Seeking healthcare under the National Health Insurance Scheme’s capitation payment method in Wa Municipality, Ghana: Subscribers’ perspectives

Abstract

The National Health Insurance Scheme (NHIS) in Ghana has three key stakeholders: National Health Insurance Authority, preferred primary providers (PPP) and subscribers. Since the introduction of the capitation payment method (CPM), research has focused on the NHIS and care providers with little attention on subscribers as stakeholders of the policy. This study sought to solicit the perspectives of the NHIS subscribers on the prospects and challenges of the NHIS CPM. Survey design was employed in this study involving 135 subscribers who were conveniently selected at 11 health facilities. Questionnaires were used to collect the data which were analyzed using the Statistical Package for Social Sciences (SPSS). The results show that subscribers have little knowledge on how the CPM works as serious efforts have not been made to adequately educate the public on the policy. It was also found that subscribers were not able to obtain quality drugs from their PPPs due to the fact that some drugs which previously were on the NHIS drug list have been removed. This paper concludes that subscribers were ill-informed about the CPM even though it has the potential to improve access to health history of subscribers which is critical in providing quality healthcare.

Keywords:

• capitation
• health insurance
• preferred primary provider
• NHIS subscribers
• Wa