 has been plunged into a severe operational crisis, as a nationwide breakdown of its digital platform has forced hospitals and clinics to revert to the dreaded ‘Cash and Carry’ system, leaving thousands of insured patients stranded and unable to access care.){kind=link}
Ghana’s National Health Insurance Scheme (NHIS) has been plunged into a severe operational crisis, as a nationwide breakdown of its digital platform has forced hospitals and clinics to revert to the dreaded ‘Cash and Carry’ system, leaving thousands of insured patients stranded and unable to access care.
The NHIS, introduced in 2004 to replace the ‘Cash and Carry’ regime, currently has over 16 million active members. The ongoing system paralysis, if not urgently resolved, could mark a major setback for one of Ghana’s most important social protection programmes.
The disruption, which has persisted for over a week, has effectively halted digital verification and claims processing across the country, denying cardholders the benefits of the scheme that was designed to provide affordable healthcare for all Ghanaians.
The situation was visibly dire at the Gbawe SDA Hospital in the Weija-Gbawe Municipality on Tuesday, October 7, 2025. Patients who had endured muddy, rain-soaked roads to reach the hilltop facility were met with a grim reality, their NHIS cards were temporarily useless.
“My mother and I were told the system was down, so we had to pay cash,” recounted Nii, who accompanied his 75-year-old mother for a routine visit. “I spent over GH₵200 today when I should have spent less than GH₵150 if NHIS was working.”
At the same hospital, the consultation fee for NHIS members reportedly jumped from GH₵18 to GH₵54, a 200% increase, while basic laboratory tests such as malaria and Full Blood Count (FBC) were no longer covered.
Another patient, recently discharged after a brief admission, said she paid GH₵1,500, estimating that her bill “would have been less than GH₵1,000” under a functioning NHIS system. “Not everyone can afford healthcare without insurance. This is a big challenge,” she lamented.
Responding to growing public outrage, Dr. Victor Asare Bampoe, Chief Executive of the National Health Insurance Authority (NHIA), confirmed that several facilities had been unable to authenticate patients’ membership due to the system failure.
“We want our members to have a cash-free experience as much as possible, regardless of the challenge,” Dr. Bampoe said during a visit to the Ho Teaching Hospital on October 8. “This situation is unacceptable.”
He explained that the national electronic health records and hospital management system that underpins the NHIS’s digital operations is owned and managed by a separate entity, but assured that urgent measures were underway to restore functionality.
Dr. Bampoe said the NHIA is exploring short- to medium-term interventions to minimize out-of-pocket payments, including the possible deployment of NHIA staff to health facilities to support manual verification and prevent the rejection of insured patients.