title: [Buruli ulcer and the National Health Insurance Scheme in Ghana].
abstract: The objectives of this paper are to grasp the current status of an endemic disease in the Republic of Ghana known as Buruli ulcer(BU) and to clarify relationships between the National Health Insurance Scheme(NHIS) and the health care system. As for the method of the study, I have adopted field investigations conducted in Ghana in March, 2009 and August, 2011. All the counter-measurements on BU taken either by the very government or international NGOs have been administered and controlled the disease in accordance with the National Buruli ulcer Control Programme(NBUCP) under the guidance of Global Buruli ulcer Initiative which was established in Geneva, Switzerland in 1998 as an advisory committee of the World Health Organization. BU patients can receive treatments free. The government sponsored NBUCP and direct and indirect donations from various NGOs provide the cost of medical treatments. The Ghanian NHIS of 2003 aimed to ease and improve the health situations of the people. Some of serious endemic diseases like BU, however, are excluded from the schemes. While the NHIS remains ineffective to the diseases like BU, the burden of treatment costs puts the strain on NBUCP. The field researches indicate that the budgets provided by the NBUCP often faile to cover the fundamental medical supplies like bandages. This causes to give an extra burden on the already constrained hospital budgets. Only reliefs the hospitals can rely on are the international aids which often determine the fate of the national disease control. The research reveals that the region's health system remains unsound. Ghana represents such realities of West Africa as a whole.
authors.affiliation: Japan Society for the Promotion of Science 56-1 Toji-in, Kitamachi, Kita-ku, Kyoto, Japan 603-8577. niiyama@fc.ritsumei.ac.jp
authors.forename: Tomoki
authors.initials: T
authors.lastname: Niiyama
mesh_terms: D054312:Buruli Ulcer / Q000453:epidemiology; D003150:Community Health Workers; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D019458:Insurance Coverage / Q000191:economics; D009313:National Health Programs / Q000191:economics