Universal Health Coverage for Inclusive and Sustainable Development : Country Summary Report for Ghana

Ghana is a country in West Africa with a population of about 25 million. The country is a stable democracy and achieved lower middle-income status in 2011 with a per capita gross national income (GNI) of $1,410. The prevalence of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in Ghana is among the lowest in the Sub-Saharan Africa region, and this too makes its status related to life expectancy relatively better. The government made a commitment to universal health coverage when it passed the national health insurance scheme (NHIS) law, act 650, at the end of 2003. The law was revised in 2012 (act 852) to bring the district insurance schemes into a single pooled fund, thus eliminating fragmentation. Act 650 established the national health insurance authority (NHIA) to implement the NHIS and mandates that all residents of Ghana enroll in one of the accredited insurance schemes. The law does not specify consequences for failing to enroll, nor are residents automatically enrolled, so until now the NHIS has been operating as a de facto voluntary scheme. With the 2003 NHIS law, the health financing system in Ghana is now a combination of supply-side subsidies for public and faith-based providers directly through the government budget, entitlement-based insurance coverage financed through a combination of earmarked taxes and individual-paid premiums, and direct out-of-pocket payments. The report is divided into two parts: part one gives universal coverage - status and sequencing; and part two present lessons to be shared