The Role Of Physician Assistants In Primary Health Care Delivery

Health care in Ghana is a fundamental human right that every citizen is entitled to. This sterns from one of the major declarations from Alma-Ata conference, which states that health is a fundamental human right and the attainment of the highest possible level of health is the most important World-wide social goal. Primary Health Care (PHC) is essential health care made universally accessible to individuals and families in the community by means acceptable to them, through their full participation and at a cost the community and the country can afford. The aim of primary health care is the attainment of better services for all. That is, through prevention, curative, promotion and rehabilitative care.

In Ghana, the people tasked with providing primary health care include Physician assistants. A primary health care provider (PCP) is a health care practitioner who sees people that have common medical problems. This article will look at Physician Assistant roles in primary health care, and their history behind the profession in Ghana.

In Ghana, the training of Physician Assistants can be traced back to the mid-60s. During this time, the training was meant to give the trainees the necessary skills to enable them to cater for certain specific purposes and the training was controlled by the ministry of health.it was done on an ad-hoc basis. Later on, the demand for Physician Assistants became increasingly high. There was an acute shortage of trained Physician Assistants and the few that were available were not equally distributed across the country. For this reason, an institution was established at Kintampo. It was the first of its kind to be set up by the Ministry of Health. It was called the Rural Health Training School and it was used to train health professionals with an aim of distributing them to the areas that were affected by the shortage of qualified health professionals, especially the remote areas of the country. The training offered was specifically structured to enable them work as clinicians in the different health centres across the country. The title given to them was that of “health superintendents”

The scope of practice for Physician Assistant is set by state laws and regulations, which define the types of services they can provide and the conditions in which they are allowed to provide them. A physician assistant is required to have acquired physician assistant degree which is purse for four years. It also requires an intensive training in the medical field. This program involves a lot of clinical rotations to prepare the student to face the health needs of the society. To start practising, graduates has to MEDICAL AND DENTAL COUNCIL (MDC)’S EXAMINATION. After appropriate orientation and supports, sites, introduction of Physician assistant into family medicine, primary care, and health care delivery should experience the following benefits: increased patient access, increased patient attachment, improved communication and documentation, improved quality of care etc

In this article, the role of physician assistant would be clearly stated since most Ghanaians do not have in-depth knowledge about physician assistant in the provision of appropriate health care delivery.

ROLES OF PHYSICIAN ASSISTANT IN THE HEALTH SECTOR

The roles of physician assistant in health care delivery can be divided into clinical roles and non-clinical roles. The clinical roles include the following;

CLINICAL ROLES

The clinical roles as outlined in the job description of PAs include:

Assess and prioritize patients presenting at Health Centers/polyclinics or hospitals, according to their medical need. This is achieved via:

Undertaking confidential patient consultations consisting of:

1. Take or review patients’ medical histories
2. Examine patients
3. Order and interpret diagnostic tests, such as X-ray, blood tests, electrocardiogram (ECG)
4. Diagnose a patient’s injury or illness.
5. Prescribe medicine
6. Initiate and implement care plan for patients; emergency cases, minor surgical interventions, O & G cases, paediatric/geriatric cases, chronic ailments, EENT cases, etc. etc. according to training and competence. PAs also offer primary care to patients with mental health problems and refer as appropriate
7. PAs are also to participate in Clinical meetings, Morbidity/mortality meetings and general staff meetings etc
8. Conduct or participate in outreach programs, talking to groups about managing diseases and promoting wellness.

NON CLINICAL ROLES

EDUCATION ON HEALTH ISSUES THROUGH COMMUNITY WORK

The Physician Assistants usually work in health centers which are based at the community level by participating in the outreach community health activities within their catchment area like organizing clean-up exercises through this educate them on the need to keep their environment clean and the importance it brings to their health and well-being this is most effective if the chiefs, elders and opinion leaders of the community are involved in health programmes. They also organize durbar to educate the community on maternal and child welfare, family planning programmes, cleanliness and many others.

ADMINISTRATIVE AND MANAGEMENT

In many sub-districts in the country, the health team is headed by a Physician Assistant, they ensure day-to-day management of the health centre as well as the supervision of other health stations within the sub-district thus Community clinics, CHPS compounds, urban CHPS, maternity homes and others. They prepare and plan and budget make periodic reports on the activities of the health centre and other health stations in the sub-district, alongside devising improved job methods for increasing efficiency and efficacy in the health centre. Another major role they play is to supervise revenue collection as well as ensuring strict accountability at the health centre. In fact due to the non-availability of funding to the Municipal or District health directorates from the government of Ghana in recent years, the health centers have become the financial backbone of the health service in the municipal or district health directorates.

RESEARCH RESPONSIBILITIES

Physician Assistant also undertakes surveys and researches in the catchment area on various issues including the most common local endemic diseases, their causes, how to prevent them, and also procuring of equipment when there are outbreaks since the trends of these diseases have been studied.

WRITTEN BY:

OPPONG FELIX

PHYSICIAN ASSISTANT STUDENT, LEVEL 200

UNIVERSITY OF CAPE COAST (UCC)