Kadjebi: Mr. Israel Quarme Ayer, the Senior Manager of Monitoring and Evaluation at the National Health Insurance Authority (NHIA), Oti Regional Office, has identified utilisation dynamics, illegal co-payments, and extortion as major challenges distorting the Authority's performance narrative. He stated that these practices significantly affect membership renewal behavior, coverage growth, and overall member confidence in the Scheme.
According to Ghana News Agency, Mr. Ayer disclosed these issues during an interview at Kadjebi in the Oti Region. He explained that when members enroll in the Scheme but fail to utilize healthcare services, the perceived value of membership declines, renewal motivation weakens, and word-of-mouth advocacy reduces within communities. "Low utilisation creates an incomplete performance picture. It affects how we measure growth and impact because active membership is different from mere enrollment," he elaborated.
Mr. Ayer further noted that illegal co-payments and extortion at some service delivery points discourage beneficiaries from seeking care, thereby eroding trust in the Scheme. "These unauthorised charges defeat the purpose of financial risk protection under the National Health Insurance Scheme. When members are asked to pay extra, confidence in the system drops," he said.
In contrast, Mr. Ayer indicated that positive service experiences at accredited health facilities significantly improve voluntary renewals and strengthen community-level advocacy. He mentioned that satisfied beneficiaries often become mobilisers, encouraging family members and neighbours to enrol and renew their membership.
He stressed the need for intensified monitoring, stakeholder engagement, and strict enforcement of regulations to curb illegal practices and improve service utilisation. Mr. Ayer reaffirmed the Authority's commitment to strengthening supervision and public education to ensure that members enjoy the full benefits of the Scheme without exploitation.