Chapter 2 Overview of the Health System in Ghana

Chapter 2

Overview of the Health System in Ghana

The health care system in Ghana is confronted with the formidable task of improving and guaranteeing the health and well-being of the Ghanaian people. The health system has the responsibility of combating illnesses associated with poverty and lack of education; at the same time, it has to deal with a growing population, inadequate funding and resources, and an increasing burden on the health care system due to the HIV/AIDS epidemic.

This chapter provides a brief overview of the health care system in Ghana as it relates to infrastructure and outpatient services. The chapter provides a context in which to view the findings of the Ghana Service Provision Assessment (GSPA) survey.

Information is presented with respect to the following:

? Relevant history, including health sector reforms and reforms in drug policy ? General organization of the health care system ? Health facilities ? Health manpower ? Public health programmes ? Health insurance.

2.1 History

2.1.1 Overview of the Health Situation

The health of Ghanaians has been improving since Ghana's independence in 1960. Infant mortality rate (IMR) among Ghanaian children has fallen from 133 deaths per 1,000 live births in 1957 to 57 deaths per 1,000 live births in 1988, and the under-five mortality rate (U5MR) has decreased from 154 deaths per 1,000 live births in 1957 to 110 deaths per 1,000 live births in 1988 (Ghana Statistical Service and Macro International, 1999). Although improvement has been seen, the Ministry of Health (MoH) is of the view that rates of change have been slow, with current rates still far from desirable. The national level rates obscure the substantial differences that exist between groups and sectors of the country, and this is of great concern to the MoH. For example, IMRs vary from less than 57 deaths per 1,000 live births in the southern part of the country to over 100 deaths per 1,000 live births in the northern part.

Table 2.1 shows the major endemic health problems of various age groups in Ghana according to the Ministry of Health. The primary causes of preventable deaths in children under five years are malaria, malnutrition, diarrhoea, and acute respiratory infections (ARI).

With the current gross domestic product (GDP) estimated as US$390 per capita, Ghana faces economic challenges, which are reflected in Ghana's poor state of health. These economic conditions make the choices of how to use Ghana's scarce resources to positively affect health care all the more important.

2.1.2 Health Sector Reforms

The health sector has seen many changes during the past decades. Initially, the MoH assumed the role of the sole provider of services with collaboration from the missions and the paragovernment institutions such as the military, the police, and the mines. Its services were oriented more toward curative care than preventive care and involved programmes that were to a large extent donor driven.

OVERVIEW OF THE HEALTH SYSTEM IN GHANA 13

Table 2.1 Burden of disease

Age group

Disease (percent)

Disease (percent)

Disease (percent)

Disease (percent)

Disease (percent)

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