BY Nadia Ntiamoah
The National Health Insurance Authority (NHIA) is facing significant operational challenges in the Oti Region, with low service utilisation, illegal co-payments, and extortion at some health facilities identified as key issues undermining the effectiveness of the Scheme.
Israel Quarme Ayer, Senior Manager for Monitoring and Evaluation at the NHIA’s Oti Regional Office, told the Ghana News Agency (GNA) in an interview in Kadjebi that these practices distort the Authority’s performance metrics and negatively impact membership renewal, coverage growth, and public confidence.
Low Utilisation Undermines Membership Value
Ayer explained that many enrolled members do not consistently use healthcare services, creating an incomplete picture of the Scheme’s performance.
“When members enrol but fail to utilise healthcare services, the perceived value of membership declines, renewal motivation weakens, and word-of-mouth advocacy reduces within communities,” he said.
He emphasised that active utilisation of services is a better indicator of the Scheme’s impact than mere registration numbers. Low usage, he noted, not only affects statistical reporting but also weakens community-level support for the NHIS.
Illegal Co-Payments and Extortion
According to the NHIA official, another critical challenge is the prevalence of illegal charges at some accredited service points. Members are reportedly asked to pay unauthorised fees or extorted, undermining the Scheme’s goal of financial risk protection.
“These unauthorised charges defeat the purpose of financial risk protection under the National Health Insurance Scheme. When members are asked to pay extra, confidence in the system drops,” Mr. Ayer said.
Positive Service Experiences Encourage Renewal
Conversely, Ayer noted that positive service delivery experiences have a measurable effect on membership retention and growth. Beneficiaries satisfied with the quality of care at accredited facilities are more likely to renew their membership voluntarily and encourage family and community members to join.
“Members who experience good services often become mobilisers, encouraging others to enrol and renew,” he said.
Strengthening Monitoring and Regulation
To address these challenges, Ayer called for intensified monitoring, stakeholder engagement, and strict enforcement of regulations at health facilities. He reaffirmed NHIA’s commitment to supervision, public education, and awareness campaigns to ensure that members access the full benefits of the Scheme without exploitation.
The NHIA continues to emphasise that protecting members from illegal charges and ensuring consistent service utilisation are critical to sustaining trust in Ghana’s health insurance system and achieving the intended health outcomes.
