NHIA explores strategies to decrease costs for medical care, achieve Universal Health Coverage

The National Health Insurance Authority (NHIA) has co-organised with the World Health Organization (WHO) a regional conference to deliberate on financing the Universal Health Coverage (UHC) and ensuring health security in the African Region.With over 50 African countries in attendance, the overall objective of the two-day conference is to redesign health financing mechanisms that also work for the vulnerable as well as steer markets towards the public good since financial hardship is worsening in the world and the African Region.Speaking on behalf of Vice President Mahamudu Bawumia, the Minister of Health Mr Kwaku Agyemang Manu said the Regional Conference would provide the platform for sharing lessons learnt from experiences, disseminating good practices, and contributing to capacity and institutional development relative to health financing.Mr Agyemang Manu also said that the conference would offer the opportunity to share experiences, successes, challenges and innovative ideas towards ensuring sustainable financing for health on the continent.He added the fact that even though Ghana's National Health Insurance Scheme has improved the quality of life in terms of maternal and child health, the 20 years of the scheme were still battling with exploring strategies to decrease costs for medical care while expanding social insurance to cover the poor."We need reforms to improve the health security of the region, contribute significantly and impact positively towards preparedness and response to public health emergencies and contribute to global health security agenda", he said.Mr Agyemang Manu charged the participants to leave the Regional Conference more committed to delivering essential quality health care to everyone everywhere in the continent.The Chief Executive Officer of the National Health Insurance Authority, Dr Bernard Okoe Boye in an interview with the media said the conference would allow countries to learn from each other how they were tackling inequities in their health systems.Speaking on the theme "Overcoming Financial Barriers and Providing Financial Risk Protection", Dr Okoe Boye said he was happy that over 50 African countries for the first time are participating in a conference that is discussing how to finance health.He said that although Ghana is one of the shining examples of how the state has stepped in to help people access healthcare, the conference would help the National Health Insurance Authority to listen to what other African countries are doing to better the delivery of healthcare.Touching on the role of the World Health Organization in the conference, Dr Okoe Boye said the international body has seen the effort of Ghana to contribute to global health security coupled with the fact that the 20th anniversary of NHIS coincided with the 75th anniversary of World Health Organization (WHO)."...that is why you see the World Health Organization acting as a co-organiser for this conference together with the National Health Insurance Authority (NHIA)", he said.With the support of the World Health Organization (WHO), Dr Okoe Boye noted that there would be guidance on the priority setting of the benefit package using Health Technology Assessment (HTA) which plays a crucial role in the assessment of new healthcare technologies, such as pharmaceuticals, medical devices, or diagnostic tests, ensuring a systematic and objective way of making decisions concerning pricing, reimbursement and the adoption of new intervention by comparing costs, effectiveness and impact on patients outcome.He said that WHO would provide support for the alignment of the Essential Health Services package of the Ministry of Health to the National Health Insurance Scheme Benefit Package to generate evidence on the gap and propose mechanisms and interventions to bridge it.He said there was a capacity-building initiative by the WHO with a memorandum of understanding with the School of Public Health, University of Ghana to develop a cadre of skilled health economists who can contribute to evidence-based decision-making and policy formulation in the health sector, both at the national and regional levels."To date, 37 staff of the Ministry of Health have been trained, with 20 per cent from the National Health Insurance Authority (NHIA).The World Health Organization intends to support the migration of ICD 10 to 11 which will improve the accuracy and specificity of disease classification to guide the claims processing mandate of the NHIA", he disclosed.Meanwhile, Professor Francis Chisaka Kasolo, Country Representative for WHO Ghana said that the conference would also help countries to explore newer opportunities and ways to work together to advance the agenda of Primary Health Care (PHC) reforms in the region."We should move towards systems where people have access to services without paying unreasonable amounts of money", he said.Commenting on the current situation of health financing, Professor Kasolo mentioned that the level of financing for health remained inadequate when compared to the resource requirements."Insurance coverage is low in sub-Saharan Africa, at an average of only 8 per cent compared to 100 per cent in developed economies.

Only four countries in sub-Saharan Africa have so far attained insurance coverage for more than 20 per cent of their populations", he disclosed.He further mentioned that people paying for health care through out-of-pocket spending was not only inefficient but also an inequitable way of paying for health care services."The proportion of the population incurring catastrophic health payments and impoverishment due to out-of-pocket payments remains high", he said.Limited options for financing health care for the elderly he said, was another challenge in the African Region as the number of older people was growing fast.He added that ageing had been noted as a predisposing risk factor for financial hardship, especially among the poorest parts of the population."...the prevalence of catastrophic spending and impoverishment is reported to be higher in households with non-communicable diseases", he said.He underscored that equity in access remains a challenge as there were differentials in access to health care as the population in higher income groups were more likely to access health care than those in lower income categories."This puts the latter group at high risk for financial burden as health insurance coverage remains very low and mainly among the rich", he said.He mentioned that the conference would ensure the strengthening of institutional capacity in generating evidence through priority setting to design, implement and monitor health financing reforms for Universal Health Coverage (UHC) consistent with national sustainable development strategies.He said the conference would also prioritize addressing the key drivers of out-of-pocket spending especially among the poor and vulnerable.He however said that the conference would offer the opportunity to address and agree to scale up coverage of social protection mechanisms for people and work comprehensively and inclusively since the government cannot take on all the interventions needed to make progress towards universal health coverage.“We must continue to take every opportunity to advocate for an increase in investment in health and translate government commitment to health into a reality”, he outlined.