Let Free Medical Care Link Into School Health

The attempts to support and bring people up from the poverty ladder are commendable. They come in very refreshing and leave you believing that there is hope for the future. Life may never be fair, but I believe fairness is always within our reach.

That is why I laud the drive of the Department of Social Welfare for the painstaking job they are doing in the collection of data for the Livelihood Empowerment Against Poverty (LEAP) programme.

They may not be adequately equipped in their jobs, but a visit to their head office at the ministries last week gave me a satisfying feeling that serious work actually goes on in some departments within the Civil Service.

Last week saw a further boost in the cap of the LEAP, one of the social intervention programmes introduced by the last NPP administration.

According to a Daily Graphic story published last week, as many as 17,341 children under 18 years and the elderly above 75 would have free medical care. These would not be required to pay the National Health Insurance Scheme (NHIS) registration fees.

Is it not encouraging that the LEAP programme is being looked at with microscopic lenses in the bid to improve and widen it? Already, 26 more districts have been added to the number where the NPP government left off, bringing the number of beneficiary districts to 80.

In a 'fact-finding' trip to the Department of Social Welfare last week, the Assistant Director, Lawrence Ofori-Addo, who willingly and readily spoke to me with so much passion, told me about all the things being added to the LEAP programme in order to move the beneficiaries at the bottom of the poverty ladder up.

For this reason, therefore, other pro-poor interventions such as fee-free education, free school meals, free uniforms, free textbooks, and free health care have been introduced or are being considered.

In a very insightful interview with the Assistant Director at the Department of Social Welfare, between GH¢8 and GH¢15 paid out per month to beneficiaries of the LEAP programme alone is not enough to achieve the main objective driving the introduction of the programme — to move them out from the bottom of the pyramid.

That is why currently, in conjunction with the Ministry of Health, the Ministry of Education and the Ministry of Employment and Social Welfare are seriously looking at certain interventions to support the beneficiary families.

The intervention is laudable. Of course, I am a dutiful student of the old thought that you teach people how to fish for themselves and not provide them with fish all the time.

But when people are terribly hungry, they need help with whatever morsel in order to gather up their strength to go fishing.

The Free Compulsory Universal Basic Education (FCUBE) policy has helped so far, to get a sizable number of children to be enrolled in school. Good!

The Ghana School Feeding Programme has added to the attractiveness in being in the classroom as opposed to loitering. Great!

Thankfully, we now are going to add free school uniforms and books.

Excellent! All these education support mechanisms lift a chunk of financial burden off the shoulders of the parents in the LEAP programme.

The case of free medical care now being extended to 28,434 children and the aged in 54 districts nationwide who are already beneficiaries of LEAP is welcome news.

According to statistics available, only 16 per cent of those at the bottom of the pyramid have enrolled in the NHIS obviously due to affordability. This figure compares to 40 per cent enrolment in other income earning households.

A Memorandum of Understanding (MoU) signed between the Ministry of Employment and Social Welfare and the Ministry of Education ensures that children in the LEAP programme enjoy all free education initiatives currently being implemented by the education sector.

But just as education is key to lifting people out of ignorance and poverty, so is health critical in the development of people.

That is why I welcome with a gladdened heart the joint move by both the Ministry of Health and the Ministry of Employment and Social Welfare to release GH¢41, 358 to facilitate free medical care for beneficiary children and the aged under the LEAP programme.

The money has been released to the respective District Mutual Health Insurance Schemes through the National Health Insurance Authority (NHIA).

Indeed, we are on the right track and will definitely get somewhere one day with abject poverty, ignorance and diseases drastically reduced, if not eliminated.

We however, need to move a few more steps forward. Yes, free medical care is all well and good for the vulnerable children.

However, if the system continues to remain as it is with overcrowding, long waits at the out-patient departments, poor record keeping, poor attitudes of health personnel and the like, then being on free medical care will not be a joy. If the drugs would be available for people to access, if children within the school age could be allocated a waiting area in all NHIS hospitals and clinics and attended to with much speed, then free medical care will make much sense.

At the moment, the NHIS is not working to the satisfaction of contributors. What the Ministry of Health needs to do is to begin to take advantage of the NHIS to extend much-needed health programmes and interventions in our schools.

The Ministry of Health now needs to focus attention on a dedicated school health programme firmly based at the district level, working in close conjunction with the Ministry of Education and the Ministry of Employment and Social Welfare.

It should be feasible for the Ministry of Health, through its district health offices, to have a liaison desk that is specifically dedicated to schools.

The focused jobs of these district school health offices would be to, on a monthly or quarterly basis, visit the schools under them and administer health care to them.

These would be the times when health screenings are done on the children, immunisations given where necessary, deworming carried out, nutritional programmes given and basic health advice given. It should be a permanent feature and not haphazardly done.

Through such regular school health interventions, referrals could be made for children with learning disabilities to receive help rather than dismissed as unintelligent, referrals where children with sight, hearing or speech defects could be helped, so they do not grow up with disabilities that will cut short their search for knowledge and a better future.

There are many children who have sight or dental problems, for example, but not identified early enough for help, either due to parents not being able to afford or out of ignorance.

Our approach to reducing poverty and ignorance should be a holistic one, tackling all the facets that contribute to development. Tackling one and leaving the others is only a half-baked pastry. It is of no benefit once it is taken out of the oven.

That is why I will always refer to good and practical examples elsewhere which we can steal with pride to better our system.

In Britain, for example, advanced as they are, they have their fair share of social problems as well. They have the rich and the poor, the haves and the have-nots. That is why they have social interventions to try and bridge the gap.

They also indeed have their equivalent of LEAP. They have used a three-pronged approach to tackle theirs —education support, health support and financial support.

The British main stream education has a school health service in each education district working hand in hand with education welfare departments.

The school health nurses, doctors and child psychologists visit their allotted schools regularly to conduct medical inspections and attend to cases referred to them by school welfare officers.

The doctors refer those who need specialists care and do follow-ups sometimes, including home visits. From this approach, they are making sure that schoolchildren are receiving the best of care and focus.

As we welcome free health care for the vulnerable schoolchildren in the 54 already identified districts under the LEAP programme, let our district health offices throw in some innovation by taking health care that will directly benefit our children to their doorsteps — the schools.

We have too many good policies gathering dust in cupboards and on people's desks. All it needs is strong will, commitment and a stronger leadership direction at the various implementation stages to convert them into action.

Free medical care should provide an easy linkage to the creation of district school health departments overseeing regular health checks at our schools. The benefits would be enormous.

Credit: Vicky Wireko/Daily Graphic