The Pharmaceutical Society of Ghana/ BUSAC Advocacy Project has launched a 67 page report aimed at mainstreaming pharmaceutical practice for a national comprehensive health care delivery system.

The report focused mainly on a study of the challenges facing Community Pharmacy Practice (CPP) in Ghana under the National Health Insurance Scheme (NHIS).

The report covered the Greater Accra Region, which represented the southern sector, Ashanti Region, for the middle sector and Northern, Upper East and Upper West Regions, representing the northern sector.

The respondents were selected NHIS clients and accredited community pharmacies. In all, 2,400 clients and 170 providers were interviewed in the three sectors using a list obtained from the National Health Insurance Authority.

The document covers the NHIS, problems facing the CPP, delays in provider claims reimbursement, decreasing prescription turn-over, the proposed capitation system, relevance of the problems and justification of an advocacy action and data analysis.

The survey was undertaken in 2011, seven years after the introduction of the NHIS.

Clients sampled included persons who are 15 years and above and had registered with the NHIS at the time of the study.

The document assessed the veracity of the problems associated with the NHIS and how they affect accredited community pharmacies in meeting the pharmaceutical care needs of clients.

It determined the effect of the delays in claims reimbursement on NHIS accredited pharmacies and clients, explored clients ’preferences for separating prescribing and dispensing functions as a means to improve quality of care under the NHIA.

It touched on the proposed capitation by the NHIA and how it would affect community pharmacy practice in Ghana.

The study assessed the impact of the NHIS on the performance of National Health Insurance (NHI) accredited Community Pharmacies in meeting the pharmaceutical care needs of insured patients and the sustainability of Community Pharmacy Practice.

The data collection tool was designed to elicit information such as; how long it took for claims reimbursement, prescription turnover prior for one to be accredited, NHIS and non-NHIS prescription turnover after accreditation.

It also examined measures put in place to overcome challenges imposed by the scheme and how it affects service to clients registered with the scheme and future outlook of practice.

The study recommended that although the level of awareness of the NHIS was high, there was the need for the NHIA to engage in some education about the scheme.

It touched on the right of patients to exercise an option of being served at a NHI facility or going to an accredited community pharmacy to be served.

This will help provide a level playing field for the public and private sector participation in the pharmaceutical care service delivery in Ghana.

The report said the NHIA should develop innovative ways of reimbursing accredited Service Providers and this should involve: “designing an on-line submission of claims so as to reduce claim reimbursement time and therefore prevent capital lock up and consequent increasing cost of capital to the private Pharmaceutical Service Providers”.

“The NHIA in collaboration with the Ministry of Health and the Ghana Health Service as well as the Teaching Hospitals should engage stakeholders including accredited community pharmacies even as the programme of capitation is being piloted in the Ashanti Region. Such an engagement will discuss any implementation-related challenges of capitation as a health care financing option in Ghana and take on board the concerns of accredited community pharmacies.”

The report concluded that the practice of NHI facilities prescribing and dispensing at the same facility is not in tune with international best practice.

It said though the practice appears to be a likeable option in terms of convenience to patients, there were obvious disadvantages, which should be mainstreamed in order not pose a serious challenge to the delivery of quality pharmaceutical care in Ghana.**