Global Action Plan Signatory Agencies back Ghana's Health Financing Reforms – World Health Organization (WHO)
Ghana’s government is striving to achieve Universal Health Coverage (UHC), yet financing issues remain a challenge. To address this issue, Ghana hosted a Health Financing Forum from 25 to 27 November 2019, under the theme, “Sustainable Health Financing for Universal Health Coverage (UHC).” To achieve UHC, Ghana has identified Primary Health Care (PHC) as one of the key strategies in implementing its National Roadmap for UHC. The purpose of the meeting was to identify priorities and actions for achieving sustainable financing for UHC, through the revision of the National Health Financing Strategy and Implementation Plan.
Nearly 100 delegates from the Ministry of Health, Ministry of Finance, Ghana Health Service, National Health Insurance Agency (NHIA), National Health Insurance Scheme (NHIS) and international organizations such as Gavi, the Vaccine Alliance, the Global Financing Facility (The GFF), Japan International Cooperation Agency (JICA), the United Nations Children’s Fund (UNICEF), the United States Agency for International Development (USAID) the World Bank and the World Health Organization (WHO) were present.
Addressing the audience, Minister of Health, Kwaku Agyemang-Manu said, “As Ghana initiates reforms geared towards achieving UHC, we must mobilize more domestic resources for health. Increasing funding is not enough. Resources must be used efficiently, and this underscores the need for improving the purchasing function of health financing, including reviewing the benefits package to guarantee essential service delivery for all Ghanaians.”
Ghana was one of the first countries in Africa to have a National Health Insurance Scheme (NHIS) that was explicitly designed to go beyond the formal sector and help people access health care when they need it without experiencing financial hardship. However, only one-third (37%) of the population are members of the scheme, with the reliance on individual contributions remaining a barrier to its sustained expansion. The NHIS is also skewed towards providing curative care and gives little priority to the preventive and promotive services that are needed to enable sustainable progress towards UHC.
Additionally, Ghana’s primary health care system receives funding from multiple sources that are channelled through various financing agents, and the fragmentation in financing flows is a source of inefficiency. Furthermore, many of these organizations have different planning and budget implementation and reporting systems leading to delayed payments to health facilities.
Acting WHO Representative to Ghana, Dr Neema Kimambo said, “Ghana has made a strong political, legislative, and fiscal commitment to reforming its health system to achieve UHC. Despite these efforts, more health financing reforms are required to accelerate country progress towards UHC. For instance, Ghana will need to mobilize additional revenues for the health sector by adopting sustainable fiscal space expansion mechanisms.”
Dr Kimambo noted during her remarks that several of the signatory agencies to the Global Action Plan are ready to support Ghana’s reforms by offering collective and coherent support to the government. 
During the two-day meeting, delegates identified several priorities and opportunities to improve Ghana’s National Health Financing Strategy. These actions include but are not limited to:
Enabling sustainable financing for health
The Global Action Plan for Healthy Lives and Well-being for All launched in September at the UN General Assembly is a useful resource that outlines how 12 multilateral agencies will collaborate more effectively and provide more streamlined support to countries to accelerate progress towards the health-related SDGs.
Several of the signatory agencies to the Plan, namely the GFF, Global Fund, UNICEF the World Bank and WHO attended the meeting to engage with national stakeholders to identify critical areas where they can collectively offer support to the Government.
“Ghana has made remarkable progress. To help the country on its path to achieving UHC and the health-related SDGs, the World Bank along with Gavi, the Global Fund, the GFF and WHO are looking at ways to offer a comprehensive and cohesive package of technical and financial assistance to strengthen Ghana’s National Health Financing Strategy and a prioritized operational plan to implement the UHC roadmap,” said Toomas Palu, Senior Advisor on Health, Nutrition and Population for the World Bank.
Leaving no one behind
Reaching every person and community with comprehensive, quality health services and people-centred care requires putting the poorest and most marginalized first. Engaging civil society organizations is essential to ensure that Ghana’s reforms are responsive to people’s needs.
Cecelia Senoo, Executive Director for Future Generation and Chair of the Country Coordination Mechanism (CCM) and Member of the Civil Society Engagement Mechanism (CSEM) of UHC2030 said, “At the heart of UHC is equity. The Global Action Plan provides a powerful platform for civil society to engage and monitor the implementation of Ghana’s National Health Financial Strategy to reach those who need healthcare the most. We have a Social Accountability Mechanism that already exists. This mechanism will be expanded to monitor the implementation of UHC.”
The county has laid a good foundation for achieving UHC. Now it’s time for implementation.
