User:Eowoyele/Healthcare in Ghana

Lead Section

In the precolonial period traditional village priests, clerics, and herbalists were the primary care givers, offering advice and treatment to the sick. Premodern traditional beliefs stressed the combination of spiritual and physical healing with priests and clerics identifying the supernatural causes of disease and its remedies and herbalists offering medicinal herbs. The intersection of spirituality and medicine can be seen in priests using practices such as divination to determine the cause of illness and suggesting curative sacrifices before prescribing medicinal herbs obtained from herbalists.

History (only a section of history portion)

The World Health Organization and the United Nations Children's Fund were active in providing money and support to provide additional western medical care in Ghana. They provided, "financial and technical assistance for the elimination of diseases and the improvement of health standards." Traditional health practices were not recognized by these initiatives or the British Medical Department in urban areas and were shunned by Christian missionaries in rural areas. However, traditional priests, clerics, and herbalists still remained important health providers especially in rural areas where health centers were scarce. After independence in 1957 Kwame Nkrumah pushed health and education policies that aimed to make these services more available and accessible; however, these policies were still mainly targeted at urban populations with 76% of doctors practicing in urban areas while only 23% of the population lived there. Health programs were financed entirely through general taxation but with free public healthcare and large government spending, Ghana found itself struggling economically. After Nkrumah left office in 1966, subsequent governments decided to continue to keep out of pocket fees low in addition to cutting government healthcare spending with the 1969 Hospital Fees Decree and the 1970 Hospitals Fees Act in the hopes of recovering fees and bolstering the economy. Even with the cut in government spending, economic conditions continued to worsen as did healthcare services. By the 1980s, many social services, including healthcare, were inadequate and could not provide sufficient care and drugs despite the fact that healthcare was virtually free.

National Health Insurance

Main article: National Health Insurance (Ghana)

Ghana has a universal health care system, National Health Insurance Scheme (NHIS), and until the establishment of the National Health Insurance Scheme, many people died because they did not have money to pay for their health care needs when they were taken ill. The system of health which operated prior to the establishment of the NHIS was known as the "Cash and Carry" system. Under this system, the health need of an individual was only attended to after initial payment for the service was made. Even in cases when patients had been brought into the hospital on emergencies, it was required that money was paid at every point of service delivery. When the country returned to democratic rule in 1992, its health care sector started seeing improvements in terms of:

• Service delivery
• Human resource improvement
• Public education about health condition

even with these initiatives in place, many still could not access health care service

Article Draft

Lead Section

Healthcare in Ghana has taken many shapes throughout the country's history. In the precolonial period traditional village priests, clerics, and herbalists were the primary care givers, offering advice and treatment to the sick and the use of traditional healers persists mostly in the rural regions of Ghana.The post-colonial period marks the beginning of government intervention on behalf of healthcare through a variety of policies on different government regimes. These policies culminate to the implementation of the National Health Insurance Scheme (NHIS). The NHIS is currently serves people in both the formal and informal employment sectors and seeks to increase access to healthcare for all Ghanaians.

History Addition

(bold text= additions)

The World Health Organization and the United Nations Children's Fund were active in providing money and support to provide additional western medical care in Ghana. They provided, "financial and technical assistance for the elimination of diseases and the improvement of health standards." Traditional health practices were not recognized by these initiatives or the British Medical Department in urban areas and were shunned by Christian missionaries in rural areas. However, traditional priests, clerics, and herbalists still remained important health providers especially in rural areas where health centers were scarce. After independence in 1957 Kwame Nkrumah pushed health and education policies that aimed to make these services more available and accessible; however, these policies were still mainly targeted at urban populations with 76% of doctors practicing in urban areas while only 23% of the population lived there. Health programs were financed entirely through general taxation , so anyone could receive medical care in any government hospital at no cost. Public Health workers would conduct inspections in workplaces to evaluate cleanliness to ensure that all citizens were living and working in environments that promoted preventative care. But with free public healthcare and large government spending, Ghana found itself struggling economically. Declining world prices of its cash crops put more strain on the Ghanaian economy. After Nkrumah in 1966, subsequent governments decided to continue to keep out of pocket fees low in addition to cutting government healthcare spending with the 1969 Hospital Fees Decree and the 1970 Hospitals Fees Act in the hopes of recovering fees and bolstering the economy. Even with the cut in government spending, economic conditions continued to worsen as did healthcare services. By the 1980s, many social services, including healthcare, were inadequate and could not provide sufficient care and drugs despite the fact that healthcare was virtually free. By 1981, the health services had dramatically declined to the extent that hospitals lacked basic supplies, while healthcare workers left the country in hordes. In some public hospitals, patients had to provide their food, medicine, and bedding and could be detained until they paid their hospital bill. Others were forced to self-medicate due to the high prescription costs. To combat this, the government regime at the time, Provisional National Defense Council PNDC, implemented structural adjustment programs and instated the Hospital Fees Regulation in 1985. The Law was supposed to help the government make up 15% of healthcare servicing costs that it had lost in earlier years, by significantly increasing the amount and price of fees for health consultations and services . Citizens were essentially expected to cover the full cost of their care and if they did not have the resources to be able to do so, they went without. Structural adjustment policies also led the Ghanaian expenditure on healthcare to decrease from 10% in 1983 to 1.3% in 1997.

National Health Insurance Additions

The current NHIS operates under the one-time premium policy, where people make one payment for a lifetime of healthcare. The one-time premium policy was used as a way to increase access to healthcare services to those “outside formal sector employment”, allowing taxi drivers, street vendors, etc to benefit from the NHIS. The one-time payment plan has been unable to fully fund health services for all citizens. These services may have to funded by tax revenue. In addition, the actual act of collecting premiums from the informal employment sector can be costly and there has been allegations of fraud on the part of the official collectors. Those in the informal sector, who do not have the means to pay the one-time premium are essentially locked out of the NHIS benefits if they cannot get access to premium exemptions. Due to the unevenly spread benefits, the poor benefit less from the system..