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Should our Health Minister continue to be at post?

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Kwaku Agyemang-Manu

Kwaku Agyemang-Manu

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 Amendment Act 852 (2012), every Ghanaian is required to enroll in the health insurance scheme, which is regarded as one of the social inter­vention programme introduced by the government to provide financial ac­cess to quality and affordable health care to Ghanaians.

The scheme is largely funded by the National Health Insurance Levy (NHIL), which is a 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.

BACKGROUND OF NHIS

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For the benefit of my readers and to refresh their minds about how this laudable initiative came into being, let me take them down memory lane so they can better understand the emergence of the NHIS. The idea to establish 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. He promised to abolish the so-called “Cash and Carry” system of health delivery in the country when he gained power in the county. True to his campaign promise, President Kufuor, after winning the election, introduced the scheme in 2003, during his first term in office.

The main objective of the NHIS was to ensure that it covered all indig­enous Ghanaians with the purpose of delivering comprehensive and affordable health care nationwide. The scheme was designed to cover employees both in the formal and informal sectors, the unemployed in rural and urban communities across the country. Since its introduction, the scheme has witnessed remarkable progress in various regimes that came after former President Kufuor’s ad­ministration. Former presidents John Evans Atta Mills, John Dramani Maha­ma and the current President, Nana Addo Dankwa Akufo-Addo, readily embraced the scheme because of its immense benefits to the people and the country in general, and therefore they adopted it as one of the social interventions in the health sector and gave the scheme the needed push.

EXEMPTION OF CERTAIN CATEGO­RIES

The scope of the scheme was therefore widened to rope in more beneficiaries and was made compul­sory by the government based on past experiences that showed that most of the citizens could not engage in the programme and the fact that the government has the duty to protect the general welfare and well-being of all Ghanaians. The flexible nature of the scheme and its lower registration fees made it quite easy for people to register and enroll as members. The scheme was designed to exempt certain categories of people, includ­ing older people, from paying certain charges.

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Like all human institutions across the globe, the HNIS, despite its successful implementation over the years in the country, has been con­fronted with a number of challenges and problems, such as poor coverage, poor quality care, corruption, poor stakeholder participation, a lack of clarity on concepts in the policy, intense political influence, and poor funding. These administrative lapses, coupled with other in-built challeng­es, are indeed, affecting the smooth operation of this laudable scheme. It may interest my readers and patrons to know that the scheme has passed through the hands of many experts on health issues, but to no avail. The current head of the NHIA, Dr. Ber­nard Okoe Boye, a young and affable medical officer and one-time Deputy Minister of Health, who was appoint­ed by the government recently to manage the place, is overwhelmed with problems, although he is trying his possible best to streamline oper­ations of the NHIS. He has introduced far-reaching ideas to solve some of the problems within the system, but there is still more to be done to make the system productive.

SYNCHRONIZING NHIS AND GHANA CARDS

For instance, plans are well ad­vanced by the new head to team up with his counterparts at the Nation­al Identification Authority (NIA) to synchronize the NHIS card with the Ghana Card as a common medium to access primary health care in Ghana. The scheme has also been digitalised to make registration and renewal of cards easier and more effective. Suffice it to say, the NHIS, unlike the “cash and carry” system, which requires upfront payment of medical care and imposes financial stress on Ghanaians in terms of health care delivery, has been a laudable social intervention that needs to be ade­quately supported by the government if we are to achieve universal health care for all Ghanaians by the year 2024 and beyond.

Frankly speaking, the NHIS has been a source of hope for the ma­jority of people in rural areas who depend on it to access their health needs. However, this all-important scheme is confronted with huge arrears for the service providers, who are finding it difficult to operate the system effectively. When patients visit some of these service providers, they will only be examined by doctors at the Out-Patient-Department (OPD) and told to buy the drugs (even those covered by the scheme) from the pharmacy shops.

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HEALTH MINISTER’S ADMISSION OF NHIS FAILURES

Recently, the Minister of Health, Kwaku Agyemang-Manu on whose bosom the whole NHIS lies, admitted that the scheme was not function­ing properly as it should, claiming that instead of benefiting from the scheme, poor subscribers were being overcharged and denied necessary services that they had already paid for. He cited his own experienc­es, claiming that he had to pay for healthcare services out of his pocket when he visited hospitals like Ridge and the University of Ghana Medical Centre (UGMC), even though he is an NHIS subscriber. That was when the minister addressed the Ghana Health Service Senior Managers Meeting 2023 on Tuesday, April 18, 2023.

