Browsing by Author "Sodzi-Tettey, S."
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Item Challenges in provider payment under the Ghana National Health Insurance Scheme: a case study of claims management in two districts(Ghana medical journal, 2012-12) Sodzi-Tettey, S.; Aikins, M.; Awoonor-Williams, J.K.; Agyepong, I.A.In 2004, Ghana started implementing a National Health Insurance Scheme (NHIS) to remove cost as a barrier to quality healthcare. Providers were initially paid by fee – for - service. In May 2008, this changed to paying providers by a combination of Ghana - Diagnostic Related Groupings (G-DRGs) for services and fee – for - service for medicines through the claims process. Objective: The study evaluated the claims management processes for two District MHIS in the Upper East Region of Ghana. Methods: Retrospective review of secondary claims data (2008) and a prospective observation of claims management (2009) were undertaken. Qualitative and quantitative approaches were used for primary data collection using interview guides and checklists. The reimbursements rates and value of rejected claims were calculated and compared for both districts using the z test. The null hypothesis was that no differences existed in parameters measured. Findings: Claims processes in both districts were similar and predominantly manual. There were administrative capacity, technical, human resource and working environment challenges contributing to delays in claims submission by providers and vetting and payment by schemes. Both Schemes rejected less than 1% of all claims submitted. Significant differences were observed between the Total Reimbursement Rates (TRR) and the Total Timely Reimbursement Rates (TTRR) for both schemes. For TRR, 89% and 86% were recorded for Kassena Nankana and Builsa Schemes respectively while for TTRR, 45% and 28% were recorded respectively. Conclusion: Ghana’s NHIS needs to reform its provider payment and claims submission and processing systems to ensure simpler and faster processes. Computerization and investment to improve the capacity to administer for both purchasers and providers will be key in any reform.Item Challenges in provider payment under the Ghana National Health Insurance Scheme: a case study of claims management in two districts.(Ghana medical journal, 2012-12) Sodzi-Tettey, S.; Aikins, M.; Awoonor-Williams, J.K.; Agyepong, I.A.In 2004, Ghana started implementing a National Health Insurance Scheme (NHIS) to remove cost as a barrier to quality healthcare. Providers were initially paid by fee - for - service. In May 2008, this changed to paying providers by a combination of Ghana - Diagnostic Related Groupings (G-DRGs) for services and fee - for - service for medicines through the claims process. The study evaluated the claims management processes for two District MHIS in the Upper East Region of Ghana. Retrospective review of secondary claims data (2008) and a prospective observation of claims management (2009) were undertaken. Qualitative and quantitative approaches were used for primary data collection using interview guides and checklists. The reimbursements rates and value of rejected claims were calculated and compared for both districts using the z test. The null hypothesis was that no differences existed in parameters measured. Claims processes in both districts were similar and predominantly manual. There were administrative capacity, technical, human resource and working environment challenges contributing to delays in claims submission by providers and vetting and payment by schemes. Both Schemes rejected less than 1% of all claims submitted. Significant differences were observed between the Total Reimbursement Rates (TRR) and the Total Timely Reimbursement Rates (TTRR) for both schemes. For TRR, 89% and 86% were recorded for Kassena Nankana and Builsa Schemes respectively while for TTRR, 45% and 28% were recorded respectively. Ghana's NHIS needs to reform its provider payment and claims submission and processing systems to ensure simpler and faster processes. Computerization and investment to improve the capacity to administer for both purchasers and providers will be key in any reform.Item Evaluation of water, sanitation and hygiene status of COVID-19 healthcare facilities in Ghana using the WASH FIT approach(Creative Commons, 2021) Ashinyo, M.E.; Amegah, K.E.; Dubik, S.D.; Ntow-Kummi, G.; Adjei, M.K.; Amponsah, J.; Ayivase, J.T.; Amoah, S.; Ashinyo, A.; Sodzi-Tettey, S.; Awekeya, H.; Codjoe, A.; Tegbey, I.E.; Kwakye, A.T.O.; Akoriyea, S.K.Access to improved water, sanitation and hygiene (WASH) is essential for the delivery of high-quality care in healthcare facilities and the prevention of hospital-acquired infections such as the transmission of the SARS-CoV-2. In addition, unimpeded access to WASH facilities in coronavirus disease 2019 (COVID-19) treatment centres (TCs) is central in facilitating compliance with infection prevention and control protocols. However, data for the WASH status of COVID-19 TCs in Ghana are limited. We evaluated the WASH status of seven COVID-19 TCs in Ghana using the WHO/UNICEF water and sanitation for health facility improvement tool (WASH FIT). The water domain had the highest number of indicators meeting standards with an average percentage score of 90.5% (range: 