The National Health Insurance Scheme (NHIS) faces financing shortfalls that are undermining progress in health and protection of vulnerable groups, the World Bank has revealed in its key findings in Ghana’s Public Finance Review.

According to the Bretton Woods institution, though the progress in health and nutrition outcomes has been supported by public funding, there are challenges.

It said the financing shortfalls for NHIS are undermining progress in health.

First, the NHIS no longer receives its full National Health Insurance Levy (NHIL) allocation, due to the capping law.

Secondly, there is a gap between budgeted allocations and actual cash received from the Ministry of Finance

Additionally, there is high administrative costs hindering spending efficiency as less than 60% of NHIS budget goes to claims.

Social Assistance Programmes Impact Limited

Meanwhile the World Bank says the social assistance programmes are well-targeted to the poor, but their impact is limited by low benefit levels.

It explained that the main targeted social assistance programmes (LEAP, LIPW, GSFP) represent 0.2% of Gross Domestic Product (2025 target: 0.3%) and 1.0% of overall government spending, far below comparator countries (1.5% of GDP).

For comparison, energy subsidies spending represented about 2% of GDP in 2023 (US$1.5 billion).

Therefore, it pointed out that external funding is critical to these programmes.