The Upper West Regional director of the Ghana Health Services, Alexis Nangbaifuba has expressed worry about the quality of service been rendered to clients under the National Health Insurance Scheme and wondered whether clients in the region get their money’s worth under the scheme.His worry stems from the fact that the region has only four doctors instead of 25.The Upper West Regional director made the statement at a stakeholders’ forum organized by the National Health Insurance in WaDr. Alexis said as the director of service providers in the region, he felt bad about the service been rendered to clients which he believe is not value for money.‘’It is up to us to sit together and think and decide to take action to improve upon the service we are delivering’’, Dr. Alexis stressed.The Upper West Regional Manager of the scheme, John Boscos Zuri said the total active membership list of the National Health Insurance Scheme (NHIS) in the Upper West Region stood at 350,724, representing 50.9 per cent of the total population. It has also been estimated that 90 per cent of the population of the region have registered with the scheme at one point or the other. It has also been established that 24,781 pregnant women have been registered since 2008 under the free maternal healthcare policy of the government. Mr. Zuri said two production centres for the production of identity cards for members have been set up which facilitated the clearing up of all backlog and reduced waiting period to less than three months in most cases.He said the new ID cards in circulation is valid for five years and can be renewed at any NHIS office nationwide on annual basis. He said clinical audit which was introduced in 2010 exposed some problems associated with the scheme in the region. He said for example wrong application of tariffs, submission of claims from non-accredited facilities through accredited facilities, inflation of quantities of medicines, substitution of medicines and inadequate documentation and record keeping which in some cases no records of visit by clients are some of the issues bedeviling the scheme in the region. The Upper West Health Insurance Manager said in order to strengthen membership drive; the scheme has introduced new policy developments. For instance a subscriber whose ID card expires for more than three months is declared as a defaulter who will undergo a waiting period of additional three months before accessing care. He said in an attempt to achieve MDGs IV and V all children less than five years and pregnant women do not undergo any waiting period, as registration for them is instant. He said some of the challenges the scheme face in the region include refusal of some providers to use NHIS ICT platform for the verification of members. He said lack of transportation is hindering renewal as negative perception of subscribers about quality of care at provider sites is a great source of worry for them in the region. He was particularly worried about fraud, impersonation, health shopping and over billing as some of the setbacks of the scheme. He concluded that in spite of these challenges, the scheme in the region has chalked some successes. According to him; new offices have been procured for Nadowli and Wa West districts. The scheme has 154 accredited centres across the region.