Like many other countries in sub-Saharan Africa Ghana's health sector is deteriorating, and of one the main reasons why is the loss of Ghanaian doctors, nurses and pharmacists to developed countries.
Ghana, with a population of about 19 million, is estimated to have just 2,000 doctors in the public and private health sector, while dozens every year are recruited by international recruitment agencies to work in countries like the United States and Britain, which are also understaffed.
The result, according to British-based Ghanaian medical researcher P.Y. Tsikata, who recently completed a field study on the topic, is alarming.
"From all indications, it looks as our health sector is just in a total mess. It is almost collapsed," he said. "Can you imagine when we have one doctor to about 20,000 people? In the rural areas, they do not have health professionals."
It is the same pattern for nurses and pharmacists. In recent years, studies have shown there has been a slowing in the rate of improved child mortality in Ghana, which British-based medical consultant Mike Rowson attributes in large part to the drain of health workers.
"One of the most important things I suppose about health worker migration is that it takes also the brightest and the best very often and so it beheads the capacity of the system," he said. "That has a sort of filter down effect to the whole system, neglecting training capacity and less ability with these very very complex problems that so many sub-Saharan African countries are facing now. Many of them are not just facing AIDS and infectious diseases which is bad enough but the diseases of modern society as they are called, non-communicable diseases like heart disease, diabetes and so on."
The Ghanaian researcher, Mr. Tsikata, says he understands health workers are attracted by higher wages, but because they are trained with Ghanaian money, he says they should be forced to work in Ghana for several years at least.
"I think these individuals are really doing what every right thinking person would do to protect his or her future but I think that it's incumbent on the Ghana government now to take serious measures to implement what we call the legal instrument in the form of bonding of health workers for them to at least serve some number of years before if they even want to migrate," he said. "Can you imagine when we spend our hard earned tax that is one and take loans from the West to train our doctors and they end up in the West? And then they expect us to pay these loans back it does not make sense!"
Medical consultants are advising Ghana's health ministry to raise wages. They also say western countries should send resources to help health sectors of sub-Saharan countries since they are taking away their best workers.
Young medical volunteers and aid workers do come from richer countries to get experience in poorer countries, but consultants say this can only be beneficial if it is organized under coordination by the receiving country's health ministry, or else they warn it ends up fragmenting the health system even more.