The Centre for Active Learning and Integrated Development (CALID) located in the Tamale Metropolis of the Northern Region is an Anti-Corruption partner working on the project “Fighting Unapproved Charges for Health Services (FUChaSS)”.
The challenge of fighting corruption is not the absence of legislative framework, but the selective application and enforcement of the status and weaknesses prevailing in the bureaucratic and governance structures, and the weak capacity of civil society to demand accountability and expose corrupt public officials. The issue of unapproved charges by most health facilities across the country has become a worrying trend for some time now as some staff of hospitals have been charging patients and pregnant women illegal fees which often are not receipted, for instance, clients who go to retrieve the bodies of their deceased relatives are asked to pay without receipts.
It was on this basis that CALID in collaboration with the League of Youth (LoY) embarked on this project targeting women (pregnant women), the disabled, the aged, children and minority tribes like the Fulanis as they are the most vulnerable to the issue of unapproved fees charged in the hospitals.
After 8 months of project implementation, the revenue base of the Tamale Teaching Hospital (TTH) has gone up by 50% because of the vigilance in the hospital by the LoY and community members (patients) visiting the hospital. In some cases, some hospital workers drew the attention of the Coalition to areas of suspicion to be investigated (labs, etc.). According to Dr. Ken Osei Mensah; PRO Tamale Teaching Hospital:
“The CALID/ League of Youth project has enabled the hospital to identify and seal to some extent the loopholes of seepage of revenue in the hospital. This has been done with the help of reports from the youth on the SMS Voices Platform. As a result, the hospital revenue has gone up by 50%.”. The SMS Voices platform has enabled the youth (reporters) to send reports of unapproved fees charged at the hospitals to hospital authorities. During the quarter under review, a total of 6 reports have been sent. Some of the hospitals have taken drastic measures and sanctions have been placed on staff involved in the extortion of clients. Hospital authorities have collated the other issues and are still investigating for actions to be taken. Not only that they are going ahead to provide training for health workers on the customer care services."
Hospital authorities see the project as an opportunity for them to clear a lot of issue in the hospitals including criminal matters and the Administrator of the Tamale Central Hospital (TCH) had this to say when he was asked on the progress of the project in his hospital - “We will hold a crunch management meeting and also present these same findings to them for collective action”.
Town Hall Meetings were held to engage and draw the attention of the hospital authorities to extortions/unapproved charges at the various health facilities in the Tamale Metropolis. It also served as an interface between citizens, hospital authorities and the National Health Insurance Authority (NHIA) to discuss issues that were generated from the citizens’ scorecard.
Again, it created the space for the hospital authorities to restore the confidence of citizens in accessing quality health service delivery by making commitments to put in place measures to deal with corrupt acts in the hospitals as well as ‘negligent’ attitudes of some staff of the hospitals. For instance, the Tamale Teaching Hospital committed to training staff on customer care relations. Whiles the Tamale West Hospital (TWH) committed themselves to step down the Town Hall Meeting to their staff. Citizens clearly expressed their frustrations and sounded a word of caution to the hospitals. They were very concerned that the hospitals were becoming a business centre for health workers and wanted them to desist. A community member who participated in the meeting had this to say:
“The Town Hall meeting gave us an opportunity to ask the hospital authorities critical questions and seek clarity about some payments made at the TTH we deem to be illegal fees. For instance, some payments we make at the theatre when we go for deliveries. We were sensitized by hospital authorities on the legal charges and appropriate payment points. It was really an enlightening experience.”- Alhassan Barkisu; Dabokpa community
“The CALID/LoY project has brought to our attention challenges faced by clients of hospitals with regards to the National Health Insurance Scheme (NHIS). Most especially the issue of top-ups for drugs by clients at NHIS accredited pharmacies in the Tamale Metropolis. The authority has consequently verified these allegations and is taking measures to sanction pharmacies found culpable.” Mr. Ahmed Abdul Ganiyu; Tamale Metro Manager; National Health Insurance Authority.
In line with this, drug lists covered by the NHIS have been published by dialing *929# across all mobile networks to gain access. This is meant to cure the mischief of patients being told: “this drug is not covered by NHIS”. It will also deal with the illegalities citizens face at the various pharmacies.
The project is also enjoying positive collaboration with other stakeholders including the media. For instance, the Executive Director of CALID and the President of the League of Youth were both interviewed on Joy FM /TV documentary which was also highlighting corruption at various hospitals. Equally the victims who were supported by the project to petition the Commission on Human Rights and Administrative Justice (CHRAJ) were visited at their various homes for interviews and shooting.
Through the project and in collaboration with the Boabab Market Series, the Regional Manager of the NHIA participated in the Health Convening that took place in Tamale and gave additional education on the work, plans and mandate of the authority. Participants were reassured of sanctions to be taken on the issue of the co-payments and unapproved charges reported.
Patients/citizens now feel empowered and demand official receipts for services provided whiles others also look for the reporters to report one issue or the other. To sustain the gains of the project the Tamale Teaching Hospital (TTH) has established a Customer Care Centre where complaints are captured for sanctions or recommendations taken for improvement of service delivery. Numbers for the Customer Care Centre are (0) 546 347 216 / 204 364 358 / 372 000 180.
Group photo of participants at the event
