Evaluation Plan For The National Health Insurance Program In Ghana

Question: Discuss about the Evaluation Plan For The National Health Insurance Program In Ghana. Answer: Introduction: The evaluation plan is the assessment of the work based on value and impact when the managers ask questions, take feedback, consult their partners. Then the managers collect the information for the improvement of the program. Such type of assessments clearly defines the evaluation term that what, why and how it is necessary for every program. Any action that is taken to improve the public health can be the part of the evaluation plan, for example, a public health of providing healthy breakfast to the grade school students to improve their nutrition, a training program to reduce the unemployment in urban areas. This report will develop an evaluation plan for the national health insurance program in Ghana. This NHIS scheme provides the maximum medical facilities to the Ghanas citizen by paying a small instalment of the annual premium. The NHIS covers the outpatient cost, hospitalization cost, laboratory test cost and the cost of the certain medicines also (Nsiah-Boateng, 2014). The pur pose of the NHIS program is to provide health care services to every citizen of Ghana that no one dies because of a medical problem that has not been allied due to financial problem. Evaluation plan There is a number of ways to evaluate the health care program but in this CDC framework of evaluating the program is used. The CDC framework guides to effectively evaluate the public health program and use of the evaluation finding for the decision making and programs improvement (Nsiah-Boateng, 2014). There are number of steps for evaluation of a public health program Step 1: Stakeholders engagement Step 2: Description of the program Step 3: focus on the design of evaluation Step 4: gathering the credible evidence Step 5: conclusion justification Step 6: assurance of using and sharing lessons learned from evaluation According to the CDC framework, there are four standards for the evaluation: utility, feasibility, accuracy, and propriety. Utility means serving information to the intended users Feasibility means be diplomatic, realistic, prudent and frugal Propriety means to behave ethically, legally and in the welfare of those who are affected and involved Accuracy means evaluation should be based on realistic and comprehensive data. Stakeholders engagement Purpose identification of the evaluation is of equal importance as identifying the end users of the program. These evaluation aspects serve as the foundation for the evaluation focus, planning, design, interpretation and results usage (Nsiah-Boateng, 2014). If the results of the evaluation will determine that either the program will continue or stopped, the stakeholders should aware of this. Table: 1 Stakeholders engagement Stakeholder Evaluation focus Purpose Person who are involved or affected planning, design, interpretation and results usage Improvement and decision making Program description The description of the program clears the purpose of the evaluation, development stages, activities, improvements and implementation process. The programs shared understanding that what the evaluation plan can deliver and cannot deliver is important for the implementation of the activities successfully. The program managers and the stakeholders should agree on the stages of the evaluation development, logical model, and the evaluation purpose (Alatinga Williams, 2015). Table: 2 Program descriptions Development stage Program Planning Implementation Maintenance Logic model Assessment of the environment, resources needed for the policy implementation Policy passed but not implemented What impact on the policy of health care unit Evaluation focus There should be potentially no limit on the information gathered regarding the program. Mostly, the evaluation criteria are restricted to the questions that are asked realistically and answered qualitatively. The depth and scope of the evaluation program depend on the priorities of the stakeholders and program managers; available resources that are the availability of contractor and staff and time period devoted to the evaluation (Brugiavini Pace, 2016). Gathering the credible evidence After focusing the evaluation and identification of the questions, now it is essential to find out the appropriate methods for the evaluation of the questions that have been selected. Sometimes the evaluation method is the favorite method of evaluator and evaluation planning tries fit into them. This will provide incomplete and incorrect information (Brugiavini Pace, 2016). Thus, for the effective evaluation method, there should be a focus on the purpose, logic model, development stages and what the evaluation can deliver and cannot deliver. Table: 3 Evaluation plan Questions of evaluation Performance indicators and measures Procedures Data source Responsibility Which is the lead for the implementation policy Description of the stages of development, activities and strategies Documentation, case studies, interviews and reviews Print reports and sites visits Evaluation team Conclusion justification For the justification of conclusion, in this step, there will be a proper analysis of the data and their interpretation. After the analysis and the interpretation, the evaluator draws the conclusion. The evaluator will make planning for the analysis and interpretation. This analysis