Making public policy implementable: The experience of the National Health Insurance Scheme of Ghana

The article looks at the relationship between policy design and implementation. It addresses the main question: what factors make public policy implementable? It assesses how policy design affect implementation with empirical evidence on the implementation of the National Health Insurance Scheme (NHIS) in Ghana. Winter's heuristic integrated implementation model serves as the theoretical/analytical framework. It utilises qualitative research with positivist tradition in which data is obtained from multiple sources including in-depth interviews, focus groups discussions, documentation and on-site direct observations. It identifies some policy design factors that facilitated the implementation process of the NHIS (success) and those that impeded the implementation process of NHIS (failure). Evidence shows that the involvement of both public and private sectors increased beneficiaries' access to healthcare services. It identifies policy design process as shrouded in secrecy, less policy actors' inputs at formulation stage. It recommends design process should be open and with fewer clearance points.