Impact of the National Health Insurance Scheme on Health Care Quality and Access in Asitey Sub-Municipal of Lower Manya Krobo Municipality

Abstract

Health care financing in Ghana has seen several changes since independence in 1957. Initially, central government used tax resource to finance all public sector health care services making it free for patients at public health care facilities. Due to economic stagnation during the early 1970s, the then government and subsequent ones could no longer maintain the tax-based health care financing system giving rise to substantial adverse impact on the health system and healthcare seeking behaviour of the citizenry. This development resulted in a situation which became known as “Cash and Carry”- a system where patients were made to pay for full cost of drugs and other medical consumables out of pocket whenever they visited any public health facility. Government was now responsible for other costs including consultations, salaries and emoluments for doctors, nurses and other healthcare workers in public health facilities. The country’s health care financing again saw another change in 2003, this time it was implementation of National Health Insurance Scheme (NHIS) to assist subscribed residents in paying for the cost of health care services and also protect them against high cost of basic health care. In so doing, the NHIS seeks to improve access to quality basic health care in health facilities in the country for all residents. It has now been well over a decade since the commencement of NHIS’ operations, and this study has been conducted to assess its impact on health care quality and access among residents in Asitey sub-municipal of Lower Manya Krobo Municipality.