Significant Out- Of-Pocket (OOP) health spending has been a major hindrance to achieving universal health coverage and financial security over the years. In 2022, OOP health spending remained the main financing scheme in 30 low and lower-middle income countries according to WHO’s Global Health Expenditure Report (2024). 

Latest reports by the World Bank Group indicates that, in Sub-Saharan Africa OOP expenditure constituted about 30.36% of health expenditure in 2023 with less than 10 African countries falling below 10%. While Ghana’s OOP was estimated close to the SSA average of 26.68%,some countries deviated with ratios as high as 70%. Ghana’s Free Primary Health Care (FPHC) policy has been well received by the masses and commended by major stakeholders as a milestone to achieving universal health coverage. This is intended to reduce OOP, and deliver preventive, promotive and early curative  healthcare services to citizens, starting with underserved areas in the country, targeting nationwide coverage by 2028.

What does this mean for the average Ghanaian?

• Increased financial protection in health with broader socio-economic benefits.
• Improved population well-being resulting in longer life expectancy.
• Reduced barrier to accessing basic healthcare services.
• Reduced disease burden with early detection and screening.
• An avenue for collecting health data for scientific research to advance healthcare
• Improved workplace productivity with fewer extended hospital stays associated with complications of diseases.

The success of this policy however, will be hinged on its sustainability. Here are a few points for consideration for  implementing this policy and ensuring its longevity.

• Strengthening And Securing More Reliable Financing Sources For The Health System: The policy implies a significant increase in Government’s expenditure on health. However, expanding expenditure without corresponding increase in financial inflows risks compromising the system’s financial sustainability. Mobilising private sector capital beyond grants, CSR activities or heavy tax obligations, will go a long way to promote sustainability of the policy and its expected impact.

• Investment in the Health Workforce: A resilient health system recognizes the health workforce as a core pillar for healthcare delivery hence prioritizing sustained investment in its health workforce. This policy primarily relies on nurses and midwives at the primary level with physicians supporting through consultations and referrals. Strengthening the workforce therefore should include decent remuneration, organizing training and re-training workshops for professional development and regular stakeholder engagements.

• Effective Referral Systems: Advanced care for patients must be well structured within a coordinated national referral system to reduce congestion at higher level facilities. Supporting infrastructure including the technology and devices have to be made readily  available in adequate volumes with proper maintenance structured to ensure smooth delivery of healthcare services.
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• Transparency and Accountability: Proper monitoring, evaluation and feedback measures must be put in place to ensure efficient use of resources without compromising.

The FHCP can be a game changer for Ghana, however, the success or failure of this would be dependent on its implementation and monitoring structures.

Looking forward to seeing tangible gains and significant milestones across our health sector with this programme.

References

https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS?locations=ZG-EG-DZ-MA&name_desc=falsehttps://iris.who.int/server/api/core/bitstreams/6a22149b-17d5-4afb-a89b-14a3e8c12442/content