planning helps the evaluator to know what the evaluation data really reveal about the program. After this, there will be a justification for the conclusion. Table: 4 Conclusion Evaluation findings Tools Evidence Responsibility Conclusion drawn Analysis and interogation Review and feedbacks, critical Evaluation team Assurance of using and sharing lessons learned from evaluation After drawing the conclusion that is the evaluation outcomes, should be used for the improvement of the program and decision making. These evaluation outcomes should be used properly for effective improvement and decision making. Table: 5 Evaluation findings Evaluation outcomes Target audience Equipment Dissemination Stakeholders News release, websites, print report and mass communication Utilization Policy Makers Monthly meeting and documentation Evaluation plan for public health program In the West Africa, Ghana is the developing country having a population about 25 million. Economically, it is a poor country but enriched with the proud history. The medical system of the Ghana mainly centred in the two cities Accra and Kumasi. Ghana required the medical facilities in the small town where most of the citizen lives. Twenty five years back, the rural hospitals were visited by the European physicians but this program did not succeed for the longer time. Now the health care system of the Ghana includes the government hospitals and the clinics, CHAG (Christian health association of the Ghana) clinics and hospitals and private hospitals. The government pays salaries to the doctors, nurses and other medical staffs of government and CHAG hospitals and for the other expenses, the CHAG hospitals and clinics depend on the patients charges. For the development, expansion and special projects, they depend on the non-governmental organizations and the foreign countries. The health ministry of the Ghana has introduced the NHIS program that is national health insurance system. NHIS pays for the hospitalization, laboratory tests, and outdoor patient visit and for some medication also. NHIS pays monthly bills to the hospitals for the NHIS provider patients. NHIS does not cover the thoracic, HIV medication, infertility conditions, neuro-plastic surgeries, transplant surgery and medication and among cancers, they only pay for the breast and cervical cancer. The insurance also does not cover the physician visit and long ongoing medication of the patient. In Ghana, a weekly dose of Amoxicillin cost about one dollar but for the hospitalized patient, ceftriaxone cost about six dollars a day because of the antibiotic resistance. In Ghana, GDP (Gross domestic product)/person is about 1602 dollars per year as compared to the 51,700 dollars in the US. Most of the families that do not have the insurance, they decided to quit the medicine in between because of the financial condition. The annual premium of NHIS program is 10 dollars, most of the poor sickest families are unable to sign in the program. Thats why the full implementation this program requires many years. For the evaluation plan, in this CDC framework of evaluation will be used. This evaluation plan includes six steps of the evaluation. Step1: In the first step, there will be the identification of the stakeholders and purpose because it has the same importance as the purpose identification of the evaluation plan. Stakeholders are mostly the consumers because they are involved and affected by the evaluation outcomes (Jabot, Turgeon Carbonnel, 2011). These evaluation aspects stakeholder identification and the purpose identification plays important role in deciding the focus, planning, interpretation, designing and results usage. As this report is dealing with the national health insurance program in Ghana. First, there will be the identification of the purpose and identification of the stakeholders. The purpose of the evaluation can be lower publicity of the program in spite of providing the maximum health coverage in the lowest annual premium (Sobelson Young, 2013). After identifying the purpose, there is need of the identification of stakeholders. In NHIS, the stakeholders may be citizens of the Ghana, policy makers or the staff. From these all stakeholders, the stakeholders that are much more affected by the evaluation outcomes should be identified and involved in the evaluation plan (Schaffer, Goodhue, Stennes Lanigan, 2012). Step2: In the second step of the evaluation plan, there will be a brief description of the program. The description of the program helps to understand the purpose of the program, their development stages, activities, healths improvement capacity and implementation contexts. A better understanding of the program, what the evaluation plan can deliver and cannot deliver helps in proper implementation of the evaluation outcomes and results. Both the stakeholders and program evaluators should agree on the logic model, description stages, and the evaluation purpose (Jabot, Turgeon Carbonnel, 2011). So, for the NHIS the stakeholders and evaluators should sit together and discuss the program and then the logic model and purpose of the evaluation. After discussion, if both are agreed then the next step should be proceeding otherwise there will be a revision of the logic model and purpose. Step3: In the third step, there will be a focus on the evaluation, there will be designed of the evaluation question based on the purpose of the evaluation. For the NHIS, the evaluation question