Table 3 Interventions ranked according to net health benefit
From: Supporting a review of the benefits package of the National Health Insurance Scheme in Ghana
# | Intervention* | Category | Provision level | Annual patient population | Budget impact (GH₵) | Total physician demand (FTE)** | Total NHB (DALYs avoided) |
|---|---|---|---|---|---|---|---|
1 | Drug treatment uncomplicated malaria in < 5 s | Malaria | Primary | 3,358,476 | 63,724,968 | 0 | 12,821,265 |
2 | Minimal DOTS plus resistant cases | Tuberculosis | Secondary and above | 25,977 | 3,212,898 | 0 | 1,959,392 |
3 | Full combination DOTS | Tuberculosis | Secondary and above | 44,029 | 5,237,814 | 0 | 1,947,790 |
4 | Full DOTS | Tuberculosis | Secondary and above | 44,020 | 1,323,359 | 0 | 1,942,992 |
5 | Minimal DOTS | Tuberculosis | Secondary and above | 25,097 | 972,379 | 0 | 1,908,354 |
6 | Emergency obstetric care | Maternal and neonatal | Secondary and above | 35,432 | 45,713,781 | 14 | 931,631 |
7 | Skilled maternal and immediate new-born care | Maternal and neonatal | Primary | 876,577 | 79,109,064 | 318 | 621,643 |
8 | Use of insecticide-treated bed nets | Malaria | Primary | 3,774,440 | 7,169,971 | 0 | 563,514 |
9 | Inguinal hernia repair | Surgical | Primary | 59,447 | 16,084,990 | 0 | 544,304 |
10 | Community-based support for low birthweight babies | Maternal and neonatal | Primary | 43,595 | 113,245 | 0 | 448,821 |
11 | Drug treatment sexually transmitted infections | Sexual and reproductive health | Primary | 5,713,958 | 90,384,670 | 0 | 356,543 |
12 | Voluntary Counselling and Testing | Sexual and reproductive health | Primary | 125,524 | 1,690,712 | 0 | 284,050 |
13 | Emergency neonatal care | Maternal and neonatal | Secondary and above | 104,627 | 124,202,759 | 758 | 247,883 |
14 | Antivenom for snakebites | Neglected tropical diseases | Primary | 10,417 | 1,939,617 | 8 | 242,841 |
15 | Oral rehydration solution for diarrhoea in < 5 s | Child health | Primary | 7,928,521 | 20,898,714 | 0 | 224,820 |
16 | Cataract surgery | Surgical | Primary | 48,000 | 3,172,331 | 0 | 185,475 |
17 | Tetanus toxoid vaccination (as part of antenatal care) | Maternal and neonatal | Primary | 877,816 | 8,428,905 | 0 | 172,185 |
18 | Drug treatment childhood pneumonia | Child health | Primary | 1,095,649 | 8,846,996 | 0 | 159,424 |
19 | Iron supplementation (pregnant women) | Maternal and neonatal | Primary | 877,816 | 5,326,667 | 0 | 152,174 |
20 | Syphilis detection and treatment (as part of antenatal care) | Maternal and neonatal | Primary | 798,813 | 5,989,133 | 0 | 144,805 |
21 | ART (first- and second-line treatment, intensive monitoring) | Sexual and reproductive health | Secondary and above | 313,809 | 252,271,535 | 985 | 143,634 |
22 | Antenatal corticosteroids for preterm labour | Maternal and neonatal | Primary | 122,894 | 21,215,994 | 45 | 142,176 |
23 | ART (first- and second-line treatment, no intensive monitoring) | Sexual and reproductive health | Secondary and above | 280,208 | 214,576,816 | 271 | 139,873 |
24 | Pre-referral rectal drug treatment malaria in < 5 s | Malaria | Primary | 176,762 | 3,683,790 | 0 | 135,228 |
25 | ART (first-line treatment, intensive monitoring) | Sexual and reproductive health | Secondary and above | 219,667 | 124,887,298 | 690 | 132,020 |
26 | ART (first-line treatment, no intensive monitoring) | Sexual and reproductive health | Primary | 219,667 | 116,512,735 | 212 | 128,537 |
27 | Community-based management of neonatal pneumonia | Maternal and neonatal | Primary | 229,940 | 1,229,183 | 0 | 122,117 |
28 | Male circumcision | Sexual and reproductive health | Primary | 425,611 | 20,546,102 | 0 | 109,716 |
29 | Antibiotics for pPROM | Maternal and neonatal | Primary | 27,897 | 136,028 | 5 | 96,482 |
30 | Case management of epilepsy | Psychological and neurological | Primary | 137,757 | 19,285,785 | 33 | 66,738 |
31 | Screening hearing loss | Ear, nose and throat | Primary | 45,385 | 15,962,992 | 0 | 52,335 |
32 | Intermittent preventive drug treatment malaria during pregnancy | Malaria | Primary | 877,816 | 593,377 | 0 | 45,084 |
33 | Heavy alcohol use, brief advice | Psychological and neurological | Primary | 296,118 | 868,919 | 0 | 43,038 |
34 | Pre-referral rectal drug treatment malaria in > 5 s | Malaria | Primary | 50,014 | 1,042,305 | 0 | 41,638 |
35 | Diabetes, retinopathy screening + photocoagulation | Non-communicable diseases | Primary | 748,660 | 5,177,610 | 109 | 40,699 |
