Public Health Challenges in Ghana
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Questions and Answers

What is the primary objective of the PHC Investment Program for Results: 2022‒2025?

  • To increase the human capital index
  • To strengthen the capacity of the Ministry of Health
  • To improve the quality, utilization, and equity of PHC services (correct)
  • To increase the percentage of NHIS expenditures at the sub-district level to 50%

The GFF partnership in Ghana aims to support the country's RMNCH program through the Health Sector Working Group.

True (A)

What is the estimated budget for the PHC Investment Program from the GoG National Budget?

US$ 193M

The PHC Investment Program is expected to contribute to ______ coverage.

<p>UHC</p> Signup and view all the answers

Match the funding source with its corresponding amount for the PHC Investment Program:

<p>IDA = US$ 150M GFF = US$ 31M GAVI = US$ 1.5M FCDO = US$ 1M</p> Signup and view all the answers

What is the primary goal of the GFF Partnership's collaboration in Ghana regarding PHC reforms?

<p>To support the scale-up of PHC service delivery and capture lessons learned (B)</p> Signup and view all the answers

The GFF Partnership directly engages with the Ghanaian government to facilitate multi-sectoral engagement and DP alignment.

<p>True (A)</p> Signup and view all the answers

What is the specific name of the World Bank operation that the GFF Partnership is supporting in Ghana?

<p>GFF co-financed WB operation</p> Signup and view all the answers

The GFF Partnership provides ______ to support the implementation and institutionalization of the NoP reform.

<p>continuous technical assistance</p> Signup and view all the answers

Match the following GFF support areas in Ghana with their corresponding objectives:

<p>Health sector strategy (Investment Case) and Resource Mapping and Expenditure Tracking = To facilitate country prioritization around PHC and NoP reform introduction and plan and budget for operationalization through the Health Sector Medium-Term Development Plan Health sector working group (country platform) = To support government leadership and facilitate multi-sectoral engagement and DP alignment PfR project preparation = Engagement of country platform, analytics to inform design, donor engagement and alignment, TA to ensure focus on RMNCH, $31 million in grant financing to incentivize focus on Essential Health Services and PHC Technical assistance = RMNCAHN to improve technical quality of the NoP design, monitoring and data use to ensure accountability to health strategy and enable real-time decision making within NoPs, resource tracking and Public Financial Management to support institutionalized health resource tracking for IC monitoring and strengthening GIFMIS to enable NoP autonomy and decision-making, strategic purchasing to evolve provider payment mechanisms in support of PHC</p> Signup and view all the answers

Which of the following is NOT a key programmatic milestone for the GFF Partnership's collaboration in Ghana?

<p>Developing a new national health insurance scheme (C)</p> Signup and view all the answers

The GFF Partnership's support to Ghana includes providing $31 million in grant financing to incentivize focus on Essential Health Services and PHC.

<p>True (A)</p> Signup and view all the answers

List three specific areas of technical assistance provided by the GFF Partnership to support the implementation of the Investment Case and PfR project in Ghana.

<p>RMNCAHN to improve the technical quality of NoP design, monitoring and data use to ensure accountability, resource tracking and Public Financial Management to support institutionalized health resource tracking</p> Signup and view all the answers

What percentage of NHIS claims expenditures goes to subdistrict and below?

<p>17% (C)</p> Signup and view all the answers

Preventive services at the PHC level primarily rely on government funding.

<p>False (B)</p> Signup and view all the answers

What was the name of the pilot program conducted by the MoH and USAID?

<p>Primary Care Provider Networks (PCPN)</p> Signup and view all the answers

The MoH endorsed the country-wide scale-up of networking under the leadership of ______.

<p>GHS</p> Signup and view all the answers

Which outcome did NOT result from the PCPN pilot?

<p>Increased patient fees at health centers (D)</p> Signup and view all the answers

What was the under-five mortality rate in Ghana according to the Maternal Health Survey conducted in 2017?

<p>52 deaths per 1000 live births (D)</p> Signup and view all the answers

Ghana has achieved the Sustainable Development Goal (SDG) target of 25 under-five deaths per 1000 live births.

<p>False (B)</p> Signup and view all the answers

Match the following terms with their descriptions:

<p>UHC 2030 Vision = Timely access to high quality health services PCPN = Pilot program for networking health facilities NoP = Network of Practice established after PCPN GHS = Ghana Health Service</p> Signup and view all the answers

The roadmap for achieving UHC in Ghana aims for all individuals to have healthcare access based on their ability to pay.

