NHIS owes CHAG facilities GH¢ 80 million

The indebtedness of the National Health Insurance Scheme (NHIS) to Health Facilities under the Christian Health Association of Ghana (CHAG) facilities to over GH¢ 80 million in the past eight months is seriously affecting the delivery of quality health service in the country.

Mr. Peter Yeboah, Executive Director of CHAG said the indebtedness of NHIS was highly unacceptable and a breach of the social contract between the Scheme and service providers.

Lamenting on the situation, Mr. Yeboah in an interview stated that delays in payment for services rendered by the health facilities were having adverse effects on the institutions.

“Our suppliers are unwilling to supply us with essential consumables and medicines, our equipment are breaking down due to inadequate funds for repairs/maintenance, cost of fueling the power plants for surgical and medical services has become unbearable amidst the national power crises, staff motivation allowances have not been paid for moments, life-saving infrastructures are deteriorating”, he stated, adding that managing the health of Ghanaians under such crises situation is an impossible duty!

Describing the current state of the scheme as unsustainable, Mr. Yeboah called on government to immediately settle the debt it owes the facilities to help Ghanaians access quality health care.

He said even though CHAG sees NHIS as an important social protection service and that they have a moral right to ensure the survival and growth of the NHIS because CHAG pioneered and piloted the Health Insurance Scheme in the country, stressing that as service providers “we do not intend to be victims of the situation”.   

Mr. Yeboah observed that the state of the NHIS, its design , implementation, and the expectation from clients were unsustainable and suggested the creation of an alternative national health insurance scheme that will complement and supplement the current one.

“With the revelation that NHIS has inadequate resources to even pay its debt means there was something fundamentally wrong with the scheme,” he added.

The Executive Director disclosed that CHAG in the short term will continue to impress on government to pay the debt the Scheme owes the facilities and also initiate a national dialogue to discuss sustainable ways of funding a National Health Insurance Scheme in the long term as well as relook at the premium, benefit packages and issues associated with funding Public Health in the country.

He explained that the unintended effects of the operationalisation of the NHIS has led clients and many stakeholders to develop a mindset that healthcare provision was free, making many Ghanaians unprepared to pay for health care services.

Another unintended effect, he added was that public health-disease prevention and health promotion- which should have been the cornerstone of any health system has been submerged under the NHIS, which rather incentivizes disease treatment.

“Health Providers now see any patient as money making tool, thus raising ethical/moral imperatives in the value of human health,” he added and asked who or how do we fund public health if the NHIS is not funding it?

Mr. Yeboah, reiterating the adverse effects the operationalisation of the NHIS has on the demand and supply of healthcare, challenged Ghanaians to debate and discuss the viability and sustainability NHIS in providing equitable safety nets for the rich, middle class, and the poor.

Commenting on the proposal for a Public Private Partnership (PPP) to sustain the health care provision if nothing was done to address the inherent challenges, Mr. Yeboah debunked the accusation that PPP was the reintroduction of Cash and Carry system.

He explained that patients with the NHIS Cards will still be served under the PPP arrangements but they will be directed to procure their medicines at designated places within the health facilities.

He described the PPP as an interim distress action  meant to highlight the crises situation of the NHIS, and safeguard the health of Ghanaians in the midst of the worsening financial conditions of Health Service Providers that is affecting the availability, accessibility, affordability, and acceptable of service delivery in the country.

Although, the finance Minister Seth Terkper, states that all areas owed the Scheme has been paid, there are reports that there is still a GH¢ 400 million funding gap, which if not settled could worsen the NHIS which analyst say is in crisis. Indeed there is an urgent need to look at the sustainability of the Scheme to ensure the continuous provision of quality healthcare under the Scheme.        

Catholic Mutual Health Insurance in the offing

The National Catholic Health Services (NCHS) and some stakeholders are discussing the possibility of setting up an alternative Mutual Health Insurance to help people access quality healthcare in the country.

