Physician Assistant Training In Ghana And Their Role In Health Care Delivery

INTRODUCTION
Physician assistants are versatile part of Ghana health care workforce. The profession was originally created in the mid-1960s to relieve a shortage of primary care physicians. Physician assistants (PAs) make up a small but rapidly expanding part of the health care workforce. Who is a physician assistant? Physician assistants are health care professionals licensed to practice medicine with physician supervision and educated on the medical model designed to complement physician training. Their training and education produce a sophisticated and flexible medical professional who can function in many specialty areas and within many practice structures. Because of their adaptability and lower cost, PAs play an important role in the health care delivery system.

In Ghana, physician assistant (PA) refers to three distinct groups of healthcare professionals trained in the medical model to practice medicine and dentistry: PA–Medical, also known as medical assistants; PA–Dental, also known as community oral health officers; and PA–Anesthesia, also known as nurse anesthetists.

The first training programs started in the mid-1960s on an ad hoc basis. By the late 1960s, a formal and more structured training program for these providers began at Kintampo in response to the acute shortage of physicians and the maldistribution of the health workforce in general. In 1969, the Ministry of Health established the Rural Health Training School at Kintampo. This school (now called the College of Health and Well-Being at Kintampo) trains professional nurses on the medical generalist model (an 18-month program) to care for rural and underserved populations. At the time, these clinicians were called health center superintendents because they were trained specifically to work in the health centers dotted across the country.

The training of the other two PA health professional groups started decades later with the same philosophy. Ghana has about 3,500 physicians and dentists, so training PAs to extend care is relevant and cost-effective. Ghana's physicians are unevenly distributed geographically and across medical disciplines , posing a challenge to serving its population of about 24.2 million people.

The number of PAs in all categories has been increasing since the inception of PA training and practice in Ghana. Today, the country has about 2,500 PAs. About 90% have been licensed to practice by the Medical and Dental Council of Ghana, the regulatory body for medical and dental health professionals. Of the total number of practicing PAs, close to 72% are PAs–Medical.

PAs are well accepted in Ghana and form the bedrock for primary care throughout the country. PAs-Medical work mostly in primary care settings handling about 70% of the health needs of rural and underserved populations. They practice as generalists, triaging and managing all kinds of medical and health conditions at the health facilities and within the community

PAs–Anesthesia and PAs-Dental practice mainly in the district and regional hospitals across the length and breadth of Ghana. Due to the inadequate numbers of anesthesiologists and dental surgeons, PAs-Anesthesia and PAs-Dental handle some of the physician responsibilities and work alongside physicians to provide the needed care.

Because the profession is growing rapidly, it appeals to many high school students with science backgrounds. Data from the admissions office of the College of Health and Well-Being at Kintampo indicate that one out of every five applicants would prefer taking the PA–Medical program.

More schools are training PAs in Ghana and about an equal number of institutions are applying for accreditation to start PA training programs

THE ROLES
Contributes to physician's effectiveness by identifying short-term and long-range patient care issues that must be addressed; providing information and commentary pertinent to deliberations; recommending options and courses of action; implementing physician directives.

Assesses patient health by interviewing patients; performing physical examinations; obtaining, updating, and studying medical histories.

Determines abnormal conditions by administering or ordering diagnostic tests, such as x-rays, electrocardiograms, and laboratory studies; interpreting test results.

Instructs and counsels patients by describing therapeutic regimens; giving normal growth and development information; discussing family planning; providing counseling on emotional problems of daily living; promoting wellness and health maintenance.

Provides continuity of care by developing and implementing patient management plans.

Maintains safe and clean working environment by complying with procedures, rules, and regulations.

Protects patients and employees by adhering to infection-control policies and protocol

Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.

Develops health care team staff by providing information, educational opportunities, and experiential growth opportunities. Contributes to team effort by accomplishing related results as needed.

Theophilus Amporful
Physician assistant student
Level 200
university cape coast