‘Community-based Health Services need more attention

THE immediate past Director General of the Ghana Health Service (GHS), Professor Agyeman Badu Akosa, has advocated the full implementation of the Community-based Health Planning and Services (CHPS) as a positive step to improve the country’s health care.
He explained that it was the best system that worked in tandem with a conscious effort to improve the social determinants of health at the community level through health education to reduce the burden of diseases and also ensure the financial sustainability of health insurance.
“The rural health programme, CHPS must be rolled out fully without fail. Building regional and district hospitals, and health centres although necessary will not impact on the totality of the health of the people the way the CHPS programme will”, he stressed.
Speaking at an inaugural lecture organised by the Ghana Academy of Arts and Sciences (GAAS) in Accra on Tuesday, Professor Akosa pointed out that human resource for health deficit, poor health financing and a weak governance and leadership regimes, among others, have made the health sector “very sick”.
“For many health professional groups, the country is operating on 10 to 30 per cent on need. Doctor: Patient ratio is 1:10,900. How do we get to 1:5000 by 2015 and 2020?”, he queried.
Speaking on the topic: “Treating Ghana’s Sick Health Service’’, he said the mal-distribution must be tackled with a committed political will.
Professor Akosa pointed out that health financing of about $40 per capita was woefully inadequate, adding “how could personal emoluments be 94.4 per cent of Government of Ghana budget for the health sector when we require more than twice the number of all categories of staff?”.
Professor Akosa said Ghana had been a beneficiary of a lot of Global Health Initiatives and pointed out that the Global Fund had contributed millions of dollars for HIV and AIDS, malaria and tuberculosis among other interventions from other sources.
He said the impact although significant had fallen short of expectation because of the underlying weak health system.
He said Ghana was not on track to achieve the health related Millennium Development Goals (MDGs 4, 5 and 6) and targets by 2015.
“The 2008 Ghana Democratic and Health Survey show under five mortality and infant mortality of 80 and 50/1000 live births and Maternal Health Survey 2007 show maternal mortality ratio of 451/100,000 live births”, he stated.
Professor Akosa said Ghana being signatory to the many international conventions and treatise on health, “it is amazing how we have failed to fully and successfully implement any of them, the latest being the Framework Convention on Tobacco Control.”
“We appear unable to ban smoking in public places even though the evidence is overwhelming. We seem trapped in a bubble of political inertia or in a state of paralysis that permits extraneous influences”, he pointed out.
Information provided by the academy as part of the lecture indicated that Ghana’s Health Service had over the years embarked on and successfully executed many if not all, the externally introduced health reforms which is much acclaimed by the international world and development partners.
It added that most of the reforms, however, had not translated into the expected health indices because of lack of support for scaling up the useful interventions.