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
In a country like ours in which we are aware of our challenges, all that is required is focusing on strengthening our institutional processes by making them more robust and transparent. In this regard, investment in digitilisation must be prioritised since the human element to cut corners is inherent in the psyche of some people and therefore cannot be trusted to do the right things out of their own volition.
Enforcement of existing laws and regulations must be reviewed to see what is working, which ones have to be tweaked to be able to address current challenges, and those that have become obsolete and must be discarded.
One issue that needs to be given priority attention is remuneration. A former President is alleged to declare that we pretend to pay workers and they also pretend to work. This indeed sums up the quandary facing government after government. Workers’ salaries are crucial in the fight against corruption. A realistic living wage must be given to workers; otherwise, they will seek avenues to address their personal budget deficit.
On day one, what should engage the attention of government is Energy, making it available and affordable. The industrialisation agenda cannot be successfully executed without power that is readily available, reliable, and affordable. Solar energy must be factored in the quest for affordable and reliable power for industry.
The fuel sector issues must be urgently addressed so that it can impact positively on the transportation sector, which plays a key role in the supply of goods and services. The railway infrastructure plan linking places like Boankra Inland Port to prolong the lifespan of our roads and to fast track distribution of goods from the Capital City to the inland areas of the country should be a top priority item.
A well-structured system linking industry to academia must be quickly established to serve as a catalyst towards the industrialisation drive. Research findings from the universities must be channelled to captains of industry in a timely manner. Effective channels of communication should be established to facilitate shorter product-to-market times.
An effective mechanism for fishing out needy but talented children must be established, as well as a sponsorship package for talented individuals who are needed for certain critical areas of the economy — what I term critical investment in education.
Certain changes must be made in the constitution, particularly the appointment of the heads of certain constitutional bodies or institutions. This is to ensure that the Executive arm of government does not wield too much power to ensure accountability and checks and balances really work.
The Attorney General’s Office must be detached from the Executive arm of government. The Nolle Prosequi provision must also be amended to compel the Attorney General to give an explanation of why he or she is declining to prosecute a particular case or discontinue it. The provision that protects sitting Presidents from prosecution must also be reviewed.
The punishment for some of our laws needs a review. We must review the removal of CJ provision to ensure the independence of the Judiciary.
Above all, there must be a mindset of change, i.e., a paradigm shift from inability to capability. Inferiority complex must give way to a pacesetters mentality, and all will be well. God bless.
NB: KOTOKA INTERNATIONAL AIRPORT TO KOFI BAAKO INTERNATIONAL AIRPORT
BY LAUD KISSI-MENSAH
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Features
The impact of emotional surgery and emotional elysium on neurological and neurosurgical procedures
Abstract
THIS comprehensive review aims to explore the impact of emotional surgery and emotional elysium on neurological and neurosurgical procedures. We examine the scientific literature on these approaches, including their definitions, theoretical frameworks, and applications. Our analysis highlights the potential benefits and risks of these approaches and discusses their implications for practice.
Introduction
Neurological and neurosurgical procedures are complex and delicate, requiring precision and accuracy to achieve optimal outcomes. Emotional surgery and emotional elysium are two innovative approaches that have the potential to enhance the success of these procedures. Emotional surgery involves the use of art and other creative techniques to promote relaxation and reduce stress, while emotional elysium focuses on cultivating positive emotions and promoting emotional well-being.
The Role of Emotional Surgery in Neurological and Neurosurgical Procedures
Emotional surgery has been shown to be effective in reducing anxiety and stress in patients undergoing neurological and neurosurgical procedures. By promoting relaxation and reducing stress, emotional surgery can help patients prepare for procedures, leading to improved outcomes and faster recovery times.
The Role of Emotional Elysium in Neurological and Neurosurgical Procedures
Emotional elysium has been shown to be effective in promoting emotional balance and resilience in patients undergoing neurological and neurosurgical procedures. By cultivating positive emotions and promoting emotional well-being, emotional elysium can help patients cope with the stress and trauma associated with these procedures, leading to improved outcomes and enhanced quality of life.
Benefits of Emotional Surgery and Emotional Elysium
The benefits of emotional surgery and emotional elysium in neurological and neurosurgical procedures are numerous. These approaches can:
- Reduce anxiety and stress: Emotional surgery and emotional elysium can help patients manage anxiety and stress, leading to improved outcomes and faster recovery times.
- Improve emotional regulation: Emotional surgery and emotional elysium can help patients regulate their emotions, leading to improved mental health and well-being.
- Enhance patient experience: Emotional surgery and emotional elysium can improve the patient experience, leading to increased satisfaction and improved outcomes.
Conclusion
In conclusion, emotional surgery and emotional elysium are two innovative approaches that have the potential to enhance the success of neurological and neurosurgical procedures. By reducing anxiety and stress, promoting emotional balance and resilience, and improving patient experience, these approaches can lead to improved outcomes and enhanced quality of life for patients undergoing these procedures.
Recommendations
- Further research is needed: More research is needed to fully understand the benefits and risks of emotional surgery and emotional elysium in neurological and neurosurgical procedures.
- Integration into practice: Emotional surgery and emotional elysium should be considered for integration into practice, as they may offer a valuable tool in the treatment of a range of neurological and neurosurgical conditions.
By exploring innovative approaches like emotional surgery and emotional elysium, we can improve patient outcomes and enhance the quality of life for individuals undergoing neurological and neurosurgical procedures.
BY ROBERT EKOW GRIMMOND-THOMPSON
