Health Insurance in Ghana

Lessons from a trip home during J-term
This past winter, I returned to my home country of Ghana after over a year and a half away at school. I spent the month engaged in an anti-malaria project in some slum communities near Cape Coast, Ghana. This project was the brainchild of Ahoto Partnership for Ghana, a non-profit organization I co-founded in early 2009 with students from Harvard, Cornell, and McGill University. One of Ahoto’s main projects in January 2010 was the registration of families for the government’s National Health Insurance Scheme.
For various reasons, a significant number of Ghanaians still remained unregistered for the NHIS. In Akotokyir, for instance, a survey we conducted in July 2009 found that over 65% of the inhabitants were unregistered. For most people, the reason is financial: many found even the subsidized price (about $9) to be prohibitively expensive. For many others, the inconvenience of registering annually at an NHIS office, only to have to wait for several months before enjoying the benefits, was a sufficient deterrent.
Ahoto arranged for NHIS officers to carry out registrations during our events in Akotokyir. A total of 210 individuals were registered in just three days. We discovered that inefficiencies in the insurance scheme still challenged the health delivery system. For example, there were significant delays between payments to health providers. As a result, health posts were often reluctant to provide treatment, especially to NHIS-registered individuals who could not pay upfront. It is reassuring that changes are being made to reduce inefficiency in the current scheme, and that the government is working to make the scheme more centralized.
While individuals and non-profit groups similar to Ahoto may try to minimize contact with government agencies so as to avoid bureaucracy, our experience at Ahoto showed that the right level of governmental involvement can actually go a long way. For instance, our meeting with the National Malaria Control Program in Accra proved very helpful in ensuring that our anti-malaria strategy was consistent with the national malaria-control policy of Ghana.

Timothy Kotin ‘11 is a Contributing Writer.
Photo Credit: Flickr Stream of Nite Owl