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How Ghana Can Develop A Model Healthcare System Towards A Universal Health Coverage

File Photo : Healthcare in Ghana

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Ghana seems to be sitting on a healthy time bomb that may explode in the near future.

We are either ignorant of it or unconcerned but either way, we will be setting our future healthcare practitioners and healthcare givers up for failure if we don’t critically analyse certain aspects of our healthcare system and modify them to meet the demands of the future.

The sole purpose of this editorial is to raise a couple of concerns that should spark a national debate that will put the Government of the day on her toes to ensure health security in the near future and to increase the life expectancy of the ordinary Ghanaian. 

Every nation's biggest asset is her human resource. And that means the health of the people should be of prime concern. In fact, health should be one of the greatest commodities that is universally accessible and affordable to every citizen of the country.

The current placebo kind of healthcare model seems to be more psychologically efficient in our current approach to healthcare provision. And it gives us the delirium that we are at least enjoying one of the best healthcare systems that we can afford. But it would be amusing to know that we are currently stuck to a model of healthcare that is entirely western and simply gives no room for broader consultation to be made on some health choices.

It does not only restrict choice but its training is not Ghanaian-focused and that is quite worrying enough. Besides, it does not give room for a decentralized kind of health practice as is being practiced in Brazil and Cuba (two of the countries that have been able to achieve universal health coverage).

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Our health system seems too paternalistic in its decision making process and policy implementation strategies which rather impact negatively on the overall healthcare provision. What seems more worrisome and troubling is that the future of our current healthcare system looks bleak and we may end up with a non-existent system if we don't debate these issues and draw the attention of those who matter to it.

Let us try to spark the debate then on what should be expected of our future healthcare system.

First of all, we must understand that knowledge on our health is increasing day in and day out. Invariably, both truthful claims and doubtful claims or fallacies about health are being poured on us and being shoved down our throats everyday; from the television to the radio advertisements and the drug merchants on the street and in the cars.

This should have initiated the thought for a broader consensus on health issues by now, at least for two major reasons - to demystify the broad misconceptions about certain medical conditions and to create the platform for bidirectional approach to healthcare provision. The former will help clear the fallacies whilst the latter helps to carve our healthcare delivery around the people within the various communities in the country.


Nurses attending to some SHS students


Together, the two will decentralize healthcare and make the static top-down approach to healthcare more flexible. When it is flexed, health policies will not be drawn by the Ministry of Health and Ghana Health Service alone for implementation by the communities but it will also make room for the bottom-up approach which is being practiced effectively in Brazil and Cuba. This has proven to be a more effective approach to modern healthcare delivery as against the paternalistic top-down approach.

Every citizen should be given the chance to contribute to what informs policies and decision making on health in this country. By so doing, we will avoid putting up huge ultramodern hospital facilities at places where CHPS zones with proper health intervention modules can prove more appropriate.

That said, I believe that it also about time we started thinking of a model healthcare system that incorporates both western medical practice as well as traditional healthcare. The sound argument still remains that it was the same non-evidence based traditional healthcare system that saved the lives of our fathers and mothers in the past before the arrival of the evidence-based western medical practice.

We might consider western medical practice as the Holy Grail in healthcare but we should not forget that it also started from somewhere till it was developed to what we see today. And let us also note that the concepts and training of western medicine are based on the western models of training where peripheral cyanosis is defined as the bluish colouration of the skin - something that is difficult to detect in the dark-skinned Ghanaian. And it becomes difficult to explain to the ordinary or lay person. In view of this, we have to pay attention to our traditional medicine, rebrand it and make it an integral part of our healthcare system.

China has modelled and strengthened her "Traditional Chinese Medicine" to become so effective and efficient that it is a more preferred choice to healthcare for a section of the population who believe in it. Ghana can do same by ensuring collaboration between the traditional health practice and western medicine, investigating into the healthcare provision, further licensing and regulating the traditional health workers to operate just as the medical doctors do.


Traditional Chinese Medicine


Hopefully in some few years, we should have the option to see a traditional health practitioner in his/her consulting room, attending to patients. This will broaden our choice and access to quality healthcare services. Obviously, the traditional health practitioners have proven to be indispensable and they pose a greater threat to health if our health system should avoid them like people with bubonic plague. It will worsen our overall healthcare delivery.

Finally, I suggest we start considering the option of investigating prevalent diseases in this country and seeking a more Ghanaian-based approach to tackling those issues rather than depending on only the western knowledge. They do not provide the ideal type of healthcare that Ghana should be permanently hooked on to.

As a Physician Assistant student, I consider the programme not just as a makeshift mechanism to produce middle level healthcare workers who will just augment the efforts of the medical doctors but also an avenue to train people who will be focused on health-related research. Clinical pharmacologists are gearing towards an era of pharmacogenetics which will abort the "one drug fits all" kind of treatment but rather genetically-specified drugs.

I think we need to consider a medical practice that addresses the needs of the Ghanaian so that we stop treating every medical case with a western approach. Some of them should be done with a workable approach that we have studied on ourselves.

This can cause a domino effect all over Africa.


I leave you with the popular Pauline snippet in Philippians 4:8 which says "Finally, brothers and sisters, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable - If there be anything excellent or praiseworthy - think about such things and the God of peace will be with you".


Source : John Bonney ( Level 200 - B.Sc. Physician Assistant Studies / University of Cape Coast )

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