UAHCC’S REVIEW OF GOVERNMENT’S PERFORMANCE IN THE HEALTH SECTOR FOR 2014.

Accra, December, 10, 2014—It's almost two years since the Mahama led-government was given the mandate to rule Ghana. They introduced the “BETTER GHANA AGENDA” and detailed out the various initiatives that they will like to implement especially for the Health Sector. The Universal Access to Healthcare Campaign strongly supports government in its quest to make healthcare accessible to all Ghanaians.

This press release will access the promises made by the NDC government in its 2012 Manifesto and compare it with 2015 budgetary allocations attached to each promise. Then afterwards, we will make some remarks and offer some suggestions to government which will help Ghana move closely to achieving Universal Health Coverage. Our observations of the implementation of the Better Ghana Agenda vis-à-vis the 2015 Budget are as follows:

Promise	Action	UAHCC's comments or questions
Training of Medical Practitioners The government promised to increase resources for the training of medical doctors in order to reduce the patient-doctor ratio and the long waiting times in our hospitals	We have not seen any specific action on this yet	Ghana's health human resource is inequitably distributed. Some districts in Ghana do not have one medical doctor at post. Government must do more in this area.
The government promised to double the number of compounds for CHPS from about 1600 to about 3200 to meet the needs of under-served communities	724 CHPS Zone were made functional in 2014. In 2015, Ministry will pursue expansion and construction of CHPS Zones and compounds nationwide. By the end of 2014, there will be 800 functional CHPS zones.	What happened to government's promise to double the number of compounds for CHPS services from 1600 to 3200?
The government also promised to establish new district hospitals and more polyclinics in each of the ten regions	37 million Euros to construct 15 polyclinics in Central Region and Greater Accra. The beneficiary communities are Central Region (Gomoa, Dawurapong, Besease, Biriwa, Etsii Sunkwa, Asikuma Gyamena, Agona Duakwa, Binpong Akunfude, Ekumfi Naakwa, Twifo Atimokwa and Gomoa Potsin) and Greater Accra (Adentan, Ashiaman, Bortianor, Oduman and Sege) The following constructions are on-going across the country: 600-bed University of Ghana Teaching Hospital 420-bed Ridge Hospital Expansion Project 500-bed Military Hospital Project in Kumasi 2nd Phase of the Tamale Teaching Hospital The Police Hospital Project Ashanti Regional Hospital at Sewua-Kumasi Upper West Regional Hospital	This is commendable. More needs to be done to ensure that every Ghanaian has access to healthcare.
The government promised to establish new infectious diseases management centres	Government has set up an isolation and disease management centre at Tema. The centre at Tamale is currently under construction to be followed by the centres at Kumasi and Tema.	We commend government for her quick response to Ebola.
Government promised to establish Regional Hospitals in the Eastern Region at Koforidua and the Upper East Region at Bolgatanga and complete the Regional Hospital project in Wa, Upper West Region.	The MOH completed the Tarkwa District Hospital and 5 polyclinics phase III project at Nkrankwanta, Wamfie, Kwatre, Bomaa and Techimantia in the Brong Ahafo region. Phase II of the Bolgantanga Regional Hospital has been completed.	Eastern Region still does not have a regional hospital and the Regional Hospital at Wa is yet to be completed. The campaign is reliably informed that all Ministries have been banned from taking loans to undertake projects. We will be glad if government can explain to Ghanaians what it will take to complete these projects.
Government promised to upgrade the Central and Volta Regional Hospital into Teaching Hospitals to service the University of Health and Allied Science respectively.	We have not seen any specific action on this yet	These projects have still not received government's attention. We believe that Government must show more commitment to these projects
Training of Nurses & Midwives: The NDC's government promised to expand the existing Midwifery and Nurses Training Colleges and establish new colleges in underserved areas	Some midwifery and nurses training colleges are been expanded with new ones been establish	We commend Government for this but urge government to do more.
Government promised to work with the Nurses and Midwives Council to re-introduce the Certificate in Midwifery Training Programme and in conjunction with the private sector establish more facilities for the training of auxiliary nurses to lower the current nurse-patient ratio	This has been done	Well done, Government.
The NDC promised to provide opportunities for auxiliary nurses, including those under the National Youth Employment Programme to move up the professional ladder.	The auxiliary nurses have been given midwifery training.	Thank you Government
HIV/AIDS: The Mahama-led government promised it has taken appropriate measures to ensure that it will be in a position to provide anti-retroviral drugs to persons living with HIV/AIDS even when donor funds dwindle further. To give meaning to this; government is supporting the new National Strategic with Ghc 150 million	The government has contributed to the procurement of anti-retroviral medicines for persons living with HIV/AIDS.	We commend Government for this but urge government to do more.
Traditional Medicine: Government said it will implement policies on the integration of traditional medicine into the health care delivery system in compliance with the provisions of the Traditional Medicine Practice Act 2000, Act 575	Major health facilities now have Traditional Medical Practitioners and they also dispense both traditional and orthodox medicine	Thank you Government
Malaria: The NDC government promised to extend the on-going free Insecticide Treated Nets (ITN) distribution programme to attain the 2005 Abuja Target of 60% of children sleeping under insecticide treated nets	There is an on-going distribution of Insecticide Treated Nets nationwide	We urge government to ensure that all Ghanaians expescially women, the poor and marginalized have access to these ITN.
Nutrition Government promised to fully support the implementation of the “Good Food for Good Life” campaign by adopting a multi-sectoral approach to include key sector Ministers and other stakeholders.	A National Nutrition policy has been development together with its implementation plan which will involve other ministries apart from the Ministry of Health	This policy should be made public and its implementation should be immediate
Non-Communicable Diseases Government said it will strengthen the Non Communicable Disease (NCDs) unit of the GHS for the prevention, early detection and management of diseases, such as hypertension, diabetes, kidney failure, obesity.	The National Non-Communicable Diseases Policy has been developed.	Government should move to the next stage and implement these policies
The Government promised to roll out Nationwide awareness programmes on screening for Cervical Cancer, Breast Cancer, Cancer of the Prostate and Cancer of the Colon	The National Cancer Strategy has been developed.	We applaud government for putting together a National Cancer Strategy but we urge government to share the policy with all stakeholders and move to the implementation stage.
The Government promised to support Teaching Hospitals and selected District hospitals to provide the necessary curative care for all identified early cases of Cancer.	A Standard Operating Procedure for Maternal and Child Health has been developed. Government has also equipped all Teaching Hospitals with equipment. There has been an upgrading of the Tamale Teaching Hospital in terms of infrastructure.	Government should continue with this initiative and improve the infrastructure at all Teaching Hospitals and the Regional Hospitals.
Again the Government promised to roll out an aggressive public education programme through mutually enhancing partnerships between Ministries of Health, Sports and Education in addition to leveraging the existing school health programmes to address emerging childhood obesity	We have not seen any specific action on this yet	We are reminding government of a yet to be fulfilled promised
NHIS: Government said it will make the NHIS truly national by phasing out the District Mutual Health Insurance Schemes	This is being done.	Thank you Government.
Government promised to improve efficiency in the provider payment mechanism and roll out capitation nationwide	NHIA now uses biometric registration and that has shot the active membership to 10.14 million. A new prescription level has been introduced. In 2015, capitation will soon to scaled up to Volta, Upper West, Upper East, Eastern, Central, Western and Brong Ahafo regions.	This is commendable
Government promised to broaden and expand the National Healthcare scheme for the benefit of all Ghanaians with the NHIL Bill in mind	The NHIA has a new law—NHIS Act 2012 (Act 852. We commend Government for this.	We commend government on this achievement
The government promised to expand the NHIS benefit package to possible cover family planning, mental health, prostate cancer and the physically challenged	The process for the review and expansion of the Benefit Package has began. A stakeholder dialogue was organized and all interested parties were consulted.	NHIA should speed up its work on this and roll out a sustainable Benefit Package for Ghanaians
Government promised to introduce instant NHIS Card issuance to address the inherent challenges in the current ID card management regime	This has been done and it is daily recording new members with instant membership cards.	This is commendable
National Ambulance Service Finally the NDC government promised to procure additional 200 ambulances for the National Ambulance Service to establish Accident Evacuation Service along the major road corridors	Four new ambulance stations were established in 2014. Currently there are 126 stations.	We commend government and urge government to work towards fulfilling its original promise

