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 local chapter of Transparency International (TI), Launched 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 people and institutions by forging strong, trusting and effective partnerships with government, business and civil society and engagement with the people.

CPI Score: 41

CPI Rank: 78

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Access to medicines, vaccines and other products

Information systems



Research and development




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

Theory of Change


To achieve improved transparency and accountability in the flow and utilisation of NHIS financial resources leading to improved health service delivery in selected deprived 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) undertook 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 (12) districts in six (6) regions. The project aimed to examine the various stages of health service delivery under the NHIS with a view to making the processes more participatory and transparent by empowering citizens with relevant skills and knowledge to demand responsiveness and accountability from service

The first stage of the project allowed members of the selected communities to identify issues they were experiencing with the NHIS and healthcare more
broadly. Through a scoring process called Community Scorecard (CSC), community members were assisted in ranking the most important issues to the
community as a whole and giving each 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, as well as 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 contained in this report clearly indicates, over the two year duration of the project there was a marked improvement in the perception of health service delivery in the selected districts.

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

There is still a great deal of work to be done by 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 coverage of diseases and medication (coverage)
    Media campaign
  3. Payment of additional fees
    Awareness raising
  4. Timely issuance of NHIS Cards Renewal of NHIS cards Waiting time at health facility (Time)
  5. Attitude of health workers towards NHIS clients (service)
    Awareness raising