With barely seven years to reach the 2030 target for achieving Universal Health Coverage (UHC), Ghana’s health system particularly those at the sub-district level, is still struggling with quality service delivery.  

The observation was made during a panel discussion preceding the opening ceremony at a three-day special Senior Manager’s Meeting (SMM), organised by the Ghana Health Service (GHS) in Accra. 

The panelists identified fragmentation and individualism within health systems particularly at the Primary Health Care (PHC) level, as a key challenge leading to wastage of scarce resources, unhealthy competition among facilities and health workers, resulting in poor service delivery.   

They called for the strengthening of sub-districts health systems through massive stakeholder collaboration, embracing the concept of teamwork to maximize resource usage, and the provision of clear leadership preferably by Regional Managers, to ensure comprehensive preventive, palliative and curative care.    

 The panelists took turns to educate participants, on the Network of Practice implementation, a new GHS concept with a multi-sectoral approach to building trust among healthcare workers in both public and private sectors to work together. 

This collaborative approach would maximise the use of limited resources, and prevent wastage within the fragmented systems and individuals for quality service delivery. 

The concept, had been piloted in some regions and found to be the most viable option to propel the country to achieve its UHC targets, as it created a pool of quality human resource, logistics and equipment for use by all, removed unhealthy competition among health workers and improved referral systems, they said. 

Dr Patrick Kuma-Aboagye, the Director-General of the Ghana Health Service, welcoming the participants, said the objective was to share ideas on how to translate GHS policies into practice for quality and accessible healthcare, and re-orient the service delivery capacities of its workforce.  

 The maiden meeting on the theme: “Policy and Practice for High Performance Management and Health Service Delivery to achieve Universal Health Coverage (UHC),” further unifies the need for an effective policy implementation agenda in the Service, and deepening the understanding of Senior Managers on similar initiatives, he said. 

Dr Kuma-Aboagye said the meeting would discuss innovations and improvements towards strengthening health service delivery and share best practices, lessons learnt, and receive feedback on the review of existing policies and the creation of new ones, to ensure high performance and sustainability. 

The Director-General stated that there was the need to create a common understanding of what characterised an effective Network of Practice, to drive improved and strengthened national health programme, leveraging on e-learning to re-configure GHS’s in-service training and continuous professional development policies, to address the issues of equity and access to capacity building. 

He reiterated the need for the Service to realign policy changes at the sectoral level to meet the implementation of the Network of Practice, improvement in Reproductive, maternal and child health, promoting transparency and accountability in the use of financial resources, the institutionalization of public health measures and infection prevention initiatives created in response to the COVID-19 pandemic. 

Prof. Irene Agyapong of the Faculty of Public Health, Ghana College of Physicians and Surgeons, urged the health sector managers to change their perception by “thinking systems rather than projects.”   

She said, “the systems do not talk among themselves,” pointing out that at the centre of the system are people; hence they must interact to solve the problems of the population by sharing the resources and expertise for enhanced service delivery in their respective regions and districts.     

Prof Agyapong also called for incentives to attract healthcare professionals into deprived communities and regions. 

Dr Alberta Biritwum-Naryko, the Director for Policy Planning Monitoring and Evaluation Division, GHS, said the concept of the Network of Practice was to strengthen the PHC system to help achieve the needed progress to achieve the UHC target by 2030.