Affordability barrier to chronic disease treatment — NHIA study

A study by the National Health Insurance Authority (NHIA) and the Korea Foundation for International Healthcare (KOFIH) has revealed that affordability remains a major barrier to the treatment for chronic conditions such as diabetes and hypertension in Ghana, despite increased access to health care through the National Health Insurance Scheme (NHIS).

According to the findings, out-of-pocket costs continued to determine whether patients stayed on treatment or discontinued even when they were enrolled on the NHIS.

The financial pressure, the report warned, could be the difference between managing an illness and suffering severe complications or even death.

Among some of the unexpected revelations was that NHIS members were less likely to monitor their vital signs or adhere to prescribed medications compared to those not enrolled on the scheme.

Individuals with no formal education showed stronger habits in checking vital signs, the report indicated.

Also, urban residents were generally more engaged in regular health checks, likely due to better access to healthcare services.

The findings were presented in Accra last Friday at a dissemination conference, where researchers, policymakers, development partners, and healthcare professionals gathered to discuss how to strengthen the country’s response to non-communicable diseases (NCDs).

The study sought to establish a baseline on how diabetes and hypertension are currently being managed across both NHIS and non-NHIS populations.

Responses

The Deputy Chief Executive of the NHIA in charge of Operations, Dr Senanu Kwesi Djokoto, said the findings should guide a rethink of how the health system approacheed chronic diseases.

He stated that Ghana, like many countries, was experiencing a shift in disease burden from infectious diseases to NCDs such as diabetes and hypertension  which demanded bold, evidence-driven responses.

"If we do not act with urgency and precision, the growing prevalence of chronic diseases will gradually undermine the substantial progress we have made in expanding health access and equity,” Dr Djokoto said.

He described the study not as a mere academic exercise but as a call to action and a step forward toward evidence-based policymaking and strategic reform.

“Let us align policy with evidence and ensure that no Ghanaian, regardless of income, location or circumstance, is left behind in our pursuit of a healthier nation,” he added.

President of KOFIH, Dr Ha Il-Soo, said the insights from the study would help inform future health strategies.

He emphasised the need for continued partnerships, research and targeted investment in health systems to reduce the NCD burden.

"This is not just about data, it is about improving lives and shaping a healthier, more equitable future for all,” Dr Ha said.

Economic toll

Professor Gordon Abeka-Nkrumah of the University of Ghana Business School described the findings as alarming, calling the growing burden of NCDs a development crisis.

“These are not just health statistics — they represent the daily realities of millions of fellow citizens.

The economic implications of inaction are staggering,” he noted.

He warned that NCDs were projected to cost low- and middle-income countries over $7 trillion between 2011 and 2025.

In Ghana, he said, the mean annual cost of managing diabetes was GH¢3,197, while the lifetime cost of treating hypertension could exceed GH¢869,000, depending on age and severity.

For the NHIS, he said, diabetes and hypertension already ranked among the top five cost drivers, consuming over 10 per cent of total claims.

“We must ask: Is the NHIS benefit package sustainable, given the growing burden of NCDs?” Prof. Abeka-Nkrumah asked.