In many African countries, maternal and child mortality figures fell short of the MDGs targets and achieving the SDGs remains a daunting challenge for many. Health disparities and inequalities along the path of economic, geographic, social, gender, culture, religion and ethnic lines have worsened and reduced the odds of achieving UHC. It has led to heightened inequities in benefits, access, health expenditure, and inefficiencies.
Universal Health Coverage signifies the collective crack of all partners in health with a resolve to providing quality and equitable healthcare access to all citizens at very affordable cost, to avoid the risk of impoverishing households or decreased catastrophic healthcare expenditures on patients in their quest to seek quality healthcare.
Many governments in Africa such as Ghana have however focused greatly on providing financial risk protection mechanisms i.e. health insurance schemes to the neglect of other key components of UHC such as:
1. Providing accessible road networks
2. Transportation (adequate and well-equipped ambulances)
3. Physical infrastructure for healthcare delivery
4. Training of adequate and skilled health workforce and adequate remuneration of health workers. There’s poor conditions of service which usually engenders industrial actions leading to shutdown of health facilities, more disabilities and mortalities.
5. Sustainable electricity supply
6. Services: no or Poor People-Centered Services Provision, Quality and Multi-sectorial action
7. Equity: targeting the poor and marginalized
8. Preparedness: Strengthening health systems and
9. Leadership and Governance: political and institutional foundations;
without which the road to attaining UHC would remain a mere theme with so many unmet health needs and a potential subsequent collapse of the already overburdened limited existing health systems.
Investing in health pays and has impressive outcomes such as reductions in child, maternal mortalities and increased life expectancies for the general populace. Essential infant-maternal sensitive and specific health interventions significantly reduces rates of mortalities recorded and reposes confidence in the health system.
In Ghana, many Ghanaians especially pregnant women and children continue to face several barriers in accessing healthcare. Many pregnant women still lose their lives and many record still-births during attempts to access healthcare. In the last two weeks, media reports indicates that Seven Women have lost their lives in Northern Region in trying to access healthcare resulting from poor and inaccessible road networks.
Few of such many cases are a pregnant woman who died with her unborn baby in trying to access healthcare in Kubori of the Mamprugu-Mogduri district but road to the clinic was cut-off. Another pregnant woman who was being carried across a river in Nangruma in the Mamprugu district of Northern Region lost her baby because of prolonged labor as reported by JoyNews on 14th September, 2018. Many of these are recorded daily in Ghana and across Africa which affects the dignity of man.
Events (management of NHIS) in Ghana have shown that availability of a health insurance scheme does not necessarily positively influence utilization of healthcare. Instances where clients are made to pay/co-pay for NHI covered services indicates the major managerial inefficiencies of the system.
A Memo dated 2nd September, 2018 from the medical director of the Bolgatanga Regional Hospital stated clients seeking care for wound dressing and minor stitches would have to pay ¢50.00 and extra ¢20.00 if anesthesia is required. With these barriers, the efforts to the UHC 2030 will end up as another unachieved MDG.
The barriers surrounding easy access to healthcare continues to prevent many and the less privileged from accessing quality healthcare and it is quite evident that government is not putting in adequate efforts to salvaging the situation. African governments must take vested interest in making quality healthcare available to all category of persons.
We need a strong and well-managed health system to ensure universal access to healthcare in Ghana and Africa.
Invest in health and remove the barriers to healthcare.
Executive Director, ACeHP