Agenda 111 project will be the largest investment in Ghana - NR Minister

The Northern Regional Minister, Hon. Shani Alhassan Shaibu at the 3rd Annual Performance Review Meeting of the Ghana Health Service said the agenda 111 projects will be the largest investment in the history of healthcare infrastructure in the country.   

The project, which was launched by the President, Nana Addo Dankwa Akufo-Addo, aims at improving and making quality healthcare easily accessible to every Ghanaian nationwide when completed.

The project aim is in line with this year’s theme Improving health service delivery amid the COVID-19 Pandemic: the role of health systems strengthening.

Hon. Shaibu stated that the Annual Performance Review is a laudable initiative as it creates the platform for the Ghana Health Service together with its partners and relevant stakeholders, to assess the performance of the service on various health indicators. 

“It also offers the opportunity to share ideas, identify performance gaps and come up with suitable and effective strategies to improve on the general health systems within the region and beyond,” he added.

He said that the Covid-19 Pandemic has affected our lives in many ways since its emergence. And the Government together with all its agencies have been working tirelessly to minimize the effects the pandemic has had on citizens and the nation. 

He opined that from March 2021 to 17th February 2022, the Northern region had received 622,620 of AstraZeneca, 206,850 of Pfizer-BioNTech, 200,250 of Johnson & Johnson, and 20,040 of Modena, giving us a total of 1,049, 760. Out of the total number of vaccines received so far 740,220 doses have been distributed for those who qualify to be vaccinated, 473,746 persons have received at least 1 dose of the vaccines while 186,329 have been fully vaccinated. 

Again, the government is making adequate arrangements to ensure that booster doses are being administered to the population. In this regard, a total of 2,246 people have received the first set of booster doses administered, he added.

He applauded the entire health sector for their continuous efforts in reducing the spread of the Covid-19 virus. 

The Northern Regional Director of Health, Dr. John Bertson Eleeza has stated that the processes leading up to the regional annual performance review begin with sub-district and district performance reviews. 

He indicated that all districts in the region have duly conducted their performance reviews to pave the way for the regional annual performance review.

According to Dr. Eleeza, the call for improvement in health service delivery has become more urgent than ever before, considering the extent to which the onset of the COVID 19 has exposed the weaknesses and gaps in our health services delivery system and the ramifications thereof. 

“Weaknesses in our health systems reduce our ability to cope with the devastating potentials of serious public health events like COVID-19. There is, therefore, the need to continue to explore, identify and implement pragmatic strategies that can strengthen our health systems,” he said.

This is what motivated the Northern Regional Health Directorate to choose the theme for this performance review.

He revealed that the government of Ghana signed the Astana Declaration of 2018 which aims to renew political commitment to primary health care from governments, non-governmental organizations, professional organizations, academia, and global health and development organizations towards Universal Health Coverage, which seeks to provide access by all persons to quality and affordable health services including access to medicines and vaccines. 

“This cannot be attained if there are no conscious efforts to improve upon health service delivery,” he stressed.

He briefly threw light on some selected performance outcomes that showed improvement and the areas in which the region performed poorly when measured against the national targets that were set by the GHS for all regions.

IMPROVEMENT

The Human resource situation continues to improve gradually, especially for nurses, which is also manifesting in improvement in nurse to population ratio. For instance, nurse to population ratio improved from 1:403 in 2019 to 1: 378 in 2020 and 1:369 in 2021, unfortunately, doctor to population ratio as well as the midwife to women infertility age worsened due to the refusal of doctors to accept posting to the Northern Region and the movement of midwives out of the region. 

“Our major problem with human resource has remained the lack of equity in distribution and therefore the RHD has maintained its tempo with efforts to bridge the equity gap through a moratorium on posting of additional staff to the Tamale Metropolis and Sagnarigu Municipalities, with plans to extend the measure to nearby Municipality districts like Savelugu, Tolon, Kumbungu, and Nanton respectively very shortly,” he disclosed.

He called for cooperation and support of all stakeholders to enable them to implement the measures on equitable distribution of human resources as undue interferences in posting decisions make it difficult for the region to resolve the issue of mal-distribution of staff.

He added that another area of improvement witnessed was a reduction in Institutional Maternal Mortality Ratio also declined from 144 per 100,000 live births in 2019 to 120 per 100,000 live births in 2020 and a further reduction to 99 per 100,000 live births in 2021. Still, the births rate reduced and stayed within the national target of 12%. ART coverage rate and PMTCT coverage rates also improved as well as TB case notification and treatment success rates. Again, the institutional under 5 Malaria Case fatality rate stood at 0.12 percent, a performance that exceeded the national target of 0.2 percent. Tracer medicine availability improved slightly from 50% in 2020 to 54% in 2021 even though the region needs to do more to move the percentage closer to the national target of 90%.

POOR PERFORMANCE

On the downside, he said per capita Out-Patient Department (OPD) attendance worsened from 0.63 in 2019 to 0.59 in 2020 and 0.55 in 2021.  Measles-Rubella 2 coverage fell short of the national target of 90% declining from 99% in 2020 to 86.1% in 2021. HIV viral load testing coverage rate has also remained low, declining from 7.78% in 2020 to 3.70% in 2021. 

However, he highlighted some flagship interventions that benefitted the region during the year under review. These interventions took place with the support of the Central Government through the MOH/GHS and some of the health partners form part of health systems strengthening. 

According to him, these have significantly enhanced the capacity of the region to improve health service delivery in various aspects.

He noted that the GHS headquarters rolled out a plan to provide hire-purchase utility pick-ups to be made available to hospitals and polyclinics on demand. In line with this, He announced that 8  hospitals in the region benefited from the first set of vehicles that have been delivered. 

He was optimistic that the improvement in the availability of transport in hospitals will facilitate smooth health service delivery.

In terms of health infrastructure, he revealed that the new ultramodern 60-bed capacity Tolon District Hospital was completed and handed over and that preparatory works were completed in the year under review and the hospital started providing services in January this year so far the patronage has been very impressive.

He acknowledges USAID Advancing Nutrition, USAID Impact Malaria and USAID Quality for health projects, and Pharmanova for providing some support towards this review meeting.