General Observations
1. The Health Sector budget of the 2015 budget is only 9.47%, a drastic fall of the expected 15% as stated by the Abuja Declaration which Ghana is a signatory. The Health Sector of the 2014 Budget was only 9.26%. The only time the Ghanaian budget met the 15% of the Abuja Target for the Health Sector was in 2005, 2007 and 2013 and that saw a significant improvement in infrastructure, human resource for health training, among others.

2. The current Health Sector budget as contained in the 2015 Budget is as follows:

GHS 1.4 billion( GOG)
GHS 1 billion (IGF)
GHS 713 million (Development Partners)
This means, health facilities will be pushed to raise more revenue and this means, they will be more interested in providing specialist services in order to meet the IGF target.

3. The Universal Access to Healthcare Campaign welcomes government's decision to push for additional VAT on Fee-based Financial Services and Real Estate and proceeds from this will be channeled to the National Health Insurance Scheme.

4. We will want to ask the Ministry of Finance to indicate how much has been gathered from the voluntary 10% percent pay cut from the President and his cabinet as well as government appointees. It was decided that the amount be deducted by the Controller and Accountant General and paid into a fund to be dedicated to the constructions of CHPS compounds focusing on maternal and neonatal health. So how many CHPS compounds have been constructed from this fund? We will like to know.

5. We are urging the Ministry of Finance to publicly declare how much the NHIL Levy has generated over the years and state how much it disburse to the NHIA. We are also urging the Ministry of Finance to work toward ensuring TIMELY AND EARLY RELEASE of FUNDS to the NHIA for its operations.

6. We are also encouraging the NHIA to continue to work towards removing all the bottle necks and make the scheme more efficient and work towards making the NHIS easily accessible to all Ghanaians.

7. The Mahama led government has a little over two years more for this tenure of office to expire. We want to urge government to take a second look at the unfulfilled promises and work toward fulfilling all the promises detailed out in its Better Ghana Agenda.

The Universal Access to Healthcare Campaign will continue to monitor its progress, year after year, to ensure that these promises are all fulfilled and every Ghanaian especially women, the poor and marginalized has access to healthcare without necessary paying for it at the point of use.

SIGNED
Sidua Hor
National Campaign Coordinator
0207708938/0272056410

Editor's Note:

The Universal Access to Health Care Campaign is a National Campaign driven by a network of Local and International NGOs including the Alliance for Reproductive Health Rights (ARHR), ISODEC, Essential Service Platform, SEND Ghana, and Coalition of NGOs in Health.