Supporting Ghana’s Private Health Sector
Thursday, February 4, 2010
The argument for the development of the private health sector in Africa could not have been more strongly made than at a recent international conference held in Accra under the aegis of the World Bank Group.
Featuring diverse success stories on health care financing and insurance from Ghana, Kenya and Mali, it was perhaps the story of the exploits of the Malian Association of Rural Medical Practitioners that most caught the imagination of participants and positioned an entrepreneurial private sector as possible solutions to access to healthcare. Shortages in the numbers of health professionals have also often been aggravated by inequitable distribution. The underlying reasons were most succinctly made by Dr. Khama Rogo former President of the Kenyan Medical Association and now with the World Bank Group.
Although acute shortages in health personnel have been observed, it is becoming increasingly indisputable that many African governments are unable or will be unable to adequately fund the huge wage bill that is anticipated should all these qualifying health professionals be employed in the public sector. The phenomenon was cited in Kenya for example where although the State could certainly do with more doctors, securing employment for all qualified doctors was increasingly becoming challenging due to budgetary limitations. As a result, some newly qualified doctors or housemen realizing the housemanship as a part of training have begun offering their services for free in order to be signed off for full certification. Similar scenarios have been reported in Nigeria.
In Ghana, Ministry of Health estimates put the number of doctors in 2007 at 2, 026 and yet if the West African state were to achieve prevailing doctor: patient ratios of 1: 1000 in some middle income countries by 2025 by which time its population is expected to hit 32 million, it would require not less than 32, 000 doctors. Twice this number of nurses would be required also if the estimates contained in the 2006 UN World Population Prospects are anything to go by. Assuming that governments were able to fund the training of all these doctors, is it safe to also assume the state’s ability to employ all these doctors? The clarion call for governments, doctors and other major stakeholders to embrace a new era of entrepreneurial driven health agenda could not therefore have been made more loudly. While this should not be seen purely as a commercialization of the health needs of the people, it should be positioned within a framework that ensures the availability of such health services to the less privileged and underserved areas and this the Malians seem to have done brilliantly.