Deal to save Ghana's crumbling health system

By rights it should have been one of the happiest moments of Mary Amponsah's life, taking her newborn daughter home from the Koste-Bu Teaching Hospital in the Ghanaian capital, Accra.

But without means to pay for neo-natal care needed after delivery, Mary will have to be content with stolen glances behind glass, banned from even holding her baby until she comes up with $300 to pay for emergency services.


"We've been here for ten days and I just want to go home, and take my daughter with me," said 38-year-old Amponsah, staring sorrowfully at her swaddled infant.


At a time when Ghana is being held up as an example of progress in Africa, among the chosen few to benefit from every development scheme to lift the continent from poverty, the country's health care system is in a disarray that could have disastrous consequences for generations.


There are just six doctors for every 100 000 Ghanaians, according to the Organisation for Economic Cooperation and Development (OECD), most of them attracted to Europe and the United States for their higher salaries and greater opportunities.


"Funding from the 2005 budget for the health sector has decreased by percentage, staying roughly the same as it has been for many years even as the budget gets larger," one senior Health Ministry official said.


"And the brain drain has greatly affected any effective health care delivery, not to mention our inadequate supply of equipment," he said.

"I know of many doctors who have left in disgust because they have seen people die needlessly because of the absence of basic equipment, especially in rural areas."


Problems with the health care system are particularly acute when dealing with easily treatable diseases such as malaria, which kills more than 100 Ghanaians every day, said Constance Bart-Plange, director of the National Malaria Control Program.


The shortage of doctors and nurses means longer lines at hospitals, which exposes people to germs, bacteria and contagious illnesses that could compound their own maladies.


Hospitals and clinics that fall into disrepair are magnets for mosquitos in humid climates like Ghana's, which means that people who go into hospital for one treatment often find themselves at home with a case of malaria.


"Treating malaria is relatively inexpensive and easy, yet we are losing 107 of our brothers, our sisters and our children every day to this disease," said Bart-Plange. "It's disgraceful that Ghanaians do not seem to care."


A lot of hope is pinned to the successful implementation of a national insurance scheme that aims to provide basic coverage to even the poorest among Ghana's 20 million people.

The scheme aims to completely replace the cash-and-carry system that has been in place for two decades that requires patients to pay for services up front, a policy that put even basic health care beyond the reach of many in a country where millions live on less than one dollar per day.


Ghana's inclusion in a new plan by the Group of Eight leading industrialised nations for debt relief means that there may be enough money available to invest in improving the health care system, fund new technology and perhaps pioneer treatments for diseases like malaria.


President John Kufuor was one of eight African leaders representing the continent at a G8 summit last week in Gleneagles, Scotland at which the world's leading industrialised nations committed an extra $25-billion annually to development aid.


"We have a really good chance now, with Ghana being eligible for debt relief, to provide some level of health care for everyone," said another senior Health Ministry official.


"It means better packages for our health care professionals and help the government upgrade health facilities, especially in the rural areas that are home to more than half of our population."