According to ghana news agency:ccording to Ghana News Agency, Dr Djokoto shared these insights during an academic symposium on sustainable financing for primary healthcare held by the Fred N. Binka School of Public Health of the University of Health and Allied Sciences (UHAS), Hope for Future Generations (HFFG), and the Global Health Advocacy Incubator (GHAI) in Ho. The event focused on advancing sustainable financing for primary healthcare in Ghana.
Dr Djokoto, in his keynote address on 'Ghana's Pathway Towards Universal Health Coverage,' discussed the significant progress made since the NHIS was introduced in 2003. Before the scheme, the healthcare system operated under a 'cash-and-carry' model, requiring patients to pay directly for services, leaving many without social protection. The NHIA was established under Act 650 in 2003 to address this issue.
The NHIS is funded through a 2.5 per cent National Health Insurance Levy on Value Added Tax (VAT), contributions from Social Security and National Insurance Trust (SSNIT), premiums from informal sector workers, and investment income. Initially focused on curative care, the scheme now aims to expand to preventive and promotive healthcare services.
Government financing currently covers 56 per cent of healthcare expenditure, with out-of-pocket payments accounting for 26 per cent and development partners contributing about four per cent. This decline in external funding is attributed to changes in international development financing and Ghana's transition to lower-middle-income status.
By 2030, it is expected that Ghana will fully finance its vaccine programmes without Gavi, the Vaccine Alliance's support. Dr Djokoto emphasized the importance of preventive healthcare, noting that investing in prevention could save significant future healthcare costs.
Ghana's health reforms, including the Free Primary Healthcare initiative, aim to provide basic healthcare services at various facilities regardless of NHIS card possession. Patients needing referrals will be assisted to enroll in the NHIS to avoid out-of-pocket expenses.
The Ghana Medical Trust Fund is supporting treatment for non-communicable diseases, and plans are underway to expand coverage. However, fraud and claims leakages present challenges, with leakages costing the country over GHS1 billion annually. The NHIA is implementing measures to enhance efficiency and reduce waste.
The government has uncapped the National Health Insurance Fund, generating additional resources to meet vaccine co-financing obligations and support the Free Primary Healthcare programme. Dr Djokoto reiterated the commitment to sustainable financing for primary healthcare and welcomed recommendations to improve NHIS efficiency and explore additional revenue streams.