Increasing Participation, Accountability, Responsiveness and Transparency (PART): focus on the National Health Insurance Scheme (NHIS) and other MDG-related interventions in the health sector in Ghana’

Chapter: Ghana | Project range: Local | Year: 2014

Chapter details

About the chapter:
Ghana Integrity Initiative (GII) is the Ghanaian chapter of Transparency International (TI). Established in 1999, GII is a non-partisan, non-profit civil empowerment organisation focused on the delivery of a National Integrity System. GII’s mission is to fight corruption and promote good governance in the daily lives of citizens and institutions by forging strong, trusting and effective partnerships with the government, the private sector and civil society actors and through continuous engagement with the people of Ghana.

CPI Score: 41

CPI Rank: 78

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Access to medicines, vaccines and other products



Global Partners:
UNDP World Health Organisation (WHO)
National Partners:
Governmental Institution

Theory of Change

Policy & Insititutional Change
Improved enforcement of policies Better Institutional Processes
Behaviour Change
Community Action
Change Type:




The central aim is to enhance transparency and accountability in the flow and utilisation of NHIS financial resources which is aimed to lead to improved health service delivery in selected marginalised districts by December 2014. The original project was focused on three regions and was financially supported by STAR-Ghana, a multi-donor agency.


In 2012, Ghana Integrity Initiative (GII) started a two-year health project titled ‘Increasing Participation, Accountability, Responsiveness and Transparency (PART): focus on the National Health Insurance Scheme (NHIS) and other MDG-related interventions in the health sector in Ghana’. Financially supported by STAR-Ghana and the UNDP, the project covered twelve districts in six regions. The project aimed to examine the various stages of health service delivery under the NHIS with view to making the processes more participatory and transparent by empowering citizens with the relevant skills and knowledge to demand responsiveness and accountability from service providers.

The first stage of the project allowed members of the selected communities to identify issues they were experiencing with the NHIS and health care in general. Through a scoring process called Community Score Card (CSC), community members were assisted in ranking the issues according to which they perceived as most important to the community by giving each issue a quantitative score. Using this data and a platform for open discussion, community members were able to voice their concerns with health service providers, including representatives from District Health Directorates, the NHIS and health workers from their local facilities.

The data was gathered and validated through the CSC process, and added to data collected on community perceptions on the same issues two years later. Following the interface meetings and subsequent actions taken by NHIS offices and health service providers, as the data analysed in this report clearly indicates, there was a marked improvement in the perception of health service delivery in the selected districts over the two-year duration of the project.

Following the CSC process, all communities experienced positive changes in health service delivery in their communities, including an increase in education initiatives and improved services from health care workers. At the end of the research validation process, community members participated in capacity building workshops to ensure their continued active engagement in improving health care in their communities.

There is still a great deal of work to do for health service providers at the district level, including ongoing and intensified community education on the rights and responsibilities of patients, as well as the coverage, benefits and processes associated with the NHIS.


  1. Awareness on the of NHIS scheme (Knowledge)
    Awareness raising
  2. NHIS media coverage of diseases and medication (Coverage)
    Media campaign
  3. Payment of additional fees (Money)
  4. Timely issuance of renewed NHIS Cards, reducing waiting time at health facility (Time)
    AdvocacyStrategic working groups & Collaboration
  5. Attitude of health workers towards NHIS clients (service)
    Awareness raising