THE ASSESSMENT OF FINANCIAL SUSTAINABILITY OF HEALTH INSURANCE IN AFRICA: A CASE STUDY OF GHANA'S NATIONAL HEALTH INSURANCE SCHEME

Most nations prioritize the provision of affordable healthcare for their residence via health insurance. However, a substantial financial base recognized widely as a prerequisite for the provision of an efficient health care delivery system. This study aims to assess the financial sustainability of health insurance in Africa using Ghana's National Health Insurance Scheme as a case study. The study examined the funding regime, the growth rate of claims, premium payments, and income and expenditure trends of the scheme from 2008 to 2014 with GNHIS's annual reports used as data collection. The study adopted the "four pillars of financial sustainability" to test the impact of claims and investment on return on asset (ROA) of the scheme, using ROA as a proxy for financial sustainability. The results show a statistically significant negative relationship between ROA and Investment (?=-0.1700964, p=0.049) implying that a unit point increase (or decrease) in the scheme's investments will cause the scheme's ROA to decrease (or increase) by approximately 0.17 units points. Likewise, claims payment showing a statistically significant adverse impact on ROA (?=-0.2278903, p=0.036). Unit growth in claims payment reduces the scheme's sustainability by 0.22 units. Overall, investment and claims jointly influence 86.39 percent of the variation in the scheme's financial viability. This study's findings give credence to the need for coherent policies directed to salvage GNHIS from imminent collapse. The study concludes that GNHIS needs immediate policy diagnostics and operational restructuring to avert the current financial challenges bedeviling the scheme.