Emerging issues in public health: a perspective on Ghana’s healthcare expenditure, policies and outcomes

Abstract

Ghana's healthcare expenditure has increased over the past two decades. Increased healthcare expenditures are required to enhance the acquisition of better hospital resources that may improve healthcare. This study presents an overview of healthcare expenditures and health outcomes (i.e. infant mortality, under-5 mortality and life expectancy) from 1995 to 2014 in Ghana. Infant and under-5 mortalities have declined by 50 and 25%, respectively, as of 2014, while life expectancy has increased from 60.7 to 64.8 years. Private spending on health, especially out-of-pocket payments, declined but is higher than the World Health Organization's recommended financial threshold. Non-communicable diseases (NCDs) are rising with healthcare costs leading to catastrophically high healthcare expenditures in the future. While government's investments on healthcare have yielded positive results, the improvement in the health outcomes cannot be attributed to increased health expenditure alone. Therefore, this paper outlines policies on maternal health, national health insurance and healthcare reforms that have influenced health outcomes. In parallel, the paper highlights challenges of the Ghana health system of which the major ones are (1) inadequate financial investments in health and (2) limited health workforce and facilities. These challenges can be ameliorated by (1) establishing new health institutions and expanding existed ones; (2) providing incentives to discourage the exodus of health workers; (3) introduction of the concept of predictive, preventive and personalized medicine (PPPM) for treating NCDs; and (4) alternative insurance schemes for vulnerable groups. This, coupled with the will of the government to curb misappropriation of funds, will be important to achieving better health outcomes.

Within country inequalities in caesarean section rates: observational study of 72 low and middle income countries

“… 54 55 56 57 In Ghana, the national policy to exempt women from paying for delivery care introduced in 2004 was successful in improving coverage and outcomes and in reaching poor women. 58 59 In 2004, Indonesia started the implementation of a government financed health insurance programme for poor people, which was expanded in 2008 to include near-poor people, and the Jamkesmas is currently the largest social health insurance programme in the country. Although this programme does not overcome all the barriers, evidence shows that membership to Jamkesmas can reduce some financial barriers.…”

Barriers to formal healthcare utilisation among poor older people under the livelihood empowerment against poverty programme in the Atwima Nwabiagya District of Ghana

“…Issues such as financial problems, limited health workforce, and facilities are the major challenges facing the healthcare system in Ghana [25,26]. Consequently, the utilisation of formal healthcare services among older people involves numerous barriers [10,27,28].…”

Socioeconomic and Gender Health Disparities in Diabetes: The Lower Middle Income Case of Ghana

“…Diabetes is also among the top five leading causes of NCD deaths in Ghana (Adua et al. ). Like most LMICs that have historically targeted their health resources toward addressing maternal–child conditions and communicable diseases like malaria and HIV/AIDS, Ghana currently lacks comprehensive policies and infrastructure to effectively combat NCDs like diabetes (Adua et al.…”

“…Like most LMICs that have historically targeted their health resources toward addressing maternal–child conditions and communicable diseases like malaria and HIV/AIDS, Ghana currently lacks comprehensive policies and infrastructure to effectively combat NCDs like diabetes (Adua et al. ). As a result, the economic and personal costs of diabetes to both patients and family members can be catastrophic (Abegunde et al.…”