The global pursuit of attaining Universal Health Coverage (UHC) has occasioned the development of policies, frameworks, and activities centered on the provision of quality healthcare services to address the health needs of people in an equitable distribution.
In line with this thinking and as part of Ghana’s roadmap to attaining Universal Health Coverage (UHC) by the year 2030, the Ministry of Health (MoH) has developed a National Essential Health Services Package (EHSP) which has five main domains.
The core domains of the EHSP were developed with attention to these dimensions of promotive, preventive, curative, palliative and rehabilitative.
The NHIS Benefit Package, derived from the National Health Insurance Act, 2012 (Act 852) was determined based on the epidemiological data of Ghana as at the inception of the scheme in 2003 and therefore focuses mainly on the curative dimension.
The Ministry of Health tasked the National Health Insurance Authority (NHIA) to align the EHSP to the National Health Insurance Scheme (NHIS) Benefits Package.
The objective was to determine which interventions in the EHSP were “Fully Covered,” “Partially Covered” and “Not Covered” by the NHIS Benefit Package.
Upon completion of the task, a stakeholders’ meeting was organized to disseminate the output of the alignment exercise on December 20, 2022, in Accra.
Notably present at the meeting were Dr. Isaac Morrison, a member of the NHIA Governing Board, representatives from the MoH, Ghana Health Service, Christian Health Association of Ghana (CHAG), Society of Private Medical and Dental Practitioners (SPMDP), Private Health Facilities Association of Ghana (PHFAG), Ahmadiyya Muslim Health Services (AMHS), some selected staff of the NHIA and donor partners including UNICEF and the World Bank.
In her presentation, the NHIA’s Ag. Director of the Strategic Health Purchasing Directorate (SHPD), Ms. Gertrude Dorcas Laryea indicated that, of the four hundred and thirty-eight (438) services /interventions listed on the EHSP, a hundred and eighty-five (185) representing 42% were fully covered by the NHIS Benefit Package, 35 (8%) were partially covered, whilst 218 (50%) of the services/ intervention were not covered.
A cross-section of the participants appreciated the extent of coverage of the NHIS Benefit Package in terms of the services/interventions listed on the ESHP.
They were however of the opinion that services/interventions not covered by the NHIS Benefit Package needed to undergo Health Technology assessment or actuarial assessment to determine their cost-effectiveness and budget impact.
This, according to them will assist policymakers in their decision-making process on possible sources for funding the gaps identified.
As the Chair, Dr. Isaac Morrison in his closing remarks pointed out that Ghana’s NHIS has been praised globally as an excellent example of how Universal Health Coverage can be promoted and achieved in low- and middle-income countries.
“Therefore, the output of the alignment exercise which brought to the fore the health service gap that existed between the EHSP and the NHIS BP should underscore the need for alternative funding measures to improve the country’s health needs”, Dr. Morrison emphasized.
Source: ABDUL KARIM NAATOGMAH