NHIA considering coverage of childhood cancers, family planning

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The National Health Insurance Authority (NHIA) is considering the coverage of the treatment of childhood cancers and family planning services under the National Health Insurance Scheme (NHIS).

This follows the successful piloting and actuarial studies conducted to determine the financial sustainability of the scheme.

Dr. Lydia Dsane-Selby, Chief Executive Officer (CEO) of NHIA, stated this in an engagement with some senior editors and presenters in Accra ahead of the launch of the 2021 National Health Insurance Week, on Monday, November, I5.

It is under the theme: “NHIS: Using the Ghana Card for Expanded Health Service.”

Dr. Dsane-Selby said analyses indicated that the scheme could accommodate the treatment of childhood cancers and provision of family planning services without much strain.

The decision is in line with the 2030 Universal Health Coverage (UHC) target of achieving an 80 per cent reduction of health care cost for patients, 80 per cent coverage of the population on NHIS, and making health care accessible to 80 per cent of the population.

In Ghana, about 1200 children under the age of 15 are estimated to develop cancer annually.

Leukaemia, lymphoma, retinoblastoma, Wilms’ tumour, soft tissue sarcoma and neuroblastoma are among the most common forms in the country.

Experts, however, estimate that only about 20 to 30 per cent of patients receive professional treatment, often due to inhibitive costs.

The average expenditure for treating childhood cancer is estimated at US $1000.

In the treatment of Leukaemia, however, the cost can reach $ 7000 for up to three years.

Dr. Dsane-Selby stated that the treatment of childhood cancers was less expensive and that there was a 90 per cent survival rate on a global stage, with Ghana now having a 37 per cent survival rate.

On Family Planning, she said,
“If we are to add family planning, there would be an initial pressure but it won’t affect us that much and it would be very easy to add both of them on.”

After a two-year piloting of family planning in nine districts, she said, the cost was bearable with the modalities working well.

She, however, noted that there existed a challenge of low uptake due to cultural and social barriers.

There are about 1.6 million women who are using a modern method of contraception, with 23.2 per cent prevalence rate in all women and 29.8 per cent prevalence in married women, according to the Track 2020 Family Planning Project.

The most common forms in use are injectibles, pills and implants.

Dr. Dsane-Selby said NHIA was working towards the achievement of Universal Health Coverage by Ghanaians by 2030 and worried that though 80 per cent of the population was captured on the NHIS database, only 52 per cent was active because of the unwillingness to renew their membership.

“The issue is staying active because it requires annual activation and at this moment, we have 15.1 million active subscribers.”

There are 4,291 credentialed health facilities across the country out of which National Community Health Planning Services compounds (CHPS) make about 55.1 per cent.

Dr Dsane-Selby expressed optimistism that with the implementation of the Government’s Agenda 111, to provide health facilities across districts in the country, subscribers in rural areas would be assured of improved healthcare services.

Data from August to October 2021 indicate that the Bono, Upper East and Upper West regions have the highest active subscriber population with a rate of 75. 71.8 and 66.3 per cents, respectively.

The Oti, Northern and Greater Accra regions have the lowest active membership rate of 34.0, 36.3 and 39.5 per cent respectively.

Special attention, she said, would, therefore, be paid to those regions to understudy the trends to improve their subscriber base.

The Authority plans to promote preventive health care over curative interventions to save lives and reduce the funding burden on the scheme.

There will, therefore, be more screenings for diseases such as breast and cervical cancers.

The 2021 NHIS Week Celebration, among other targets, aims at increasing membership and creating awareness on childhood cancers and family planning.

The celebration will also serve as a platform to extend health care access by promoting the use of the Ghana Card to renew NHIS membership and also deepen awareness and knowledge of the NHIS benefit package.

She, however, stated that: “The challenge of charging unauthorised fees at service delivery points is true and we need to find a way to reduce it.”

Dr. Ernest Kwarko, Chairman of the NHIA Board, who hosted the media practitioners, said all strategies would be deployed to enroll the urban poor and other indigenes to ensure that they receive the needed medical attention.

On the payment of claims arrears to service providers, he said the electronic submission and processing system was making it easier to speedily vet claims for prompt payments and to deal with irregularities.

He said there would hardly be any arrears should facilities submit their genuine claims on time.

The NHIS is funded by an earmarked levy that includes the NHIL and SSNIT, which constitute about 90 per cent of inflows.

Other funding sources, include sector budget support, returns on investments, premiums and registration fees.

The scheme covers 95 per cent of diseases, taking up costs of consultation, laboratory examinations, delivery of babies, essential medicines and emergency surgeries.

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