will be based on the lowest usage of the valuable insurance. Depending upon the purpose, the evaluation team will design questions. Evaluation question may include the question on the health problem, facilities and insurance good points and bad points (Jabot, Turgeon Carbonnel, 2011). Step 4: In the fourth step, there will be the choice of the best suited method for the evaluation question. The evaluation method should focus on the purpose, logic model and the evaluation criteria. The evaluation method should be properly fitted to the evaluation questions. The best method for the evaluation of NHIS, to select the hospitals in the Ghana, visits the hospitals and do questioning from the patients (Sakeah et al., 2014). Step 5: In the fifth step, on the basis of the answer given to the evaluations questions, a conclusion will be drawn. This conclusion should be evidenced by the data collected. For the conclusion justification, evaluation team will deeply analyze and interpret the collected data (Sakeah et al., 2014) Step 6: In this step, from the conclusion of the data, the evaluation team will derive the evaluation outcomes that support decision making and improvement of the program. These evaluation findings should be disseminated to the stakeholders through the news media, press, website and emails server. After dissemination, there should be the successful utilization of the findings (Sobelson Young, 2013). Factors that influence the successful dissemination and utilization of the evaluation findings Successful Dissemination For the successful dissemination, the evaluation finding should be disclosed to all stakeholders; consumers, staff, management. These evaluations finding support the decision making for the improvement of the program (Sekyi, Aglobitse Asante, 2015). These individuals are ready and receptive for the evaluation finding as evaluation is based on the interest and priorities of these people. There are numbers of ways to disseminate the evaluation findings such as news release, detailed reports, press conferences, email based service, seminars and through social media. Researchers have found that the website, workshop media and print reports are more effective way to satisfy the stakeholders and promotion of dissemination. There should be dissemination plan for the NHIS that have objectives and goals. In NHIS, mass communication should be the best media for the dissemination (Sekyi, Aglobitse Asante, 2015). During dissemination, it should be clear that that will be affected by the evalua tion finding. This information got from the stakeholder analysis. In the NHIS, the main stakeholders that are affected are the insurance enroller. There should be easy access and availability of findings for the longer time that whenever the stakeholder has the time they can easily find and read evaluation findings (Sekyi, Aglobitse Asante, 2015). Utilization Once the evaluation finding has been distributed to the stakeholders, the next goal of the evaluator should be its usage in making improvement in the program. The policy makers and the most of the population think that the quality of the evaluation supports the decision making. More and more complicated evaluated plan, more complicated concluded and whole some more complicated conclusion and finding and even more complicated the decision making. There are numbers of ways by which the evaluators can increase the acceptance of the evaluation findings. From these one way is to have evidence based evaluation report (Gajate Garrido Ahiadeke, 2012). Discussion and feedback of the stakeholders are the best way of the dissemination that can improve both quality and chances of the utilization. In NHIS, the health ministry should do discussion and take feedback from the stakeholder for the evaluation finding for the improvement of quality and chances of the utilization. Conclusion This report has concluded that the evaluation plan supports the improvement of the program and decision making. The evaluation plan focuses on the identification of purpose and identification of the stakeholder that are involved and affected by the evaluation. The stakeholder and evaluation team collectively focus on the purpose, development stages, logic models and what the evaluation can deliver or cannot deliver (Gajate Garrido Ahiadeke, 2012). After this, the evaluation team designed the evaluation questions. There is a selection of an appropriate method for the evaluation question. After using the appropriate method, the data is collected based on the answers to these questions. This data is critically analysed and interpreted by the evaluation team. Then the evaluation team searches out the evaluation findings. But the work of the evaluation team did not stop at this point (Alatinga Williams, 2015). There should be proper dissemination and utilization of these findings. The d issemination of the evaluation finding is done to the stakeholders through the mass communication, news release, print reports, websites and email servers. After the dissemination, there will be effective utilization of the findings. The effective utilization can only be done if the evaluation findings are evidence based and easily to understandable. In the last, evaluation plan include the search of the evaluation findings and their effective dissemination and utilization (Alatinga Williams, 2015). References Alatinga, K., Williams, J. (2015). 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