By Michael Foli Jackidy, GNA
Ho (V/R), June 20, GNA – Dr Senanu Kwesi Djokoto, the Deputy Chief Executive Officer of the National Health Insurance Authority (NHIA), says Ghana’s health financing system remains one of the most impressive among lower-middle-income countries and continues to attract international attention.
He said countries such as Chad and Ethiopia were scheduled to visit Ghana next week to understudy the country’s National Health Insurance Scheme (NHIS) and learn from its experiences.
Dr Djokoto said this at an academic symposium on sustainable financing for primary healthcare organised by the Fred N. Binka School of Public Health of the University of Health and Allied Sciences (UHAS), Hope for Future Generations (HFFG) and the Global Health Advocacy Incubator (GHAI) in Ho.
The symposium was held on the theme: “Advancing Sustainable Financing for Primary Health Care in Ghana: From Academic Research to Policymaking.”
Delivering the keynote address on the theme “Ghana’s Pathway Towards Universal Health Coverage,” Dr Dzokoto said Ghana had made significant progress in healthcare financing since the introduction of the NHIS in 2003.
He said prior to the scheme, the country’s healthcare system largely operated under the “cash-and-carry” system, where patients had to pay directly for healthcare services, leaving many without social protection.
“It was that bad. People walked into health facilities and if they could not pay for healthcare, they would simply perish,” he said.
Dr Dzokoto said the establishment of the NHIA under Act 650 in 2003 was a major intervention to address the challenge.
He explained that the NHIS was funded through a 2.5 per cent National Health Insurance Levy on Value Added Tax (VAT), 2.5 per cent deductions from Social Security and National Insurance Trust (SSNIT) contributions, premiums from informal sector workers and investment income.
He said the scheme initially focused on curative care, covering about 95 per cent of common disease conditions in Ghana, but preventive and promotive healthcare services were largely excluded.
According to him, government currently finances about 56 per cent of healthcare expenditure through the NHIA, while out-of-pocket payments account for 26 per cent and development partners contribute about four per cent, down from 17 per cent in previous years.
He attributed the decline to changes in international development financing and Ghana’s transition to lower-middle-income status.
He noted that by 2030, Ghana would fully finance its vaccine programmes following its transition from support provided by Gavi, the Vaccine Alliance.
Dr Djokoto stressed the need for a paradigm shift towards preventive healthcare, citing evidence that every dollar invested in prevention could save between three and seven dollars in future curative healthcare costs.
He said non-communicable diseases, including hypertension, diabetes and cancers, were placing increasing pressure on Ghana’s health financing system.
He said the country’s current health reforms sought to expand benefits to include preventive and promotive healthcare services through the Free Primary Healthcare initiative.
The initiative, he explained, would provide basic healthcare services at Community-based Health Planning and Services (CHPS) compounds, health centres, clinics, maternity homes and polyclinics, regardless of whether patients possessed NHIS cards.
However, patients requiring referrals to district, regional or tertiary hospitals would be assisted to enroll onto the NHIS to avoid out-of-pocket payments.
Dr Djokoto said Ghana was also strengthening interventions for non-communicable diseases through the Ghana Medical Trust Fund.
He said the fund was already supporting the treatment of eight cancers, including prostate, breast and cervical cancers in adults, and childhood cancers such as acute lymphoblastic leukemia, Wilms tumour and retinoblastoma.
He said the package would eventually be expanded to cover additional complications arising from non-communicable diseases.
The NHIA Deputy Director also expressed concern over fraud and claims leakages within the health insurance system.
He said Ghana currently paid about GHS3 billion annually in claims liabilities, warning that leakages estimated at 15 to 20 per cent could cost the country more than GHS1 billion every year.
Dr Djokoto said the NHIA was implementing efficiency measures, strengthening governance systems and increasing transparency to reduce waste.
He commended government for uncapping the National Health Insurance Fund, which generated an additional GHS3 billion in 2025 and was expected to increase further in 2026.
He said the additional resources had enabled Ghana to meet its vaccine co-financing obligations on time, committing US$24 million in 2025 and US$22 million this year.
He said the government had also earmarked more than GHS1 billion to support the implementation of the Free Primary Healthcare programme.
“We are committed to the President’s vision of sustainable financing for primary healthcare because a healthier population is critical for national development,” he said.
Dr Djokoto welcomed recommendations from academia, including calls to improve NHIS efficiency, reduce fraud and explore additional revenue streams such as earmarked taxes to support health service delivery.
GNA
Edited by Maxwell Awumah/Benjamin Mensah