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Through the last years Ghana made a huge development in the health care sector. Still, there are a lot of people who cannot profit from a health insurance.

The National Health Insurance Scheme (NHIS)

The National Health Insurance Scheme is a system build up by the former president John Kufuor. In 2000, when he applied for the mandate of the president, he promised to disestablish the so-called “Cash and Carry System”. In fact, you had to pay for your treatment before you received medical supply. If you couldn´t pay you got no help in the hospital.

John Kufuor got president of Ghana in the year 2000 not at least for this promise and three years later, the scheme was passed into law.

What is the current situation?

Sadly, there are less statistics and researches that are up-to-date about this topic. Nevertheless, the non-governmental organization Oxfam published an extensive report about health insurance in Ghana in 2015.
This organization has revealed that just 18% of the citizens in Ghana profiting from the health care system while every citizen pays for this system through VAT. Furthermore, twice as many rich people are signed up to the NHIS as poor people. 64% of the rich are registered compared with just 29% of the poorest.
The promise made by John Kufuor in 2000 that he would disestablish the Cash and Carry System was broken because the citizens that are excluded from the NHIS still pay user fees in the cash and carry system.

Improvement in Health Care – What can be done?

An estimated 36% of health spending is wasted due to inefficiencies and poor investment. Moving away from a health insurance administration alone could save US$83 million each year. This is enough to pay for 23,000 more nurses.

In 2016, about 23.000 children died from malaria in Ghana. This number could be much smaller if hospitals would be reachable for everybody. One quarter of the population live over 60km from a health facility where a doctor can be consulted and skilled birth attendance is low at only 46%.

By progressive taxation of Ghana’s own resources, especially oil, the government could afford to increase spending on health by 200%. This would mean a spending of US$ 54 per capita.

Stethoscope on a printed sheet of paper


Ghana compared to other countries

Unfortunately, the Cash and Carry System is still part of Ghana. But what is the situation in other countries?

Let´s look at America. Since 2015 it is compulsory to have a health insurance in the USA. If you have no health insurance you have to pay money to the government. The payment is at least about US$695 or higher.  Hospitals have to provide medical care to patients who are in lively danger. If the patient is not in lively danger they are allowed to send him away. In the year 2017 only 13.5% of the inhabitants did not have a health insurance.

In Germany it is compulsory as well to have a health insurance and it works way better than it does in the US. Only 0.2% of the citizens in Germany have no health insurance. The costs for your insurance represent 14.7% of your income.  The one half of this amount is payed by the employer and the other half is payed by the employee.

SOURCE: Lisa-Marie Wala/