Sustaining The National Health Insurance Scheme Through Strengthening Preventive Medicine

The advent of the National Health Insurance Scheme (NHIS) has undoubtedly benefited the nation massively. However, recently the operational efficiency of the scheme has come under criticisms partly due to economic challenges. It is evident everywhere that Mother Ghana is going through harsh economic conditions and indeed the sitting president of the nation has admitted to this fact.

This is why economic pundits are calling for a slash down in government expenditure as a short term intervention to cope with the situation. This problem of inadequate finances to run the affairs of the nation has spread its tentacles into the NHIS and somehow interfering with the smooth running of the scheme. It is becoming a daunting task for the government of the day to settle bills generated by the NHIS claims on frequent basis.

This has further been compounded by the fact that a huge number of people fall sick on daily basis to seek medical care and so at the end of the day, the scheme has to pay the gargantuan monies incurred by these hospital patients. Again, the technical question that preventive medicine experts ask is; can't this huge hospital attendance be reduced to the barest minimum as a measure to ease the burden on the NHIS? Seriously dieticians, nutritionists, health promotion experts, physiotherapists, naturopathic doctors and environmental health workers can be equipped to control this mess. Now let's take a look into how the environment, exercise and faulty diet could contribute to the incidence of diseases and indirectly create pressure on the NHIS.

Environment; one cannot quantify the number of sicknesses that affect people as a result of poor sanitation. Cholera is a typical example which is increasing the already rising mortality rate in the country. It is pathetic that just recently cholera has succeeded in wiping away many precious lives in the likes of Atebubu-Amantin district, Asunafo North (Goaso) district, mion district, wa municipality and the almighty Accra, the seat of the president ; as for the number of admissions at hospitals, we can`t even quantify. Honestly environmental health officers should be actively recruited and brought back into the system to help ease the burden in hospitals and for that matter the burden on the NHIS.

Exercise: exercise is very essential in maintaining body fitness and ensuring overall health. Currently, 60 minutes of moderately intense physical activity a day is recommended for healthy living. People who combine diet and exercise typically retain more muscle, and gain less weight. Besides this, those who exercise frequently stand the chance of reducing abdominal obesity (pot belly); improve their blood pressure and insulin function and cardiovascular health regardless of weight loss. Abdominal obesity has a correlation with type 2 diabetes which is among the leading causes of kidney disease according to research.

Exercise also release stress, makes one active, stimulate the bone marrow to produce blood cells and makes one appear attractive, charming and sterling. It again slows down the aging clock. Let's ask ourselves how many players die or even fall seriously sick within a decade. What is Ghana doing to make exercise appealing to people as a measure to promote and prevent sicknesses? Besides physiotherapists are the experts in the field of exercise and their advice could yield valuable dividend.

As for nutrition, it is the foundation of good health and no health expert can overrule this assertion. The human biochemistry is made up of certain key ingredients (nutrients) supplied by the mother during pregnancy. Inadequate or excess of these nutrients results in health deficits capable of affecting the health status and potentials of the human being throughout the life cycle.

A good number of persons are queuing up in hospitals and battling with sicknesses that could be managed using specific dietary prescriptions yet dieticians and nutritionists are not common in our health institutions; is it because of unfavorable political environment / we just have not thought over it / it is not an area of priority? We prefer that people fall sick all the time to create pressure on Government resources.

How many times has it been reported that Hospital management authorities have bemoaned increasing death rates creating pressures in mortuary rooms. Low birth weight makes up 60-80% of the infant mortality rate in developing countries as a result of medical complications such as poor maternal nutritional status, lack of access to prenatal care, preterm birth, maternal sickness during pregnancy and unhygienic home environments. Interventions such as diet therapy (limiting intake of salts, sugars, bad fats, gaseous/artificial drinks, chemical additives/ sweeteners/ preservatives and colors in canned/ packaged/ bottled foods, intake of natural fruits and vegetables, whole grains, legumes and nuts, natural vegetable oils and natural spices, eating moderately), water therapy, physical therapy, love therapy, sex therapy and body massage (especially the feet) could deliver significant, surprising and overwhelming results.

I believe that it is about time that we adhere to due diligence and back the preventive medicine sector with the necessary tools, resources and political power to fully commence serious operations if not, I fear that days are coming that nothing could be done to control disease and death rates in Ghana. If this happens, people could be wiped off like fowls. We are in the modern age and the people of Ghana can no longer endure one way method of health care (curative medicine through the use of drugs). Doctors and nurses are trained every day but mortality keeps on rising.

I therefore humbly recommend that experts from the field of preventive medicine should actively be included in the health committee that advises the government. Consequently Government, NGO's, private sector, donor agencies, district assemblies, international health partners should join forces to champion the operations of preventive medicine than curative medicine and help improve the health of Ghanaians, ease burden in hospitals and for that matter on the NHIS and above all provide an alternative source of lively hood to the Ghanaian citizenry through a disease free future.

Muntala Jabir: community nutritionist/community nurse.
Box 31, Nkoranza- B/A. Email; [email protected]:
0246179160.