This move comes in the wake of challenges in sustaining the National Health Insurance Scheme (NHIS) as a result of the National Health Insurance Authority’s delay in repaying health facilities for services rendered to clients of the scheme for the past eight months, which is threating the survival of many of these facilities.

The mutual scheme idea was hinted at a recent meeting between Most Rev. Joseph Afrifah-Agyekum, Bishop of Koforidua and Bishop in-charge for Health with Ghana Catholic Bishops’ Conference (GCBC) Representative on the Christian Health Association of Ghana (CHAG) Board in Accra.

Dr. Agatha Bonney, member of the Board, argued for the establishment of the alternative Health Scheme, and expressed disappointment in government for taking the mission health facilities for granted, because of their Christian obligation to cater for the sick and bring Christ’s healing to them no matter the circumstance.

With NHIA’s delay in settling their indebtedness to the facilities, she stated that CHAG cannot watch their facilities collapsed and emphatically stressed that “we (Ghanaians) cannot toil with the health of the people. We cannot wait and see things fall apart. We as Christians must work and find alternative ways to sustain the health of our people”.

Dr. Kwabena Adu Poku, Board Chairman of CHAG, observed that apart from the delays in paying health facilities for servicing rendered to subscribers of the NHIS worsening; the NHIA was yet to honour issues agreed upon with the Minister of Health which necessitated the withdrawal of services to clients of NHIS last year.

He said CHAG was studying alternate financing mechanism to the NHIS.        

Even with this considerations, Bishop Afrifah-Agyekum, indicated the readiness of CHAG to continue engaging the NHIA to redeem their indebtedness to help ensure the smooth running of the health facilities.

He commended the Board members for their efforts at promoting the quality health delivery and thanked them for availing their professional expertise at no cost for the growth of CHAG.

Dr. Adu Poku and other members of the Board acknowledged the effective management some health facilities even with scares resources but called on other CHAG member institutions to plug loopholes that leaked the finances of their facilities and ensure they run well.

They mentioned the appointment of Mr. Peter Kwame Yeboah, the former Director for Health at the Goaso Diocese, as the new Executive Secretary of CHAG in March. He replaces Dr. Gilbert Buckle, now Chief Executive Officer of the Korle-Bu Teaching Hospital.

Among other issues discussed were the works on the Charter of CHAG, guidelines to ensure that all institutions associated with the Trust were owned by established Churches as well as discussion to find sustainable ways of running CHAG.

The Board also informed the Bishop about efforts made to acquire and develop a 50 acre land at Dodowa for CHAG.

It will be recalled that an orientation programme for the Bishops’ Conference representatives on the CHAG Board, in March 2014 charged members to promote the values and interest of the Church on the Board among other things. 

 

                        *Bishop Afrifah-Agyekum with members of the Board at the meeting

Zan speaks at the UN

Mr. Samuel Zan Akologo, Executive Secretary of the Department of Human Development at the National Catholic Secretariat, Accra, will be speaking at the United Nations Intergovernmental Negotiations of the Post-2015 Development Agenda at the United Nations, New York.     

He is being invited as a representative of Caritas Internationlis in Rome and member of Post-2015 Working Group. He is expected to contribute to the voice of the Catholic Church on the new successor framework to the Millennium Development Goals (MDGs), which expires this year.

Mr. Akologo will make his intervention on April 23^rd, during the interactive dialogue with Major Groups and other stakeholders as part of the joint session of the Post-2015 Development Agenda and Financing for Development negotiations.

This meeting according to development analyst is the second and most critical phase of the Post-2015 Development Agenda, which seeks to tackle new financing formula for development and prepare the final Post-2015 Development Agenda draft for the UN Head of States Submit in September 2015.    

Mr. Akologo with over 25 years of Civil Society activism locally and internationally, the opportunity to speak at the UN platform comes as a plus to his career and the Church in Ghana and Africa. He will draw lessons and experiences as the former Country Director of SEND-Ghana, a National Public Policy Advocacy NGO and his many years of Human Rights activism with Amnesty International.

