In Ghana, many studies have provided evidence of infectious pathogens failing to respond to
conventional antibiotics available in the health systems. This proves the high prevalence of
antibiotic resistance in the country. Nevertheless, little data on the overall prevalence of the
problem is available except for specific diseases like TB. Ghana ranks high among states with
drug-resistant TB in Africa. According to (Owusu- Dabo & Ohene, 2006) an overall primary
drug resistance rate of 23.5% was found in Ghanaian TB Patient.
Before 2017, Ghana lacked a national antibiotic use policy that should have otherwise control
the resistance and guide the use of antibiotics. This has resulted in an immense rise in abuse of
antibiotics throughout the country. (MOH Republic of Ghana Policy on Antimicrobial Use and
Resistance. 2017)
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This has been evident in claims bills submitted by health facilities to the National Health
Insurance Authority Ghana (NHIA). A 2016-2017 analysis of antibiotic prescription on 11
facilities that submitted claims electronically showed that antibiotics prescription contributed to
22.3% of the total cost of medicines prescribed. (Ghana NHIS, claim-it analysis on medication
and services 2017).
Throughout the years The NHIS of Ghana has continued to see claims payment skyrocket. This
trend has led to delay in reimbursement to health providers, leading to continues indebtedness to
providers with undesirable consequences' that occur on the consumer such as the facilities
charging unauthorized /illegal co-payment, denying care to subscribers and finding innovative
ways to increase claims bills. (Ghana NHIS Annual Report, 2013).
To control the escalating claims cost, the government of Ghana saw it prudent to introduced
measure that will see a more efficient claims processing system that prevented abuse and
wastage.
The institution of clinical audit, the establishment of centralized claims processing centers,
development and implementation of prescription levels, and the introductions of the electronic
claims submission and processing which an aim of bringing greater efficiency in the vetting of
the claims.
Despite all these ongoing efficiency strategies and relative gains made, the growth of claims
expenditure has continued to outpace the growth of NHIS revenue.
Wrong prescription and over prescription of medicines had not only bloated claims bills and
threatened the financial sustainability of the NHIS, but the negative consequences of
antimicrobial resistance on the health of the population and globally population at large also
cannot be overlooked.
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This study was, therefore, conducted to assess the rate of inappropriate antibiotics prescribing for
URTI within healthcare facilities across Ghana. Findings of this study will serve as a basis for
policy formation, and to institute a more detailed criteria-based medicine use studies to check the
appropriateness of antibiotics prescription, identify the associated factors, and thereby optimize
their use. This will contribute its part to the national effort on Antimicrobial resistance
