How an effective NHIS would have helped in this time of a pandemic

The coronavirus pandemic is ravaging the entire world and nations are struggling to keep with its devastation. This devastation in Europe has been unimaginable and experts have predicted a scary picture for Africa should the ravaging force of COVID-19 hits us with a similar intensity.

The effects of the pandemic has only exposed the inefficiencies in health systems the world over. Systems we counted as robust like those of America, Europe and China have come crumbling under the force of COVID-19. Within a few weeks, hospital beds in these powerful nations are woefully inadequate. Ventilators scarce to find and health workers suddenly are in short supply to the extent that they are now importing health workers from outside to assist. A classic example is the arrival of Cuban and Chinese health workers in Italy to help manage the situation.

Last month March, Ghana recorded some few cases and has consistently increased from as low as 4 to the current 195 cases as at the time of writing this piece. The recording of the first cases caused a serious panic within the general populace and even within the health system itself. A report was told of nurses and doctors fleeing the hospital premises when suspected cases were brought. This happened in one of Ghana’s premier hospitals. What does this tell us of our health system? It simply means we have a very weak health system which cannot help us in this time of need. But should we be surprised when doctors and nurses are scared and running away from their patients and clients? No we should not. Any health system in the world is the direct measurement of investments made in that health system. So if we are now recognizing that our health system is unable to support us in the matter in which we want it to, then we should quickly also recognize that we have not placed our own health and safety as the number one priority. We have collectively failed as a nation and God forbid but if the ravaging force of COVID-19 claims hundreds of lives in Ghana, we should be prepared to blame ourselves as a people for not ensuring that we have a health system that could have served us much better.

Over the years, political leadership has toyed with our health and safety and we did nothing about it. Following the declaration of universal health coverage by the United Nations, Ghana in 2003 adapted the concept of the health insurance and by 2005, its implementation was in full force. As a result, many thought this would address the many concerns confronting health delivery in the country. To a large extend it did. Access in some cases increased by over 100% and health facilities enjoyed the lump sums that came in as claims every 3 months. However over the past few years, the story of the NHIS has changed for the wrong reasons. It has become so ineffective to the extent that many health facilities had not been paid for over a year. Many in February issued threats of going on strike for the non-payment of financial claims. As a result of the lack of financial resources in health facilities, basic supplies like gloves, cotton, bleach, essentials medicines/drugs and the procurement and maintenance of hospital equipment were not done. Many lacked the capacity to adequately attend to patients and the emergence of this pandemic (COVI-19) has made matters worse. So why will the doctor not run when he/she knows there are no common gloves or face mask to help preserve his/her life.

I believe that if health facilities were adequately resourced and funded through the NHIS, many of them would have been in the position to procure their own PPEs and other equipment long before time and not wait for government to bring them common sanitizers, gloves and soap to wash their hands. Managements of health facilities were so bankrupt they virtually could do nothing than wait for the government to provide basic supplies for their work. This ought not to be the case. Why should we descend so low to the point central government has to now organize basic hospital supplies for hospitals to function properly? Is it not because we have refused to allow systems to work? Your guess is as good as mine.

Taxes are collected from all of us in the name of health insurance levy, yet the health insurance authority is starved of funds and the resultant effect is the deteriorating health facilities we see all over in the country. Leave Accra and Kumasi and go to the districts and communities and you will be sad. Why should it be so? If we cannot as a people prioritize our own health then what else shall we take as important? I heard the finance minister made a release of GHC 300 million to the health insurance authority for onward distribution. The question is, should we wait to the point of death recognize the importance of having a robust health system? Well we may say they have done well by releasing this amount. But of what importance would it be if in this heat of the crisis nations cannot procure the necessary health supplies and equipment because they are all in short supply. If these monies were released earlier and consistently, I believe our health facilities would have been in better a position to have all the necessary supplies and as well serve us better. After this crisis we the citizens must rise up and decouple health funds collected through the NHIS levy from the consolidated fund. If the law does not accept that then an alternative should be found to ensure health facilities get the funds they deserve on time and consistently. We cannot leave everything in the hands of politicians to toy with.

The law was made for the benefit of man and not man for the law. Let’s find a way to ensure funds for the health system goes to the health system and not used to fulfill partisan political promises. Does the way health systems are built.

Thank you.

The writer is Prince Abugri, a public health specialist in Bolgatanga.

(abugriprince@gmail.com)