Gh a n a Population over 65 3% Commonwealth Health Partnerships 2015 177 The Ghana AIDS Commission, which is largely supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as international donor agencies, has stated that the Eurozone crisis has badly affected its funding. For definitions, sources and explanations on the Millennium Development Goals see page 314. Universal health coverage Some 43 per cent of health care in Ghana was paid for by patients or funded by other non-governmental entities – such as private insurers, charities or employers – in 2012. Total health expenditure constituted 5.2 per cent of GDP in 2012, of which 57 per cent (US$47 per capita) was covered by the government. The mandate of the GHS is to provide a comprehensive and accessible health service, with special emphasis on primary health care at regional, district and sub-district levels. In 2005 the National Health Insurance Scheme (NHIS) was introduced nationally with the aim of ensuring access to free basic health care services to all residents. People pay a levy of 2.5 per cent on certain goods and services, and a 2.5 per cent monthly payroll deduction. Those working in the informal economy can also contribute via a slightly different route. The poorest people, pregnant women and children are exempt from premium payment. The NHIS funds health services, including outpatient consultations, essential drugs, inpatient care and hospital beds, maternity care (including caesarean delivery) and eye, dental and emergency care. However, some services are excluded, often due to cost. Exclusions include cosmetic surgery, some drugs (including antiretroviral treatment), assisted reproduction and organ transplants. The government has also been implementing strategies to promote universal health care based on the Ouagadougou Declaration for Primary Health Care and Health Systems. A close-to-client service delivery model has been adopted through Community Health Planning and Services since 2000. Within this model, community health nurses are placed in communities to offer public health, outreach and some clinical services, functioning as the first point of contact and referral. The One Million Community Health Workers Initiative was also established to tackle the shortage of health care professionals. Two current campaigns include a package of care aimed at pregnant women and newborns, and the National TB Control Programme. However, despite the efforts of the GHS, people in rural areas can often be some distance from the nearest health post, making it difficult for them to obtain even basic health care. In rural areas, consequently, there is still a big market for locally available traditional medicine. The WHO Country Co-operation Strategic Agenda 2008–13 identifies a need to intensify efforts to prevent and control noncommunicable diseases, as well as strengthening the health system, with a focus on primary health care. Ghana has signed and ratified the International Covenant on Economic, Social and Cultural Rights, which includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination. Care of the elderly: Around 900,000 people in Ghana are over the age of 65 – three per cent of the total population (2013). At the age of 60 a person living in Ghana can be expected to live for an additional 15 years, on average (2013). Overall, public pension spending is equivalent to 1.3 per cent of the country’s total economic output (2010). In 2010 the government approved a national policy on ageing. Initiatives include offering hearing aids and glasses to those who need them and exempting the over-70s from contributing to NHIS, while ensuring that free medical care is still available to them. The GHS is also working to improve its offering to the elderly, encouraging attendance at clinics and giving staff additional training in geriatric care. Undiagnosed and untreated hypertension among older people is another priority that has been identified. Mercy Mission operates a nursing home in Accra. There are also private home help services for the elderly people who can afford them, as well as some charities providing assistance. As in most African countries, many elderly people are cared for by members of extended family. Further information Ministry of Health: www.moh-ghana.org Commonwealth Health Online: www.commonwealthhealth.org/health/africa/ghana
Commonwealth Health Partnerships 2015
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