Having studied Education at the Bimbilla College of Education and University of Education, Winneba, Mr. Akologo holds a Post-Graduate degree in Public Administration from the Ghana Institute of Management and Public Administration (GIMPA) and a Masters in Government and Economic Reform at the University of Westminster in London.

He has served on Committees of many Public Institutions including Senior High Schools, Council for Technical and Vocational Education and Training (COTVET) and the Public Interest and Accountability Committee (PIAC) of Ghana’s Petroleum Revenue Management.  Zan belongs to the Community of Practitioners (CoP) of Gestalt Psychology and Organizational Development (OD) certified by the University of Cleveland (USA) and the OD Centre in Ghana.

So far, over 1000 Civil Society Organisations from 130 countries around the world has signed on to the Beyond 2015 campaign, which is strongly pushing for a legitimate successor framework to the Millennium Development Goals, which is likely to be christened Sustainable Development Goals (SDGs).

Asked how he felt about the invitation, Mr. Akologo said he was humbled by the recognition and noted that one good news for Africa in the development discourse was that the Africa Union was presenting a Common Africa Position (CAP) in Post-2015 Development Agenda.  He also thinks the focus of the April Session on Means of Implementation of the Post-2015 Development Agenda makes it crucial for him to express an opinion.

The City of God in Ghana?

What comes to mind when City of God is mentioned? And how will you feel if you hear that there is a City of God in your neighbourhood?

These were but few curious questions that crossed my mind when I first heard the name City of God. I wondered where this City of God could be? Could it be the haven of heavens? What does it look like?

Generally, names like City of God comes with a reverence that inspires holiness and hope. My first encounter with the name was several years ago when I heard of St. Augustine of Hippo’s classic De Civitate Dei contra Paganos, translated in English as The City of God Against the Pagans or The City of God.

Considered as one of St. Augustine’s important works, the 5th century book, which espoused Christian philosophy, was in response to allegations that Christianity brought about the decline of Rome. Many scholars agree that The City of God is a cornerstone of Western thought, expounding on many profound questions of theology, such as the suffering of the righteous, the existence of evil, the conflict between free will and divine omniscience, and the doctrine of original sin.

After St. Augustine’s book in the in the 5^th century a lot of literature and other audiovisual materials have been produced on the City of God.   

In Accra there is a shantytown along the Odaw River and the Korle Lagoon, originally christened Old Fadama. Old Fadama, with an estimated population of over 80,000, and makeshift kiosks, has derogatively been referred to as “Sodom and Gomorrah”.

Similar to the classic of St. Augustine, the Catholic Archdiocese of Accra through The City of God is laying a cornerstone of evangelising people, bringing relief to the suffering of the righteous, bring light to dispel the darkness of evil, as well as reorient Ghanaians that the people of City of God are good and godly people created and loved by God.

With demand far outstripping inadequate social amenities such as sanitation, running water, medical services in the midst of heaps of waste, including electronic waste and metal scraps, life in the largest slum in the Ghana could be perilous, dangerous and uncertain or unreliable opportunities for social advancement and progress.

As inhabitants of the place are largely stigmatised for where they live, with constant threat of eviction by governments without a corresponding degree of commitment to support the inhabitants, leave much to be desired. But Rev. Fr. Subash Chittilappilly, MC, says there are Gods people living there and that, Ghanaians have no right to describe the place derogatively.

He says there was need to consciously support the people there overcome their challenges instead of stigmatising and neglecting them totally.

In his two years duty stay at the City, Fr. Chittilappilly of the Missionary of Charity, urged stakeholders to support the people of Old Fadama, and entreating retired teachers and the youth of the Catholic Archdiocese of Accra, particularly those with expertise in English, Mathematics and Computer Science to volunteer their time to help train some of inhabitants at the City of God.           

It is true there is a City of God at Old Fadama, striving to improve upon the many lives of people living there and help improve their living standards, as well as erase the offensive name and stigma given those living there.    

As Jesus Christ invited his disciples in John 1: 39 to come and see his place, Fr. Chittilappilly also throws on open invitation to all to come and see what goes on at the City of God.