He said the NHIS accounted for about 85 per cent of the Internally Generated Funds (IGF) of the Scheme and Ghana recognised health financing as the third arm of Universal Health Coverage beyond access and quality care.

He said it was not surprising that Ghana was often considered an example of global “good practice” and was amongst only a handful of emerging countries in Africa to actively start implementing universal health insurance coverage by providing formal coverage to its vulnerable population.

Mr Agyemang-Manu said this at the 68th Session of the World Health Organisation Regional Committee for Africa, held in Dakar, Senegal from August 27 to 31, 2018. He spoke on the topic: “Sustainability Financing for Universal Health Coverage in Africa in the Midst of Changing Global and Local Economic Factors,” a statement issued to the Ghana News Agency said.

“In the past 15 years, Ghana has made substantial progress in its quest to attain Universal Health Coverage. Active membership of the Scheme has increased form 1.3 million in 2005 to almost 11 million in 2018, representing 38 per cent of Ghana’s population.

“Over the years, many countries in Africa and beyond continue to visit the National Health Insurance Authority to understudy its operations for possible replications in their respective countries,” he added.

The Minister said despite the progress made over the years, the Scheme was confronted with sustainability challenges, which Ghana believed Member States could learn from. Key among the challenges, he said, were high utilization rate by members; fraud and abuse of the system by some credentialed service providers resulting in high claim costs; premiums not actuarially determined; administrative and operational inefficiencies, and clearly defined benefit packages.

Mr Agyemang-Manu said year-on-year the Scheme had been confronted with funding gaps leading to about five per cent of claims payments running into arrears. He said to address the aforementioned sustainability challenges, measures were being implemented including the financing model to secure additional inflows; operational efficiency; re-structuring of the entire NHIA; reviewing of NHIS benefit package, and full automation of claims processing to minimise fraud and abuse.

The rests are strengthening of Quality Assurance and Internal Audit functions; amendment of the NHIA Law to make crime against it more punitive and obtaining of prosecutorial powers from the Attorney-General to prosecute service providers who abuse the system.

The Minister said Ghana believed that the health insurance reform should be accompanied with a comprehensive health systems reform.  “In this regard, my delegation particularly endorses the Framework of actions for Strengthening Health Systems for Universal Health Coverage and SDGs in Africa, which encourages innovative means to raise funds.

“We welcome all the actions proposed by the team. Additionally, we encourage the setting up of health technology assessment agencies in Member States. They would conduct cost effective analysis and Budget Impact Analysis before interventions are accepted in the areas of medical devices, vaccines, pharmaceuticals,” he added.

The debate around Universal Health Coverage dates from a World Health Assembly Resolution of 2005 that stated that “everyone should be able to have access to health services and not be subjected to financial hardship in doing so”. Since then the influential 2010 World Health Report was dedicated to Universal Health Coverage and several conferences around the globe were organised around this theme.