TOWARDS UNIVERSAL ACCESS TO QUALITY BASIC HEALTHCARE FOR ALL: WILL THIS ELECTION DELIVER FOR GHANAIANS?
Our friends from the media fraternity, Representatives of Civil Society Organizations present, Ladies and Gentlemen, The Universal Healthcare Campaign welcomes you to this event, and thank you for making time to be here this afternoon.
Today’s press conference is motivated by one key question: What priority will be given to healthcare in this year’s electoral campaign?
As you are aware, Ghana took a very bold step in 2003 to move away from a ‘cash and carry’ era towards a National Health Insurance Scheme which sought to increase citizens’ access to healthcare and also provide financial protection to patients.
On paper, the National Health Insurance Scheme (NHIS) provides a comprehensive package of services to people with valid NHIS cards. But in reality majority of NHIS clients do not actually benefit from most of these services due to reasons such as stock run-outs, ill equipped health facilities, inadequate or lack of trained health personnel, and discrimination against clients with valid NHIS cards. It is therefore not surprising that only34% of the population have valid NHIS cards as at 2011. In the 2010 Annual Report of the National Health Insurance Authority (page 16), Ghanaians have been made to understand that the actual population coverage of the NHIS at the beginning of 2011 was not 68% as it has been widely communicated but rather 34% of the population (i.e. 8.16million active members). We therefore ask: why is it that despite the generous package provided by the NHIS nearly two-thirds of the population is not covered by the scheme?
Ladies and Gentlemen, the situation of healthcare in this country has not improved much over the past twelve (12) years. In the urban centres, maternity wards are often over crowded to the extent that pregnant women sleep on floors. Most of the health facilities still lack basic but vital equipments necessary to save lives. How can we therefore achieve the shared goal of zero maternal mortality rate with this state of affairs?
In the rural areas, the situation is worse. In some parts of the country, health facilities do not exist at all. In places where they exist, they either lack the requisite equipment, trained health personnel or both.
Affordability of Healthcare in Ghana
- Healthcare in Ghana is still predominantly cash and carry (Note: NHIS coverage is only 34% of the total population, meaning nearly two-thirds of the population still pay for user fees)
- Those in the upper and middle income bracket are more able to afford the NHIS premiums.
- Majority of the poor are unable to afford healthcare services. The inequities are striking, with 20 percent of upper wealth quintile men having NHIS cards, compared to only 10 percent of those in the lower wealth quintile. For women, the comparable percentages are 29 percent for the top wealth quintile verses 17 percent for the lowest wealth quintile. Hence Majority of the poor still do not have access to basic healthcare services.
Quality of Healthcare
Quality of healthcare is generally poor across the country. As a result, a lot of preventable deaths are being recorded daily.
Clearly the NHIS has not delivered the kind of healthcare it is supposed to deliver, and in its current form, it risks collapsing as it is not financially sustainable - this, the NHIA has acknowledged in its own 2010 annual report.
Ladies and Gentlemen, it is important to state that the above situation is not peculiar to any particular Government.
Since the year 2000 to date, many promises have been made in previous elections and our health care system is still in need of repair as seen above. We still have serious problems with accessibility and staffing, not to mention funding. Are we going to see more promises this time or will we have a commitment to solve these problems?
Ladies and gentlemen, we recognise that opinions are largely divided among policy circles on the best way of financing the NHIS. While we do not aim to support any political party’s position on this subject, we strongly believe that the mandatory premium required by the NHIS for non-formal workers need to be reviewed if Ghanaians are to attain a Universal Health Coverage
Why should the premiums be reviewed?
- From the National Health Insurance Authority’s own annual report (2010) ,contributions from annual premiums to the total inflows is less than 5% compared to VAT and SSNIT contributions. If the total contribution from premium seems relatively insignificant and it is keeping nearly two-thirds of the population away from enjoying quality healthcare, why should we maintain that?
- The administration, operational and logistical cost of collecting these premiums is about ten times the total amount raised from the premiums. This means the premium-based NHIS is not cost effective in its current form.
- The contribution from the VAT has proven that taxed based funding is efficient, effective, predictable and sustainable. We should therefore concentrate on these elements rather than the premium.
As the nation approaches the parliamentary and presidential elections in December 2012, it is time to take stock and tackle the challenges facing the health sector. Which candidate will demonstrate the commitment necessary to correct the injustices described above? Ladies and gentlemen, that aspirant will be the Candidate Ghanaians will vote for!
In light of the above, the Universal Healthcare Campaign calls on the general public to make universal access to basic quality healthcare services a priority issue in this year’s election.
As a starting point, the public should find out whether the health policies and programmes proposed in the political parties’ manifestoes are realistic, achievable and whether they will guarantee universal basic healthcare to the people, especially the poor and vulnerable.
Secondly, citizens should not just listen to campaign promises on healthcare but should dialogue with the political parties to proof how they will reform the health system when elected, particularly the National Health Insurance Scheme to ensure universal basic healthcare to all in Ghana.
Finally, ladies and gentlemen of the media, in the forth coming elections we urge all citizens (and political parties’ alike) to cast their votes for policies that clearly lays out plan towards achieving universal access to quality healthcare for all Ghanaians as well as policies that stipulate clear plans for the removal of all forms of user fees and out-of pocket payments—which will make healthcare accessible for all citizens at the point of use.
Vote for quality Health !!!
Vote for Universal to Access to quality basic Healthcare in Ghana!!!!
21st August, 2012
The Free Universal Access to Health Care Campaign is a National Campaign driven by a network of Civil Society Organisations in Ghana including the Alliance for Reproductive Health Rights (ARHR), ISODEC, Essential Service Platform, SEND Ghana, and Coalition of NGOs in Health.
National Coordinator: Universal Access to Healthcare Campaign
Coordinator: Essential Service Platform
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