Access to essentials like banking, healthcare, and travel hinges on having the correct ID. For residents and visitors, the Ghana Card is at the forefront, making life smoother. The Ghana Card is the country’s official national identity card. What data is stored? The chip stores personal details, including name, date of birth, nationality, sex, and digital biometric records. The Ghana Card opens numerous doors.
The Executive Secretary of the NIA, Mr. Deku, explained that the law (LI 2111, passed in 2012) makes the Ghana Card the mandatory source of identification for all official transactions, including obtaining a driver’s licence, passport, and other essential documents. Whether we like it or not, the Ghana Card has become a crucial ID for Ghanaians since its introduction in 2018. Without a Ghana Card, one cannot undertake banking transactions, acquire a passport, get a driver’s license, register a SIM card, or properly verify their identity.
Yet many people born and raised, as well as new arrivals, still find the process confusing. What documents do you need? How much will it cost? Where can you apply? This post gives straightforward answers to questions about what the Ghana Card is, who needs it, how to apply, and the costs for citizens, foreigners, and non-citizens.
Registration and Application Process
If you want to apply for a Ghana Card, you can find several centers that are set up for both residents and new arrivals:
- Go for biometrics: Attend your booked appointment.
- Please wait for processing: Citizens typically receive their cards within 2-4 weeks.
These offices handle first-time registration, renewals, replacements, and updates. At NIA centres, district offices accept cash or mobile money. A scratch card must first be bought from any Cal Bank branch nationwide and this purchase triggers the registration process where applicant completes registration form, personal information and biometrics (fingerprints and photograph) are then taken.
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Premium Service Centers
Not everyone wants to wait in line at a busy district office. At a Premium Centre, you pay GHS 310 for first-time registration, renewal, or updating records. Using a Premium Centre is optional. Officials explained that while registration at district offices remains free, premium centres were introduced in 2023 to provide faster services, particularly when government was struggling to pay private partners for card production. These centres have more staff, can process over 100 registrations a day, and also support online applications via the register.gov.gh platform.
Benefits of Premium Service
- Faster Service: Premium centers offer quicker processing times compared to district offices.
- Increased Staff: More staff are available to assist with the registration process.
- Higher Capacity: These centers can process over 100 registrations per day.
- Online Support: Premium centers support online applications through the register.gov.gh platform.
Eligibility and Requirements
On the issue of ineligible registrations, Mr. Deku reiterated that only Ghanaians are entitled to the card, and that applicants must prove citizenship, typically with a birth certificate.
On the GTV Breakfast Show, Mr. Deku clarified the situation regarding registration for children aged 0-5 and 6-14 years. Registration for children under five was paused due to technical issues that created multiple PINs for the same child. For children aged 6 to 14, about 6.3 million were targeted, but registration suffered printing setbacks.
Non-Citizen Ghana Card: Registration of foreigners for the Non-citizen Ghana card is an on-going process. It is a primary identification card to get a work permit or residence permit. Currently, dual citizens do not register for the Non-citizen Ghana card. The Non-citizen Ghana card is the mandatory form of identification to be used in all transactions for e.g.; applying for or renewing residence permit, opening or running a bank account etc. It is the defacto proof of identity to aid in all transactions requiring identity.
Renewal and Fees for Non-Citizens
Renewal of the Non-citizen Ghana card is on a yearly basis. One year after the issuance date of the card, the present card will be changed to a smart card on renewal at a fee of USD 60.00. Thereafter renewal will be done electronically on each renewal date upon payment of the prescribed fee of USD 60.00.
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Ghana Card and Healthcare Access
Ghana's National Health Insurance Scheme (NHIS) was created by the National Health Insurance Act of August 2003, and is one of very few attempts by a sub-Saharan African country to implement a national-level, universal health insurance program. The NHIA licenses and regulates district-level mutual health insurance schemes (DMHISs) as well as other schemes allowed under the Act, accredits providers, determines-in consultation with DMHISs-premium levels, and generally oversees and reports on NHIS operations.
