Evaluating Stakeholder Engagement And Communication Strategies In Improving NHIS Coverage In Ghana

Abstract

Despite two decades of implementation, Ghana's National Health Insurance Scheme maintains low active membership coverage nationally, with Greater Accra Region exhibiting particularly low enrollment despite higher awareness levels, indicating coverage challenges stem from communication and engagement deficiencies rather than lack of awareness. This study assessed current stakeholder engagement practices and communication strategies employed by the National Health Insurance Authority in Greater Accra, examined stakeholder perceptions, and identified public relations best practices for enhancing coverage, grounded in stakeholder theory, Grunig's public relations models, and health communication theories. A quantitative cross-sectional survey collected data from respondents comprising active members, lapsed members, non-enrolled individuals, healthcare providers, and NHIS staff through structured questionnaires via Google Forms, analyzed using descriptive statistics and one-sample t-tests. Findings revealed moderate awareness levels regarding enrollment procedures but critical deficiencies in stakeholder engagement quality, particularly responsiveness and participatory decision-making, with communication operating predominantly through one-way dissemination rather than dialogic engagement. The study concludes that achieving universal health coverage requires transitioning from asymmetric to symmetric communication models, institutionalizing responsive feedback mechanisms, implementing participatory structures, enhancing insurance literacy, and building trust through transparent communication.