Financing Health Care In Ghana To Accelerate The Achievement Of Universal Health Coverage: The Way Forward

Universal Health Coverage is one of the major milestones of Goal 3 of the Sustainable Development Goals (SDGs). Universal Health Coverage (UHC) means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course (WHO).

One key factor that drives the achievement of UHC is financing of health care. In Ghana, Health care is largely financed by Government and Donors. Since the year 2000, Government has spent less than 5% of Gross Domestic Product (GDP) on health care. This level of investment in health care is woefully inadequate. Research shows that Government will need to increase investment in health, at least by up to 10% of GDP to achieve desired levels of quality and coverage of health care in the Country.

Unfortunately, having attained a lower middle income Country status, donor funding towards health care is beginning to dwindle.

Government therefore needs to step-up its role in health financing to accelerate the achievement of UHC. The current high level of medical tourism among politicians and many affluent Ghanaians to the United Arab Emirates, South Africa, India, United Kingdom, United States of America and many other Countries is a reflection of the consequence of under investment in health care.

The Way forward for Health Care Financing

According to the WHO, raising domestic public funds is essential for UHC. No Country has made significant progress towards UHC without increasing reliance on public revenues. Therefore, domestic tax systems that are essential to support the Country’s fiscal space expansion are central to the UHC agenda. This is the main reason why I will advise Parliament to approve the Electronic Transactions Levy Bill into law, at least if not in its current form but in a modified form to take in the opinions of Ghanaians on the rate to charge. If revenue from the levy is used judiciously, it will forestall frequent Government borrowing and its related issues.

While the level of revenue matter, the allocation and use of these revenues are two crucial elements in supporting effective progress towards UHC.

Public Financial Management (PFM) systems are key enabling factors to support appropriate formulation, execution, and accounting of Government expenditure.

Also, dialogue between the Ministry of Health and Finance is necessary, with the aim of strengthening domestic PFM Systems and make budget practices more effective.

Improved efficiency in the use of public resources for health, aligning budget resources and health priorities as well as closing the gaps between health budget allocation and expenditure are key ways to achieving the goal of UHC.

Conclusion

UHC is achievable in Ghana. Raising domestic revenue to finance health care is the most sustainable means by which UHC can be achieved.

Based on the foregoing, it is my considered opinion that the E-levy should pass, considering that Government has limited options on borrowing. It is also my considered view that Government should prioritize the Health Sector by increasing budgetary allocations.

THE AUTHOR:

Farouk Adam Iddrisu

MSC.(LONDON), BSC. ADMIN.(GHANA), LL.B (GHANA)

HEALTH POLICY, PLANNING, FINANCING AND MANAGEMENT SPECIALIST

MEMBER OF THE ASSOCIATION OF HEALTH SERVICE ADMINISTRATORS-GHANA