6 April 2021

Supporting children gain access to health care in Ghana through NHIS registrations

The World Health Organization has recently launched a new campaign to build a fairer, healthier world; one where everyone, everywhere can realize the right to good health. As part of our efforts to tackle child labour, the International Cocoa Initiative (ICI) recognizes the crucial role access to health care can have on children’s welfare and protection. That’s why supporting children in Ghana register for the National Health Insurance Scheme (NHIS) is an important part of our work.

Ghana’s National Health Insurance Scheme, established in 2003, offers free access to basic health services to all its citizens. Certain barriers exist that can limit the number of registrations within cocoa-growing communities such as long distances to health or registration centres or difficulties making registration or renewal payments. This means that many children are not registered or do not have their registration renewed, leaving them vulnerable in case of accidents or illness.

ICI, through the Child Labour Monitoring and Remediation Systems (CLMRS) it implements with its partners, works to break down these barriers to help children gain access to the medical system, as part of a wider effort to address child labour and increase child protection. CLMRS are systems that are embedded in cocoa supply chains at the cooperative level and work through Community Facilitators, often farmers themselves, who identify the needs of children in, or at risk of, child labour, to provide solutions to address or prevent cases.

As one of the major barriers to NHIS registration is the cost, these expenses can be covered; while through collaboration with District authorities, travel and logistic issues can be resolved by either bringing officials in charge of registrations to the communities, or supporting farmers travel to the District offices with their children. Over 450 children have received assistance with NHIS registration through ICI-supported CLMRS.

Registering children to the NHIS does not necessarily reduce the risk of child labour though it can reduce the potential harm caused by its consequences. It can also increase the welfare of children by facilitating access to health services which may otherwise be unattainable. In tandem, supporting children to register with the NHIS can also raise awareness of its benefits amongst adults and encourage them to sign up as well. As injuries to parents can sometimes result in an increase of child labour, coverage of the entire family, can be equally beneficial.

NHIS support, however, can go together with other remediation activities which are also designed to increase children’s welfare and protection such as awareness-raising on the dangers of child labour, support to diversify farming families’ sources of income, and the development of school infrastructure including classrooms, toilets, teachers’ accommodation, and canteens. It is important to note that when schools have state-run school canteens with a school feeding programme in place, enrolled children can register to the NHIS for free. In this case, NHIS officials visit the schools to register children as part of a government programme.

Tackling child labour is vital, but so too is addressing issues directly related to children’s welfare and their future success, such as access to adequate health care and school enrolment, to ensure they can learn and thrive. Implementing these solutions will continue to be an important part of our work at ICI as we seek to scale up effective systems, such as CLMRS, to address and prevent child labour across the cocoa supply chain in West Africa with our partners.

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