Takoradi, Feb. 21 -GNA-The implementation of the National Health Insurance Scheme (NHIS) has led to an increase in the utilization of health services in the Western Region, Mr. David Yaro, Chief Director of the Western Regional Coordinating Council (RCC) said on Friday. Addressing the closing session of the 2008 Annual Performance Review Meeting of the Health Sector in the Western Region at Takoradi, he said out-patient department (OPD) attendance in the region increased by 66 percent from 1,724,606 in 2007 to 2,599,045 in 2008. The review meeting was under the theme: "Prudent Management of Resources for Effective Public Health and Clinical Care Services Delivery." Mr. Yaro said insured clients represented 63 percent of all cases at the OPD and 50 percent of all admissions in the region during 2008. He said the overall NHIS coverage in the region increased from 40 Per cent in 2007 to 58 per cent in 2008. Mr. Yaro noted that, the NHIS is still saddled with some teething problems including delayed payment of claims by the scheme, delayed submission of claims by providers due to enormous paper work and difficulty to receive payment for services rendered to clients belonging to the scheme without any service agreement with particular provider.

Mr. Yaro said other problems facing the NHIS were frivolous consumption of services by the insured, increased workload on staff and preferential payment arrangement.

He said the government is aware of these setbacks and intends to modify the NHIS into a Universal Health Insurance Scheme (UHIS). Mr. Yaro said the UHIS would cut down on health insurance bureaucracy and plough back savings into health care as well as review the disease and drug categories under the scheme.

He said, "All these noble programmes, however, cannot be sustained or achieved without prudent management of available resources for service delivery".

Mr. Yaro said certain developments and practices within the health sector in the region were conspiring to undermine the full realization of the benefits of well-intended health interventions. He said reports from various monitoring activities have shown that resources in some districts and facilities in the region were not being managed effectively and efficiently.

Mr. Yaro said there are also credible reports that in some facilities and districts, internally generated funds (IGF) are disbursed without any reference to laid down procurement procedures. He said another area that had come under scrutiny is the relationship with clients, adding that the poor reception of clients by some staff had brought the image of some heath facilities in the region into disrepute. Mr. Yaro said the new elements introduced by the Ministry of Finance and Economic Planning (MOFEP) for allocating items 2 and 3 votes in 2009 underscord the importance of the theme for the review meeting. He said under the new guidelines, operational cost of hospitals would be financed entirely from the IGF and NHIS, while electricity bills would no longer be paid centrally by the MOFEP. Mr. Yaro said there is, therefore, the need to focus available resources towards the implementation of interventions and programmes on health issues.

Dr. Linda Vanotoo, Regional Director of Health Services, said malaria continued to take the first position for OPD attendance in the region. She said most malaria cases were diagnosed clinically and efforts were being to improve "confirmation by laboratory testing". Dr. Vanotoo said HIV/AIDS featured in the top 10 causes of admissions and deaths in some districts and no cases pf cholera and guinea worm were recorded in 2008 but this should not make health staff complacent since the environment was still not good. She said maternal mortality and stillbirths still continue to be a problem for the region, adding, "although there was a reduction of maternal deaths from 108 in 2007 to 99 in 2008, we still need to reduce the death rate further". Dr. Vanotoo said a conference on Maternal and Child Health has been planned for March this year and expressed the hope that this would help to critically examine the systems in place for provision of maternal and child health services in the Western Region and develop appropriate interventions to address shortfalls. She said 485 surgeries have been carried out under the hernia project since 2006 in the region and the limb fitting centre at Supomu Dunkwa Health Centre is now operational.