Humanities and Social Sciences

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Effect of the National Health Insurance Scheme on Community-Based Health Planning and Services in the Vieri Zone of Wa West District of Ghana

Received: 23 January 2017    Accepted: 09 February 2017    Published: 04 March 2017
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Abstract

Ghana launched the Community-based Health Planning and Services (CHPS) initiative in the year 2000 in furtherance of the ideals of primary health care. The CHPS strategy was adopted by the MOH as a national programme to bridge the gap in access to healthcare. It provides for a Community Health Officer (CHO) to be resident in a community and with the help and support of the community members, to render some basic packages of PHC especially preventive services including home visiting, educational programmes and other health promotion activities and not sedentary clinical services at the health facility. With the introduction of the National Health Insurance Scheme (NHIS), which is a form of Health care financing in order to serve as a conduit for providing financial access to health care. This has perceptively resulted in an increase in out-patient attendance at all facilities especially CHPS facilities. This tended to constrain the CHOs from embarking on their mandated task of home visitation, educational programmes and other health promotion packages. It is against this background that this research work has been carried out to ascertain why the focus of CHPS is shifting from a preventive to a curative approach. The methodology adopted was a case study using a before and after approach to make comparison of the preventive health care activities of the CHO before and after the introduction of NHIS as well as access of people to the Vieri CHPS compound. Simple random sampling was used to select 165 households who were interviewed. We purposively sampled CHOs, the Community Health Management Committee (CHMC) and Community Health Volunteers (CHVs) who have in-depth knowledge on the operations of the CHPs. The study revealed that the frequency of household visitation and the educational programmes organized by the CHOs have declined. This is due to the net effect of NHIS on the facility and the CHOs due to increased attendance at the facility. This did not only negatively affect the activities that the CHOs are supposed to carrying out but also on the health infrastructure. The study also revealed various challenges faced by CHMCs and CHVs.

DOI 10.11648/j.hss.20170501.16
Published in Humanities and Social Sciences (Volume 5, Issue 1, January 2017)
Page(s) 31-45
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Health, Care, Effects, National, Health, Insurance, Scheme, Community-Based, Health Planning Services

References
[1] Apetorgbor, V. E. A. (2008). Review of the Implementation Process of Community-based Health Planning and Services, unpublished MSc. Public Health Thesis, Vrije Universiteit Amsterdam, The Netherlands.
[2] Cutler, D. M. and Zeckhauser, R. (2003). Extending the Theory to Meet the Practice of Insurance. Harvard University and NBER. Retrieved from, http://www.scholar.havard.edu/cutler/publications/extending-theory-meet-practice-insurance.
[3] Dekker, M. Community-Based Health Insurance in Ethiopia, retrieved June 12th 2013, from http://www.ascleiden.nl/?q=research/projects.
[4] Faden, L., Vialle-Valentin. C. Ross-Degnan, D. and Wagner, A., (2011). Review series on pharmaceutical pricing policies and interventions: The role of Health Insurance in the cost-effective use of medicine (working paper 2), WHO/HAI Project on Medicine Prices and Availability. Retrieved from http://www.haiweb.org/medicineprices/197073376/competition final May 2011.
[5] Gajate-Garrido, G and Owusua (2013). The National Health Insurance Scheme in Ghana: Implementation challenges and proposed solutions. IFPRI Discussion Paper 1309. Washington, D. C.: International Food Policy Research Institute (IFPRI).
[6] Retrieved from http://www.ifpri.org/publication/national-health-insurance-scheme-ghana.
[7] Ghana Health Service, (2005). Policy Document No. 20, Community-based Health Planning and Services (CHPS) Operational Policy, Accra.
[8] Ghana Millennium Development Goals, (April 2010). 2008 Ghana Millennium Development Goals Report.
[9] Heitman, E. and McKieran, L. C. (2003). Community-Based Practice and Research (module 4): Collaboration and Sharing Power. Retrieved from http://www.asph.org/userfiles/module4.pdf.
[10] Ministry of Health (1999). Community-based Health Planning and Services Handbook.
[11] Ministry of Health (2000). Community-based Health Planning and Services (CHPS) Implementation Guide.
[12] Ministry of Health (2009). A report of the Annual Health Sector Review, In-depth Review of the Community-based Health Planning Services (CHPS) Programme, Accra.
[13] Ministry of Health, (2012). Half Year Report, January-June, Accra.
[14] Ministry of Health/Ghana Health Service, (2002). Technical Report No. 32, CHPS Lead District Readiness Assessment Ghana.
[15] Nang-Beifubah, A. (2010). GHS/JICA Disseminate Final Report on CHPS Project, retrieved from http://www.ghanaweb.com/home/news/health/article/175405.
[16] NHIA (2010). Annual Reports. National Health Insurance Scheme, Ghana.
[17] World Health Organization (1978). Primary Health Care. Report of the international conference on primary health care. Alma-Ata, USSR: WHO Geneva 1978.
[18] World Health Organization (WHO, 2004). Centre for Health Development, Ageing and Health Technical Report (Volume 5): A glossary of terms for community health care and services for older persons. Retrieved from www.who.nit/. ahp_vol.5.
[19] World Health Organization (WHO, 2008). The World Health Report 2008, Primary Health Care-Now More than Ever, Geneva.
Author Information
  • Department of Governance and Development Management, Faculty of Planning and Land Management, University for Development Studies, Wa Campus, Ghana