Coming as a consequence of the deleterious effects of user fees, one of the primary goals of Ghana's NHIS was to increase affordability and utilisation of drugs and health services in general, and among the poor and most vulnerable populations in particular.
Official statistics on NHIS registration provided by the National Health Insurance Authority show the increase in enrolment since operations began in late 2005. As Table 1 shows, the total number of active members reportedly increased from 2.4 million in 2006 to 11.1 million in 2009, suggesting that close to 50% of the population was covered by the insurance by 2009.
We analyse six measures of health care use collected as part of the WHSA-II interview to investigate whether NHIS enrolment is associated with changes in health behaviour in general, and increased use of formal health care in particular. Our main hypothesis is that, conditional on several observable characteristics, being enrolled in NHIS should increase the probability of women seeking care. Women who fall ill without insurance are likely to self-treat themselves if possible in order to avoid incurring external treatment cost.
In this paper, we analysed data from wave II of the Women's Health Study of Accra to investigate the association between NHIS insurance enrolment and health seeking behaviour among women in the Accra Metropolitan Area. We demonstrated that on average women enrolled in the insurance scheme are more likely to seek formal care when sick, have a larger number of prescriptions, are more likely to have visited a clinic or hospital in the year prior to the interview, and are substantially more likely to have experienced an overnight stay at a hospital in the last year.
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The notion that insurance increases usage is consistent with our theoretical priors as well as a few previous attempts to quantify the effects of the NHIS on access to health care.
HOW TO REGISTER YOUR BUSINESS IN GHANA - STEP BY STEP
The Cost of the Ghana Card
One may argue that we need to be careful not to lose it, but is it always possible? How do you prevent getting robbed, fire outbreaks or experiencing other events that can lead to loss?
The high replacement cost for the Ghana Card is unfair to poor Ghanaians. In effect, we are denying these people their official ID until they have the money to pay. It is understandable to increase the price of passports or, if we wish, Voter IDs, but the current hefty price for replacing an official identity card needs to be reconsidered, as this means denying someone their right to an official identity card because they do not have the money. The National Identification Authority (NIA) should make the Ghana Card replacement either free or very affordable, just like the Voter ID or NHIS cards.
In a country where the minimum wage is GH₵18.15, which is approximately GH₵490.05 a month, why do we peg such a crucial national identity card, which all-rich or poor-must have, at a hefty price? Interestingly, the cost to replace a lost Voter ID card is only GH₵10. The Voter ID serves the sole purpose of electing leaders, some of whom do not even care about the people. To make it accessible for all and not disenfranchise anyone, it has been made very affordable for all. The same goes for the NHIS card. As of 2024, the cost of replacing a lost or damaged National Health Insurance Scheme (NHIS) card in Ghana is only GH₵8.00, which is very reasonable because everyone needs access to healthcare, rich or poor. So why is the Ghana Card, which is equally crucial because without it one cannot access essential services and benefits, priced so high?
NHIS Enrollment Patterns
Std. Figures 1-3 show NHIS enrolment patterns across educational attainment, self-assessed health status, and age groups. While there is some education gradient in enrolment, the likelihood of NHIS enrolment is nearly equal across the main four attainment groups (i.e. up to senior secondary), and only slightly higher for women with tertiary education. NHIS enrolment by self-assessed healthEven more surprising is the weak relation between enrolment in health insurance and self-assessed health, with women who assess their own health as “poor” only marginally more likely to be enrolled in the NHIS than women who rate their own health as “excellent”. Enrolment is highest among the “good” and “fair” health groups. From the three variables analysed, age appears to be by far the best predictor of NHIS enrolment.
