Researchers from University of the Witwatersrand Describe Findings in Health Insurance (Stakeholders Perspectives on the Success Drivers in Ghana’s…

Managed Care Weekly Digest

Researchers from University of the Witwatersrand Describe Findings in Health Insurance (Stakeholders Perspectives on the Success Drivers in Ghana's National Health Insurance Scheme - Identifying Policy Translation Issues)

By a News Reporter-Staff News Editor at Managed Care Weekly Digest -- Investigators publish new report on Health Insurance. According to news reporting out of Johannesburg, South Africa, by NewsRx editors, research stated, "Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation."

Our news journalists obtained a quote from the research from the University of the Witwatersrand, "The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Based on an empirical qualitative case study of stakeholders' views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. In the study, interviewees referred to both 'hard and soft' elements as driving the 'success' of the Ghana scheme. The main 'hard elements' include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The 'soft' elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years, amounting to a process best conceived as germination as opposed to emulation. The Ghana experience illustrates that in adopting health financing systems that function well, countries need to customise systems (policy customisation) to suit their socio-economic, political and administrative settings."

According to the news editors, the research concluded: "Home-grown health financing systems that resonate with social values will also need to be found in the process of translation."

For more information on this research see: Stakeholders Perspectives on the Success Drivers in Ghana's National Health Insurance Scheme - Identifying Policy Translation Issues. International Journal of Health Policy and Management, 2016;6(5):273-283 (see also Health Insurance).

Our news journalists report that additional information may be obtained by contacting A. Fusheini, Centre for Health Policy, MRC Health Policy Research Group and School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. Additional authors for this research include G. Marnoch and A.M Gray.

Keywords for this news article include: Johannesburg, South Africa, Health Insurance, Insurance Companies.