1. Delivering on the NHIS Promise 1 NATIONAL HEALTH INSURANCE AUTHORITY PRESENTATION AT THE DONOR FORUM ON WORLD BANK GROUP PARTERNSHIP, PROGRAMS AND TRUST FUNDS PARIS, FRANCE MAY 20-21, 2008 BY RAS A. BOATENG (CHIEF EXECUTIVE)

2. Delivering on the NHIS Promise 2 Outline Of Presentation Overview of Health Insurance Act Private Sector Participation Status of Implementation Challenges Strategies to address challenges

3. Delivering on the NHIS Promise Overview Of Health Insurance Act Subsidize Cost to DMHIS Reinsure DMHIS against cost fluctuations Fund Indigent Healthcare cost Provide access to health service ACT 650 NATIONAL HEALTH INSURANCE COUNCIL TYPES OF HEALTH INSURANCE SCHEMES NATIONAL HEALTH INSURANCE FUND Education Programs Implement NHI Policy Register, license & Regulate HIS Grant accreditation to Healthcare Providers Manage NHI Fund Determine Premiums Promote Health Education Establishment of District Mutual Health Insurance Establishment of Private Commercial Health Insurance Establishment of Private Mutual Health Insurance

4. Delivering on the NHIS Promise Private Sector Contribution to the growth of Health Insurance in Ghana 1993: Nationwide Mutual Medical Insurance Scheme ( by the Private Medical Practitioners Association; reached subscriber base of 20,000 people in 2 years, corporate subscribers paid premia annually, half yearly or quarterly and was based on the benefits level ) 1997: Metropolitan Health Insurance Plan ( by Metropolitan Insurance company Ltd., As at September 2001, 15,000 subscribers were on full cover, 25,000 on partial cover. Over 100 companies had subscribed. Had designed a package for the educational sector workers and was working with Defence to design one for the Civilian workers/dependants of the Military) 1999: The Ghana Healthcare Company ( by SSNIT but still at gestation period) The Nkoranza Community based Mutual Health Scheme

5. Delivering on the NHIS Promise Private Sector Participation in NHIS Implementation (Financing side) Gemini Life Insurance Company Vanguard Assurance Momentum Health Insurance

6. Delivering on the NHIS Promise Category of ProvidersNumber Accredited Hospitals/Clinics301 Dental Clinics7 Maternity Homes201 Pharmacies301 Chemical Shops229 Diagnostic Centres96 Total Accredited1135 Private Sector Participation in NHIS Implementation (Provider side)

7. Delivering on the NHIS Promise Percentage Market Share of Health Service Provision Service ProviderNumber of Facilities PercentagePercentage HR Ghana Health Service and Teaching Hospitals 1,1104967 Faith Based Providers2311015 Private Hospitals and Clinics & Maternity Homes 8783910 Quasi4828

8. Delivering on the NHIS Promise Status of Implementation Schemes in Operation145 Total Registered11,279,67855% Members eligible for ID Cards9,773,10048% Informal Adult2,456,01225% 70 years and above405,4744% Under 18 years5,985,15261% SSNIT Contributors625,7836.5% Pensioners52,3001% Indigents248,3792.5% ID Card Bearers8,291,66642%

9. Delivering on the NHIS Promise YEAR Hospital/Clinic Attendance Active Members 2005552,0001,388,662 20063,213,4503,955,203 20076,835,1048,291,666 Status of Implementation (Cont’d)

10. Delivering on the NHIS Promise Challenges of the Private Sector in Health Private Health Insurance side: initial capitalisation, e.g. the security deposit Private Provider side: disincentive in locating at hard to reach areas Initial capitalisation Technical Personnel

11. Delivering on the NHIS Promise Incentivise private providers to operate in hard to reach areas. Use of accreditation of existing private providers to redistribute health facilities to improve geographical access Encouraging Ghanaian doctors/Nurses in Diaspora to relocate and establish modern health facilities in the country through the franchise idea Proposed strategies to address challenges

12. Delivering on the NHIS Promise 12 END OF PRESENTATION THANK YOU