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This volume analyzes Ghana s health system performance and highlights the range of policy options needed to improve health system performance and health outcomes.
This volume analyzes Ghana s National Health Insurance Scheme and highlights the range of policy options needed to assure its financially sustainable transition to universal coverage.
Ghana National Health Insurance Scheme (NHIS) was established in 2003 as a major vehicle to achieve the country’s commitment of Universal Health Coverage. The government has earmarked value-added tax to finance NHIS in addition to deduction from Social Security Trust (SSNIT) and premium payment. However, the scheme has been running under deficit since 2009 due to expansion of coverage, increase in service use, and surge in expenditure. Consequently, Ghana National Health Insurance Authority (NHIA) had to reduce investment fund, borrow loans and delay claims reimbursement to providers in order to fill the gap. This study aimed to provide policy recommendations on how to improve efficiency and financial sustainability of NHIS based on health sector expenditure and NHIS claims expenditure review. The analysis started with an overall health sector expenditure review, zoomed into NHIS claims expenditure in Volta region as a miniature for the scheme, and followed by identifictation of factors affecting level and efficiency of expenditure. This study is the first attempt to undertake systematic in-depth analysis of NHIS claims expenditure. Based on the study findings, it is recommended that NHIS establish a stronger expenditure control system in place for long-term sustainability. The majority of NHIS claims expenditure is for outpatient consultations, district hospitals and above, certain member groups (e.g., informal group, members with more than five visits in a year). These distribution patterns are closely related to NHIS design features that encourages expenditure surge. For example, year-round open registration boosted adverse selection during enrollment, essentially fee-for-service provider mechanisms incentivized oversupply but not better quality and cost-effectiveness, and zero patient cost-sharing by patients reduced prudence in seeking care and caused overuse. Moreover, NHIA is not equipped to control expenditure or monitor effect of cost-containment policies. The claims processing system is mostly manual and does not collect information on service delivery and results. No mechanisms exist to monitor and correct providers’ abonormal behaviors, as well as engage NHIS members for and engaging members for information verification, case management and prevention.
Private Health Sector Assessment in Ghana is part of the World Bank Working Paper series. These papers are published to communicate the results of the Bank?s ongoing research and to stimulate public discussion. The private health sector in Ghana is a large and important sector in the market for health-related goods and services. However, little has been documented concerning the size and configuration of private providers and their contribution to health sector outcomes. With better information about the size, scope, distribution, and constraints of private actors, Ghana?s public policy makers
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Chronic non-communicable diseases (NCDs) such as hypertension, stroke, diabetes and cancers, are major causes of disability and death in Ghana. NCDs are not only public health problems. They are also developmental problems, because the rising prevalence of long-term chronic conditions has major social and financial implications for affected individuals, families, healthcare providers and the government. This University of Ghana Readers volume from the Regional Institute for Population Studies presents social and medical science research on Ghanas NCD burden. The body of multidisciplinary research spans the last fifty years and offers important insights on NCD prevalence and experience as well as cultural, health systems and policy responses. This volume will be an essential resource for researchers and students in the health sciences, healthcare providers, health policymakers, and lay individuals with an interest in Ghanas contemporary public health challenges.
Since the private health sector is an important, and often dominant, provider of health services in Sub-Saharan Africa, it is the job of governments as the stewards of the health system to engage with it. Increasing the contributions that the existing private health sector is making to public health is an important, but often neglected, element of meeting the daunting health-related challenges facing African nations. This Report presents newly collected data on how and how effectively each country in the Africa region is engaging the respective private health sectors; and how the engagement compares across the region. While the approach taken by governments varies greatly between countries, there is much room for improvement in the Africa region overall to engage more effectively and room for exchange of ideas and good practices on how to do so. Improved solutions on the policy/regulatory side should be supported by effective organization of the private sector itself and by adjustments in donor programs that take the dynamics of the private health sector better into account.
World Health Statistics 2015 contains WHO's annual compilation of health-related data for its 194 Member States and includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets. This year it also includes highlight summaries on the topics of reducing the gaps between the world's most-advantaged and least-advantaged countries and on current trends in official development assistance (ODA) for health. As in previous years World Health Statistics 2015 has been compiled using publications and databases produced and maintained by WHO technical programmes and regional offices. A number of demographic and socioeconomic statistics have also been derived from databases maintained by a range of other organizations.
This book focuses on Africa’s challenges, achievements, and failures over the past several centuries using an interdisciplinary approach that combines theory and fact and evidence-based practices and interventions in public health, and argues that most of the health problems in Africa are not a result of scarce or lack of resources, but of the misconceived and misplaced priorities that have left the continent behind every other on the globe in terms of health, education, and equitable distribution of opportunities and access to (quality) health as agreed by the United Nations member states at Alma-Ata in 1978.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.