Ghana Learning Exchange with Taiwan Builds Confidence, Cooperation in National Health Insurance Agency

Universal health coverage (UHC) is a goal in Ghana, with the National Health Insurance Scheme (NHIS) covering more than a third of the population. The NHIS is working to become a more financially sustainable organization by reforming its payment system and improving its generation and use of data for decision-making. In Taiwan, UHC is a reality, with the National Health Insurance (NHI) covering 99.9% of the country's population through a centralized, single-payer system. Taiwan's insurance system is built on a strong foundation of proven information technology, allowing both administrators and patients to closely track health information and make informed decisions. The system is perhaps most well-known for its use of a SmartCard to track patient visits and public health information. A delegation of eight Ghanaians from the NHIA, the Ministry of Health, and Ghana Health Service visited Taiwan's NHI in Taipei for a learning exchange and study tour. During the week-long exchange, the Ghanaian delegation attended the two-day NHI 20th Anniversary Symposium and Round Table, participated in a three-day course led by Taiwan NHI staff, and made field trips to regional health offices. The delegation witnessed firsthand the rigorous clinical review processes of Taiwan's NHI and observed how clinicians and patients interact with the IT systems in place. The visit reinforced for Ghana's NHIA Deputy Director of Operations, Nathaniel Otoo, what the NHIA is already doing right, but also highlighted areas for improvement, including strengthening provider payment, quality measurement, and how IT is positioned in the health system. Participants discussed both short-term and longer-term actions that could be taken in Ghana based on the materials being shared, including the development of a feedback loop with providers using facility data. The Ghanaian delegation was able to build stronger working relationships during the exchange, with officials from across Ghana's health sector able to collaborate and share ideas. The symposium also featured prominent health economists and health insurance experts who discussed Taiwan NHI's successes since its inception and the challenges the system currently faces. The Ghanaian delegation, along with delegations from Malaysia, South Africa, Nigeria, and the Philippines, participated in a more in-depth three-day course led by Taiwan NHI staff on the organization's operations across a variety of areas.