Stakeholder Engagement on NHIA Activities in East Gonja Municipality

National Health Insurance Authority (NHIA) operates in the East Gonja Municipality through the Municipal Health Insurance Scheme office in Salaga.

Stakeholder engagement is critical to increasing active membership, reducing drop-out rates, ensuring provider compliance, and improving client satisfaction with the National Health Insurance Scheme (NHIS).

Effective engagement in East Gonja, focuses on bridging the gap between NHIA, health providers, Municipal Assembly, traditional authorities and community members, given the municipality’s mix of urban, peri-urban, and hard-to-reach riverine communities.

Key Stakeholders Identified include;
1. *Traditional and Religious Leaders* – Chiefs, queen mothers, and imams/pastors in Salaga, Kpembe, and surrounding communities. They influence community acceptance and mobilization.
2. *Assembly Members and Unit Committee Members* – Serve as the closest link to communities for information dissemination and grievance redress.
3. *Health Service Providers* – East Gonja Municipal Hospital, CHPS compounds and private clinics enrolled as NHIS credentialed facilities.
4. *Community Health Volunteers and CHWs* – Assist in door-to-door education and registration drives in hard-to-reach areas.
5. *Schools and Youth Groups* – Used for sensitization on the student/teenage membership drive.
6. *Media* – Local FM stations like Kashinteng Radio, Kan FM, Magyk FM and community information centers for announcements and call-in programs.
7. *Civil Society Organizations and NGOs* – Support in targeting vulnerable groups such as pregnant women, PWDs, and the aged.

Engagement undertaken was stakeholder review meeting on;
1. Free registration/renewal exercise
2. Free primary health care and
3. NHIS electric health facility attendance management system

Challenges/Setbacks include;
1. *Network and Connectivity Issues* – Poor network in riverine areas disrupts mobile renewal and biometric verification.
2. *Low Awareness of Benefits Package* – Some clients expect coverage for services not included in the NHIS benefit package, leading to dissatisfaction.
3. *Provider Attitude and Illegal Charges* – Complaints of clients being asked to pay for covered services, which undermines trust.
4. *Seasonal Migration* – Farmers migrating for dry-season farming miss renewal cycles, reducing active membership.
5. *Limited Logistics* – The Municipal office has limited vehicles and staff for sustained outreach in a geographically large Municipality.

Outcomes and Lessons Learned
1. *Increased Renewal Rates* – Communities where chiefs publicly endorsed renewal drives saw a 15 – 25% increase in the quarter following the durbar.
2. *Trust is Built Through Face-to-Face Engagement* – Radio alone is not enough; physical presence of NHIA staff with Hon. Assembly Members builds credibility.
3. *Use of Local Language is Critical* – Sessions in Gonja, Hawsa and Dagbani improve understanding, compare to English-only sessions.
4. *Feedback Loops Improve Service Delivery* – Regular meetings with providers led to faster resolution of client complaints and reduced illegal charges in some facilities.
5. *Partnership with Assembly Members is Cost-Effective* – Leveraging their structures for mobilization reduces NHIA’s logistics burden.

Recommendations
1. Sustain quarterly durbars with traditional authorities before and after the farming season.
2. Strengthen the complaint resolution mechanism between NHIA, providers, and the Assembly’s Public Relations and Complaints Committee.
3. Provide solar-powered mobile registration kits for island communities to address network challenges.
4. Integrate NHIS education into existing MMDA programs such as LEAP, school health, and maternal health outreaches to maximize reach.

Conclusion
Stakeholder engagement in East Gonja Municipal Assembly has shown that NHIA’s success depends less on policy alone and more on how well local structures are mobilized and trusted. When chiefs, Assembly members, and health providers are actively involved, communities are more likely to register, renew, and use their NHIS cards appropriately.