Indeed, the unfortunate state­ment from the Health Minister goes to prove he is not on top of issues regarding his outfit, especially the health issues of Ghanaians, which should be his major concern. The entire NHIS programme falls within your purview, and you have to take a keen interest in the scheme and ensure that it works efficiently and satisfactorily. If, as a sector minister, you are complaining and condemning the NHIS as not working, then, as a minister, you don’t know your job and, therefore, you have failed com­pletely. Who do you expect to come and fix the problem when those work­ing there, especially the bosses, take instructions from you, the political head of that place? Elsewhere in cer­tain jurisdictions, you will lose your job immediately for that unguarded and unsavory comment.

MINISTERS MUST OPERATE RE­SPONSIBLY

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Ministers of state are appointed by the President to represent his inter­ests in the portfolios they have been assigned. They are expected to see to the smooth operations of estab­lishments under their various min­istries by ensuring that they remain efficient and effective in their daily operations. Failure to ensure that the establishment under their control as ministers of state and political heads is potent and smooth-sailing means they have failed completely and, therefore, are not fit to be in that office.

As a matter of principle, Ghanaians expect people placed in positions of authority by the government to be more responsible and proactive in their daily activities instead of apportioning blame, which is unnec­essary. These service providers need money to purchase drugs and other equipment to serve subscribers of the NHIS efficiently. However, if the gov­ernment defaults on reimbursement, how can they operate effectively?

Contact email/WhatsApp of au­thor:

HYPERLINK “mailto:ataani2000@ yahoo.com”ataani2000@yahoo.com

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By Charles Neequaye

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The eye is indeed the lamp of the body

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There is a scripture that is found in Matthew 6:22 which says that the lamp of the body is the eye and therefore the eye must see well to enable the body to get to its destination.  

What most people do not know is that behind the scenes, there is a strong interaction between the eyes and the brain before a picture becomes clear.  The state of mind therefore is crucial to the eye seeing clearly to enable the body to process accurately the information the eyes are feeding it for proper identification of what the eyes see. 

This is similar to how a person behaves i.e. what informs the decisions that forms in the mind that results in the actions that a person performs.  The actions of a person does not therefore just happen but is as a result of things that went on in the mind, which in most cases resulted from information passed on to it by the eyes either consciously or unconsciously.

There are so many issues that affect our society which makes one wonder, whether the people who displayed such acts were created by someone or something other than God. 

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How can a person see a beach created by God with beautiful beaches and fresh air blowing all around, decides to defecate at such places, and therefore desecrate the environment?  lt is simply mind boggling? 

When other people in other countries who dwell on the coast are using their beaches for tourist attraction purposes as a means of livelihood and also to promote environmental health, some people living around our beaches, have turned them into rubbish dumping sites and toilets. 

It is a very sad situation and the earlier we did something about it the better.  It is a national emergency that must engage the attention, first of the government and then the citizenry, where religious bodies and NGOs must play a critical role.

The things we focus on in this country, needs to be addressed.  Our minds which processes the info the eyes send to the brain, must be disciplined.  There are certain behaviours that a disciplined mind can ignore even when the eye has provided info to the brain.  One of the things a disciplined mind does, is the avoidance of a second look, which is critical for every person who wants to avoid adultery or fornication. 

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Once a person is not blind, he will see things.  The boobs, the ‘shankus’, the coca cola shapes, the light complexioned, the dark complexioned etc. the eyes will definitely see and report same to the brain.  What the brain or the mind decides to do or instructs the eye to do is the issue. 

It can decide to instruct the eye to take a second look and let the mind drool over it or say ignore it and that will be the end.

If the mind becomes trained to focus on environmental issues like clean environment, the eyes will automatically be reporting on insanitary conditions to the brain as and when it sees them.  The mind will pay attention to such data and begin to process them and to identify solutions to deal with the reported insanitary conditions. 

There is the need to encourage citizens to train the mind to focus on the right thing so that in tandem with the eyes, focus will be maintained.  When the mind is so trained, it communicates with the eye to also focus on hood things that helps in both are spiritual life and our secular lives, for indeed the eyes are the lamp of the body.  God bless.

