On Tuesday 10 November, the Ghanaian Ministry of Gender, Children and Social Protection (MGCSP), the Ghanaian National Health Insurance Authority (NHIA) and the international African Health Markets for Equity (AHME) consortium launched their strategic partnership to enroll more poor people into the National Health Insurance Scheme (NHIS). As keynote speaker, the Minister for Gender, Children and Social Protection Nana Oye Lithur emphasized that universal access to healthcare is a right and that through this partnership her government is working “to make this right a reality for every Ghanaian.”
The NHIS was formed in 2003 to provide equitable access and financial coverage for basic healthcare services to Ghanaian citizens. It currently has 10.9 million members, representing 40% of the population. Nathaniel Otoo, the acting CEO of NHIA, gave some background on the partnership: “About three years ago, the NHIA started working with AHME partners to address some of the challenges facing the NHIS, especially in the identification of the poor and vulnerable populations as well as improvement of quality of healthcare services through supply-side interventions.”
He addressed the importance of ensuring that the NHIS, which is by design a pro-poor program, does in fact provide financial risk protection and access to quality basic healthcare for all Ghanaians. “As we strive as a country to attain universal health coverage, we recognize that we must do more to remove the barriers that hinder the enrollment of the poor and the vulnerable onto the NHIS.”
Electronic system for identifying the poor
In Ghana, AHME is made up of the International Finance Corporation, PharmAccess Group and Marie Stopes Ghana, working together with the NHIA and MGCSP. One of the ways in which AHME is improving access to healthcare in Ghana is through the development of a technological system that can objectively and scientifically identify the poor.
The Proxy Means Test (PMT) tool consists of a digital set of questions based on the Ghana Living Standards Survey (GLSS 6). Once identified, the poor become eligible for health insurance exemptions and cash transfers. In addition to the PMT tool, district social protection officers now have access to tablets and motorbikes in order to enroll the most vulnerable and remote groups into the health insurance scheme.
Dr. Khama Rogo, Lead Health Sector Specialist of the World Bank’s Health in Africa Initiative, emphasized that “the issue of healthcare cuts across nationalities, it cuts across ethnicities, and it definitely cuts across all the socio-economic classes. What is happening here today is a hallmark for the whole of Africa.”
Otoo expects that the new approach will remove some of the bottlenecks that have contributed to the relatively low registration of the poor into the scheme across the country. The project will start in 10 Ghanaian districts on a pilot basis and seeks to enroll 150,000 households, 900,000 persons and 70,000 extremely poor people onto the national NHIS data by 2016.
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The African Health Markets for Equity (AHME) consortium is a five-year partnership led by Marie Stopes International and funded by the Bill & Melinda Gates Foundation and the UK’s Department for International Development (DFID). AHME strives to improve health outcomes for the poor by enhancing the quality of care in the private sector in Ghana, Nigeria and Kenya. AHME is implemented through a partnership between:
- Marie Stopes International, Population Services International, Society for Family Health , which focus on social franchising
- International Finance Corporation (IFC), which works on policies, legislative and governance frameworks as well as demand-side financing, and
- PharmAccess, Medical Credit Fund and SafeCare, which cover demand-side financing, access to capital and quality improvement.