t suffer under Pontius Pilate.
In short, they were angels in human form, spoke in a special way, walked with a unique and danced with heavenly steps. They were taught by Holy Nuns and so were quite different from us who had no hope of making any spirito-culturo-scholastic progress.
I confessed to Korkorti that I wanted a girl from Holy Child, not for immoral purposes but to partake of their saintly ways so that when it was time for going to heaven, Kwame Alomele could also be considered.
During vacations we met girls from Mawuli, Ola, Accra Girls, St. Roses, Wesley Girls but none from Holy Child. Then one day, Kwame Korkorti whispered into my ear that a Holy Child babe was in town and that he was sure my dreams had come true.
Korkorti organised it and we positioned at a spot, knowing the girl would traverse en route to the library or the market. After a boring period of waiting, Korkorti suddenly espied the child coming. I looked at her face and saw of an angel. What! This was the kind I always wanted. God bless my soul! This was really my chance and Korkorti had prophesied it.
“Hello Sister,” Korkorti called her when about to leave us.
The girl slowed down and looked at us. My heartbeat increased in tempo. What really was I going to tell this angel? Wouldn’t she think Korkorti was Satan and me a common red-eyed demon? I gathered courage.
“What do you want?” she asked in a sweet voice. My heart melted instantly. Spotless beauty with voice that did something to me. Good gracious!
“Eh-h, my friend says he likes you,” Korkorti to her bluntly.
At that very moment I felt as if a sledge-hammer had hit my chest with the force of a dynamite. What a blunder! What a shock! I felt dizzy instantly. My bosom friend had balked the whole agenda. Before I could recover from the shock, the girl had walked away. From that day. I never met another holy child.
In January, this year, I miraculously received a letter from an 18-year old Holy Child student who said she was my fan. It was a nicely written letter and I enjoyed reading it. I then relived the Korkorti incident and laughed aloud to myself.
So when Korkorti and Kofi Owuo summoned me, I reminded them of the day my heart melted at the sight of the angel; that angel which disappeared before my eyes and made me go back home not crying and yet not laughing.
This article was first published on Saturday, March 18, 1996
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