Review NHIS free maternal health care policy

The Head of Obstetrics and Gynecology of the Korle-Bu Teaching, Professor Samuel Amenyi Obed, has called for a review of the National Health Insurance Scheme (NHIS) and the free maternal care policy in the country.

He said hospitals, especially Korle-Bu Teaching Hospital, are struggling to develop and maintain their infrastructure and are being run down as tariffs paid the hospital are inadequate and irregular -- and they only cover 45 percent of the cost of care for each client attended to under the free care policy.

“Sadly enough, the payment from NHIS has not been regular; the last time they paid this institution was somewhere in April 2014. Our only source of revenue to cater for everything apart from salaries is from internally generated funds; and if you are not getting your money for months, how do you run the service?

“Even when they pay, what they pay only covers 45 percent of the cost. It means that the institution is incurring 55 percent of the cost for each client that is attended to,” he said.

In September 2003, the Ministry of Health introduced an exemption policy directed at making maternal care free. It was also to meet the deadline for the Millennium Development Goals 4 and 5, which seek to reduce maternal mortality by 75 percent by the end of this year.

But professor Obed fears that given the current situation which requires health institutions to fund all hospital’s needs excluding salaries from internally generated funds, coupled with NHIS inability to reimburse institutions on a regular basis, the country is in danger of missing the goals set under the MDGs.

“The National Health Insurance Authority is supposed to reimburse the health institutions after the women have utilised the services. What they pay is not enough, and this excludes salaries and wages. And as you know, it is a government policy that everything that the hospital needs should be obtained from internally generated funds, and for maternity services where we have the free maternal care policy our internally generated funding is surely reimbursement from National Insurance,” he said.

He said the aforementioned factors are the reasons the hospital is unable to reduce mortality ratios, and that it has also put the hospital in a difficult position as it is incapable of raising funds to maintain and buy basic clinical materials.

“The free maternal care is something that we should critically look at as well as the National Health Insurance Policy. It is a very good one, but the reimbursement should be very regular and also the tariffs that are being paid should be reviewed periodically to reflect the economic situation of the time.

“We occasionally run out of consumables, especially the materials that we use for emergency surgery and you can imagine what the situation would if someone’s wife or sister is in labour and needs a caesarean section and the materials that we need to do the surgery are not available. What happens?” he added.

He disclosed that up until last month uniBank Ghana Limited came to their aid and adopted the second floor, which it refurbished at a cost of GH¢2.1million, the maternity ward became a place where most well-to-do Ghanaians were shying away from.

Currently, the maternity block -- built in 1964 and which houses six wards -- is in a sorry state; and the hospital says it is financially constrained and, therefore, unable to carry out maintenance works on the structure.

“It came to a point that the hospital was trying to stand on its own by only seeking items for clinical care, like medications and other consumables. This has led to decay and deterioration of the facilities and equipment that we use,” he said.