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SECTION 1 2 3
WHAT CAN BE DONE
CASE STUDY
GHANA: WEAK HEALTH SYSTEMS
COST THE POOREST THEIR LIVES
Babena Bawa was a farmer from Wa East district; a remote and
underdeveloped area in the upper-west region of Ghana, where seven
health centres serve a population of nearly 80,000 people. There are
no hospitals, no qualified medical doctors and only one nurse for every
10,000 people. In May 2014, Babena died of a snake bite that would
have been easily treatable, had any of the health centres in his district
stocked the necessary anti-venom. Instead his last hours on earth were
spent in a desperate race against time to reach the regional hospital,
120km away. The road to the regional centre was too poor and the
journey too long, and he died before making it to the hospital.
The story of Babena stands in stark contrast to that of presidential
candidate Nana Akufo-Addo. When faced with heart problems in 2013,
he was able to fly to London for special treatment.
Public services have the power to transform societies by enabling people
to claim their rights and to hold their governments to account. They give
people a voice to challenge unfair rules that perpetuate economic inequality,
and to improve their life chances.
It is estimated that if all women had a primary education, child marriage and
child mortality could fall by a sixth, while maternal deaths could be reduced
by two‐thirds. 414 Moreover, evidence shows that public services can be great
equalizers in economic terms, and can mitigate the worst impact of today’s
skewed income and wealth distribution. OECD countries that increased
public spending on services through the 2000s successfully reduced income
inequality and did so with an increasing rate of success. 415 Between 2000
and 2007, the ‘virtual income’ provided by public services reduced income
inequality by an average of 20 percent across the OECD. 416
Long-term trends in poorer countries echo these findings. Studies show
that taking the ‘virtual income’ from healthcare and education into account
also decreases real income inequality by between 10 and 20 percent in five
Latin American countries: Argentina, Bolivia, Brazil, Mexico and Uruguay. 417
In 11 out of 12 Asian countries studied, government health spending was
found to be ‘inequality reducing.’ 418 Education played a key role in reducing
inequality in Brazil, 419 and has helped maintain low levels of income inequality
in South Korea. 420
However, the extent to which public services are able to achieve their
inequality-busting potential depends on how they are designed, financed
and delivered. Unfortunately today, in too many cases, the policy choices
being made punish the poor, privilege elites, and further entrench
pre‐existing economic inequality.
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