Ghana’s health sector makes progress- study

By: Fred Yaw Sarpong

A study from the Overseas Development Institute (ODI) shows that Ghana has made progress in the health sector, stating that Ghana stands out in the region and also among lower- middle income countries worldwide.

The ODI report said child nutrition outcomes have improved consistently, and Ghana outperforms other countries in the region on most nutrition-related indicators. The report ranks Ghana 13th out of 51 countries for reductions in child stunting measured by deviation-from-fit.

It said there has also been impressive progress on immunization, which has been a priority under the strategy of the Ministry of Health (MoH) to enhance preventative health care.

The report noted that between 1998 and 2008, child immunization rates increased dramatically, from 19% to 70% (Ghana Statistical Service, 2009). By 2008, Ghana’s measles-vaccination rate stood at 91% – well above the regional average of 75% – and there had been no death from measles in the country for seven years. This progress , it said has been supported by national outreach campaigns such as the Expanded Programme on Immunization and National Immunization Development Days have both contributed to these high rates.

 It said Ghana was also the first country in Africa to simultaneously introduce the pneumococcal and rotavirus vaccines to tackle pneumonia and diarrhoea, two of the biggest killers of children in the country. These vaccines were made available from every health clinic and the efficiency of this campaign and its effective outreach strategy have been highly regarded, offering insights for other countries in the region.

‘‘Ghana’s child mortality rate does, however, remain relatively high at 78.4 deaths for every 1,000 live births. While this is lower than the sub-Saharan African average of 92 deaths per 1,000 (2013), it remains higher than the lower-middle income country (LMIC) average of 59 death per 1,000 (2013). Persistent inequalities in children’s access to health services and remaining deficiencies in the quality of the health services provided, particularly in more remote areas, have been holding back Ghana’s progress in reducing child mortality,’’ said the ODI report.

The study also mentioned that Ghana remains one of the better-performing countries in sub- Saharan Africa, where maternal health has been neglected until only recently.

‘‘There have been recent efforts to accelerate Ghana’s progress in maternal health, and one senior health official interviewed for this case study stated that the MoH is conscious of its shortcomings in this area and confirmed that this is a key priority for the Ghana Health Service (GHS). In 2008 Ghana declared maternal mortality a national health emergency, and in 2011 the GHS agreed a MDG acceleration framework with its development partners. Three priority interventions areas were identified under this agreement: family planning, skilled delivery and emergency obstetric and new-born care”, it said.

The report said the major achievement in the health sector in Ghana has been the creation of a country-wide national health- insurance scheme. It said Ghana is one of only a handful of countries worldwide with established universal health coverage and is among the very few non-OECD countries to have such a scheme. ‘‘The National Health Insurance Scheme (NHIS) was introduced in 2003 to replace a ‘cash-and-carry’ system in which patients were required  to pay a user fee with a new approach based on low premiums and exemptions for vulnerable populations,’’ the report noted.

The team said many interviewees for this case study credited the introduction of this scheme with having had the biggest impact on health-service access of any policy, and the accompanying increase in health infrastructure and trained medical staff to accommodate more patients and cover remote areas has been instrumental in translating this policy into improved health outcomes.

‘‘The introduction of the NHIS has also had an equalizing effect on access to health services through its fee exemptions for vulnerable groups and the expansion of health clinics into more remote rural areas. To ensure the affordability of care, the NHIS provides heavy subsidies for vulnerable populations. It also set up accreditation to ensure an improvement in quality standards. The benefits package covered by the NHIS is also quite comprehensive; as a result, claims have increased substantially,’ it added.