The continuous strike action embarked upon by health workers has contributed to the poor performance of the Service's health care delivery.
It has also contributed to the decline in utilization of services from the health facilities, whilst Out-Patient per capita income, In-Patient admissions and many other hospital indicators also suffered decline in 2006.
This was made known by Dr Frank Nyonator, Director of Policy, Planning, Monitoring and Evaluation (PPME) of GHS in an interview with the Ghana News Agency (GNA) in Accra last Tuesday after Ghana Health Service's (GHS) first Senior Managers Meeting over the weekend in Agona Swedru to review their performance for 2006 programme of work.
He explained that the numerous strike actions that occurred last year came from, the junior doctors, consultants and Health Workers Groups which comprised nurses and other supporting staff in health care delivery.
The Meeting, which is organised annually, was to share experiences on best service delivery practices, update the Senior Managers of the Service on key strategies areas, reflect on the ten years implementation of the Service ACT 525 which spells out the mandate and responsibilities of the GHS and the teaching Hospitals and define the strategic direction with the newly appointed Director-General, Dr Elias Sory.
Dr Nyonator noted that the decline in Out-Patients attendance affected each region with a national total of 11,611,763 attendance recorded in 2006 as compared to 11,650,188 attendance recorded in 2005.
Upper West region recorded the lowest Out Patient attendance with 339,923, attendance in 2005 to 259,205 in 2006.
Upper East region followed next with 561,182 recorded in the Out Patient attendance in 2005 and dropped 538,202 in 2006.
Hospital admissions nationally, also dropped from 800,437 admissions in 2005 to 728,926 admissions in 2006. Upper West region again recorded the lowest admission cases from 36,047 in 2005 to 259,205 admissions in 2006.
“The meeting recommended that some regions have best practices and such best practices needed to be well documented and disseminated for others to emulate”.
The PPME Director told the GNA that aside the strike action contributing to the poor performance of the Service, other issues such as inadequate budgetary provision, irregular flow of funds, and added that the meeting recommended that financial management and internal audit systems be strengthened whilst the service would deploy Information Communication and Technology to support decentralization in all sectors.
The guinea worm disease, he said, was noted as a problem and new strategies such as inaction of bylaws to prevent people from contaminating water sources, improving availability of portable water in all endemic areas, and strengthening of community based surveillance systems were devised for its total eradication. Ghana ranks second on the world table next to Sudan.
On Human Resource, inadequate human resources and ageing of the workforce were seen as key issues and cited that most medical assistances and enrolled nurses were almost due for retirement but there were no trained people for replacement.
He explained that midwives were lacking, imbalance in the mix of cadres, over reliance on casual staff, high attrition of staff, low motivation and poor staff attitude towards work were also key issues which the meeting identified and recommended that trainees such as community health nurses, midwives, and staff nurses be bonded for a period of three years in their regions whilst management of training institutions be brought back as part of the Regional Health Services administration within the GHS.
“Motivation of staff through acquisition of land for staff, provision of birthday cards and medical examination for staff are all ideas considered to address the poaching of GHS staff by other health facilities outside GHS”, the PPME Director noted.
The meeting advocated for effective collaboration, advocacy and dialogue with District Assemblies, other sectors to improve health systems, collaboration with Ghana Private Road and Transport Unit for emergency transport for referrals, cross border integrated service delivery and collaboration with traditional healers and leaders including queen mothers.
The Senior Managers meeting pledged to improve service delivery and rededicate themselves towards a better performance in 2007 and subsequent years.
The new Director-General, Dr Sory noted that his focus was to examine managerial factors with special attention on working relationships and team building.
He urged all to adopt mentorship to develop people who will in-turn take over from them and also exhibit the qualities of fairness, firmness, punctuality, commitment and transparency in their workplaces.
“We must understand that health delivery in Ghana is not only dictated by the health needs of people living in the country, but also by international treaties or organizations which Ghana is a signatory. These must add to guide our strategic direction and the implementation process”, he added.—GNA