Abstract:

The Ghana National Health Insurance Scheme (NHIS) is to assure equitable and universal access for all residents of Ghana to an acceptable quality package of essential health care services without out-of pocket payment. The objective of this study is to examine the perceptions and experiences of health care providers and clients in the Upper East Region of Ghana regarding the NHIS. The study was cross-sectional and Patient exit interviews, in-depth interviews and focus group discussions (FGDs) were used to collect data. The NHIS was seen by all participants of the study to be beneficial. It led to an increase in the utilization of health care services for the insured and mobilized health resources for facilities. Insured clients reported verbal abuse, long waiting times, not being physically examined and discrimination in favour of the uninsured and the rich. Providers think that the insured were abusing their services by frequenting the facilities, and sometimes faking illness to collect drugs for their uninsured relatives. The biggest challenge was the delay in reimbursement of claims as a result; providers were not able to purchase drugs and non-drug supplies threatening the sustainability of the NHIS.

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