<p>False (B)</p> Signup and view all the answers

What were the maternal mortality ratios in Ghana from 2005 to 2017 according to the maternal health survey?

<p>470 per 100,000 births in 2005 to 310 in 2017</p> Signup and view all the answers

The Department of ______ plays a crucial role in managing the resilience of sub-district health centers.

<p>health</p> Signup and view all the answers

The current under-five mortality rate from the DHIMS2 is ___ deaths per 1000 live births in June 2022.

<p>9.6</p> Signup and view all the answers

Which year is the next Ghana Demographic and Health Survey scheduled for?

<p>2023 (D)</p> Signup and view all the answers

Match the following statistics with their corresponding years:

<p>Maternal mortality ratio in 2005 = 470 per 100,000 births Maternal mortality ratio in 2017 = 310 per 100,000 births Under-five mortality in 2021 = 10.7 deaths per 1000 live births Under-five mortality in June 2022 = 9.6 deaths per 1000 live births</p> Signup and view all the answers

The maternal mortality ratio improved from 2005 to 2017.

<p>True (A)</p> Signup and view all the answers

What is the target maternal mortality ratio as per the Sustainable Development Goals (SDG)?

<p>70 per 100,000 births</p> Signup and view all the answers

What was the FP acceptor rate in June 2022?

<p>34.6% (A)</p> Signup and view all the answers

The Community Health Planning and Services (CHPS) strategy began in Ghana in 1994.

<p>True (A)</p> Signup and view all the answers

What is the purpose of the National Health Insurance Scheme (NHIS) in Ghana?

<p>To remove financial barriers in accessing health services.</p> Signup and view all the answers

The percentage of married women aged 15-49 years who used any method of contraception in the Maternal Health Survey (2017) was ___.

<p>31%</p> Signup and view all the answers

Which of the following statements is correct regarding the number of CHPS zones?

<p>There were 5,580 CHPS zones in Ghana in 2021. (D)</p> Signup and view all the answers

Population coverage under NHIS decreased from 35.3% in 2017 to 54.4% in 2021.

<p>False (B)</p> Signup and view all the answers

When was the National Health Insurance Scheme (NHIS) established?

<p>2003</p> Signup and view all the answers

Match the following years with their respective NHIS population coverage:

<p>2017 = 35.3% 2021 = 54.4%</p> Signup and view all the answers

Flashcards

Under-five Mortality Rate

The rate of deaths of children under five years old per 1000 live births.

SDG Target

The Sustainable Development Goals (SDGs) are a set of 17 goals adopted by the United Nations in 2015 to achieve a better and more sustainable future for all.

DHIMS2

The District Health Information Management System 2 (DHIMS2) is a digital platform used to collect, analyze, and disseminate health data in Ghana.

Maternal Health Survey (2017)

The Maternal Health Survey (2017) is a nationwide survey conducted to assess the health status of mothers and children in Ghana.

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Ghana Demographic and Health Survey (2014)

The Ghana Demographic and Health Survey (2014) is another nationwide survey conducted to gather data on population, health, and family planning in Ghana.

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Maternal Mortality Ratio

The rate of deaths of mothers during childbirth or shortly after per 100,000 live births.

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UHC Roadmap

The UHC Roadmap outlines a strategy for achieving universal health coverage in Ghana.

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Primary Healthcare (PHC)

Primary Healthcare (PHC) refers to the essential healthcare services that are accessible to everyone, especially at the community level.

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What is the CHPS strategy in Ghana?

A program aiming to deliver primary healthcare and family planning services at community and doorstep levels.

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What is the NHIS in Ghana?

A national program in Ghana aiming to remove financial barriers to accessing healthcare.

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What is a main challenge in Ghana's PHC financing?

A key challenge in Ghana's healthcare system is the lack of adequate financing for primary healthcare.

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What is a key challenge in Ghana's family planning coverage?

The coverage of family planning services in Ghana is lower than expected given the country's economic level.

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What is a CHP 'zone' in Ghana's context?

A CHP zone is a geographical area with a population of 3000-4500 people, designed to deliver health services.

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What is the recent trend in the number of CHPS zones in Ghana?

The number of CHPS zones in Ghana has increased from 5,547 in 2020 to 5,580 in 2021.

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What is the NHIS's objective, and what does it cover?

