Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana

This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana’s National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the policy debate advance arguments to legitimize their claims about the contested capitation payment system. In addition, we found that the health of poor communities, women and children are being used as surrogates for political and individual arguments in the policy debate. The article recommends a more holistic and participatory approach through persuasion and negotiation to join interests and core evidence together in the capitation policy making in Ghana and elsewhere with similar contexts.

Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Atuoye, K. N., Vercillo, S., Antabe, R., Galaa, S. Z., Luginaah, I. Tags: Original Articles Source Type: research