Abstract:
A National Health Insurance Scheme was introduced in Ghana in 2005
as part of strategies to ensure a sustainable health financing and improve
access to services. After almost ten years of implementation, little is known
about the views of health care providers as a major stakeholder on the critical
experiences of health care providers on the implementation and sustainability
of the National Health Insurance Scheme. It adopted in-depth interviews,
observations and documentary review as methods of data collection. Forty
health care providers working in 19 governments, private, quasi-government
and mission health facilities in the Cape Coast metropolis were interviewed.
Data from the interviews were analyzed using the Nvivo 7 software and by
content analysis. There is a broad acknowledgement of the scheme as a propoor
policy which has made a positive impact on access to health care. The
involvement of front line health care providers in the policy formulation and
processes was however, minimal. The sustainability of the scheme is largely
threatened by the delayed and erratic reimbursement of claims and the
unprofessional behaviour of providers and scheme managers. The proposed
one-time premium payment policy can negatively affect the scheme. To
for prompt reimbursement of claims, regular dialogue among stakeholders,
explore additional funding sources and promote greater efficiency in the
management of the scheme.
