MAY 20

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5 Things you can do to prevent stroke
• Lower blood pressure
High blood pressure is a huge
factor, doubling or even quadrupling
your stroke risk if it is not
controlled. ‘High blood pressure is
the biggest contributor to the risk
of stroke in both men and women.
• Lose weight
Obesity, as well as the complications
linked to it (including high
blood pressure and diabetes),
raises your odds of having a
stroke. If you're overweight, losing
as little as 10 pounds can have a
real impact on your stroke risk.
• Exercise more
Exercise contributes to losing
weight and lowering blood pressure,
but it also stands on its own
as an independent stroke
reducer.Take a walk around your
neighborhood every morning after
breakfast.
Drink in moderation
Drinking can make you less
likely to have a stroke up to a
point. Studies have shown that if
you have about one drink per day,
your risk may be lower.
WWW.DAILYHERITAGE.COM.GH
DAILY HERITAGE MONDAY, MAY 20, 2019
&Env.
Physician assistants: the major pillars
of primary healthcare in Ghana
BY SAMUEL WIAFE
PRIMARY HEALTH-
CARE (PHC) refers to
‘essential health care’ that
is based on scientifically
sound and socially acceptable
methods and technology,
which make universal health
care accessible to all individuals and
families in a community.
It is through the full participation
of all stakeholders and at a cost that
the community and the country can
afford to maintain at every stage of
their development in the spirit of selfreliance
and self-determination.
This ideal model of healthcare was
adopted during Alma Ata Declaration
in 1978 at Kazakhstan, and became a
core concept of the World Health Organization's
goal of Health for all.
The Alma Ata Conference mobilised
a ‘Primary Healthcare movement’
of professionals and
institutions, governments and civil society
organizations, researchers and
grass-roots organizations that undertook
to tackle the ‘politically, socially
and economically unacceptable’ health
inequalities in all countries
Ultimate goal of
primary healthcare
The ultimate goal of primary
healthcare is the attainment of better
health services for all. It is for this reason
that the World Health Organisation
(WHO) has identified five key
elements for achieving this goal,
namely universal coverage reforms;
service delivery reforms; public policy
reforms; leadership reforms; and increasing
stakeholder participation.
Behind these elements lies a series
of basic principles identified in the
Alma Ata Declaration that should be
formulated in national policies in
order to launch and sustain PHC as
part of a comprehensive health system
and in coordination with other sectors.
The 4th, 5th and 6th portions of
the eight Millennium Development
Goals set in the year 2000 place emphasis
on reducing child mortality, improving
maternal health and
combating HIV/AIDS, malaria and
other diseases.
Therefore in order to achieve this,
a comprehensive healthcare is required
which relies on an adequate number
and distribution of trained physicians,
nurses, allied health professions, community
health workers and others
working as a health team and supported
at the local and referral levels.
(WHO)
Additionally, it requires the commitment
of the government of the
day to infuse into the health system resources
to improve the health of the
citizens in the country.
But how is this achievable if the
government does not have a team of
dedicated work force, who are ready to
serve in their capacity everywhere they
are posted within the country?
With the growing demand for better
health care across the country by
citizens of this country, which has led
to government upon government embarking
on various forms of expansion
at various health facilities, it
seems not to be enough to accommodate
all our patients in the country
leading to congestion and spill over at
the various health facilities, especially
regional and tertiary health institutions.
Ghana, as a country, has chalked
up successes from adopting the PHC
model.
The burden of the community in
having to travel distances to seek
health care and the numerous number
• Physician assistants are the pillars of healthcare in rural communities
of mortalities that occur through these
means have drastically reduced though
not eliminated. This is in spite of the
implementation of the CHPs concepts,
establishment of health centres
and district hospitals, increased training
of health workers, particularly
those who serve at the community and
in rural areas and deployment of logistics
to such hard-to-reach areas for the
initiation of care and to fall on referral
protocols, if necessary. Among the
cadres that work in such deplorable
areas are the Physician Assistants.
Who is Physician
Assistant?
Who is a Physician Assistant (medical)
in Ghana and around the globe?
Formerly called Medical Assistant, A
Physician Assistants (PA) is one
trained by the health training institutions
in the country to bridge the gap
between doctor-patient ratio and to
save the dying who could not reach
the hospitals but yet need urgent care
to survive.
They are trained in community
medicine and health, public health,
surgery and obstetrics and gynaecology
within a period of four years and
practise independently after their internship
at over thousand health centres
across the country and do so
within their scope of practice guarded
by the laws of the country and ethics
of the profession.
They are regulated by the Medical
and Dental Council of Ghana. This
category of workers practise medicine
and dentistry across the globe with
names such as Physician Assistants
(Ghana,USA, UK), Clinical Officers
(Kenya, Tanzania, Zambia, Burkina
Faso) etc.
A Physician Assistant is the subdistrict
head, though unofficially appointed,
and is answerable to the
district director of health services and
manages the health centre, with his or
her headship covering Administration,
Human Resource clinical work, health
promotion, Research & Surveys and
supervision of activities of the CHPS
compounds and Community-based
Volunteers within his catchment area.
From the 1950s up to the adoption
of PHC concept in 1978 and beyond,
the government saw a huge deficit in
the health sector due to the lack of
doctors in the country, which made it
impossible to achieve universal health
coverage and the then sustainable development
goals, now revised to millennium
development goals, hence the
need to train this special work force of
Physician Assistants to intervene in
the collapsing situation and bring
health closer to the people.
Unfortunately, after the Physician
Assistants have been and employed,
everyone including the government,
forgets about them and leave them to
their fate in deplorable facilities with
scarce resources, which most at times
leaves them to improvise but they have
survived and continue to sacrifice their
quota for this country to where it has
reached today. Not being privileged to
have electricity and even reception for
phone calls, the Physician Assistants
manage to deliver.
If someone will hear my voice
today as I put it in writing, they should
pat this category of health workers on
the back, motivate and give them the
requisite remunerations for their sacrifices,
for where there is no doctor
there is a Physician Assistant.
Threat
So if there is any threat against this
professional group, who are doing this
tremendous work in the country, then
it should be the concern of all to defend
them because without their efforts
our fathers, mothers, siblings,
uncles, nephews etc living in the rural
areas would either die in an emergency
because of lack of transportation coupled
with our bad roads or even suffer
complications because they could not
reach on time the hospital far away
from their commuinities.
Should this category of workers
not be empowered through career
progression and given other opportunities
to enable them to deliver better
services to the patients they treat every
day? Food for thought.
Physician Assistants are also found
in the consulting rooms of most of
our hospitals treating patients every
day. In Kenya and the other countries
they are also trained to perform caesarean
session and other surgeries as
well. They have gained the name doctor
in their villages where they practise
as some would ridiculously say village
doctor but they are proud of what
they do and proud to be called their
own name as Physician Assistants
(medical).
The country would not have
gained this much without the PHC
concept and would not have gained
same either without Physician Assistants
at the grass roots.