Ghana Reviews Insurance Benefits Package

Ghana’s National Health Insurance Scheme (NHIS) has captured the attention of the global health community as one of the most ambitious plans for universal health coverage (UHC) in Africa. For more than a decade, NHIS has offered insurance benefits to thousands of Ghanaians in the formal sector, and covers an estimated 35% of the overall population.

At the end of October, the National Health Insurance Authority (NHIA), which oversees NHIS, met with a more than 50 stakeholders, including health workers, academics, and private insurers, to review their benefits package. This meeting was the first of its kind. Mr. Sylvester Mensah, Chief Executive of the NHIA, explained that given how much the insurance scheme has grown over the last ten years, the “time has come for us to re-look at our benefit package in a manner that will ensure quality of care and make the NHIS buoyant.”

Currently, the benefits package is implicit; that is, it provides a list of services that are not covered. As a result, over the past decade, there has been “benefits creep,” which has meant covering some conditions that are beyond the scope of Ghana’s health care structure.

The stakeholder dialogue,An Equitable and Sustainable Benefits Package based on Evidence,” was held in Accra October 23-24. Akua Kwateng-Addo, Director, Health, Population and Nutrition Office, USAID/Ghana, participated in the opening of the meeting. HFG technical experts participated in plenary sessions, which included: the Development of Standard Treatment Protocols; Overview of Ghana’s NHIS Benefit Package; International Experience on Benefit Package Design; Evidence as a basis for design: the role of Health Technology Assessment; and Effective Monitoring and Evaluation.

Afterwards, Mr. Nat Otoo, NHIA’s Deputy Chief Executive for Operations, expressed his appreciation for HFG’s support. “I wish to personally thank you for the clarity you brought about the way forward with the technical assistance project, which was greatly appreciated by our team, as well as for your responsiveness, technical inputs and personal presence, which all contributed to the success of the stakeholder dialogue on benefits package. I look forward to the next steps on the project and the outcome of the stakeholder dialogue.”

As a result of this dialogue, NHIA will convene a national task force to begin developing an appropriate package of health services based on input from the stakeholders. HFG will continue to work with NHIA in three key areas ‒ purchasing, systems, and operations ‒ and to refine the benefits package to support Ghana’s progress towards UHC.

HFG at Work in Ghana >

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