National Health Insurance Scheme

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Charity, Mme Lardi (Second Wife) and Lauretia, her youngest daughter

Ghana has a national health insurance scheme and soon my hosts, of the Tikaha Family, are going to be registered members. My host father Patrick, as a civil servant, is entitled to a discounted rate with NHIS. A fact that he was not aware of until very recently. He feels that as a teacher and a civil servant, at least, he should make the effort to ensure that his family is covered under NHIS.

My observations on NHIS from a Canadian perspective are that more wealthy Ghanaians are much more aware of the scheme than those in rural communities. It seems that Ghana could do more to make sure that those in Northern rural areas patronize the program. The lack of accessible information for illiterate persons, NHIS fee, and additional travel expenses make rural families much less likely to register.

Charity (First Wife, Augustine’s, Daughter in Law) and her daughter Emmanuela (10 weeks, 1 day)

Here is a brief description of NHIS from an online article:
“The idea was to replace the old cost-recovery health system in operation since 1985 and known infamously as “cash-and-carry,” under which patients were required to pay up-front for health services at government clinics and hospitals.

The new bid to provide care for even the poor and the vulnerable among Ghana’s 19 million people was described just this week by one editorialist as “perhaps the biggest social development project undertaken by any government since (Kwame) Nkrumah after Ghana’s independence.”

NHIS, which is not yet fully in effect across the country and still has a number of glitches to be smoothed, is supposed to make health care affordable for ordinary Ghanaians. ” (article 2 below)

See the following two critical articles for details:

1) Ghana: Three Years On, Whither the NHIS?

http://allafrica.com/stories/200703050506.html

2) GHANA: Despite new health scheme, newborn babies detained in hospital pending payment

http://www.irinnews.org/report.aspx?reportid=56380

Donald in the dooway (First Wife, Augustine’s, Grandson by her daughter Lariba), Florence, Lauretia in front and Terimba (Second Wife’s Daughter) holding Emmanuel.

Since Patrick is a civil servant, all of his children can be covered for basic health service for one year quite cheaply, at 1GHC (0.99CAD). He was not aware of this until recently. Each of his two wives will be covered for the regular fee of 10GHC (9.87CAD)/year, which has recently been increased from the original charge of 6.60CAD. Unfortunately, there only clinic for them to register is in Bolgatanga, and the lorry fare is 0.50GHC per person. For Patrick the cost will total 26GHC.

Florence (First Wife, Augustine’s, youngest daughter) poses with new shoes and her mother’s purse

The fee itself is prohibitively expensive for the average rural family even though all of the children of an insured mother will be covered by her insurance.

The normal cost of NHIS for a family this size would be 35GHC or an estimated 8% of annual income. Another challenge is that rural families do not hold this amount in cash at any one time due to irregular household cash flow. The International Fund for Agricultural Development’s LACOSREP project found the average net family income of a project participant to be 437.88 GHC (432.31CAD)…somewhat questionably inflation adjusted from 17.6 GHC/annum (17.38CAD) in 1990 -online reference footnoted.

Today everyone is traveling to Bolgatanga to have their pictures taken for ID cards. Therefore, the whole family was looking bright this morning, dressed in their best. As you can see we took a few pictures even though everyone had not yet assembled…

Linus and Donald are the children of Lariba, Augustine’s daughter

footnote IFAD reference for income of LACOSREP project participants, see Project Achievements section: http://www.ifad.int/evaluation/public_html/eksyst/doc/prj/region/pa/ghana/s026ghbe.htm

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