An Exploration of Moral Hazard Behaviors under the National Health Insurance Scheme in Northern Ghana

Maxwell Dalaba, Navrongo Health Research Centre
Samuel Chatio, Navrongo Health Research Centre
Patricia Akweongo, Navrongo Health Research Centre

The study aims to document behaviors and practices of service providers and clients of the National Health Insurance (NHIS) in the Kassena-Nankana District (KND) of Ghana that constitute moral hazards (abuse of the scheme) and identify strategies to minimize such behaviors. Quantitative and qualitative methods were employed. 588 exit interviews, 14 Focused Group Discussions and 5 In-depth Interviews were conducted between December 2009 and January 2010. Results revealed that community members, health providers and NHIS officers are aware of various behaviors that constitute abuse of the Scheme. Behaviors such as frequent and ‘frivolous’ visits to health facilities, impersonation, feigning sickness to collect drugs for non-insured persons, over charging for services provided to clients, charging for services not provided and over prescription were identified. Attention should be focused on addressing the identified moral hazard behaviors and pursue cost containment strategies to ensure smooth operation of the scheme and to speed up universal health coverage