The NHIS aims to support Universal Health Coverage (UHC) by removing financial barriers to healthcare. It covers about 95% of common curative conditions.

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What is the recent trend in the NHIS population coverage in Ghana?

The NHIS population coverage has increased from 35.3% in 2017 to 54.4% in 2021.

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UHC Roadmap & Sub-District Expenditures

The UHC roadmap aims to increase the percentage of NHIS expenditures at the sub-district level to 50%. This signifies a shift towards strengthening primary healthcare by directing more resources to local communities.

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Project Development Objective

The project's primary goal is to improve the quality, utilization, and fairness of primary healthcare services within Ghana.

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GFF Partnership with Ghana

The Global Financing Facility for Women, Children and Adolescents (GFF) partners with Ghana to support the alignment of health programs, prioritize reproductive, maternal, newborn, child and adolescent health (RMNCH) within primary healthcare reforms, and strengthen national health systems.

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One Plan, One Budget, One M&E

A key aspect of the GFF partnership is to help Ghana develop a unified approach to health planning, budgeting, and monitoring & evaluation through the Health Sector Working Group. This aims for a coordinated and streamlined health system.

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Prioritizing RMNCH

The GFF partnership ensures that RMNCH remains a priority within primary healthcare reforms and World Bank operations. This emphasizes the importance of maternal and child health within the broader healthcare system.

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What is the weakest link in the Ghanaian PHC system?

Sub-district health centers are the weakest link in the Ghanaian PHC system. They struggle with service delivery, operational efficiency, system strengthening, and demand generation.

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How are PHC services funded in Ghana?

The MoH and NHIS are two main channels supporting PHC services. However, only 17% of NHIS claims expenditures reach sub-district level and below.

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How do PHC facilities operate without sufficient funding?

PHC facilities rely heavily on internally generated funds (IGF) from NHIS and donor assistance for their operations. This means they are often underfunded and rely on external support.

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What is the funding situation for preventive services in Ghana?

Preventive services, which are crucial for public health, are significantly reliant on donor funding. This makes them vulnerable to fluctuations in donor support.

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What initiative did the MoH launch to improve PHC services?

The Ministry of Health (MoH) piloted networking under the name Primary Care Provider Networks (PCPN) in two Ghanaian districts, aiming to improve PHC service delivery.

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What were the results of the PCPN pilot?

The PCPN pilot showed positive results, including increased collaboration, wider service delivery, better referral systems, and improved NHIS claims management.

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How did the MoH respond to the PCPN pilot's success?

Based on the successful PCPN pilot, the MoH endorsed a country-wide scale-up of networking under the name Networks of Practice (NoPs). This signifies a shift towards a more integrated approach to PHC.

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What is the focus of Networks of Practice (NoPs) in Ghana?

Networks of Practice (NoPs) focus on building the capacity of health centers to be effective hubs within a network. They are supported by USAID and aim to improve the overall health system.

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What is 'PHC Reform'?

A plan for improving primary healthcare (PHC) within a country, often focusing on essential health services and a specific approach like the NoP (National Operational Plan).

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What are the 'Next Steps' in PHC Reform?

The process of implementing a plan or strategy to improve something. In this context, it relates to carrying out the steps outlined in the PHC reform plan.

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What is a 'NoP' (National Operational Plan) in the context of PHC Reform?

A plan that outlines the goals, strategies, and activities for improving PHC within a country, often focusing on specific areas like maternal and newborn health.

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How are 'Stakeholders' involved in PHC Reform?

The process of ensuring the NoP is followed and its goals are met, including tracking progress and addressing any challenges.

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What does 'Institutionalizing' NoP mean?

The process of making changes to the way healthcare services are organized and delivered to improve their effectiveness. Think 'changing how things work.'

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How does 'Financing' support PHC Reform?

Strengthening the financial systems and processes within the healthcare sector to support and align with the NoP.

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What is the 'RMNCAHN' approach to PHC Reform?

A specific approach to organizing and delivering primary healthcare services that focuses on providing essential services and ensuring equitable access to care, especially for mothers and newborns.

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How does 'Monitoring' support PHC Reform?

Gathering information, analyzing it, and using it to make better decisions about improving healthcare services. Think 'data-driven decision making.'

