2012 Holistic Assessment of Health Sector POW - Ministry of Health

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Acknowledgements The holistic assessment of the health sector 2012 Programme of Work was done internally by the Ministry of Health. A team of five people from Ministry of Health and Ghana Health Service undertook the review and holistic assessment. The members of the team were Dr. Afisah Zakariah, Daniel Degbotse, Dan Osei, Dr. Anthony Ofosu and Dr. Andreas Bjerrum. The team would like to thank all individuals who contributed to this review and who kindly gave their time and support to the review process. 4
Executive summary The year 2012 represented the third year of the implementation of the current Health Sector Medium Term Development Plan (2010-2013). The review has placed emphasis on the performance of the sector according to identified health objectives as outlined in the Four-Year Sector Medium Term Development Plan and the derived Annual Programme of Work for 2012. The review assessed the overall sector performance for the year 2012 using the agreed Holistic Assessment tool. The Holistic Assessment tool was adopted in 2008 and has been used to assess the sector performance since its inception. The report is organized into six chapters and a conclusion. 1. Assessment of the Health Sector using the Holistic Assessment Tool The purpose of the holistic assessment is to form a basis for a balanced discussion between the Ministry of Health, its agencies and development partners to reach a common conclusion of the sector’s performance. The outcome of the assessment is that the health sector in 2012 was a positive sector score of +3, which is interpreted as a highly performing sector. 2. Assessment of indicator Trends Health Objective 1: Bridge equity gaps in health care and ensure sustainable financing arrangements that protect the poor The equity index for supervised deliveries by region improved and reached the target of 1.7 comparing the best to the worst performing region with regards to coverage. Performance improved among both the best and worst off regions. Almost all regions’ performance were above 50% except Volta Region at 46.5% and Northern Region at 49.9%. Coverage increased in all regions except for Ashanti Region, which experienced a drop of 2.1%. The poorest staffed region with regards to nurses is the Northern Region Volta and Upper West Regions stand out with critical reductions in midwife populations. The Doctor to population ratio did not change much and with 11 times less doctors per population in Upper West Region compared to Greater Accra Region equitable distribution of doctors remains a major challenge to the health sector with one nurse to 1,601 population compared to the national average of one nurse to 1,251 population. The National Health Insurance since its introduction has led to increase in utilization of OPD services across all the regions. Ashanti region like all the regions showed an increase in OPD attendance till 2012 when it experienced a drop in OPD per capita Health Objective 2: Strengthen governance and improve efficiency and effectiveness of the health system In 2012, the ministry introduced performance contracts with four agencies: the three Teaching hospitals and Ghana Health Service. Government of Ghana contribution increased by 126.9% from GH¢771 million in 2011 to GH¢1,750 million in 2012. Internally Generated Fund (IGF) increased by 8.9% from GH¢392 million in 2011 to GH¢427 million in 2012. Contribution from donors in 2012 was GH¢290.8 million whilst there was GH¢259.2 million contribution in the same period of the previous year, an increase of 12.2% over the same period of 2011.Total Gross Revenue, recorded by the Ministry was GH¢2,489.8 million. The Ministry recorded a total expenditure of GH¢2,613.4 million for the period under review Debtors have decreased from GH¢137.7 in December 2011 to GH¢115.9m in December 2012, a decrease of 15.8%. 5
Page 1 and 2: Ministry of Health Ghana Holistic A
Page 3: List of abbreviations and acronyms
Page 7 and 8: 3. Regions of excellence and region
Page 9 and 10: Food and Drugs Authority From the n
Page 11 and 12: Korle-Bu Teaching Hospital The hosp
Page 13 and 14: Introduction The year 2012 represen
Page 15 and 16: 2012 POW 2007 2008 2009 2010 2011 T
Page 17 and 18: Figure 1: Supervised deliveries by
Page 19 and 20: Figure 3: Doctor: population ratios
Page 21 and 22: Figure 5: OPD visits by gender and
Page 23 and 24: Total Gross Revenue, recorded by th
Page 25 and 26: 2.2.3 National Health Insurance Act
Page 27 and 28: The proportion of pregnant women at
Page 29 and 30: eastfeeding. There will be the need
Page 31 and 32: 2.5 Health Objective 5: Strengthen
Page 33 and 34: 3.0 Regions of excellence and regio
Page 35 and 36: The development of the health care
Page 37 and 38: such as deep-freezers, chest freeze
Page 39 and 40: plan was finalized and submitted to
Page 41 and 42: • Organization of training progra
Page 43 and 44: ACHIEVEMENTS HO1: Bridging the Equi
Page 45 and 46: Under a programme to prevent, detec
Page 47 and 48: 2010 N=160 2011 N=197 2012 N=165 1
Page 49 and 50: 2012 Achieved 2011 Achieved Patient
Page 51 and 52: Ashanti 5 11 16 Eastern 4 11 15 Cen
Page 53 and 54: • Quality of care challenges •
Page 55 and 56:
• The improvement in service outp
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6.0 Follow-up on Aide Memoire recom
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OPD The number of outpatients per c
Page 61 and 62:
Annex 1: Sector Wide Indicators and
Page 63 and 64:
Annex 2: Sector wide indicator tren
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The indicator has experienced a rel
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Wealth Quintile 2003 2008 2012 Redu
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Figure 15: Supervised deliveries by
Page 71 and 72:
parts of the region has not benefit
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Greater Accra continue to be the Re
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2012 Performance: 38.5% 2012 Target
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Total fertility rate 2012 Performan
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2009 - 59.7% 78.2% - 87.4% 46.9% 71
Page 81 and 82:
Discussion: The slow reduction in t
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Figure 21: Penta 3 coverage by regi
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Source: National TB Programme Outco
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Basket of critical equipment functi
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mortality ratio at all levels of th
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Annex 4: Indicator definitions and
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TB success rate Psychiatric patient
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vulnerable Update National Health A
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Some district assemblies organized
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and Volta 3.2 Reduce the major caus
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Implement national strategic plan t
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atio of 10. 4.2 Improve prevention,
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Bolgatanga Regional Hospital about
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Annex 6: Capital Investment Update
Page 109 and 110:
21 1 Regional Hosp., Ridge Greater
Page 111 and 112:
Dua Yaw Nkwanta PATS Classroom Bloc
Page 113 and 114:
4 Boosting Reproduction and Child H
Page 115 and 116:
Annex 7: Procurement plan Draft 201
Page 117:
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2012 Holistic Assessment of Health Sector POW - Ministry of Health

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