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Make NHIS Membership Compulsory - Lecturer
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A lecturer at the School of Public Health at the University of Ghana, Professor Irene Agyepong Amarteyfio, has recommended a compulsory enrollment into the National Health Insurance Scheme (NHIS), to help sustain the scheme.

She said since formal sector workers were already on a payroll and computerised databases, it was possible to negotiate with the labour unions and employer associations to register the workers and their families and deduct the registration fee from source.

That arrangement, according to Professor Amarteyfio, would put a stop to the needless phenomenon where formal sector employees go to the scheme offices to register.

She was delivering a lecture in Accra on Thursday, to mark the 10th anniversary of the NHIS.

The lecture was on the theme: “Where have we come from, what have we learned and where are we going?”

It was attended by some renowned Ghanaian medical professionals, including Prof. Agyeman Badu Akosa, a former Director General of the Ghana Health Service, and Prof. Kwabena Frimpong-Boateng, a former Chief Executive Officer of the Korle-Bu Teaching Hospital.

Currently, active membership (valid cardholders) of the scheme is about 40 per cent but almost 90 per cent of Ghanaians have ever been insured.

Professor Amarteyfio explained that reducing the current burden on the district schemes would enable them to channel their efforts into house-to-house renewal and issuance of cards to non-formal sector households, rather than waiting for people to come to them.

Establishment of NHIS

The NHIS law was passed in 2003 to abolish the cash and carry system of health delivery.

Under the cash and carry system, the health needs of an individual was only attended to after initial payment for the service was made and even in cases where patients had been brought to hospital in emergency situations, it was required that money was deposited at every point of service delivery.

The NHIS law established the National Health Insurance Authority (NHIA), which licenses, monitors and regulates the operation of health insurance schemes in Ghana.

Interim measures

Prof. Amarteyfio noted that as part of an interim measure, given that the country’s current financial situation and context did not make 100 per cent compulsory enrollment possible, there was the need to stimulate voluntary enrollment of the poor and ensure that members got value for money.

She listed improvement in the production and distributions of NHIS cards and the need for public trust in the management of the scheme, as the areas to be strengthened to stimulate enrollment.

Prof. Amarteyfio entreated the scheme managers to improve human resource, infrastructure, equipment, tools and supplies, among others.

“Reduce provider availability overlaps and gaps by having a minimum and maximum number of providers who can be accredited to provide the same service in a given geographical area in relation to population,” she advised.

Increasing population coverage

On how to increase population coverage, Prof. Amarteyfio called for the elimination of leakages and inefficiencies in the NHIS that might be reducing the size of the National Health Insurance Fund (NHIF).

She explained that it was important for the populace to clearly understand what purpose the fund was used for, stressing that the “NHIF must not be borrowed for any other purposes”.


Like all insurance schemes, different types of premiums are available under the NHIS.

Ghanaian contributors are grouped according to their levels of income and premiums are paid based on the group a contributor belongs.
Source: Daily Graphic

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