HEALTH INSURANCE SCHEME MAKES PROGRESS (PAGE 15, NSEMPA)

By Akwasi Ampratwum-Mensah

THE Asutifi District is one of the 22 districts in the Brong Ahafo Region. It is located at the South Western part of the region, which shares boundaries with the Sunyani Municipality in the North, Tano South District in the northeast and Ahafo Ano North in the Ashanti Region.
The district, which has Kenyasi as its capital and about 50 kilometers from the regional capital, Sunyani, has an estimated land areas of 1,500 square kilometers.
Its population, according to the 2,000 Population and Housing Census is about 84,475 but the current figure is believed to hover around 92,475.
The people are predominantly farmers with about 77.6 per cent of the labour force engaged in agriculture that is crop farming and animal rearing. The major items produced are cocoa, cassava, plantain, oil palm, cocoyam and maize.
Activities of Newmont Ghana Gold Limited (NGGL) currently operating the Ahafo Mine have in a way brought some fortune to some major towns in the area, namely Kenyasi, Ntotroso, Gyedu and Wamahinso.

Healthcare providers

Thanks to the introduction of the National Health Insurance Scheme, (NHIS), healthcare in the district has been tremendously boosted. A number of mutual health schemes, have been created and they are offered at the St. Elizabeth Catholic Hospital at Hwediem, Kenyasi, Acherensua, Gyedu and Dadiesoaba Health Centres, The Gambia and Sienchem clinics as well as a number of CHPS compounds and maternity homes.
There are three main referral providers, namely the St John of God Hospital at Duayaw Nkwanta, Komfo Anokye Teaching Hospital (KATH) in Kumasi and the Regional Hospital in Sunyani.
According to a recent report on the Asutifi District Health Insurance Scheme (ADHIS), as at December 31, 2008, the total enrolment figure for both new registrations and renewals, increased from 47,301 in 2007 to 70,812, representing 52.0 per cent and 76.6 per cent respectively. The coverage for the district from 2005 to 2008 stood at 77.98 per cent of the total population.
In terms of gender, 33,990 of males registered, while 36,822 females enrolled in 2008, representing 48 per cent and 52 per cent respectively, as indicated in the report. However, in 2005, 17,896 people representing 19.4 percent registered while 25,097 representing 27.1 per cent joined in 2006.

New registrations and renewals

Enrolment analysis under new registrations indicates that 25,551 children under 18 years representing 54.85 per cent registered, Informal (18-69), 15,164, representing 32.55 per cent; SSNIT contributors 738, (1.58 per cent), SSNIT Pensioners, 56 (0.2 per cent), Aged 2,755 (5.91 per cent), indigents 38 (0.08 per cent) and pregnant women 2,280 (4.89 per cent).
For Renewals, 15,328 children under 18 years renewed their cards, representing 63.26 per cent, Informal, 4,617 (19.05 per cent), SSNIT contributors 1,525 (6.29 per cent), SSNIT pensioners 81 (0.33 per cent), Aged 2,651 (10.94 per cent) and Indigents, 28 (0.12 per cent).
The total income for the scheme in 2007 stood at GH¢ 350, 046.31 while the figure rose to GH¢ 924,825.23 with expenditure totaling GH¢ 195,311,36 for 2007 and GH¢ 1,808, 645.45 in 2008.

Attendance
For both Out-Patients Department (OPD) and In-Patients Departments (IPD) as at the end of December 2008, the attendance of insured clients of the Scheme who utilised the accredited health facilities was OPD - 311,550 and IPD - 7, 505, totaling 319,055.
The cost incurred for the insured clients covering the same period were, GH¢2,736,743.85 (OPD), GH¢592,314.45, totaling GH¢3,329,058.30.
The scheme has also adopted very cordial and excellent relations with its publics by ensuring that all matters are resolve in an amicable manner.

Challenges
The ADHIS has observed that the processing of the national ID cards took a long time, which therefore, caused frustrations for clients. The scheme is also calling for a review of the drug list to include some basic medicines, which had been excluded.

Way forward
It is expected that, at least 90 per cent of members will renew their membership each year for the next five years and that, all monthly claims from the various health providers will be thoroughly vetted and payments made by the middle of every ensuing month.
The scheme also expects that, fraud control measures would be instituted by the end of June 2009 and claims administration computerised by 2010.