Some residents in the Sekondi-Takoradi metropolis are hailing the newly revamped national call center for the National Health Insurance Scheme (NHIS) for the difference it has made to the delivery of service.

The national call center, set up in April 2012, is part of numerous innovations that the scheme has adopted to bring efficiency to its work. The center helps the NHIS to receive and address complaints about the scheme which is one of Ghana’s most funded social intervention programmes.

“My cousin came to live with us to give birth. When we went to the hospital, the Holy Child Health Center in Fijai, they said she needed a caesarian session. And she had to about 1600ghc. We were not happy but we paid, though she had the NHIS card active. After she gave birth, I lodged a complaint with NHIS. I think they also forwarded the case to the region. But after like 2 months, our money was refunded to us,” says Mabel Nyame a trader in Mampong, a small community in the STMA area.

She was one of several villagers who gathered at a day’s Beneficiary Community Dialogue on Social Protection (SP) within the Sekondi-Takoradi Metropolitan Area.

The dialogue was organised by the Ministry of Gender, Children and Social Protection (MOGSP) in partnership with the Civil Society Platform on Social Protection Ghana (CSPSP-GH) and the Journalists in Social Protection (JISOP) with funding support from UNICEF Ghana.

Mabel’s cousin was happy with the turn of events.

“As for my cousin, she was very impressed with getting the money. She told me that now she knows that the NHIS is working but it is the hospitals that are not doing the right thing.”

Mabel has since begun to use the call center to seek redress for her friends and family who are not treated right at the hospitals.

“I didn’t even like the idea of having the NHIS Card because too many people complain that it doesn’t work. But when my wife was pregnant, we got one. But me, I prepared for the worst in case it doesn’t work. So, at the hospital, they said my wife needed C-session to deliver and we had to pay GHC1600. Me I just paid, but when we got home my wife was furious. They gave some small booklet, so, my wife found the number and called. It took sometime but they got the money for us,” said Kofi Baiden, another user of the scheme’s call center.

District Manager for the NHIS in Sekondi-Takoradi, Seth Kwasi Nyarko explained that he receives calls from the National NHIS Call Center usually about complaints from clients or members of the scheme which mostly have to do with extortion of money at the hospitals.

“One of such ones was at Effienkwanta where they [The Call Center] asked me to do an investigation about why the person was asked to pay money. So, we did the investigation, we gave them the report for them to follow-up,” he reminisced.

He further explained that most of the complaints referred to him from the Call Center regard issues of patients with NHIS cards being asked to pay for medicines or caesarean sessions both of which are covered by the scheme.

In such instances, “we follow up with the facilities and we let them know the contract that they have signed or the benefit package [for clients] includes caesarean. We have occasions where we have had a refund for a number of people. At my district for example, I’ve had about four people that money has been refunded to them for caesarean session.”

Social Protection and NHIS in Ghana

After Ghana’s independence in 1957, healthcare was free and funded by tax payers.

But, according to researcher Nathan Blanchet, Günther Fink and Isaac Osei-Akoto, this was not sustainable.

For decades, until 2003, other methods of healthcare financing were tried, including the ‘Cash-and-Carry’ system in the 1980s and the NGO-Initiated Community-Based Health Insurance Schemes (CBHIS) in the 1990s.

“Ultimately, the National Health Insurance Scheme (NHIS) was established under Act 650 [amended in 2012 as Act 852] of 2003 by the Government of Ghana to provide a broad range of health care services to Ghanaians through district mutual and private health insurance schemes,” the researchers stated.

The NHIS became a buffer for poor persons who needed support in paying for healthcare services.

Currently, the NHIS is one of five programmes included in the Social Protection Basket as captured in the Ghana National Social Protection Policy drafted by the MOGCSP.

Currently, to boost the scheme’s contribution to social protection in the country, there are special services provided for Livelihood Empowerment Against Poverty (LEAP) beneficiaries, pregnant women and new mothers, children under five years, adults 70 and above among others.

For one, members of these categories can register for and renew their membership of the NHIS for free.

They can also use their cards immediately after registration or renewal, whereas regular members of the scheme would have to wait for one month to be able to use their cards.

Either through the Social Welfare Department, community leaders or a medical practitioner, Mr. Nyarko explained that “They give us a list of all those members, with their ID cards and they come to our office and we register them. Sometimes, we collaborate with the social welfare people, we go to the community and we bus them to a particular point and then we do it for them because in some of the hinterlands, we get difficulties and getting the networks.”

He also revealed that preparations are well underway to enroll children from ages six to 14 onto the scheme.

The National Health Insurance Authority (NHIA) and the National Identification Authority (NIA) have signed a joint agreement to register and issued Ghana Cards to children in that age bracket for them to access essential healthcare.

“So, we will be using our staff but we’ll use their technology or their system, for which we have already gone for training and somewhere this month, I’m told 15th [July, 2024], we are taking off. We will be moving to schools to do that registration,” Mr. Nyarko disclosed.

Speaking during the signing event in May of this year, Dr. DaCosta Aboagye, the Chief Executive of NHIA, stated that the partnership between his outfit and NHIA highlighted a deliberate effort by the government to increase the reach of social services and expedite administrative procedures.

“The issuance of Ghana cards to children aged between 6 and 14 years represents a pivotal step in safeguarding their rights and enabling their full participation in society,” he stated.