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.
Contact email/WhatsApp of author:
0277753946/0248933366
By Charles Neequaye
Features
Tears of Ghanaman, home and abroad
The typical native of Sikaman is by nature a hospitable creature, a social animal with a big heart, a soul full of the milk of earthly goodness, and a spirit too loving for its own comfort.
Ghanaman hosts a foreign pal and he spends a fortune to make him very happy and comfortable-good food, clean booze, excellent accommodation and a woman for the night.
Sometimes the pal leaves without saying a “thank you but Ghanaman is not offended. He’d host another idiot even more splendidly. His nature is warm, his spirit benevolent. That is the typical Ghanaian and no wonder that many African-Americans say, “If you haven’t visited Ghana. Then you’ve not come to Africa.
You can even enter the country without a passport and a visa and you’ll be welcomed with a pot of palm wine.
If Ghanaman wants to go abroad, especially to an European country or the United States, it is often after an ordeal.
He has to doze in a queue at dawn at the embassy for days and if he is lucky to get through to being interviewed, he is confronted by someone who claims he or she has the power of discerning truth from lie.
In short Ghanaman must undergo a lie-detector test and has to answer questions that are either nonsensical or have no relevance to the trip at hand. When Joseph Kwame Korkorti wanted a visa to an European country, the attache studied Korkorti’s nose for a while and pronounced judgment.
“The way I see you, you won’t return to Ghana if I allow you to go. Korkorti nearly dislocated her jaw; Kwasiasem akwaakwa. In any case what had Korkorti’s nose got to do with the trip?
If Ghanaman, after several attempts, manages to get the visa and lands in the whiteman’s land, he is seen as another monkey uptown, a new arrival of a degenerate ape coming to invade civilized society. He is sneered at, mocked at and avoided like a plague. Some landlords abroad will not hire their rooms to blacks because they feel their presence in itself is bad business.
When a Sikaman publisher landed overseas and was riding in a public bus, an urchin who had the impudence and notoriety of a dead cockroach told his colleagues he was sure the black man had a tail which he was hiding in his pair of trousers. He didn’t end there. He said he was in fact going to pull out the tail for everyone to see.
True to his word he went and put his hand into the backside of the bewildered publisher, intent on grabbing his imaginary tail and pulling it out. It took a lot of patience on the part of the publisher to avert murder. He practically pinned the white miscreant on the floor by the neck and only let go when others intervene. Next time too…
The way we treat our foreign guests in comparison with the way they treat us is polar contrasting-two disparate extremes, one totally incomparable to the other. They hound us for immigration papers, deport us for overstaying and skinheads either target homes to perpetrate mayhem or attack black immigrants to gratify their racial madness
When these same people come here we accept them even more hospitably than our own kin. They enter without visas, overstay, impregnate our women and run away.
About half of foreigners in this country do not have valid resident permits and was not a bother until recently when fire was put under the buttocks of the Immigration Service
In fact, until recently I never knew Sikaman had an Immigration Service. The problem is that although their staff look resplendent in their green outfit, you never really see them anywhere. You’d think they are hidden from the public eye.
The first time I saw a group of them walking somewhere, I nearly mistook them for some sixth-form going to the library. Their ladies are pretty though.
So after all, Sikaman has an Immigration Service which I hear is now alert 24 hours a day tracking down illegal aliens and making sure they bound the exit via Kotoka International. A pat on their shoulder.
I am glad the Interior Ministry has also realised that the country has been too slack about who goes out or comes into Sikaman.
Now the Ministry has warned foreigners not to take the country’s commitment to its obligations under the various conditions as a sign of weakness or a source for the abuse of her hospitality.
“Ghana will not tolerate any such abuse,” Nii Okaija Adamafio, the Interior Minister said, baring his teeth and twitching his little moustache. He was inaugurating the Ghana Refugee and Immigration Service Boards.
He said some foreigners come in as tourists, investors, consultants, skilled workers or refugees. Others come as ‘charlatans, adventurers or plain criminals. “
Yes, there are many criminals among them. Our courts have tried a good number of them for fraud and misconduct.
It is time we welcome only those who would come and invest or tour and go back peacefully and not those whose criminal intentions are well-hidden but get exposed in due course of time.
This article was first published on Saturday March 14, 1998
Join our WhatsApp Channel now!
https://whatsapp.com/channel/0029VbBElzjInlqHhl1aTU27
Features
Decisions have consequences
In this world, it is always important to recognise that every action or decision taken, has consequences.
It can result in something good or bad, depending on the quality of the decision, that is, the factors that were taken into account in the decision making.
The problem with a bad decision is that, in some instances, there is no opportunity to correct the result even though you have regretted the decision, which resulted in the unpleasant outcome.
This is what a friend of mine refers to as having regretted an unregretable regret. After church last Sunday, I was watching a programme on TV and a young lady was sharing with the host, how a bad decision she took, had affected her life immensely and adversely.
She narrated how she met a Caucasian and she got married to him. The white man arranged for her to join him after the marriage and processes were initiated for her to join her husband in UK. It took a while for the requisite documentation to be procured and during this period, she took a decision that has haunted her till date.
According to her narration, she met a man, a Ghanaian, who she started dating, even though she was a married woman.
After a while her documents were ready and so she left to join her husband abroad without breaking off the unholy relationship with the man from Ghana.
After she got to UK, this man from Ghana, kept pressuring her to leave the white man and return to him in Ghana. The white man at some point became a bit suspicious and asked about who she has been talking on the phone with for long spells, and she lied to him that it was her cousin.
Then comes the shocker. After the man from Ghana had sweet talked her continuously for a while, she decided to leave her husband and return to Ghana after only three weeks abroad.
She said, she asked the guy to swear to her that he would take care of both her and her mother and the guy swore to take good care of her and her mother as well as rent a 3-bedroom flat for her. She then took the decision to leave her husband and return to Ghana.
She told her mum that she was returning to Ghana to marry the guy in Ghana. According to her, her mother vigorously disagreed with her decision and wept.
She further added that her mum told her brother and they told her that they were going to tell her husband about her intentions.
According to her, she threatened that if they called her husband to inform him, then she would commit suicide, an idea given to her by the boyfriend in Ghana.
Her mum and brother afraid of what she might do, agreed not to tell her husband. She then told her husband that she was returning to Ghana to attend her Grandmother’s funeral.
The husband could not understand why she wanted to go back to Ghana after only three weeks stay so she had to lie that in their tradition, grandchildren are required to be present when the grandmother dies and is to be buried.
She returned to Ghana; the flat turns into a chamber and hall accommodation, the promise to take care of her mother does not materialise and generally she ends up furnishing the accommodation herself. All the promises given her by her boyfriend, turned out to be just mere words.
A phone the husband gave her, she left behind in UK out of guilty conscience knowing she was never coming back to UK.
Through that phone and social media, the husband found out about his boyfriend and that was the end of her marriage.
Meanwhile, things have gone awry here in Ghana and she had regretted and at a point in her narration, was trying desperately to hold back tears. Decisions indeed have consequences.
NB: ‘CHANGE KOTOKA INTERNATIONAL AIRPORT TO KOFI BAAKO INTERNATIONAL AIRPORT’
Join our WhatsApp Channel now!
https://whatsapp.com/channel/0029VbBElzjInlqHhl1aTU27
