Thousands of people have flooded Ghana’s hospitals since a scheme to make affordable healthcare available for all was launched last year, but many patients are still going untreated because of administrative hiccups and overstretched resources.
Under the National Health Insurance Scheme (NHIS) launched in 2004 by the government of President John Kufuor, adults were supposed to receive unlimited treatment for an annual fee of 75,000 cedis (US $9). Children would be seen free of charge if both of their parents were registered.
It was an ambitious plan. Most West Africans are forced to pay for sub-standard care in government-owned health centres that lack equipment, staff and sufficient funds. Few patients can afford to pay for treatment at private health facilities.
The Ghanaian scheme was touted as the silver bullet that would give Ghana’s rich and poor, elderly and young equal access to health services, and end the days of patients being told to pay up-front or go home. Even women admitted for emergency caesarean births used to have their newborn children held at the hospital until the medical bills were paid.
Although all that has passed, Ghana’s lowest earners have found little to please them in the new scheme.
Long waits
One recent day, Dorothy Mensah, 18, had been waiting for six hours outside the Korle Bu Poly Clinic, the biggest public clinic in Ghana. She said she registered with the health insurance scheme seven months ago, but was told she could not benefit from free medical services until she received the card.
Sweat pouring off her face because of painful stomach cramps, Mensah’s father, Erik Mensah, said he was disappointed by the new scheme.
"Today she is sick, and nobody wants to attend to us since we have nothing to prove that she is covered by the scheme. It takes a long time for you to get a card; it is like there is bureaucracy in the system and that is very bad," Mensah told IRIN.
Ekow Ansah, 55, said he had also been waiting for several hours because patients with cash, who are not part of the scheme, were being seen first.
"I was told by one attendant that the process was cumbersome and that I had to sign a lot of documents even though I have my card,” Ansah said.
Finally, Ansah had to wait more than four hours, “by which time many of the others I came with had been seen because they were paying cash," he said.
Drugs unavailable
Another common complaint is that the dispensaries and local pharmacies designated to supply drugs to members of the insurance scheme are also turning patients away, either because the drugs are not available or are not covered by the plan.
"If the drugs are not on the list of the National Health Insurance Scheme, we cannot supply them,” Anim Kwakye, a pharmacist accredited by the plan, said.
Even if the drugs are on the list, Kwakye said delays in payments by the insurance company are making him unwilling to participate.
“We send claims to the scheme and they are supposed to reimburse us two weeks after we present our claims and documents to support it. But often it takes a long time for them to reimburse us. That's a major problem," Kwakye said.
Abeiku Owusu, a spokesman for the Ga region’s Mutual Health Scheme, which is under the national plan, admits there have been some problems with implementation, including the processing of cards for eligible recipients.
System overwhelmed
"We do not have a perfect system. NHIS is a new concept and as such we are bound to have many challenges,” he said.
However, Owusu denied the company was to blame for the delays.
“The challenges have to do with the hospitals," he said. He added that a “massive rush” of people into the health plan since it was introduced two years ago has overwhelmed the system.
Owusu said the refusal by some pharmacies to attend to cardholders is a problem. He said the health plan’s rigorous fraud-protection efforts were responsible for delays in paying the pharmacies.
He said a more comprehensive list of drugs would be added to the current listing.
em/ak/nr/cs
Under the National Health Insurance Scheme (NHIS) launched in 2004 by the government of President John Kufuor, adults were supposed to receive unlimited treatment for an annual fee of 75,000 cedis (US $9). Children would be seen free of charge if both of their parents were registered.
It was an ambitious plan. Most West Africans are forced to pay for sub-standard care in government-owned health centres that lack equipment, staff and sufficient funds. Few patients can afford to pay for treatment at private health facilities.
The Ghanaian scheme was touted as the silver bullet that would give Ghana’s rich and poor, elderly and young equal access to health services, and end the days of patients being told to pay up-front or go home. Even women admitted for emergency caesarean births used to have their newborn children held at the hospital until the medical bills were paid.
Although all that has passed, Ghana’s lowest earners have found little to please them in the new scheme.
Long waits
One recent day, Dorothy Mensah, 18, had been waiting for six hours outside the Korle Bu Poly Clinic, the biggest public clinic in Ghana. She said she registered with the health insurance scheme seven months ago, but was told she could not benefit from free medical services until she received the card.
Sweat pouring off her face because of painful stomach cramps, Mensah’s father, Erik Mensah, said he was disappointed by the new scheme.
"Today she is sick, and nobody wants to attend to us since we have nothing to prove that she is covered by the scheme. It takes a long time for you to get a card; it is like there is bureaucracy in the system and that is very bad," Mensah told IRIN.
Ekow Ansah, 55, said he had also been waiting for several hours because patients with cash, who are not part of the scheme, were being seen first.
"I was told by one attendant that the process was cumbersome and that I had to sign a lot of documents even though I have my card,” Ansah said.
Finally, Ansah had to wait more than four hours, “by which time many of the others I came with had been seen because they were paying cash," he said.
Drugs unavailable
Another common complaint is that the dispensaries and local pharmacies designated to supply drugs to members of the insurance scheme are also turning patients away, either because the drugs are not available or are not covered by the plan.
"If the drugs are not on the list of the National Health Insurance Scheme, we cannot supply them,” Anim Kwakye, a pharmacist accredited by the plan, said.
Even if the drugs are on the list, Kwakye said delays in payments by the insurance company are making him unwilling to participate.
“We send claims to the scheme and they are supposed to reimburse us two weeks after we present our claims and documents to support it. But often it takes a long time for them to reimburse us. That's a major problem," Kwakye said.
Abeiku Owusu, a spokesman for the Ga region’s Mutual Health Scheme, which is under the national plan, admits there have been some problems with implementation, including the processing of cards for eligible recipients.
System overwhelmed
"We do not have a perfect system. NHIS is a new concept and as such we are bound to have many challenges,” he said.
However, Owusu denied the company was to blame for the delays.
“The challenges have to do with the hospitals," he said. He added that a “massive rush” of people into the health plan since it was introduced two years ago has overwhelmed the system.
Owusu said the refusal by some pharmacies to attend to cardholders is a problem. He said the health plan’s rigorous fraud-protection efforts were responsible for delays in paying the pharmacies.
He said a more comprehensive list of drugs would be added to the current listing.
em/ak/nr/cs
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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