We analyse six variables capturing respondents' health seeking behaviour. The first two items we analyse capture preventive exams: 15.4 per cent of women indicated having had a general health exam over the last 12 months, and 8 per cent of women indicated that they had had breast examinations (Table 3). The remaining four items capture typical health seeking behaviour as well as the individual experience over the last year: when asked about where they usually go when they get sick, 79.7 per cent of women indicated that they seek care at a “formal” facility (clinic, doctor, hospital, maternity home). When asked whether they had visited a health clinic/centre or hospital over the past 12 months, 57.4 per cent of women stated this to be the case; a remarkably high 9.9 per cent of women reported to have been hospitalized overnight over the previous 12 months. Last, women were also asked whether they had been prescribed medicines by a doctor, such as medication for cholesterol, de-worming pills, antibiotics, vitamins, weight loss or weight gain supplements, malaria treatment, pain killers, birth control items, hormone replacement therapy, or other health treatments.
Std. Table 4 shows the six health care seeking variables for non-enrolled and enrolled women, respectively. The mean value of all six variables is higher in the NHIS-enrolled group, and the difference between the two groups is significant at the 99 per cent confidence level in all variables except for the breast exam, where the absolute likelihood is below 10 per cent for both groups. The difference between the two groups is largest for the clinic visits and prescriptions: 76.3 per cent of women enrolled in NHIS visited a health clinic or hospital during the twelve months preceding the interview, compared to just 50.2 per cent of women without insurance. The relative differences appear to be particularly large for hospitalization and prescriptions. While only 7.4 per cent of women not enrolled in the NHIS report a hospitalization during the 12 months preceding the interview, the same was true for 12.7 per cent of women enrolled in NHIS.
Given that women with NHIS enrolment on average appear to be more educated and older than women without health insurance, the increased use of health services among insured women reported in Table 4 may reflect differences in respondent characteristics rather than true differences generated by health insurance. In order to reduce the risk of confounding, we use propensity score matching to compare enrolled women to non-enrolled women conditional on all observable characteristics. The results of the propensity score matching estimation are displayed in Table 5. Conditional on all observable characteristics, women enrolled in the NHIS appear to be substantially more likely to seek formal care and to go to a clinic. Keeping all other factors constant, NHIS-enrolled women are 40 per cent more likely to have attended a clinic over the past year, and they have about 57 per cent more prescriptions.
Health Insurance in Ghana: A Brief History
Health care financing in Ghana began with a tax-funded system that provided free public health care services to all after independence. As this system gradually became financially unsustainable with economic stagnation in the 1970s, initially low user fees were established for hospital services to discourage unnecessary use, locally recover some costs and generate provider performance incentives.
Starting from the early 1990s, Ghana began to seek other ways of financing health care, including NGO-initiated community-based health insurance schemes (CBHIS). While popular among members and international donors at the time, the schemes were only targeted to specific areas, failed to address key social insurance issues, and were not supported by general government revenue to allow them to cater for the poor. Most importantly, with CBHIS covering only about 1% of the population with limited benefit packages, the system of user fees remained the predominant means of paying for health care.
Behavioral Effects of Insurance
A large literature has investigated the behavioural effects of insurance in general, and the effects of health insurance on health seeking behaviour in particular. From a theoretical perspective, being covered by insurance can be expected to affect individual behaviour through several distinct mechanisms. First, individuals may feel safer with insurance, and thus take on more risk in the presence of insurance, a problem commonly referred to as the moral hazard problem in the economics literature.
Second, insurance may change the choices individuals make once health problems arise. From the perspective of a rational decision maker, insurance makes formal treatment cheaper in comparison with other treatment modalities, and thus induces a shift towards increased service utilisation. In the context of health, moral hazard is generally considered of lesser importance, since insurance covers the financial consequences of ill health, but offers only limited protection against the physical and emotional burden of ill health generated by risky behaviour. Changes in relative cost, on the other hand, appear to be of central importance for the rollout of health insurance in general, and in a developing country setting in particular.
In the presence of user fees and transaction costs, poor populations may refrain from seeking professional health care from doctors or hospitals. Health insurance lowers this barrier to access, and is thus designed to increase use of professional medical care in general, and particularly among the poor who may be deterred by often steep user fees. The hypothesis we wish to test in this paper is whether insurance affiliation is associated with increased utilisation of formal care.
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