Positioning the National Health Insurance for financial sustainability and Universal Health Coverage in Ghana: A qualitative study among key stakeholders.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
19
04
2020
accepted:
28
05
2021
entrez:
15
6
2021
pubmed:
16
6
2021
medline:
16
11
2021
Statut:
epublish
Résumé
The National Health Insurance Scheme (NHIS) was introduced in 2003 to reduce "out-of-pocket" payments for health care in Ghana. Over a decade of its implementation, issues about the financial sustainability of this pro-poor policy remains a crippling fact despite its critical role to go towards Universal Health Coverage. We therefore conducted this study to elicit stakeholders' views on ways to improve the financial sustainability of the operations of NHIS. Twenty (20) stakeholders were identified from Ministry of Health, Ghana Health Services, health workers groups, private medical practitioners, civil society organizations and developmental partners. They were interviewed using an interview guide developed from a NHIS policy review and analysis. All interviews were recorded and transcribed verbatim. The data were analysed thematically with the aid of NVivo 12 software. Stakeholders admitted that the NHIS is currently unable to meet its financial obligations. The stakeholders suggested first the adoption of capitation as a provider payment mechanism to minimize the risk of providers' fraud and protection from political interference. Secondly, they indicated that rapid releases of specific statutory deductions and taxes for NHIS providers could reduce delays in claims' reimbursement which is one of the main challenges faced by healthcare providers. Aligning the NHIS with the Community-based Health Planning and Services and including preventive and promotive health is necessary to position the Scheme for Universal Health Coverage. The Scheme will potentially achieve UHC if protected from political interference to improve the governance and transparency that affects the finances of the scheme and the expansion of services to include preventive and promotive services and cancers.
Identifiants
pubmed: 34129630
doi: 10.1371/journal.pone.0253109
pii: PONE-D-20-11276
pmc: PMC8205146
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0253109Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Prog Cardiovasc Dis. 2013 Nov-Dec;56(3):326-35
pubmed: 24267440
CMAJ. 2009 May 26;180(11):E72-81
pubmed: 19468106
Lancet. 2011 Feb 5;377(9764):505-15
pubmed: 21227492
Lancet. 2015 Mar 28;385(9974):1230-47
pubmed: 25458725
BMC Med Inform Decis Mak. 2012 Jan 04;12:1
pubmed: 22217121
BMC Health Serv Res. 2016 Aug 24;16(1):437
pubmed: 27557551
Health Policy Plan. 2005 Jan;20(1):25-34
pubmed: 15689427
Glob Health Action. 2012;5:1-8
pubmed: 22479235
Reprod Health. 2013 Jul 26;10:36
pubmed: 23890362
Health Econ Rev. 2012 Jul 23;2(1):13
pubmed: 22828034
PLoS One. 2016 Nov 10;11(11):e0165151
pubmed: 27832082
Health Policy Plan. 2012 Mar;27 Suppl 1:i13-22
pubmed: 22388496
BMC Health Serv Res. 2016 Sep 21;16(1):504
pubmed: 27655007
Lancet. 2010 Nov 20;376(9754):1785-97
pubmed: 21074253
Int J Soc Welf. 2011 Oct 1;20(s1):s4-s17
pubmed: 21984870
Health Policy Plan. 2019 Nov 1;34(9):694-705
pubmed: 31539034
BMJ. 2004 Jan 24;328(7433):220-2
pubmed: 14739194
J Epidemiol Community Health. 2004 Aug;58(8):655-8
pubmed: 15252067
BMC Health Serv Res. 2013;13 Suppl 2:S3
pubmed: 23819518
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
Int J Equity Health. 2015 Sep 15;14:80
pubmed: 26369417
PLoS One. 2015 Mar 19;10(3):e0120556
pubmed: 25789874
Int J Health Plann Manage. 2016 Oct;31(4):e273-e289
pubmed: 26189569
Stud Fam Plann. 2004 Sep;35(3):161-77
pubmed: 15511060
Int J Epidemiol. 2001 Aug;30(4):720-3
pubmed: 11511591
J Health Popul Nutr. 2019 Nov 27;38(1):34
pubmed: 31775904
S Afr Med J. 2012 Aug 01;102(10):794-7
pubmed: 23034207
PLoS One. 2018 Jun 14;13(6):e0198915
pubmed: 29902224
Health Care Manag Sci. 2008 Dec;11(4):353-8
pubmed: 18998594
Ghana Med J. 2012 Jun;46(2):76-84
pubmed: 22942455
BMC Cancer. 2014 May 23;14:362
pubmed: 24884730
Harv Bus Rev. 2016 Jul-Aug;94(7-8):102-11, 134
pubmed: 27526566
Health Econ. 2010 Sep;19 Suppl:95-106
pubmed: 20730999
BMC Int Health Hum Rights. 2009 Aug 28;9:20
pubmed: 19715583