In 2015, the out-of-pocket expenditures on health care decreased to 26.8 per cent. These savings have been realised through the National Health Insurance Scheme (NHIS), which the Government of the Republic of Ghana launched in 2004. The NHIS is a decentralised insurance scheme that is comprised of a private health insurance scheme, district mutual health insurance scheme (DMHIS), and a non-profit community based scheme. The NHIS compliments an additional scheme for the formal sector and is administered by the National Health Insurance Authority, which also manages public and private health care providers at all levels of the health care system, including 400 hospitals and clinics and 128 diagnostic facilities in 138 districts.
The NHIS package provides coverage for approximately 95 per cent of the most common causes of illness in Ghana, and includes inpatient and outpatient care, comprehensive maternity care, diagnostic testing, generic medicines and emergency care. The NHIS is mandatory and requires all residents in Ghana to be enrolled under one of its schemes through which they can access free health care. The DMHIS is available in all districts and is a public and non-profit system that each Ghanaian resident can access. Those who enroll are required to pay a one-time registration fee of USD 2 and premiums between USD4 – 24 per year depending on their income status. Children under 18 whose parents are enrolled, adults over 70 years of age, pregnant women, and those without employment or a fixed place of residence are exempt from paying premiums. By the end of 2008, 70 per cent of NHIS members were in the exempt category; and, overall in 2009 the NHIS insured 67.5 per cent of all residents of Ghana.
The NHIS has dramatically reduced the financial barriers to access health care in Ghana and is supported by a strong legal framework through the 2003 National Health Insurance Act. While the NHIS has extended services to many, the scheme has faced some difficulty in enforcing compliance across the informal sector. Despite this challenge the NHIS targets all residents of Ghana including migrants and is an important step toward the creation of Ghana’s social protection floor.
Further Reading:
Delanyo Y. Dovlo (2005). Social dialogue in the health sector: Case study Ghana. International Labour Office working paper no. 234. International Labour Organization, Geneva. Accessed from http://193.134.194.19/wcmsp5/groups/public/---ed_dialogue/---sector/documents/publication/wcms_161165.pdf on December 2016.
Jennifer De la Rosa and Xenia Scheil-Adlung (2007). Enabling transition to formalization through providing access to health care: The examples of Thailand and Ghana. International Labour Office, Geneva. Accessed from http://www.ilo.org/emppolicy/events/WCMS_125994/lang--en/index.htm on December 2016.