The Ghana Universal Access to Healthcare Campaign, a network of local and international NGOs has urged Ghanaians to reject a World Bank (WB) proposal to government to adopt cost-sharing to sustain its National Health Insurance Scheme (NHIS).

The WB, in its report themed: “Health Financing in Ghana at Crossroads”, said Ghana’s NHIS basic benefit package was financially unsustainable and therefore asked the government to consider cost-sharing if it wanted to continue providing services under the program.

The report, published in January, this year, further recommended the use of co-payments for some covered services and sections of the populations as a strategy for increasing the NHIS revenue and directing utilization towards more cost effective services.

However, at a press conference here on Wednesday, the group faulted the WB for suggesting to the Ghana government not to increase financial allocation to the health sector because the economy was fragile. “While we agree that the economy needs improvement, we also equally agree that Ghana’s economy has survived the HIPC era and grown from four percent in 2009 to 14.4 percent in 2011. With revenue from the oil and other sectors, the economy has a great potential to grow,” Cecelia Lodonu-Senoo, Vice Chairman of the campaign, said.

She said since the report acknowledged that Ghana’s health expenditure, as a percentage of GDP (4.9 percent), was below the average of other low-middle income countries (lMIC), and health expenditure as a percent of GDP had declined since 1995, the campaign rather thought government should increase its financial allocation to the health sector.

The WB report also expressed dissatisfaction about the highly subsidization of the NHIS, further stating that about 46 percent out of the total 65 percent registered members of the scheme belonged to the high income groups and could be roped in to pay premium.

“Yes, the campaign agrees that the NHIS is highly subsidized. But that is the way to go because even in the current state of affairs, a majority of the poor are still unable to afford the premiums. It is the best step towards universal health care in Ghana,” she said. “Although we equally share in the belief that the NHIS as currently constructed cannot achieve universal coverage for healthcare in Ghana, going to a cost-sharing model will threaten the gains already made by the NHIS,” she said.

Lodonu-Senoo called on the government to remain focused and ensure that more resources were injected into the health sector by motivating the sector’s human resource, improving accessibility to quality healthcare, providing modern health facilities and ultimately working towards making healthcare free at the point of delivery.

Ghana has a well-developed integrated multi-level health system distributed throughout the country, composed of community-based health planning and services (CHPS) zones, health centers, district, regional and teaching hospitals, private health providers, and non-governmental health-related organizations.

The study focused on structural and operational reforms of Ghana’s health financing system in terms of its performance to date and future available fiscal space.

Relative to its health expenditure, the WB said Ghana performed worse on the under-five and maternal mortality than other LMIC, and thus concluded that the West African country was off-track to meeting the MDGs on maternal and child health.

By 2015, the campaign with members from the Alliance for Reproductive Health Rights (ARHR), SEND Ghana, Coalition of NGOs in Health, Essential Service Platform and Integrated Social Development Center (ISODEC), hope to press on the government to implement the universal health care system where Ghanaians could access health services at the point of use without any financial commitment.