Legal Resources Centre holds forum on how to ensure affordable premium in the Bongo District.

Story: Benjamin Xornam Glover, Bongo Participants at a stakeholders meeting to map out measures to ensure affordable premiums for rural and informal sector population in the Bongo district of the Upper East Region have identified extreme poverty as accounting for some people’s failure to enroll unto the scheme. They are therefore advocating for the expansion of the various government social safety net programmes, improvement of the local economy, change in lifestyles on the part of the people, yearly fundraising programmes by the various communities and intense public sensitization to help get a lot more people enroll and get access to health care. Other recommendation made by participants is the need for the MP for the area to use at least one per cent of his share of the Common Fund to register people, support from NGOs. The stakeholders particularly the traditional rulers also proposed that the premium of the NHIS be reviewed downwards from GH c 8.00 to Gh c 5 Ghana, adding that apart from the Gh c 8.00 they pay, they still pay for administrative cost of Ghc 4.00 making it 12 Ghana cedis. The stakeholder’s forum which was organized the Legal Resources Centre(LRC) with support from STAR-Ghana under the “Right to Health” project was aimed at increasing the uptake of rural and informal sector populations unto the National Health Insurance Scheme (NHIS) in six communities in the Bongo and West Mamprusi Districts of the Upper East and Northern. Participants at the forum included staff of Bongo office of NHIS, the Bongo District Health Directorate, the Social Welfare Department, the District Assembly, Traditional authorities and Assembly persons Mr Samsom Akanpigbiam of the LRC noted that a research study carried out in the Bongo District revealed that one of the critical issues facing the community based NHIS registration and renewal system for rural and informal populations was the high rate of poverty among the community members. He said the lack of money to register and renew cards due to poverty came out strongly in their work adding that another major finding was that the premium is high for People with Disability (PWDs) and the poor in general. Mr Akanpigbiam said following on the major findings in the selected communities about the high rate of poverty among the community members and community members’ perception of the premiums being charged by the NHIS as high for them, the forum was organized to discuss how to ensure affordable premium for the selected communities. The Bongo District Manager of the NHIS Manager, Mr. Clement Agana Ayamga said although the scheme offers premium –free incentives to pregnant women, indigents and children below the ages of five, many more people who forms part of the informal sector of the populations in the district are unable to afford the premiums and renewals. He added that even though the scheme has maintained the premium of GH 7.2 since the scheme started operations in the district in 2004, a lot more people are enrolling due to the deprived nature of the district. Mr Ayamga disclosed that in July this year, the Scheme in collaboration with the World Bank organized a registration free of charge of over 11, 000 people captured as indigents. He however expressed the fear as to how that can be sustained since it was clear that the people have not gotten used to paying their annual NHIS premium and renewal. He said once the scheme has grown to become the major instrument for financing health care in the country, a lot more efforts need to put in to ensure sustenance. The District Coordinating Director for Bongo, Mr Jasper Adenyo, advocated a change in lifestyles and habits such as alcoholism and rather channels their resources into issues of health care and education. “People are quick to say we are poor. Poverty is relative. Visit the homes of most of our people and see the number of livestock and guinea fowls they have. Why can’t they sell at least one fowl to cater for their premiums? Instead what do we see, on market days, people ride their bicycles to market and can make the return journey home because they are drunk. If they can channel some of these resources into other sectors, they can turn around their poverty”. -End- Writer’s email: benjamin.glover@graphic.com.gh Quick Read Ø The lack of money to register and renew cards due to poverty has been identified as a major setback for the uptake of NHIS in Bongo District. Ø Another major finding was that the premium is high for People with Disability (PWDs) and the poor in general. Ø A study carried out by the Legal Resource Centre among others is the need for waiver of registration and renewal of premiums for the rural and informal sector population in order to get such populations on to the NHIS.