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Breast Cancer treatment included in Ghana’s NHIS since inception, not ‘now covered’ as claimed by politician

Breast cancer awareness pink ribbon. Image source: mom.com 5 mins read

Claim: Breast cancer has now been included under the country’s National Health Insurance Scheme.

Verdict: Partly True. According to the National Health Insurance Scheme (NHIS), breast cancer is fully covered under the scheme. This has been in place since the scheme started operations, not a new initiative. However, some hospitals have indicated that the breast cancer treatment under the NHIS is not fully covered.

Full Text

Gabby Otchere-Darko, leading member of the New Patriotic Party and Founder and Executive Director of the Danquah Institute, posted on his Twitter timeline that Breast Cancer is now covered by the National Health Insurance Scheme in Ghana. 

“Breast cancer treatment now covered under Ghana’s national health insurance scheme,” he tweeted.

Image source: mom.com

The tweet supported with a photo promoting the ‘4more4nana campaign’ was shared on September 29th, 2020 and has garnered 81retweets, 19 comments and 288 likes as of  Tuesday, October 13.

It was met with a mix of excitement, indifference, and doubt from twitter users, while others have prompted that it is only partially covered. In the comments section, for instance, KojoMensah with the handle @Citizenmensah in response to the post, questioned, “Point of correction: Breast cancer treatment, partially covered”. Nokware y3 baako p3.” Also questioning, WannaCryRansomeWare tweeted from the handle @_negroid,,“That thing does it work at all?”. 

On the other hand, some Twitter users believe the content of the tweet. For instance, Spencer Kyere Felix, with the handle @spencee62 , replied “wish my mum would be alive to witness such great news. Breast cancer treatment is very costly esp the drugs” while Mati Kasa GH, with the handle @LamarSode, commended the government, tagging the move as “ a good and laudable initiative which should be commended.

Image source: Twitter.com

Dubawa set out to verify if indeed the NHIS covers breast cancer treatment and how extensive is the coverage.

Verification

On the NHIS website, breast cancer is indeed included in the list of benefits for card holders.  The provision was found at point three under the In-patient section of the benefits package. Here, cervical and breast cancer treatment is listed as a health condition for which NHIS card holders can receive treatment.

Ghana’s National Health Insurance Scheme(NHIS) was launched in 2013 under the Kuffour administration. The scheme was introduced by the government to provide  access to quality health care for Ghanaian residents.

Image source: nhis.gov.gh

In a telephone conversation, a customer service representative of the NHIS call centre said that breast cancer treatment  is fully covered under the scheme from inception in 2013.

“There is no such thing as a partial cover. If it is covered, it is covered”, said  the customer service representative, who prefers not to be named.

She added that once a hospital is accredited under the scheme, breast cancer treatment is accessible to active NHIS card holders.

This would then imply that the treatment has not just become covered but has actually been covered since the beginning of NHIS.

A news publication on the NHIS website supports this. The article, which was published in January 2016, noted that the service is available to card carriers and for 95% of all reported disease conditions in Ghana. 

As stated in the report, breast and cervical cancers are covered by the Scheme . 

“Head of Communications at the NHIA, Selorm Adonoo, told Afia Adutwumwaa Morosa on UTV’s late news, that breast and cervical cancers are comprehensively covered by the Scheme and expressed surprise why people suffering the condition would have to endure the agonizing pain for a long time before seeking treatment. According to him, “most people think that cancers are costly to treat, perhaps that’s the reason why they wait that long before seeking proper medical help. But the good news is that the NHIS covers breast and cervical cancers so why do you wait till it’s too late before reporting for medical treatment?” The NHIS has been said to run a vast benefits package which accounts for about 95% of all reported disease conditions in Ghana”, the article reads.

A 2017 World Bank Study also also confirms the claim that breast cancer treatment is “covered” under the NHIS in Ghana. 

Conflicting Information

Media reports, on the other hand, seem to point to the fact that breast cancer treatment has not been covered by the scheme. A news website, Ghana web, on October 19, published a story stating that the RT. Hon. Prof Mike Oquaye, the Speaker of Parliament, has directed the Ministry of Health to ensure that the cost of treatment for breast cancer is covered by the NHIS.

According to the report, this directive was given as a result of the increasing number of women afflicted by the disease, suggesting that the scheme does not cover all the costs associated with the treatment of the disease.

To clarify the different information online, Dubawa contacted some government hospitals; Greater Accra Regional Hospital(GARH),the Korle-Bu Teaching Hospital and the Bolga Regional Hospital. Government hospitals were selected because most private health facilities do not provide NHIS covered services. See list of accredited providers here.

According to the Customer Service Officer at  the GARH, breast cancer can be treated at their facility for those with the registration for the hospital card, consultation and screening covered by the NHIS. This service is accessed at the Reproductive Health Unit of the hospital. 

However, the Customer Service Officer at GARH stated that there may be some parts of the treatment that the scheme may not cover. She however indicated that the client will need to see a doctor to determine whether or not the treatment needed is covered or not.

According to information from the Korle-Bu Teaching Hospital,  breast and cervical cancer has been covered by NHIS since its inception in Ghana. Until last year when Herceptin was added to the list of cancers covered by the NHIS, it was just first-line or common cancer medication that was covered by the scheme for the treatment of breast cancer.

It was additionally stated that the labs the patient needs may vary, thus suggesting that insurance coverage is case dependent. There is a list of laboratory tests that are used to determine what is covered or not and some aspects  may or may not be covered by the scheme, depending on the case and the lab request made by the doctor.

Medical Official at Bolga Regional Hospital, Dr. Kasule Iddrisu Yakubu, has also confirmed to Dubawa that at their hospital, some chemotherapy drugs for breast cancer treatment are not covered by the NHIS. We asked whether breast cancer treatment is fully covered by NHIS in Bolga Regional Hospital.

“No please. They mostly refer to Korle Bu. Some of the drugs aren’t on NHIS…They are chemotherapy drugs”, Dr. Kasule said.

Dubawa contacted the Ministry of Health to verify the information but an email and calls are yet to receive answers from the ministry. 

Conclusion:

Breast cancer is stated as “fully covered” by the NHIS at accredited medical facilities in the country. However, some hospitals contacted have indicated that this is not the case  in all hospitals, as some medications or treatments are not covered by the scheme in every health facility.

Additionally, unlike the claim suggests, this is not a new service but an existing service since the beginning of NHIS in Ghana.

Roselena Ahiable is a Senior Researcher with Dubawa Ghana. Roselena has years of demonstrated work experience in advertising, sales and marketing, having worked with some of the leading brands in Ghana. She has completed a Master of Philosophy programme in Communication Studies at the University of Ghana, Legon, with specialisation in Public Relations and Advertising. She has also received advanced training in print and broadcast journalism. Roselena also holds a Bachelor of Arts Degree in English and Theatre Arts from the University of Ghana. As a trained journalist with interest in research, Roselena provides the team insight in news and media trend analysis.

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