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 Arming the Sikaman journalists to the teeth

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THE relationship between New Times Corporation (NTC) and African Concrete Productions (ACP) is based entirely on matters of the stomach. Each depends on the other in a dietary symbiosis, reinforced by the close proximity of each other

At lunchtime, you’d see a particular set of Times workers marching regimentally to ACP to face the wall. You’d think they are soldiers. It has long been declared that the company manufactures the best kokonte in the Greater Accra Region. ACP is, therefore, a culinary haven for those NTC kokonte fans, both male and female.

As the NTC kokonte warriors cross the border to ACP, you’d see some ACP banku fanatics dancing joyously to NTC. They are lucky folks because they do not have to obtain visa to enter into ‘Times’ to attack the balls of banku with precision and accuracy. They also claim that the lightsoup at ‘Times’ is arguably the best in West Africa.

So the relationship between the two entities was quite cordial and based practically on stomach palaver, until ACP workers staged an industrial revolution, whereupon the managing director, accountant and estate manager were allegedly stripped naked and locked up in a room. An insurgency had began in earnest.

An ACP worker came to ‘Times’, this time not to eat banku and okro. He had come to inform newsmen that juicy stuff awaited them at ACP. It could make a front page lead story.

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A camerawoman and a female reporter were accordingly dispatched to go and bring back news, juicy news as juicy as kokonte and groundnut soup.

Sikaman Palava
Sikaman Palava

I was driving to work when I espied the familiar camerawoman clicking away outside the ACP premises. I didn’t see any ‘Times’ reporter but angry workers who were on the verge of getting violent. I slowed down and the driver behind blew his horn at me like a lunatic. I drove on.

Later, I heard the reporter and camerawoman were harassed and brutalised. The report came,. “The camerawoman, Mrs Salome Adonu-Agbottah and reporter Mrs Doreen Allotey, in an attempt to retrieve the camera which the workers had seized from them were severely beaten. They were manhandled and almost pushed into a big gutter opposite the company’s premises.

BRUISES

“….The camerawoman had bruises on her body, her hand bag was destroyed and the money in it stolen. Mrs Allotey’s watch was also snatched and her feet stamped on.”

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Luckily, it was not her nose that was trampled upon. She has a beautiful nose.

The bad news was received with extreme sorrow. If the victims had been men, it would not have seemed too bad. But to brutalise women is just unacceptable. The New Times Corporation has not stopped mourning the incident which has been condemned in many circles.

Some people keep asking me why Times sent females to cover a potentially violent demonstration. I tell them they might as well ask why CNN’s amazon, Christina Amanpour, is assigned to cover the carnage in Bosnia-Herzegovina and Rwanda. She is always on the frontline in jeans and jacket.

Journalism is a potentially hazardous profession, and once you accept to study and practise the trade, you might as well bone up to face any assignment as long as your superiors feel you are capable of handling it or you have demonstrated the capacity to handle it. Both males and females can be assigned anywhere, anytime just like policemen and women are assigned.

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The only difference between cops and pressmen is that the latter are armed only with a pen and the former with a gun. The question is should newsmen also arm themselves so that in any event of an assault they would not be found wanting in self-defence? They can’t adequately defend themselves with a pen and a jotter. A pen cannot even disfigure an opponent’s upper lip.

Photo-journalists have particularly suffered violence. Spectator ace-cameraman Vincent Dzatse was severely assaulted by AMA men when he attempted to take pictures of their indiscretions.

Sports cameraman, P. K. Arthur has been beaten more than once at the sports stadium when riots errupted and he wanted to capture it on his lenses.

Some sports journalists have been banned from entering the Accra Sports Stadium by supporters because in their comments, they didn’t write “sense”. Some supporters once nearly lynched Christian Abbew, Spectator Sports Editor, near a courtroom. He was stoned like the biblical Stephen. He had gone to defend a contempt charge.

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I think it is time journalists met and discussed how best to defend themselves in any event of an attack by individuals or mobs. In the pursuance of their duty, they must be free from harassment and assault.

Some journalists go to work and return home with a black-eye or a double fore-head. It is just not right. Something has to be done about it. I think journalists should be armed. But first we must be trained in the use of firearms so that our warning shot do not hit below the belt. What about training in Kung Fu?

This article was first published on Saturday, October 17, 1998.

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