Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme
ABSTRACTGhana is a lower-middle-income economy that has made significant efforts to improve its health system, in order to achieve universal health coverage. Ghana has adopted strategic health purchasing as an important tool for efficient utilization of resources. This paper focuses on Ghana’s Natio...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-03-01
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| Series: | Health Systems & Reform |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/23288604.2022.2058337 |
| _version_ | 1811173679211479040 |
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| author | Eugenia Amporfu Peter Agyei-Baffour Anthony Edusei Jacob Novignon Eric Arthur |
| author_facet | Eugenia Amporfu Peter Agyei-Baffour Anthony Edusei Jacob Novignon Eric Arthur |
| author_sort | Eugenia Amporfu |
| collection | DOAJ |
| description | ABSTRACTGhana is a lower-middle-income economy that has made significant efforts to improve its health system, in order to achieve universal health coverage. Ghana has adopted strategic health purchasing as an important tool for efficient utilization of resources. This paper focuses on Ghana’s National Health Insurance Scheme (NHIS) analyzing its governance arrangements and purchasing functions; and providing recommendations for improvement. The study applied the Strategic Health Purchasing Progress Tracking Framework co-created by the Strategic Purchasing Africa Resource Center (SPARC) and its partners to collect data from secondary and primary sources between September 2019 and June 2020. A descriptive and narrative approach was used to synthesize information on the NHIS governance arrangements and purchasing functions based on the framework. Benchmarks were used to describe the NHIS on the continuum from passive to strategic purchasing and to identify steps to make purchasing more strategic. Strengths and weaknesses were found in governance and purchasing functions. Progress was seen in how the NHIS selects the services in the benefit package, regularly reviewing the package to respond to the health needs of the population, and in how it selectively contracts with providers, particularly private providers, to ensure that standards for quality of care are met. However, challenges remain in performance monitoring, due to claims being mostly processed manually, and provider payment, due to frequent unbundling and upcoding of services Ghana has made significant strides toward the achievement of universal health coverage, but there is room for improvement in provider payment and performance monitoring. |
| first_indexed | 2024-04-10T17:51:02Z |
| format | Article |
| id | doaj.art-a18480845c7c41249567210fcc37ec8d |
| institution | Directory Open Access Journal |
| issn | 2328-8604 2328-8620 |
| language | English |
| last_indexed | 2024-04-10T17:51:02Z |
| publishDate | 2022-03-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Health Systems & Reform |
| spelling | doaj.art-a18480845c7c41249567210fcc37ec8d2023-02-02T21:30:22ZengTaylor & Francis GroupHealth Systems & Reform2328-86042328-86202022-03-018210.1080/23288604.2022.2058337Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance SchemeEugenia Amporfu0Peter Agyei-Baffour1Anthony Edusei2Jacob Novignon3Eric Arthur4Department of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Health Policy Management and Economics, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Health Promotion, Education, Disability, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaDepartment of Economics, Kwame Nkrumah University of Science and Technology, Kumasi, GhanaABSTRACTGhana is a lower-middle-income economy that has made significant efforts to improve its health system, in order to achieve universal health coverage. Ghana has adopted strategic health purchasing as an important tool for efficient utilization of resources. This paper focuses on Ghana’s National Health Insurance Scheme (NHIS) analyzing its governance arrangements and purchasing functions; and providing recommendations for improvement. The study applied the Strategic Health Purchasing Progress Tracking Framework co-created by the Strategic Purchasing Africa Resource Center (SPARC) and its partners to collect data from secondary and primary sources between September 2019 and June 2020. A descriptive and narrative approach was used to synthesize information on the NHIS governance arrangements and purchasing functions based on the framework. Benchmarks were used to describe the NHIS on the continuum from passive to strategic purchasing and to identify steps to make purchasing more strategic. Strengths and weaknesses were found in governance and purchasing functions. Progress was seen in how the NHIS selects the services in the benefit package, regularly reviewing the package to respond to the health needs of the population, and in how it selectively contracts with providers, particularly private providers, to ensure that standards for quality of care are met. However, challenges remain in performance monitoring, due to claims being mostly processed manually, and provider payment, due to frequent unbundling and upcoding of services Ghana has made significant strides toward the achievement of universal health coverage, but there is room for improvement in provider payment and performance monitoring.https://www.tandfonline.com/doi/10.1080/23288604.2022.2058337GhanaNational Health Insurance AuthorityNational Health Insurance Schemepurchasing frameworkstrategic health purchasing |
| spellingShingle | Eugenia Amporfu Peter Agyei-Baffour Anthony Edusei Jacob Novignon Eric Arthur Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme Health Systems & Reform Ghana National Health Insurance Authority National Health Insurance Scheme purchasing framework strategic health purchasing |
| title | Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme |
| title_full | Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme |
| title_fullStr | Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme |
| title_full_unstemmed | Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme |
| title_short | Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme |
| title_sort | strategic health purchasing progress mapping a spotlight on ghana s national health insurance scheme |
| topic | Ghana National Health Insurance Authority National Health Insurance Scheme purchasing framework strategic health purchasing |
| url | https://www.tandfonline.com/doi/10.1080/23288604.2022.2058337 |
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