Since Ghana’s independence fifty years ago, various governments have been challenged with the task of improving the country’s health care system. In part three of our series focusing on the country in the run-up to its historic anniversary celebrations on March 6, we take a look at what progress has been made in the country’s health sector.
Professor Agyeman-Badu Akorsah, the director-general of Ghana’s health services, candidly admits that the country has achieved “mixed success” in its bid to ensure health for all Ghanaians. He looks to the past to apportion blame.
“The colonial legacy in the health sector was pretty bad; hospitals had been built for the Europeans, and Ghanaians had virtually nothing to contend with – a little medical folds unit to deal with some public health problems, but that was about all,” the pathologist said.
After independence in 1957, the situation improved, Akorsah said.“The first government set out to develop health infrastructure; the government made a bold initiative of starting a medical school in Ghana and starting with (employing) Ghanaians.”
Akorsah enthused that Ghana’s first medical school became “one of the best” such schools in the world. “Graduates from the medical school were everywhere,” he said.But, Akorsah explained, Ghana receded into terms of quality healthcare when subsequent governments failed to invest in the system.
“We have a policy that every district should have a hospital … but this is difficult (to accomplish) because building a hospital is a lot of money. And therefore we are heavily reliant on support from donors … So what I will say is that the amount of investment in health certainly has not been the best. And I think this would be applicable to all regimes. Some people have invested more in health; others have not,” he revealed.
A “brain drain” of health professionals leaving Ghana to seek their fortunes elsewhere had also taken its toll on the delivery of quality heath care in the country, he said.
“Seriously, it is one of my greatest headaches as the director general of the Ghana health service. We have facilities that should be manned by doctors where we don’t have doctors, so at every level you realize that you have to make serious compromises. And that for me is difficult, because if somebody goes to the hospital, the person should get the best (treatment). Currently in Ghana there are more doctors that trained outside Ghana, than (those that have) trained in the medical schools in Ghana. And that is a sad state of affairs,” he lamented.
Akorsah also bemoaned a policy that made it “easy” for health professionals to leave without “serving the country”.
He said, “We are not training enough (health professionals) - but even the few that we are training, we are unable to keep them here. And we allow them three degrees of freedom to explore the world, and Ghanaian doctors and nurses are almost everywhere in this world.”
But he was confident that Ghana could reclaim its past glory in having one of the best health care delivery systems in Africa.
“We must learn from India and Thailand; they’ve invested in private healthcare that has brought back a lot of their competent professionals from the UK and the USA. Because if they (Ghana’s health professionals) go to the private sector, they earn as much as they probably would earn in the UK and the USA, but then have the greater opportunity to acquire a lot of experience. So, one of the major attractions of the huge number of Ghanaian professionals … is our ability to develop the private sector, and create health tourism out of that,” Akorsah elaborated.
Ghana should institute a policy to ensure that a nurse would serve each and every community in the country, he said.
“The policy of putting a community nurse in every community is something that I want to see pursued to its logical conclusion. The advantage there is that the community health nurse serves as the health educator in terms of nutrition. That by itself is likely to cut the burden of disease tremendously. I want us to seek to grow as many of our health professionals (as possible), because we’ve got the capacity to do it. It involves investment,” Akorsah said.
