Table 3

Is the Ghana NHIS a social health insurance scheme?

Key criteria

How the NHIA performs


Is legislated by government and requires regular, compulsory contributions by specified population groups (usually initially covering those in formal employment and their dependants, and then gradually extending to other groups)

The NHIA meets these criteria to some extent, but rather than building up coverage of non-formal groups over time, it has built those in from the start, funded from large tax subsidies. Only around one-third of members have made any financial contribution. 70% of the funding is tax-based.


Has an income-related contribution schedule (i.e. premiums are calculated according to ability to pay), which is uniform even if the SHI consists of a number of health funds serving as the financing intermediaries for the SHI

The NHIA payments are only income-related for the 3% of the population which are formal sector members. For informal members, there is a flat rate premium per person.


Has a standardized, prescribed minimum benefit package

The NHIS does have a standardized, prescribed minimum benefit package


Source: criteria taken from [11]

Witter and Garshong BMC International Health and Human Rights 2009 9:20   doi:10.1186/1472-698X-9-20

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