'GHS, GMA can't do it alone' (Front Page)

THE refusal of health professionals to accept posting to deprived areas has evoked reactions from the Ghana Health Service (GHS) and the Ghana Medical Association (GMA), which say that the issue has gone beyond mere appeals to the conscience of individuals.
They said the critical human resource problem affecting health delivery in deprived areas, especially the northern part of the country, needed to be tackled within the general framework of addressing the inequities in the country’s development pattern.
Speaking on the issue to the Daily Graphic, the Director-General of the GHS, Dr Elias K. Sory, said since the service could not force any health professional to accept posting under the circumstances, the name of any such worker was usually taken from the payroll of the GHS.
He said the issue of the refusal of some health professionals to go to deprived areas had reached a stage where the GHS alone could not handle and, therefore, called for a holistic national approach to tackle the issue.
He said it was important for Ghana to tackle the issue with the seriousness it deserved, since there were other opportunities elsewhere, be it outside the country or in the private sector, for those professionals to take advantage of.
The director-general said the health sector had, over the years, tried hard to encourage health professionals to work in less developed communities but it seemed its packages had outlived their impact and needed to be looked at again and soon.
He explained that a policy was introduced around 2004 and 2005 to pay between 25 and 30 per cent of the salaries of doctors who worked in deprived areas and pointed out that doctors who worked in urban areas could earn more than that in an hour by doing part-time work.
He noted that unlike past years when people accepted to work under any conditions, currently things had reached a point where doctors, like many other public workers, considered economic benefits before working for experience or being patriotic.
Dr Sory said many doctors failed to accept posting to the rural areas because they could not earn as much as their colleagues in the cities and town.
That situation, he pointed out, was in addition to the lack of accommodation, schools for their children, as well as other social amenities, for those who accepted to work in those areas.
Dr Sory suggested that in addition to adequate incentives, there was the need for all the regional hospitals to be upgraded to teaching hospitals where young doctors would be made to practise within the communities after training and also be encouraged to work there.
He, however, noted that it was not only the three northern regions which had problems with inadequate health workers but also some areas which included remote areas in the Western Region.
Commenting on the same issue, the GMA stated that the matter of chronic shortage of health professionals in deprived areas, especially in northern Ghana, should be a matter of concern to all actors in the health delivery programme.
In an interview , the General Secretary of the association, Dr Sodzi Sodzi-Tettey, said while the startling doctor/patient ratio was an issue, equally important was the challenge of securing the right mix of professionals.
“We know, for example, that the Upper East and Upper West regions have only one obstetrician-gynaecologist each, with dire implications for the reduction of maternal mortality.
“But as serious as the issues are, our solutions have up till now only been limited to banal appeals to people’s consciences and the writing of critical editorials in the national dailies. The fact that the human resource challenge persists after many years of this kind of approach should alert us to look beyond the superficial and adopt bold and pragmatic measures that will give us the skills mix that we desire,” he pointed out.
Dr Sodzi-Tettey said it was in that light that the GMA dedicated the whole of its 51st AGM in November 2009 to the theme, “Towards a Better Health care for Ghana - the Human Resource Challenges and Solutions”, with Vice-President John Mahama as the special guest of honour.
He said following that, the following suggestions had been put forth by the association, including the need for a comprehensive human resource strategy to be designed by the human resource divisions of the Ministry of Health (MoH) and the GHS.
He observed that such a well-thought out strategy would ensure that, as happened last year, doctors would not assume position in the Northern Region and elsewhere in some notion of serving the nation only to have their salaries blocked in Accra, making those doctors the only ones in their facilities to return to Accra and spend months chasing salaries from one department to another.
He also said there should be an end to the situation where once a doctor accepted posting to a deprived area, he/she virtually became a prisoner in that area, with little or no opportunities for scholarships and further professional/career advancement.
He touched on the lack of accommodation, adding that “it may surprise you to know that if some deprived places were to be flooded by even 20 nurses, there would be no accommodation for them”.
The GMA General Secretary pointed out that contrary to popular belief, there was no deprived area incentive or allowance that was given to the doctor serving in an area like Bongo in the Upper East where the doctor/patient ratio is 1:82,000.
“Till we come to the point that others have in other countries of creating significant disparities in salaries and emoluments between doctors and other health professionals working in rural/deprived areas and in more endowed ones, we will not understand what it will take to start reversing this trend,” he stated.