NHIS and USAID engage health insurance stakeholders on clinical and compliance audit methods | 9/14/2023

The National Health Authority (NHIS), in collaboration with USAID, has engaged stakeholders in the health insurance sector to reach an agreement on how clinical and compliance audit methods and tools will be used across the healthcare sector in Aburi, Eastern Region.

The aim of the meeting was to provide stakeholders with an update on the new Clinical and Compliance audit process and tools for inputs in order to increase transparency, improve outcomes, and support easy implementation. 

As a pioneer in the advancement of health insurance in Ghana, the NHIS recognised the importance of a standardised approach to clinical and compliance audits, thus the need to involve all stakeholders. 

The stakeholders, who included representatives from WHO, the Ghana Health Service, and the Ministry of Health, agreed on the working manual that would enhance the quality of audits and ultimately improve patient care. 

The meeting kicked off with presentations by Mr. Ishmael Osei, Director of Quality Assurance Directorate of the NHIA, Mr. William Omane Adjekum, Deputy Director for Quality Assurance and Mr. Festus Baah.

The presenters emphasized the significance of a robust audit methodology to identify gaps in clinical practices and ensure adherence to compliance standards. 

So far the NHIS has audited over 2,000 facilities between 2018 to 2022 , with most of these facilities being public hospitals.With a regional breakdown of hospitals audited; Ashanti Region 282 facilities, Brong Ahafo 232, Central Region 326, Eastern Region 386, Greater Accra 238, Northern Region 51, Upper East 30, Upper West 143, Volta Region 371 and the Western Region 70. 

The presentation sparked lively discussions, as stakeholders shared their perspectives and insights. After extensive deliberation, the stakeholders reached a consensus on the clinical and compliance audit methodology and tools.

The meeting concluded with a sense of accomplishment and optimism among stakeholders recognizing that their collective efforts would bring about positive change in healthcare delivery. By: Angela Asiedu