Ministry of Health, Ghana Health Service Structure and Functions PDF

# Ministry of Health, Ghana Health Service: Structure and Functions By Janet Takyiwa Ama ## Ministry of Health (MOH) ### Introduction The government's goal of achieving universal health coverage and a healthy population in Ghana is being supported by the Ministry of Health's efforts to enhance the...

# Ministry of Health, Ghana Health Service: Structure and Functions By Janet Takyiwa Ama ## Ministry of Health (MOH) ### Introduction The government's goal of achieving universal health coverage and a healthy population in Ghana is being supported by the Ministry of Health's efforts to enhance the health conditions of all individuals in the country. The MOH works with agencies and stakeholders to improve human capital, thus "creating wealth through health." ### Mission The mission is to promote access to quality health for all in Ghana and contribute to socio-economic and local health industry development through motivated personnel. ### Vision To have a healthy population for national development. ### Goal To improve the health status of all people living in Ghana through effective and efficient policy formulation, resource mobilization, monitoring and regulation of delivery of health care by different health agencies. ### Policy Objectives 1. Bridge equity gaps in access to health care and nutrition services Ensure sustainable financing arrangements that protect the poor. 2. Strengthen governance and improve the efficiency and effectiveness of the health system. 3. Improve the quality of health services delivery, including mental health services 4. Enhance national capacity for attaining health-related MDGs and the gains. 5. Intensify prevention and control of communicable and non-communicable diseases. ### Roles of MOH 1. They provide overall policy direction for all stakeholders in health delivery. 2. Providing a crucial and efficient advocacy role in coordinating actions across different sectors to improve health delivery 3. Mobilization and allocation of resources to all providers in the health delivery services. 4. Provision of relevant and adequate information for coordination and management of health services. 5. Provision of regulatory framework for all providers of health services. 6. Monitoring and evaluation of health services in Ghana. ## Health Agencies Under MOH - Ghana Health Services - Teaching Hospitals - Nursing and Midwifery Council - Food and Drug Authority - Pharmacy Council Ghana - National Health Insurance Authority - Medical and Dental Council - Ghana Association of Quasi-Government Health Institutions ## Ghana Health Service ### Introduction The Ghana Health Service Council is an autonomous Executive Agency responsible for executing national policies in the public health sector. It was established under Act 525 of 1996 as mandated by the 1992 constitution and operates under the supervision of the Ghana Minister for Health. Employees and managers of GHS managers are not part of civil servants. The primary goal of GHS' independence is to enable its staff to exercise greater managerial flexibility in fulfilling their responsibilities than if they were wholly part of the civil service. Ghana Health Service does not include Teaching Hospitals, Private and Mission Hospitals. ### Vision All communities have access to timely, quality and comprehensive healthcare ### Motto Your health our concern ### Core Values of GHS - Professionalism - Teamwork - Integrity - Discipline - Excellence - People-centred ### GHS Mandate and Objectives GHS is to provide accessible and comprehensive health services, emphasizing primary care, by national policies at regional, district and sub-district levels in Ghana. ### Objectives - Implement approved national policies for health delivery in Ghana. - Increase access to good quality health services, and - Manage prudently resources available for the provision of the health services. ### Functions of GHS - Provide in-service training and continuing education in Ghana. - Establish an effective disease surveillance, prevention and control mechanism in Ghana. - Perform any other functions relevant to promoting, protecting, and restoring health in Ghana. - Promote healthy mode of living and good health habits by people in Ghana. - Determine charges for Ghana health services with the approval of the Ghana Minister of Health. - Manage and administer the health resources in Ghana's healthcare system. - Develop appropriate strategies and set technical guidelines to achieve Ghana's national policy goals/objectives. ### Directorates of Ghana Health Service A diagram depicts the organizational structure of Ghana Health Service, with the following directorates: - National - Public Health - Institutional Care - PPME - HRDD - HASS - Finance - SSDM - Internal Audit - Regional RDHS - District DDHS - Sub-District DDHS ### Organisation of GHS There are three ways in which the Service is organized: - Administrative levels - Functional Levels - Levels of Care (Service delivery) The service is organised at three levels administratively: National, regional and district. ### Organisational Levels GHS - **National Level GHS:** At the national level, policies are analysed and translated for implementation. Progress is tracked, and support is provided for regions and districts. This is done through mobilising resources, monitoring initiatives, and offering training and management development. Intersectoral collaboration and private sector involvement in health service delivery are also promoted. - **Regional Level:** The role involves offering technical, supervisory, and managerial support to the sub-districts and districts present in every region. - **District Level:** Quality service delivery is provided through comprehensive and integrated district health planning, utilizing appropriate performance assessment tools. ## Levels of Care/ Structure of Delivery of Services - **Regional Level:** Curative services are provided at the regional hospitals, while public health services are delivered by the District Health Management Team (DHMT) and the public health division of the regional hospital. The Regional Health Administration (RHA) offers supervision and management support to the districts and sub-districts within each region. - **District Level:** District hospitals, many of which are mission-based, provide