66.7–100%) across the seven TCs, followed by management (66.9%) and hygiene (58.7%). The TCs performed poorly in the sanitation and healthcare waste domain, with an average percentage score of 44.6% (range: 22.2–75%). These findings highlight the challenges being faced by COVID-19 TCs in implementing WASH services. Specific WASH interventions are urgently required to strengthen WASH services in the COVID-19 TCs. This should precede the prioritisation of resources to WASH infrastructure in the treatment facilities coupled with actions that involve all stakeholders.Item Ghana's national health insurance scheme and maternal and child health: A mixed methods study(BMC Health Services Research, 2015-03) Singh, K.; Osei-Akoto, I.; Otchere, F.; Sodzi-Tettey, S.; Barrington, C.; Huang, C.; Fordham, C.; Speizer, I.Background: Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program's strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant services. Methods: This paper uses qualitative and quantitative data from a baseline assessment for the Maternal and Newborn errals Evaluation from the Northern and Central Regions to describe women's experiences with the NHIS and to study associations between insurance and skilled facility delivery, antenatal care and early care-seeking for sick children. The assessment included a quantitative household survey (n = 1267 women), a quantitative community leader survey (n = 62), qualitative birth narratives with mothers (n = 20) and fathers (n = 18), key informant interviews with health care workers (n = 5) and focus groups (n = 3) with community leaders and stakeholders. The key independent variables for the quantitative analyses were health insurance coverage during the past three years (categorized as all three years, 1-2 years or no coverage) and health insurance during the exact time of pregnancy. Results: Quantitative findings indicate that insurance coverage during the past three years and insurance during pregnancy were associated with greater use of facility delivery but not ANC. Respondents with insurance were also significantly more likely to indicate that an illness need not be severe for them to take a sick child for care. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts. Findings from the qualitative interviews uncovered specific challenges women faced regarding registration for the NHIS and other barriers such lack of understanding of who and what services were covered for free. Conclusion: Efforts should be undertaken so all individuals understand the NHIS policy including who is eligible for free services and what services are covered. Increasing access to health insurance will enable Ghana to further improve maternal and child health outcomes. © 2015 Singh et al.Item Ghana’s National Health insurance scheme and maternal and child health: a mixed methods study(2015-03-17) Singh, K.; Osei-Akoto, I.; Otchere, F.; Sodzi-Tettey, S.; Barrington, C.; Huang, C.; Fordham, C.; Speizer, I.Abstract Background Ghana is attracting global attention for efforts to provide health insurance to all citizens through the National Health Insurance Scheme (NHIS). With the program’s strong emphasis on maternal and child health, an expectation of the program is that members will have increased use of relevant services. Methods This paper uses qualitative and quantitative data from a baseline assessment for the Maternal and Newborn errals Evaluation from the Northern and Central Regions to describe women’s experiences with the NHIS and to study associations between insurance and skilled facility delivery, antenatal care and early care-seeking for sick children. The assessment included a quantitative household survey (n = 1267 women), a quantitative community leader survey (n = 62), qualitative birth narratives with mothers (n = 20) and fathers (n = 18), key informant interviews with health care workers (n = 5) and focus groups (n = 3) with community leaders and stakeholders. The key independent variables for the quantitative analyses were health insurance coverage during the past three years (categorized as all three years, 1–2 years or no coverage) and health insurance during the exact time of pregnancy. Results Quantitative findings indicate that insurance coverage during the past three years and insurance during pregnancy were associated with greater use of facility delivery but not ANC. Respondents with insurance were also significantly more likely to indicate that an illness need not be severe for them to take a sick child for care. The NHIS does appear to enable pregnant women to access services and allow caregivers to seek care early for sick children, but both the quantitative and qualitative assessments also indicated that the poor and least educated were less likely to have insurance than their wealthier and more educated counterparts. Findings from the qualitative interviews uncovered specific challenges women faced regarding registration for the NHIS and other barriers such lack of understanding of who and what services were covered for free. Conclusion Efforts should be undertaken so all individuals understand the NHIS policy including who is eligible for free services and what services are covered. Increasing access to health insurance will enable Ghana to further improve maternal and child health outcomes.