WB Statement: 10th Anniversary International Conference of the Ghana National Health Insurance Scheme

Opening Statement by Mr. Yusupha Crookes, Country Director Ghana, World Bank

Accra International Conference Center, November 4, 2013

His Excellency John Dramani Mahama, President of the Republic of Ghana, Honorable Minister of Health, Honorable Chief Executive Officer of the Ghana National Health Insurance Authority, Honorable Members of Government and Parliament, Representatives of Development Partners, Ladies and Gentlemen: Good Afternoon.

We stand here today at a moment of celebration for a great achievement in the health and development history of Ghana. 10 years after the establishment of the Ghana National Health Insurance Scheme, Ghana stands out today as one of the few emerging countries that has taken significant steps towards demand-side financing for health, including passing legislation for universal health insurance coverage, expanding enrollment significantly while taking steps to cover the poor and vulnerable, and earmarking substantial financial resources to support the system.

Mr. President, with the institutional foundations and systems that Ghana has put in place over the last decade, universal health coverage is no longer a distant aspiration but a reality that is within Ghanas grasp.

Ghana is well-positioned to ensure that its entire people can access quality health services; that citizens are safeguarded from public health risks, and are protected from impoverishment due to illness -- whether from out-of-pocket payments for health care or from loss of income when a household member falls sick.

Of course there are challenges  and some big ones at that. As the National Health Scheme evolves into the future, a widely acknowledged one is how to accelerate the enrollment beyond the current level of 38 percent level of the total population and ensure the expanded inclusion of poorer and more vulnerable citizens, while protecting the long term financial sustainability of the scheme. This would require broad and undoubtedly tough discussions on bending the cost curve including closely examining the content of the benefits package and measures to promote the rational and efficient use of drugs, as well as possible complementary and innovative funding sources.

With the expansion of coverage, a concerted effort to improve the supply of quality health services across the country would also be requiredfrom infrastructure and technology improvements to medical care delivery in accordance with evidence-based norms and guidelines that promote effective integrated health service arrangements.

Equally important to the registration of new beneficiaries, particularly the poor, would be the need to inform and educate the public about the benefits of the scheme, for example of the free maternal care program, so that they can be motivated to register and be empowered with an informed voice to demand good services from providers.

Mr. President, I am honored to note that the World Bank Group has been part of the journey of supporting the creation and consolidation of the Ghana National Health Insurance Scheme in the past decade. And we remain committed, as an institution, to continue to support your efforts as you move into the second decade of the scheme.

Indeed, building upon the past and ongoing projects funded by the World Bank, we are currently supporting the preparation of a proposed Maternal and Child Health Project and a proposed Health Services Strengthening Project. Both projects are geared to help address the demand and supply bottlenecks in the health system that hinders effective access to health services. We look forward to the timely closure of the discussions on how we proceed further on these.

Mr. President, while a good share of problems and challenges exist, Ghanas experience has a lot to offer to other countries still struggling to find a path towards universal health coverage. Ample demonstration of this is the large number of country delegations that visit Ghana each year to see and learn first-hand of the countrys experiences. Please accept the warm congratulations from the World Bank Group on the occasion of this milestone event in Ghanas health sector.