Study On The Restricting Factors Of Public Policy Implementation Of Ghana’s National Health Insurance Scheme(NHIS)

Due to the current debates and opinions on the outcomes of policies,the study aimed to examine the restricting factors of public policy implementation of Ghana’s NHIS,with focus on the Ga West Mutual Health Insurance Scheme(GWMHS).This would help identify and ascertain some political issues,other restricting factors and the influence of stakeholders on the outcome of the GWMHS.The study therefore considered the National health Insurance Authority(NHIA),Health facilities,Subscribers as the major stakeholders of the Ga West Mutual Health Scheme.Based on the relevant literature and the implementation status of NHIS,this study constructs a hypothesis model on the restricting factors of NHIS public policy implementation,and then conducts empirical research through questionnaire survey and regression analysis.The correlation analysis coefficients indicated that,the Ga West Mutual Health Scheme is a failure due to the existence of some political,economic and technological factors.With a confidence interval level of about 95%the regression model recorded an R-squared(R~2)of 71%with a Cronbach alpha of 93%,indicating that the model is good and reliable as it explains 71%of the variation between variables.The results further indicated that Poor gatekeeper system(PG),Selection of NHIA staff(SS),High subscription fees(HSF)and Political Interference(PI)have the tendency to increase in the failure of the Ga West Mutual Scheme(FGWMHS)if care is not taken.The result from the mediating analysis showed that the complete pathway from Political Interference(PI,independent variable)to Stakeholders(SH,a mediator),to Failure of Ga West Mutual Health Scheme(FGWMHS,dependent variable)was significant(z=2.688,p=.007).The complete pathway from Poor gatekeeper system(PG,independent variable)to SH(mediator)to FGWMHS(dependent variable)was also significant(z=2.394,p=.017).High subscription fee(HSF)pathway to SH recorded a significant value of(z=2.803,p=0.005)and SS(z=2.368,p=.018).Thus,indicating that SH partially mediates the effects of both the independent variables and the dependent variable.The result indicated also that the independent variables contribute directly in explaining the variation in the failure of the Ga west mutual health scheme and indirectly via the stakeholders(SH)of the NHIS.Based on the findings,the study recommends that stakeholders should adhere to the provisions in ACT 650 that established the NHIS.All District Schemes are to be autonomous without any interference from the national level.They are entitled to mobilizing resources with the aim of sustaining the scheme.All appointments made from the National level should be based on competency and not on party affiliations.