Healthy ageing

Chief Atsrima Zacharias Kwaku, 80 shows his health insurance scheme ID card that allows him to access free healthcare. (C) HelpAge Ghana/HelpAge International Older people's capacity to earn a living and participate in community life is governed, to a large extent, by their health status.

The health of a country's population also has an impact on the level of economic growth. Therefore, protecting a good standard of healthcare must be paramount in helping people out of poverty.

Healthcare for older people in Ghana

As people grow older, their need for healthcare can increase. But older people in Ghana are experiencing a reduction in specialised healthcare services. The situation is worsened by the rising cost in medication and negative attitude of some healthcare workers towards older patients. The healthcare system also has no structure for geriatric doctors to attend to older people.

This is despite the fact that a National Ageing Policy in Ghana was approved by the cabinet in October 2010, which pledged to promote positive ageing and provide healthcare for older people.

National Health Insurance Scheme

By law, all Ghanaians must belong to a health insurance plan, although the choice of scheme is voluntary. The National Health Insurance Scheme was established by the Government to provide equitable access and coverage for basic healthcare services.

However, government expenditure on healthcare was high between the late 1960s and the mid‐1980s. As a result, the "cash and carry" system was introduced to to recover at least 15% of this health expenditure.

Under the cash and carry system, a person's health needs were only attended to after an initial payment for the service was made. Even when patients had been brought to hospital in emergencies, they had to pay at every point of service delivery.

As many people could not afford the fees, they avoided going to hospital. Instead, many self medicated to save costs, although this can be dangerous. Some communities also set up their own community‐based health insurance schemes, to ensure they could access healthcare.

Equal access to health insurance

The National Health Insurance Act 2003 and the National Health Insurance Regulations 2004 were launched in August 2004 and implemented nationwide.

They were set up so people could contribute to a fund, which would ensure they would receive affordable healthcare in the event of an illness.

The health insurance acts proposed to provide all Ghanaians with equal access to sustainable health insurance and quality healthcare.

Lifeline to older people

Health insurance is a lifeline to older people in Ghana as many cannot afford on the spot payment for services. The National Health Insurance Scheme (NHIS) is therefore an intervention older people should use. However, only 5.4% of older people who are 70 and above are covered on the health insurance scheme.

Under the law, those not registered cannot access healthcare. This means that around 95% of older people over 70 are still using the outdated and unfair cash and carry system.

Demanding better healthcare

HelpAge Ghana, in partnership with HelpAge International, believe the NHIS will not bring any significant change for older people. Ebenezer Adjetey-Sorsey, executive director of HelpAge Ghana, said:

"The country is ageing very fast and it's becoming a challenge. The 2010 census showed that 7% of the population is over 50, and we expect that figure to get higher."

As part of the Age Demands Action on Health campaign, older ADA activists will meet the Chief Executive of the National Health Insurance Authority and the Minister of Health. They will be calling for the needs of older people to be incorporated into the healthcare plans. They will also urge them to amend the Health Insurance Bill:

• The age of exemption from payment of the minimum premium into NHIS should be reduced from 70 to 60 - the definition of an older person in the National Ageing Policy approved by the cabinet in 2010.
  
• The diseases and drugs coverage should be made more relevant to the healthcare needs of older people. Currently the benefit package does not cover: optical aids, hearing aids, orthopaedic aids, dentures, AIDS drugs, treatment of chronic renal failure and heart and brain surgery.
• Geriatric healthcare should be mainstreamed into the syllabus of health institutions.