2012 Holistic Assessment of Health Sector POW - Ministry of Health

4.0 Implementation status of the POW 2012
The HSMTDP (2010-2013) has five objectives and under each objective key priorities and activities were
outlined. The extent to which these activities are carried out determines the performance of the health
sector. Clearly there were difficulties in implementing some of these activities. Reasons for nonperformance
in some instances range from non-availability of funds to lack of a clear framework for
implementing such planned activities. Some planned activities also depended on the extent to which
external agents responded to requests for support on time.
A robust system for sector wide planning and implementation of plans is critical for a coordinated
response, good performance and impact on health outcomes. The review of POW 2012 raises concern
about non-adherence by several agencies to the sector’s annual programme of work. Moreover, the review
suggests that the current capacity and framework within the sector to monitor and evaluate agencies’
performance is inadequate and must be strengthened.
4.1 Health Objective 1: Bridging Equity Gaps in Access to Health Care and
Nutrition Services, and Ensure Sustainable Financing Arrangement that Protect
the Poor
4.1.1 Strengthen district health system with a particular emphasis on primary health care
The objective of the Ministry of Health is to improve coverage of PHC services at sub-district level through
strengthening community health systems. The Ministry planned to do this by expanding CHPS coverage to
achieve 500 new functional zones during the year. Although the target was exceeded some challenges
remain.
Key among the challenges is the difficulty in deploying close to 9,000 CHOs into the zones or communities.
Some CHOs are based in the hospitals and health centres and this defeats the objective of providing
community based basic health services to deprived communities.
The CHPS operational policy prescribes a package of equipment and logistics to aid the CHO in executing
his/her mandate as required. Due to inadequate funding, districts are unable to provide the basic package
to facilitate the deployment of the CHOs. This is one of the reasons why despite the increase availability of
CHOs some have still not been deployed to CHPS zones. Weak consultative processes and poor supervision
undertaken by the district and sub-district teams have also contributed to the poor performance of the
CHPS programme. Weak consultative process results in poor community ownership and local government
support for CHPS.
4.1.2 Develop sustainable financing strategies that protect the poor and vulnerable
Under the Ministry’s leadership and guidance, four main activities were to be undertaken. These include:
• Develop a comprehensive Health Care Financing Strategy
• Update National Health Accounts and initiate institutionalisation
• Pilot capitation payment in Ashanti Region
• Pilot project on identification of the poor using the common targeting instrument
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