Presentation (CTI)

OBJECTIVES: Over two decades of the implementation of the National Health Insurance Scheme (NHIS) to address catastrophic out-of-pocket payments for healthcare services in Ghana. Despite the success achieved, claims reimbursement to health providers has been a challenge due to delay payments. The erratic payments of claims have affected quality delivery of healthcare services. Addressing these challenges, has compelled health managers adopting coping strategies. This study explored health facility managers’ perspectives on the coping strategies used to circumvent delay claims reimbursement by the NHIS and implications on healthcare services delivery.
METHODS: The study used a qualitative exploratory design with sixteen health facility managers from four district hospitals in Ghana were purposively and conveniently recruited. Semi-structured in-depth interview guide was used to obtain information from participants. The interviews were audio-recorded and transcribed verbatim and analysed thematically using NVivo 12.
RESULTS: Financial challenges emanating from delayed reimbursement of claims payment from the NHIS to health facilities was reported by all the participants. They indicated that the irregular nature of the claims disbursement to health facilities resulted in out-of-pocket and co-payments by clients contrary to universal healthcare financing thus affecting quality healthcare delivery. That the delayed claims payment also put pressure on health facility managers compelling them to adopt coping strategies of deferment of payments for medicines and other consumables obtained on hire purchase from supplies accruing high interest rates. The mangers also indicated using internally generated funds from the morgue and other sources to support healthcare delivery services to ensure sustainability of services instead of using it for infrastructure expansion and hiring and paying staff remuneration. All the participants attributed the financial challenges to lack of sustainable funding. source.
CONCLUSIONS: The myriad financial challenges affect sustainable quality care delivery in Ghana. To achieve a universal health coverage,the government need to explore sustainable domestic funding sources.