HFG at Work in Ghana

Since its establishment in September 2003, 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 in Africa. Currently covering an estimated 35% of the population, the NHIS offers a wealth of lessons around ways to raise revenue for health, organize purchasing from public and private providers, and provide financial risk protection.

HFG’s Nathan Blanchet reviewing the NHIS coverage map with Director of Management Information Systems Perry Nelson. Photo: Andrew Won.

HFG’s Nathan Blanchet reviews the NHIS coverage map with Director of Management Information Systems Perry Nelson.
Photo: Andrew Won.

USAID recognizes that ensuring the long term sustainability and success of the NHIS is a critical component of achieving the objectives of the country’s Health Financing Strategy and will require broad, forward-thinking discussions and strategy development. Key priority areas include increasing coverage, refining provider payment systems, improving quality of service delivery, strengthening support systems and management, and using evidence to continuously improve NHIS implementation.

USAID’s HFG project has partnered with the National Health Insurance Agency (NHIA) in Ghana to support the financial sustainability of the NHIS while also increasing enrollment and improving effective coverage of quality health services. HFG’s approach consists of three main activities:

  • Develop a sustainability road map for the NHIS, including a long-term vision, strategy and plans to increase efficiency and sustainability and contain costs by balancing revenue generation and expenditure management;
  • Review a pilot capitated provider payment system in primary healthcare clinics in order to align provider payment mechanisms with the variable costs of patient care, with the aim to scale-up revised capitation approach in 1-3 additional regions;
  • Support the NHIA as an evidence-based health purchaser by enhancing the NHIA’s claims data collection and analytic processes, strengthening monitoring and evaluation across NHIS operations, and by identifying and improving NHIA’s internal performance management practices that directly affect the generation and use of evidence for health purchasing.
NHIA directors and managers serve as the steering committee for the development of a monitoring and evaluation dashboard. “The work is not done – it is a first step. As a committee, we have a lot more work to do...” – Dr. Lydia Dsane-Selby on the committee’s role after a workshop on dashboard development facilitated by HFG. Photo: HFG.

Approximately 20 NHIA directors and managers serve on a steering committee for the development of a monitoring and evaluation dashboard for the NHIA. “The work is not done – it is a first step. As a committee, we have a lot more work to do,” noted Dr. Lydia Dsane-Selby, the NHIA’s Director of Claims, after a workshop on dashboard development facilitated by HFG in May 2014. Photo: HFG.

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