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Study Notes

Strengthening PHC in Ghana

  • Ghana has made economic and social progress but faces significant challenges in PHC service delivery and health systems.
  • Under-five mortality is high in Ghana, exceeding the SDG target of 25 deaths per 1,000 live births.
  • Maternal Health Survey (2017) shows 52 deaths per 1,000 livebirths.
  • Ghana Demographic and Health Survey (2014) shows 60 deaths per 10,000 livebirths.
  • Data from DHIMS2 shows improved rates: 10.7 deaths per 1000 live births (2021) and 9.6 per 1000 (June 2022)
  • Maternal mortality ratio has declined but is still above SDG target (70).
  • 2017 report shows a decline from 470 per 100,000 births in 2005 to 310 in 2017.
  • Data from DHIMS2 also shows improvements: 119.5 deaths per 100,000 live births in 2021 and 111.7 deaths per 100,000 live births in June 2022

PHC Background and Policy Context

  • Coverage of family planning is lower than expected given Ghana's economic level.
  • 2021 FP acceptor rate was 33.8%, increasing to 34.6% in June 2022.
  • 2017 survey showed 31% of married women aged 15-49 using contraception.
  • 2014 survey indicated that 26.7% of married women aged 15–49 used contraception.

Successful Strategies

  • Community-Based Health Planning and Services (CHPS) strategy, started as a pilot in 1994.
  • CHPS zones are in each of the 245 electoral areas in Ghana. Each comprises a defined catchment area up to 3 unit committees (pop. 3000–4500) within a sub-district.
  • Data from DHMIS2 show CHPS zones increased from 5,547 (78%) in 2020 to 5,580 (80%) in 2021.
  • The National Health Insurance Scheme (NHIS), established in 2003, aims to remove financial barriers to healthcare.
  • NHIS covers about 95% of common curative conditions.
  • Population coverage grew from 35.3% (2017) to 54.4% (16.7 million)(2021).

Persistent Challenges

  • Weak sub-district health centers (HCs).
  • Inadequate and fragmented PHC financing.
  • 2 financing channels: MoH and NHIS.
  • Only 17% of NHIS claims go to subdistrict level and below.
  • PHC operations rely heavily on internally generated funds (IGF).

Concept and Design of Networks of Practice

  • MoH pilot program with USAID, Primary Care Provider Networks (PCPN), in 2 districts (2017-2019).
  • Increased collaboration and mutual technical and operational support among facilities.
  • Increased range of service delivery activities improves referral and feedback systems.
  • Improved NHIS claims management.
  • Country-wide implementation under GHS leadership, with USAID support, as Networks of Practice (NoPs). Focus on building health center capacity and network hubs.

Policy and Program Implications and Way Forward

  • Ghana launched a roadmap for attaining UHC (Universal Health Coverage) by 2030.
  • The roadmap prioritizes networking of health facilities and provides policy context for NoPs.
  • The UHC roadmap aims to increase NHIS expenditures for sub-districts to 50%.

PHC Investment Program for Results (2022-2025)

  • Aims to improve quality, utilization, and equity of PHC services.
  • Expected outcomes include progress toward UHC coverage, improved health nutrition, and increased human capital index.
  • GoG budget: US$193M (estimated).
  • Planned funding: US$150M IDA, US$31M GFF, US$ 1.5M GAVI, & US$1M FCDO.
  • Implementing agency: Ministry of Health (MoH), GHS, and NHIA.

Added Value of GFF Partnership

  • Supports country alignment efforts (one plan, one budget, one M&E system).
  • Prioritizes RMNCH (Reproductive, Maternal, Newborn, and Child Health) in PHC reforms.
  • Enables scale-up of service delivery and captures lessons & best practices.

Next Steps for Delivering Ghana PHC Reforms

  • Parliamentary approval of the GFF co-financed WB operation.
  • Finalization of NoP Guidelines with stakeholders.
  • System strengthening with NoP model support.
  • Institutionalizing NoP implementation in routine health service delivery.

GFF Support in Ghana

  • Health sector strategy development and resource mapping.
  • Health sector working group (country platform) for government leadership and inter-sectoral support.
  • Project preparation, donor alignment and financing for Essential Health Services.
  • Technical assistance for NoP design, monitoring, resource tracking, and provider payment.

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Strengthening Primary Health Care in Ghana 2022 PDF

Description

This quiz explores the current state of primary health care (PHC) services in Ghana, highlighting key statistics and challenges faced in maternal and child health. Participants will review data from various health surveys and the progress made against the Sustainable Development Goals (SDGs). Test your knowledge on Ghana's health policies and systems!

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