The Association of Health Service Administrators, Ghana (AHSAG), has expressed fears, the delivery of quality healthcare in the country may grind to a halt given the present economic challenges.
The group cites rising inflation, high prices of fuel and the depreciation of the cedi as factors leading to the increased cost of service and consumables in the face of the low hospital charges.
AHSAG raised this issue during its 45th Annual General Meeting and Continuing Professional Education Programme at Takoradi in the Western Region.
In a statement to that effect, the association stressed, “service fees and charges, on the other hand, remain fixed by Parliament and NHIA, thereby eroding the meagre margins that come into the coffers of public health facilities. This has led to serious liquidity challenges for health care providers resulting in delayed payment for drugs and non-drug consumables with major pharmaceutical suppliers demanding payment on delivery.”
The Association of Health Service Administrators, Ghana is thus pushing for immediate government intervention.
“We, therefore, call on Government to institute pragmatic measures to halt the rising inflation and exchange rate depreciation to address the prevailing harsh economic conditions”, the statement read in parts.
That is not the Association’s only concern. It is equally disturbed by other working conditions including challenges with the Ghana Integrated Logistics Management Information System (GhiLMIS), contract arrangements, the Last Mile Distribution policy and most importantly, health workers leaving the country for greener pastures elsewhere.
The Conference was under the theme, “Sustainable Supply of Health Commodities for Universal Health Coverage in Ghana: The Role of the Health Service Administrator” and related matters on health care delivery.”
Find below the full communiqué
ASSOCIATION OF HEALTH SERVICE ADMINISTRATORS, GHANA (AHSAG) 45TH ANNUAL GENERAL MEETING AND CONTINUING PROFESSIONAL EDUCATION AKROMA PLAZA, TAKORADI 29TH NOVEMBER – 2ND DECEMBER, 2022
We, the Association of Health Service Administrators, Ghana (AHSAG), met in Takoradi, Western Region from 29th November – 2nd December, 2022 for our 45th Annual General Meeting and Continuing Professional Education Programme. We met at a time when the health system was recovering from the devastating impact of the COVID-19 pandemic and the disruption of global supply chains.
Against this background, we deliberated extensively on the conference theme, “Sustainable Supply of Health Commodities for Universal Health Coverage in Ghana: The Role of the Health Service Administrator” and related matters on health care delivery.”
1. Ghana Integrated Logistics Management Information System (GhiLMIS)
We welcome the deployment of the GhiLMIS as a key reform intervention to provide accurate, timely and reliable data for critical supply chain decisions especially relating to the planning and management of public health commodities. However, challenges of low system utilization across on-boarded sites, data quality issues and sustainability hamper the effective implementation of the system. We strongly recommend an immediate review of the GhiLMIS and possible synchronization with the Lightwave Health Information Management System deployed in the public health facilities to avoid duplication of efforts and wasting of man hours. We pledge our support for the intervention and call for the immediate training of all Health Service Administrators in the operations of the GhiLMIS to ensure effective deployment and utilization.
2. Framework Contract Arrangement
AHSAG recognizes the strategic role that Framework Contracting continues to play in addressing critical supply chain challenges that emerged following the inferno that ravaged the Central Medical Stores in 2015. Significant gains have since been made in the procurement and delivery of medicines and medical supplies in health facilities. To sustain the gains, we call on the Ministry of Health (MOH) and the National Health Insurance Authority (NHIA) to rationalize pricing and reimbursement policies to improve cashflow to health facilities for regular payment to suppliers to avert stockout of essential medicines and supplies due to delayed payment. The MoH and its agencies should make administrative provisions for health facilities to procure medicines in cases where the Framework Contracting fails to provide the needed medicines due to unforeseen circumstances.
We further call on Government to eliminate the difficulties associated with customs clearance of imported health commodities to enable the benefits of Framework Contracting to accrue to healthcare providers. Government should also provide the needed support to the local pharmaceutical industry to encourage local production of essential health commodities to ensure their availability at all times.
3. Last Mile Distribution
AHSAG reaffirms its support for the Last Mile Distribution policy which involves direct schedule delivery of health commodities from Regional Medical Stores to service delivery points. We note, however, that there are few operational challenges such as rising cost of transportation, inadequate funding for maintenance of vehicles and delays in requisition by some health facilities that impede the smooth implementation of the policy in some regions and health facilities. We commit to help address these challenges as a matter of priority for the improved availability of health commodities for quality health service delivery.
4. Impact of Prevailing Economic Challenges on Health Care Delivery
Rising inflation, high fuel cost and exchange rate depreciation have resulted in astronomical increase in cost of health commodities and other inputs for quality health care delivery. Service fees and charges, on the other hand, remain fixed by parliament and NHIA, thereby eroding the meagre margins that come into the coffers of public health facilities. This has led to serious liquidity challenge for health care providers resulting in delayed payment for drugs and non-drug consumables with major pharmaceutical suppliers demanding payment on delivery. We therefore call on Government to institute pragmatic measures to halt the rising inflation and exchange rate depreciation to address the prevailing harsh economic conditions.
We further call for an interim NHIS tariff dispensation and immediate reimbursement of outstanding claims to avert eminent shortage of medical commodities and the possible collapse of health care facilities in the country. Going forward, we strongly recommend that periodic reviews should be undertaken by a Technical Working Group with representation from the NHIA, Ministry of Health and Service Providers to ensure that tariffs for medicines and services reflect realistic cost of care to sustain health service delivery.
5. Staff Attrition for Greener Pastures
The prevailing harsh economic conditions seem to have given greater impetus to the migration of health professionals, particularly nurses, midwives and doctors to seek better conditions in other countries. The current exodus of health professionals out of the country is already exerting immense pressure on the staff at post who are made to cope with increasing workloads at the risk of compromising quality of care. We appreciate that the phenomenon of “brain drain” from developing countries such as Ghana to developed economies cannot be fully controlled by Government. We, however, welcome the decision by Government to streamline the migration of health professionals through bilateral arrangements with beneficiary countries as has been done with Barbados. We further wish to, once again, call on the Ministry of Health and all relevant stakeholders to urgently develop and implement strategies to retain the needed number of health professionals with the appropriate skills mix to ensure sustained delivery of quality health care at all levels of the health system. In the long-term, however, Government, working together with the various health professional associations and labour unions, must improve the conditions of service for health workers including incentives for posting to deprived areas to attract and retain a critical mass of health professionals in the country.
DATED AT AHSAG NATIONAL SECRETARIAT, DODOWA, THIS THURSDAY THE 8TH DAY OF DECEMBER 2022.