Health sector divided over NHIS capitation system

Sharp differences in opinions emerged among participants in a workshop in Accra last Friday on whether the capitation system of payment under the National Health Insurance Scheme should be withdrawn or implemented nationwide.

While some participants were of the view that the system should be scrapped for now and better packaged before rolled out in all the regions, others thought that it should be maintained and implemented in phases.

The workshop was attended by about 30 participants from the public, private and quasi-government institutions in the health sector. 

The capitation is a payment mechanism under the scheme. It was piloted in the Ashanti Region for two years.

However, the Ghana Medical Association (GMA) in the region has kicked against that system of payment.

The workshop became necessary after a report on the pilot project highlighted challenges that had to be addressed to ensure the successful adoption of the capitation payment method nationwide. 

Some of the stakeholders present at the workshop were the President of the Ghana Medical Association (GMA), Dr Kwabena Opoku Adusei; the Chairman of the Parliamentary Select Committee on Health, Dr Yileh Kyereh; and a ranking member of the Parliamentary Select Committee, Dr Richard Anane, as well as the Executive Director of the Christian Health Association of Ghana, Dr Gilbert Buckle.

Country on track
Addressing the workshop, the Minister of Health, Ms Sherry Ayittey, said the capitation would be rolled out in the other regions gradually, adding that the pilot programme in the Ashanti Region provided useful lessons on how to improve the scheme in the other regions. 

The Chief Executive Officer of the National Health Insurance Authority (NHIA), Mr Sylvester Mensah, said the pilot scheme in the Ashanti Region had provided some useful lessons which would guide the scheme in the implementation of capitation in other regions.

He said the NHIS was currently going through some implementation reforms which would address some of the challenges. 

Mr Mensah explained that the capitation had to be introduced to help streamline operational deficiencies detected in the implementation of the NHIS.

Reports on capitation
The Chairperson of the Technical Sub-Committee on the Capitation Payment Method, Professor Irene A. Agyepong, said the health system was beset with numerous challenges, including lack of access to service and poor quality data, particularly in the public sector.

She said to scale up the capitation programme, there was the need to find resources to educate more service providers.

A monitoring and evaluation report also called for strategies to be developed to help small facilities such as maternity homes and Community-Based Health Planning and Services (CHPS) compounds to survive under the  capitation. 


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