MOH/Partners Review Summit opens

Accra, April 26, GNA - Major Courage Quashigah (rtd), Minister of Health, on Tuesday noted that coverage of key health indicators had been lower than anticipated and if steps were not taken to improve performance, Ghana might not achieve the Millennium Development Goal (MDG) for health.

"Urgent actions are, therefore, required to reverse this trend and scale up priority health interventions to meet the millennium target for health by the year 2015."

Major Quashigah, who was addressing participants at the First Ministry of Health (MOH)-Partners Health Summit, noted that the health sector was under-funded.

He said the per capita expenditure on health of 13.50 dollars as at last year was still far short of the 30 dollars to 40 dollars required to deliver a minimum package of health interventions.

The Minister said the Government was, therefore, keen in working with its partners to identify and implement the priority and essential actions required to scale up priority health interventions and also increase its financing to the health sector. Health partners from both local and foreign communities as well as representative from Mali and Burkina Faso are attending the five-day summit, which provides a forum for dialogue and collaboration between the Government and its development partners.

Participants would also review the Programme of Work (POW) of the health sector for 2004 and identify challenges to be jointly addressed. Major Quashigah enumerated some selected interventions to improve performance, which include the placement of health sector investment at the centre of the National Poverty Reduction and Growth Strategy. The Minister said the MOH would urgently review the sector-wide approach to create an environment for harmonizing and aligning donor fund in support of sector priorities.

He said other interventions included ensuring improved resource allocation to the sector, as well as an improvement in inter-sectoral advocacy and action, which would cover sanitation, vehicular traffic accidents and HIV/AIDS.

Major Quashigah said since the provision of quality health involved other sectors such as education the Ministry would engage the Ministry of Education and Sports and other sectors in the planning and implementation of health activities.

He further noted that the contribution of the health system to improved health had been clearly demonstrated in the Upper East where in spite of little change in poverty and education levels in the population, under-five mortality rates dropped by 50 per cent between 1998 and 2003 through the implementation of high impact and rapid delivery programme.

"What is required to replicate such good practices nationwide include improving availability and accessibility to health services particularly in deprived areas, enhancing health institutional and organizational arrangements to ensure better coordination of efforts, straightening the role of the private sector and ensuring sustainable financing that protects the poor," he said.

Major Quashigah, therefore, urged the country's development partners to consider retaining their health and other sector specialists even as they moved into budget support under the Multi-Donor Budget Support (MDBS) mechanism, which was to be the main instrument for donor support.

He said the Government was committed to sustaining the health sector policy dialogue and any decision by partners to withdraw their sector specialists would undermine the quality of the policy dialogue in the health sector.

Dr Jan Van der Horst, Health Adviser at The Netherlands Embassy, who presented a joint response from partners on the 2004 Health Sector Review of its Programme of Work (POW), said partners were worried about the slow pace of implementation of the National Health Insurance Scheme. He also mentioned the lack of improvement of key health indicators over the last three to four years, despite increases in health sector spending and attributed the lack of progress to technical flaws, imperfections in support and management systems, institutional weaknesses and insufficient inter-sectoral collaboration.

Dr Horst said the partners recommended that attention be placed on public health programmes including the maintenance of high quality and coverage of immunization programmes, effective mother and child care interventions, increased coverage of family planning activities, improved malaria and TB control programmes and highly effective HIV/AIDS interventions.

The partners urged the Ministry to rethink how it set its targets, saying the current POW included some ambitious targets which were not always accompanied by key interventions and would be difficult to reach given limited resources.

He said targets should be based on technical analysis of what was feasible and discussed and agreed upon by the various bodies at all levels of the health system.

"Targets should be ambitious, but also realistic, so that stakeholders are not disappointed by underperformance and staff would continue to be motivated," Dr Horst said.

Dr Horst said the partners endorsed the recommendations of the annual review report to maintain and adequately fund the exemption strategy, which covered children under-five, pregnant women and the aged until the NHIS became fully operational.

He also commended the health sector for the establishment of a management information system that was shared by all actors in the sector and pledged their support in ensuring the development of a comprehensive, integrated information system.

He further commended the MOH on the institution of the Additional Duty Hour Allowance, car loans and accommodation for health professionals as incentives as well as the deprived area incentives. These, he said, could motivate and prevent them from looking elsewhere for greener pastures.