Assessing the clientele satisfaction of the implementation of the National Health Insurance Policy in Ghana: A comparative study of the District and private Mutual Health Insurance Schemes.

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Over the past two decades, the focus of major reforms in Ghana’s health sector has been to accelerate access to quality healthcare, especially for the poor and vulnerable. In order to achieve this objective, the health sector continues to deepen efforts towards enhancing efficiency in service delivery and ensuring sustainable healthcare financing arrangements that protect the poor. The implementation of the National Health Insurance Policy (NHIS) in 2004 has been one major stride towards the achievement of this objective. This study sought to find out the levels of awareness created about the National Health Insurance Policy and the level of acceptance by the citizenry in terms of enrolment and satisfaction of service provision. The cross sectional research design was adopted in order to allow statistical inferences to be made from the analysis. A Comparative Case Study Approach between the District Mutual and Private Mutual Health Insurance Schemes was adopted in order to allow the use of multiple sources of data. The Likert Scale was used as the major analytical tool to determine the clientele satisfaction of service provision under the two types of schemes. The National Health Insurance Act, 2003 (Act 650) and National Health Insurance Regulation, 2004 (LI 1809) provide guidelines for the qualification for registration and licensing to operate a health insurance scheme in Ghana. The study revealed that whilst the District Mutual Health Insurance Schemes adhere to the provisions in the Act and Regulation and thus receive state funding from the National Health Insurance Fund, the Private Mutual Health Insurance Schemes do not bother about the provisions since they do not receive any form of state funding. The results of the analysis indicated a high level of awareness about the schemes but this has not resulted in a commensurate national enrolment levels. With regards to clients’ level of satisfaction with service provision and total benefit packages, the Likert Scale depicted over 90 percent satisfaction score with the District Mutual Health Insurance Schemes and 68.33 percent score with the Private Mutual Health Insurance Schemes. Apart from the general challenges facing the implementation of the NHIS Policy in Ghana, the study identified inadequate structures for monitoring and lack of a comprehensive computerized mechanism for the administration of claims and its attendant fraudulent deals as urgent issues that need attention. Recommendations towards improving the design and operations of the NHIS include the extension of the regulatory and supervisory roles of the National Health Insurance Authority and the establishment of equitable funding arrangements for all the types of schemes established under the National Health Insurance Act. Recommendations were also made towards improving the total benefit packages, enrolment levels, attitudes of NHIS/Health Staff and more importantly establishing comprehensive structures for monitoring and administration of claims.
A thesis submitted to the Department of Planning,Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirements for the degree of Master of Science In Development Policy and Planning on October, 2010.