A health sector in transition to universal coverage in Ghana

What are Ghana’s health, nutrition and population challenges as it continues its transition to universal health insurance coverage?

1. Ghana has come a long way in improving health outcomes and it performs reasonably well when compared to the other countries in Sub-saharan Africa (SSA). However, when its health outcomes are compared to other countries globally with similar incomes and health spending levels, its performance is more mixed. Ghana’s health outcome performances, in terms of child health and maternal health, are worse than the levels found in other comparable lower middle income and health spending countries, but life expectancy is better.

2. Ghana’s demographic profile is changing, and demographic, epidemiological, and nutrition transitions are well underway. The dependency ratio is expected to be favorably affected by the expanding large numbers of individuals entering the labor force, while fertility albeit still high continues to decline. It is the right time for Ghana to take advantage of this potential demographic dividend. Taking appropriate steps to improve employment opportunities is critical or else the country will face economic pressures as well as political unrest.

3. Unmet needs are high, and contraceptive prevalence is low. Efforts are required to sustain the momentum of a declining population. Families want the ability to space births or to have fewer children, but often do not have the means to control their pregnancy patterns. Better access to contraceptives would have multiple effects: it would positively affect the health of women, and it would give the opportunity for improved quality of life to children.

4. There is a funding shortage for public health goods. Many public health goods, such as immunization and family planning, are generally heavily subsidized, with tax or donor financing. However, Ghana has a low allocation of public funds to meet the demands for family planning commodities. The private sector has responded somewhat to this market failure by selling family planning commodities in private pharmacies, thereby increasing supply. However, many poor are unable to afford and therefore unable to access these commodities. The government has not come up with a feasible solution to provide improved access and affordability to its population.

5. Morbidity and mortality from communicable disease (CD) are highly prevalent in Ghana, and make up fifty three percent of the disease burden. Although, cost-effective interventions are offered, a significant proportion of morbidity and mortality is still CD related. There is a need to have a fresh look at programmatic aspects. Health Systems issues and challenges are a key bottleneck. A quick reduction in CD, would free up resources for new and emerging diseases and for improving quality of care.

Author: Saleh, Karima; Document Date: 2012/01/01.Document Type: Other Health Study. Report Number: 67298

World Bank study : a health sector in transition to universal coverage in Ghana x