curative services. Public health services are delivered by the Public Health Unit of the district hospitals and the District Health Management Team (DHMT). The sub-districts receive supervision and management support from the District Health Administration (DHA). - **Subdistrict Level:** The health centres provide preventive and curative services and outreach services to the communities within their catchment areas. Basic preventive and curative services for minor ailments are being addressed at the community and household level by introducing Community-based Health Planning and Services (CHPS). The role played by the traditional birth attendants (TBAs) and the traditional healers is also receiving national recognition. ## Government Health Facilities The government has about 1625 health facilities. ### Health Centres The health centre has traditionally been the first point of contact between the formal health delivery system and the client. It is headed by a medical assistant and is staffed with programme heads in midwifery, laboratory services, public health, environment, and nutrition. - Each health centre serves a population of approximately 20,000. - They provide basic curative and preventive services for adults and children and reproductive health services. - They augment their service coverage with outreach services and refer severe and complicated conditions to appropriate levels. - They provide minor surgical services such as incision and drainage. They augment their service coverage with outreach services and refer severe and complicated conditions to appropriate levels. ### Health Centers - They augment their service coverage with outreach services and refer severe and complicated conditions to appropriate levels. ### Polyclinics - The polyclinic is the urban version of the rural health centre. Polyclinics are usually larger, offer a more comprehensive array of services, are manned by physicians, and can offer complicated surgical services. They are mainly in metropolitan areas. ### District Hospitals District hospitals are clinical care facilities situated at the district level. These hospitals serve a clearly defined geographical area and cater to an average population of 100,000 to 200,000. The beds in a district hospital typically range between 50 and 60. As the first referral hospital, it plays a vital role in the district health system. - **Services provided by the district hospitals:** Curative care, preventive care, and promotion of the health of the people in the district. - **Quality clinical care by a more skilled and competent staff than those of the health centres and polyclinics.** - **Services provided by the district hospitals:** Laboratory and other diagnostic techniques appropriate to the medical, surgical, and outpatient activities of the district hospital - **Services provided by the district hospitals:** Inpatient care until the patient can go home or back to the health centre. - **Services provided by the district hospitals:** Training and technical supervision of health centres, as well as a resource centre for health centres at each district hospital. - **Services provided by the district hospitals:** Twenty-four-hour hospital services. - **Services provided by the district hospitals:** clinical services include Obstetrics, gynaecology, Child Health, Medicine, Surgery, and anaesthesia. - **Services provided by the district hospitals:** Accident and emergency services. - **Services provided by the district hospitals:** Nonclinical support services. - **Services provided by the district hospitals:** Referral services. - **Services provided by the district hospitals:** Contribution to the district-wide information generation, collection, planning, implementation, and evaluation of health service ### Regional Hospital They offer secondary healthcare services within a well-defined geographical area, catering to a population of around 1.2 million. - **They provide Specialized care requiring skills and competence not available at district hospitals, making them the next level of referral.** - **Their personnel include a variety of medical professionals such as surgeons, physicians, nurses (general and specialised), midwives, and paediatricians.** - **Services at the regional hospitals:** Medicine. - **Services at the regional hospitals:** General surgery and anaesthesia. - **Services at the regional hospitals:** Paediatrics. - **Services at the regional hospitals:** Obstetrics and gynaecology. - **Services at the regional hospitals:** Dental services. - **Services at the regional hospitals:** Psychiatry. - **Services at the regional hospitals:** Accident and emergency services. - **Services at the regional hospitals:** Ear, nose, and throat - **Services at the regional hospitals:** Ophthalmology - **Services at the regional hospitals:** Dermatology ## Non-Government and Private Sectors These institutions have about 928 facilities. - **The GHS supports the health services of NGOs and the private sector in several ways.** - **In December 2002, the GHS initiated awarding contracts to NGOs to undertake specific health services based on their comparative advantage.** - **Government funds from the decentralised budget process were used to pay for the contracted NGO's service.** - **The GHS also supports Mission health facilities by seconding staff and providing some essential equipment.** - **Government support aims to increase access to services from 35% to 65% over the next few years. Meanwhile, the private sector offers mostly curative rather than preventative healthcare.** - **NGOs and private sector organizations partner with communities and the District Health Management Team (DHMT) to submit quarterly progress reports to the Ghana Health Service (GHS). Activities must follow GHS standards and protocols and GHS provides staff training, but without government funding. Reports are presented to GHS biannually.** ## Quasi-Government Health Facilities Government-owned entities that engage in health services activities but operate them in the private sector. The health services in Ghana have about 79 facilities operating as such. Examples of such institutions include the - police hospital - military hospital - Ghana Atomic energy ## Christian Health Association of Ghana Mission and church hospitals they contribute to about 220 health facilities in Ghana.