The World Bank has proposed various reform options in the health financing system – many of them currently ongoing – to support the current growth and expansion plans of the system.

Describing the system as “going in the right direction” and its revenue sources as “diversified and progressive”, the Bank noted the need for reforms in areas such as provider payment systems, and was hopeful that the capitation pilot will help orient the NHIS towards making more effective use of payment mechanisms and begin to address more fundamental problems in the service delivery system.

These were contained in a report released recently by the World Bank and titled “Health Financing in Ghana”, in which the authors described consumer satisfaction with the NHIS as high, and increase in outpatient utilization as a strength, adding that “coverage under the NHIS led to better utilization by the poor of health facilities”.

On the general health sector of the country, the publication noted that though Ghana has come a long way in meeting the health needs of its populace, more still remains to be done. The World Bank however observed that “Ghana has made substantial progress in transitioning the NHIS into a functioning health insurance program for a significant part of its population.”

The report comes at a time when there seem to have been a misinterpretation of growing utilization figures, which according to this report is a strength. It also comes to support the need for provider payment reform such as the capitation pilot which the NHIA is currently embarking upon, and the structural and operational reforms that will be brought about by the new NHIS bill that Parliament recently passed.

The National Health Insurance Authority (NHIA) has since 2009 undertaken a number of reforms which it argued will inject greater operational efficiency into the administration of the scheme. Some of these were mentioned in the report, lending credence to the initiatives. Other suggested reforms were however outside the range of operation of the NHIA as a body.

Available figures show that cash-and-carry, as measured by internally-generated funds of healthcare facilities, has reduced to its lowest since inception of the scheme.