By Issah Olegor
National Health Insurance Scheme (NHIS) has reached a significant milestone, with active membership hitting 18.5 million as of the last quarter of 2025 — translating to 56 percent of the country’s total population.
The figure, though slightly below the 2024 target of 20.8 million, marks steady progress in the quest for universal health coverage under the National Health Insurance Authority (NHIA).
The disclosure was made by the NHIA’s Actuarial Director, Magnus Owusu Agyemang, during the closing session of the Authority’s maiden stakeholders’ conference in Accra.
The two-day conference, themed “Consolidating Strategic Partnerships for a Resilient and Inclusive Health Insurance Scheme,” brought together policymakers, healthcare providers, civil society, and development partners to review progress and chart a new course for the NHIS.
Background and Progress
Since its inception in 2003, the NHIS has been one of the flagship social protection programs, aimed at removing financial barriers to healthcare.
However, the Scheme has faced recurring challenges—ranging from delayed claims reimbursements and low renewals to disparities in regional access.
In recent years, the NHIA has embarked on aggressive digital reforms and stakeholder engagements to improve transparency, expand coverage, and ensure sustainability.
Agyemang highlighted that despite missed targets, the 2025 data reflected renewed public confidence in the Scheme.
“The 18.5 million active members represent steady growth, considering population dynamics and migration challenges,” he said.
The Authority, he added, now aims to reach 21 million active members by the end of 2025, a target that would raise national coverage to about 62 percent.
Regional Disparities in Coverage
Data presented by the NHIA showed significant regional variations in enrolment and renewals.
The Ahafo and Bono regions topped the chart with participation rates well above the national average, while the Oti and Northern regions lagged behind with the lowest coverage levels.
According to Agyemang, these disparities are driven by uneven access to healthcare facilities and enrolment infrastructure.
Demographically, women aged 60 and above maintained the highest enrolment rates, while men between 18 and 59 years had the lowest participation, underscoring the need for gender-sensitive interventions to boost male enrolment.
Healthcare Utilization and Demand Trends
NHIS data analytics further revealed that health facility visits nationwide rose to 28.11 million across 5,449 accredited facilities, signaling growing confidence in the Scheme.
Agyemang explained that the average number of visits per member had increased, showing both improved access to care and rising demand for medical services.
Females aged 15 to 49 accounted for the highest frequency of visits, largely due to maternal health, antenatal, and postnatal services. Outpatient Department (OPD) visits remained the most common, with malaria, digestive tract infections, and maternal-related conditions ranking among the top ten ailments reported.
