;
as suppliers demand cash and carry while NHIA takes cover



There is imminent danger of the collapse of health care delivery system in the Upper East Region following revelation that stocks of medical supplies at the Bolgatanga Region Medical stores are running lower and lower but the region is unable to obtain medical supplies as a result of indebtedness to suppliers.
With the depletion of some essential drugs and non drug consumables including malaria drugs at the medical stores the situation if not addressed properly and timely could affect health care delivery in one of the country’s poorest regions.
The debt which is laid at the door steps of public health care providers in the region is said to be caused by delays in the payment of claims by the National Health Insurance Authority. It has been found that public health facilities in the eight districts and two municipalities in the region including Bunkprungu Yuuyoo District are indebted to the Bolgatanga Regional Medical Stores to the tune of GH¢2, 149187.92.
This came to light during a Regional Emergency Health Planning Meeting in Bolgatanga. Addressing District Health Directors, Heads of Facilities and other top health management officials, the Regional Director of Health Services Dr. John Koku Awonoor Williams said the unfortunate situation has brought the Regional medical stores down to operate at 50 % drug availability. The debt he indicated came from drugs and non drug consumables. The total debt owned the medical stores from medicine supplied stands at GH¢ 1,310,728.08 whiles that of non medicine make up for GH¢838,459.08.
The districts’ indebtedness to the regional medical stores is as follows:
District Medicine Non Medicine Total
Bawku East 130,100.93 56,883.63 186,984.56
Bawku West 103,362.62 65,505.58 168,868.20
Bolga Municipal 343,922.12 312,153.24 656,075.36
Bongo 212,052.78 144,314.41 536,367.19
Bulsa 82,659.93 37,436.95 120,096.88
Bunkrugu Yuuyoo 1,548.40 245.20 1,793.60
Garu Tempane 106,047.96 38,376.87 144,424.83
Ksena Nakana East 139,448.73 116,312.33 255,761.06
Kasena Nakana West 111,895.79 33,223.11 145,118.90
Talensi Nabdam 85,105.54 33,334.92 118,440.46
1,310,728.08 838,459.08. 2,149187.92.
Whiles admitting that suppliers of the regional medical stores have actually rejected all appeals for them to replenish depleting stock at the Bolgatanga Regional Medical Stores, Dr. Awonoor said it is not entirely the fault of the suppliers as they are faced with economic realities and practical business conditions” If we cannot pay what we have been supplied what justification do we have to ask for more” he queried. “Don’t forget we have an obligation” he continued “We have an obligation to meet the health needs of the population and we cannot afford to disappoint them when they call in. We need to pay what we own to the medical stores to keep it running so that we can continue to get medical supplies at our facilities to save lives” the Health Director pleaded.
But as many as appreciated the passion, and concerns of the Regional Health Director and the plight of the people of the region they pointed out that the problem is with the National Health Insurance Authority. In actual fact as some hinted what the providers own the medical stores represent what Health Insurance Authority owns them in most cases.
The providers poured out their frustration at the NHIA threatening that if the health system in the region collapses it is the NHIA who is actually responsible for its collapse. The providers as they sounded simply would not be able to meet their debt obligation to the Medical stores if claims submitted are not paid by NHIA as far back as June. Besides the delays in the payment of claims some providers complained of arbitrary rejection of some prescription bills and the further refusal to return those bills to the providers a situation they say is costly to them.
Responding to the anxious audience the Regional Coordinator of the National Health Insurance Scheme Mr. Roger Apusiwine pleaded with the providers to bear with the Scheme Managers saying the failure of the scheme to make prompt payment of claims is largely due to the fact that funds take time to accumulate from the various sources before payments can be made. He rebutted claims that there are usually deliberate delays in the process.
Mr. Apusiwine admitted that the Upper East Region is among the group of regions that have made payments only up to June. He however announced that his office is in receipt of the checks for July which he indicated might help to reduce the burden of debt on the regional medical stores.
Whiles the providers wished to continue to sledge things out with the Health Insurance representative the Regional Director seized the moment to continue to sound words of caution to providers to endeavor to use prudent management skills with priority for drugs availability at their facilities. He took issues with them complaining that some health authorities in the region are flouting standard financial standing orders by sending money meant for drug accounts into non drug account or using drug account fund for other purposes rather than drug procurement without due permission. Dr. Awonoor advised all those indulging in such bad financial management practices to put a stop to it before it is too late for them.
It is worth noting that the Upper East Region which is acclaimed nationwide as having one of the most efficient public health systems in the country owns much of its successes to the vibrancy of its medical supply system. Following the revamping of the Regional Medical Stores in 2009, the region instituted the door to medical supply system. This is the practice where all public health facilities in the region make their request to the Regional Medical Stores and have them delivered at the facility at no cost.
According to the Deputy Director Administration at the Regional Health Directorate, Mr. Lucio Dery, since 2009 the door to door medical supply system in the Upper East Region has worked like magic. ‘With a strategic delivery system plan called the Requisition Report Issue Received Voucher (RRIRV) adequate timely supplies are delivered at the points of need”.
The door to door delivery system in the words of Mr. Dery has also helped to cut down a lot of cost: “before the coming into being of the new system the delivery of medical supplies by individual facilities used to come with a lot of cost: You can imagine there were times some facilities in the remotest communities could dispatch the only vehicle at the facility to medical stores to fetch supplies irrespective of what else it’s needed for. Today, such and other costly experiences are now things of the past” Mr. Dery recounted. In deed everybody is aware of the importance of the door to door system hence the medical stores to health delivery in the region and this is a point NHIA wants to discount.