  • Department of Planning and Land Management, Faculty of Planning and Land Management, University for Development Studies, Wa Campus, Ghana

  • Department of Planning and Land Management, Faculty of Planning and Land Management, University for Development Studies, Wa Campus, Ghana

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    Kanlisi Kaba Simon, Issaka Abdul-Hakim, Faustina Akwetey. (2017). Effect of the National Health Insurance Scheme on Community-Based Health Planning and Services in the Vieri Zone of Wa West District of Ghana. Humanities and Social Sciences, 5(1), 31-45. https://doi.org/10.11648/j.hss.20170501.16

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    ACS Style

    Kanlisi Kaba Simon; Issaka Abdul-Hakim; Faustina Akwetey. Effect of the National Health Insurance Scheme on Community-Based Health Planning and Services in the Vieri Zone of Wa West District of Ghana. Humanit. Soc. Sci. 2017, 5(1), 31-45. doi: 10.11648/j.hss.20170501.16

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    AMA Style

    Kanlisi Kaba Simon, Issaka Abdul-Hakim, Faustina Akwetey. Effect of the National Health Insurance Scheme on Community-Based Health Planning and Services in the Vieri Zone of Wa West District of Ghana. Humanit Soc Sci. 2017;5(1):31-45. doi: 10.11648/j.hss.20170501.16

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  • @article{10.11648/j.hss.20170501.16,
      author = {Kanlisi Kaba Simon and Issaka Abdul-Hakim and Faustina Akwetey},
      title = {Effect of the National Health Insurance Scheme on Community-Based Health Planning and Services in the Vieri Zone of Wa West District of Ghana},
      journal = {Humanities and Social Sciences},
      volume = {5},
      number = {1},
      pages = {31-45},
      doi = {10.11648/j.hss.20170501.16},
      url = {https://doi.org/10.11648/j.hss.20170501.16},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.hss.20170501.16},
      abstract = {Ghana launched the Community-based Health Planning and Services (CHPS) initiative in the year 2000 in furtherance of the ideals of primary health care. The CHPS strategy was adopted by the MOH as a national programme to bridge the gap in access to healthcare. It provides for a Community Health Officer (CHO) to be resident in a community and with the help and support of the community members, to render some basic packages of PHC especially preventive services including home visiting, educational programmes and other health promotion activities and not sedentary clinical services at the health facility. With the introduction of the National Health Insurance Scheme (NHIS), which is a form of Health care financing in order to serve as a conduit for providing financial access to health care. This has perceptively resulted in an increase in out-patient attendance at all facilities especially CHPS facilities. This tended to constrain the CHOs from embarking on their mandated task of home visitation, educational programmes and other health promotion packages. It is against this background that this research work has been carried out to ascertain why the focus of CHPS is shifting from a preventive to a curative approach. The methodology adopted was a case study using a before and after approach to make comparison of the preventive health care activities of the CHO before and after the introduction of NHIS as well as access of people to the Vieri CHPS compound. Simple random sampling was used to select 165 households who were interviewed. We purposively sampled CHOs, the Community Health Management Committee (CHMC) and Community Health Volunteers (CHVs) who have in-depth knowledge on the operations of the CHPs. The study revealed that the frequency of household visitation and the educational programmes organized by the CHOs have declined. This is due to the net effect of NHIS on the facility and the CHOs due to increased attendance at the facility. This did not only negatively affect the activities that the CHOs are supposed to carrying out but also on the health infrastructure. The study also revealed various challenges faced by CHMCs and CHVs.},
     year = {2017}
    }
    

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    AB  - Ghana launched the Community-based Health Planning and Services (CHPS) initiative in the year 2000 in furtherance of the ideals of primary health care. The CHPS strategy was adopted by the MOH as a national programme to bridge the gap in access to healthcare. It provides for a Community Health Officer (CHO) to be resident in a community and with the help and support of the community members, to render some basic packages of PHC especially preventive services including home visiting, educational programmes and other health promotion activities and not sedentary clinical services at the health facility. With the introduction of the National Health Insurance Scheme (NHIS), which is a form of Health care financing in order to serve as a conduit for providing financial access to health care. This has perceptively resulted in an increase in out-patient attendance at all facilities especially CHPS facilities. This tended to constrain the CHOs from embarking on their mandated task of home visitation, educational programmes and other health promotion packages. It is against this background that this research work has been carried out to ascertain why the focus of CHPS is shifting from a preventive to a curative approach. The methodology adopted was a case study using a before and after approach to make comparison of the preventive health care activities of the CHO before and after the introduction of NHIS as well as access of people to the Vieri CHPS compound. Simple random sampling was used to select 165 households who were interviewed. We purposively sampled CHOs, the Community Health Management Committee (CHMC) and Community Health Volunteers (CHVs) who have in-depth knowledge on the operations of the CHPs. The study revealed that the frequency of household visitation and the educational programmes organized by the CHOs have declined. This is due to the net effect of NHIS on the facility and the CHOs due to increased attendance at the facility. This did not only negatively affect the activities that the CHOs are supposed to carrying out but also on the health infrastructure. The study also revealed various challenges faced by CHMCs and CHVs.
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