36 | Screening children 5–15 for uncorrected refraction error | Child health | Primary | 7,157,377 | 10,612,533 | 0 | 40,571 |
37 | Iron supplementation in < 1 s | Child health | Primary | 851,630 | 5,906,445 | 0 | 37,202 |
38 | Non-communicable diseases | Primary | 310,396 | 8,048,292 | 0 | 20,390 | |
39 | Integrated mass drug administration strategies for schistosomiasis and soil-transmitted helminthiasis (children 5–14 years old) | Neglected tropical diseases | Primary | 6,560,411 | 28,538,496 | 0 | 18,406 |
40 | Preventive drug treatment for patients at risk of post-partum haemorrhage | Maternal and neonatal | Primary | 403,796 | 2,541,925 | 0 | 15,808 |
41 | Integrated mass drug administration strategies for schistosomiasis and soil-transmitted helminthiasis (community-wide) | Neglected tropical diseases | Primary | 28,308,301 | 141,276,210 | 0 | 13,006 |
42 | Pap smear (at age 40) + treatment if necessary | Non-communicable diseases | Secondary and above | 164,014 | 4,453,800 | 6 | 11,874 |
43 | VIA (at age 40) + treatment if necessary | Non-communicable diseases | Secondary and above | 164,014 | 5,301,245 | 6 | 11,691 |
44 | Asymptotic bacteriuria detection and treatment (as part of antenatal care) | Maternal and neonatal | Primary | 877,816 | 7,939,274 | 0 | 11,123 |
45 | Drug treatment otitis media | Ear, nose and throat | Primary | 2,035,324 | 18,202,098 | 0 | 10,281 |
46 | VIA (at age 35,40,45) + treatment if necessary | Non-communicable diseases | Secondary and above | 493,792 | 15,960,298 | 19 | 6378 |
47 | Hepatitis B vaccination to prevent perinatal transmission | Maternal and neonatal | Primary | 871,896 | 14,429,873 | 0 | 3383 |
48 | Drug + psychosocial treatment schizophrenia | Psychological and neurological | Primary | 43,170 | 16,210,167 | 16 | 3124 |
49 | Isoniazid preventive therapy HIV-infected pregnant women | Maternal and neonatal | Primary | 22,823 | 914,958 | 0 | 2056 |
50 | Pap smear (at age 40) + removal of lesions | Non-communicable diseases | Primary | 164,014 | 1,608,441 | 2 | 1469 |
51 | VIA (at age 40) + removal of lesions | Non-communicable diseases | Primary | 164,014 | 2,455,887 | 2 | 1316 |
52 | Breast cancer, treatment stage I | Non-communicable diseases | Secondary and above | 566 | 765,547 | 3 | 1202 |
53 | Preventive drug treatment for patients at risk of CVD event | Non-communicable diseases | Primary | 587,544 | 270,664,608 | 284 | 957 |
54 | Isoniazid preventive therapy HIV-infected pregnant women with CD4 < 200 | Maternal and neonatal | Primary | 2282 | 91,496 | 0 | 174 |
55 | VIA (at age 35,40,45) + removal of lesions | Non-communicable diseases | Primary | 493,792 | 7,393,864 | 7 | 119 |
56 | Breast cancer, treatment stage II | Non-communicable diseases | Secondary and above | 850 | 2,597,700 | 7 | − 548 |
57 | Cervical cancer treatment | Non-communicable diseases | Secondary and above | 8733 | 36,401,464 | 42 | − 1309 |
58 | Pap smear (every 5 years at ages 20–65) + removal of lesions | Non-communicable diseases | Primary | 1,422,723 | 13,952,258 | 21 | − 2774 |
59 | Breast cancer, treatment stage IV | Non-communicable diseases | Secondary and above | 1104 | 5,757,508 | 6 | − 2944 |
60 | Breast cancer, treatment stage III | Non-communicable diseases | Secondary and above | 3476 | 15,686,449 | 39 | − 5842 |
61 | Breast cancer, treatment all stages | Non-communicable diseases | Secondary and above | 5996 | 20,386,405 | 55 | − 5899 |
62 | Pap smear (every 5 years at ages 20–65) + treatment if necessary | Non-communicable diseases | Secondary and above | 1,422,723 | 38,634,027 | 55 | − 9707 |
63 | Drug treatment of post-acute IHD & stroke | Non-communicable diseases | Primary | 98,853 | 79,725,263 | 36 | − 22,847 |
64 | Drug treatment asthma | Non-communicable diseases | Primary | 1,043,002 | 46,611,673 | 252 | − 23,914 |
65 | Drug + psychosocial treatment bipolar disorder | Psychological and neurological | Primary | 154,857 | 89,753,143 | 56 | − 26,123 |
66 | Drug treatment bipolar disorder | Psychological and neurological | Primary | 154,857 | 89,753,143 | 56 | − 28,104 |
67 | Episodic treatment unipolar depression | Psychological and neurological | Primary | 809,667 | 146,767,346 | 196 | − 39,527 |
68 | Maintained drug + psychosocial treatment unipolar depression | Psychological and neurological | Primary | 809,667 | 245,160,224 | 293 | − 82,589 |
69 | Diabetes, standard glycaemic control diabetes | Non-communicable diseases | Primary | 748,660 | 2,686,931,378 | 99 | − 1,391,459 |