A study on Maternal Health and The National Health Insurance (NHIS) in 20 poor districts and 120 communities indicates that the active membership of the Scheme stands at 10,145 representing, 38 per cent of the Ghanaian population.
One hundred and twenty communities selected from the Greater Accra and the three Northern Regions show a growth rate of 14. 2 per cent over the 2012 record, while all four targeted regions reported increased membership of between 13 per cent and 32 per cent between 2012 and 2013.
Majority of the membership of the NHIS in 2013 are females representing a majority of 57.8 per cent.
Among the 18 districts schemes, which provided data on NHIS coverage, Adenta in the Greater Accra Region reported the highest coverage of 15 per cent of its population, while the Wa Municipality in the Upper West reported the highest coverage of 90 per cent of its population.
The study reveals that the increase in the subscription to the schemes is largely due to public education and sensitisation of communities through radio and community durbars by the NHIS’ collaboration with Civil Society Organisations (CSO), improved customer service delivery, reduction in registration fees, among others.
With regards to the Free Maternal Care Programme, the study observes that a number of unapproved charges collected at health facilities, including a flask of mashed kenkey or tea, chamber pots to contain urine and vomit, six old cloths and three strong ones to wrap babies, prevent pregnant women from enjoying the full benefit of the scheme as prescribed by the policy.
The study also notes the strong collaboration between the NHIS and the Department of Social welfare (DSW) in some districts in the Northern Region, which resulted in the enrolment of LEAP beneficiaries onto the NHIS
The study, initiated by SEND Ghana, on the theme: “Making Safe Motherhood a Reality”, recommends, among other things, that to successfully enrol the majority of the core poor and vulnerable groups on the NHIS, there is the need to strengthen institutional collaboration between the NHIS and the DSW.
Mr John Nkaw and Mr Mukuila Adamu, of the SEND Ghana Programme, in the Northern and Upper West regions, respectfully, who disseminated the report, were of the view that the mere transfer of the mandate of identifying indigenes for registration to the DSW was not sufficient to widen the safety net for many poor people in Ghana.
They noted that a pro-poor programme like the NHIS should reach not only the extreme poor but the poor, in general meaning – all persons who fall below the upper poverty of GHȼ1,314.00 per a year.
Mr Siapha Kamara, the Chief Executive Officer of SEND West Africa, noted that though Ghana had made strides towards its health delivery system, the strategies to an extent had not been equity-centred , comprehensive and effective enough to guarantee all poor and vulnerable people in Ghana access to healthcare.
Mr Daniel Dogbetse, the Head of Monitoring and Evaluation of the Ministry of Heath, noted that if members of the society would take responsibility for all their health needs and make efforts to seek timely intervention, more than half of all health needs would be solved.
According to him, the trend in institutional Maternal Mortality ratio continued to improve though not at the rate that met expectation.
Maternal Mortality ratio improved from 155 per 100,000 live births (LB) in 2013 to 14 per 100,000 LB in 2014.
Institutional Maternal Mortality Ratio was high at 174 deaths per 100,000 in 2011 but had since then dropped to 144 per 100,000 in 2014, a drop of about 21 percent, he noted.
He said the magnitude and persistent high rates was an indicator of the level of development but said there were outstanding issues policy makers needed to confront.
Despite the strides made, the Ministry, he said, would continue to implement plans that placed priority on maternal and infant mortality reduction.