For a developing country like Ghana, many are those who believe and often blame the country?s inability to improve access and quality of health care on the lack of adequate resources. In sharp contrast to the above view however, is a strong assertion that if there is anything that poses a big threat to Ghana?s chances of attaining the Millennium Development Goals, 4, 5 and other health related goals it is the quality of leadership and the commitment of staff in the sector.???????????


Madam Rofina Asuru, Coordinator GEHIPThis assertion has been made by the Upper East Regional Director of Health Services Dr. Koku Awoonor-Williams. The Regional Director made the observation when he addressed health workers in Bolgatanga during a review of the Ghana Essential Health Intervention Program (GEHIP) in Bolgatanga.


Dr. Awoonor-Williams said it takes a committed workforce led by a good and inspirational leadership to get around the health system challenges some of which include: poor health seeking behaviours of communities, negative attitudes of some health staff to be able to deliver quality and accessible health care that promotes good health and reduces if not completely averts the causes of maternal and child mortality at both community and institutional levels.


As he opined, the commitment of staff and good leadership make the difference: ?you cannot expect any outstanding results from a leadership that lacks the drive and character and a staff that does not care a hood?.


The Regional Director challenged District Directors of Health of the project area to see opportunity in the additional resources and support given the GEHIP districts and take advantage to bring about rapid progress in their health indicators.


?You have no excuse; you have everything to exhibit star performance in your indicators; and I want to see that; I want to see the other districts that are not getting your kind of support coming to learn from your best practices?, Dr Awoonor-Williams admonished.?? He was emphatic that the project is on course to meeting its objectives but cautioned that the gains could only be consolidated and sustainability ensured if staff and management implementing the project are focused, and determined to contain the major hindrances encountered including shortage of key staff particularly Midwives and Doctors as well as transport logistics and ??others.


Reports from implementing districts showed marked increase in service expansion to hitherto underserved communities. In the Bongo district the number of CHPS compounds rendering 24 hour services to communities has increased from 13 in 2010 to current 27. This takes the population served by door-step health service from 39% to 67%.


Similarly, in the Builsa district the percentage of the district?s population served by door-step services through CHPS operations shot up from 27% in 2010 to 54%. This improvement in coverage results from an increase in the number of CHPS compounds from 11 in 2010 to current figure of 21. On the part of Garu-Tempane, the population benefiting from CHPS services rose from 30%, one of the lowest in the region to a record high of 83%. All three districts reported impressive results for institutional deliveries and postnatal coverage.


According to the District Director of Health Services for Bongo, Madam Juliana Anam-erime, the district has made significant gains in the struggle against pregnant women reporting in third trimester. ?This she said presents a bigger opportunity for early detection of risk factors and enable adequate education for improved maternal and child health.


She indicated that her district is committed to improving the capacity and devotion of staff at all levels to sustain the conditions for delivering improved services closer to homes. The district will also continue to deploy resources to support the free emergency ambulance service started under the GEHIP programme as well as increase community participation in health planning through durbars and community meetings with opinion leaders.


While appreciating the implementation progress of the programme, the GEHIP Coordinator, Madam Rofina Asuru entreated the districts to improve on the quality of documentation on the free emergency referral intervention being implemented. That she said was necessary to make it easy to identify gaps for the purpose of improving on the intervention for better services. Proper documentation she contended will also make it possible for easy tracking of the impact of the programme.


She charged management not just to increase monitoring visits but ensure quality supervision through attention to detail on all services at various levels as a measure for quality service. Madam Rofina admonished them to make efficiency and effectiveness in resources usage a priority so as to get value for money.


GEHIP is a health system strengthening initiative being piloted in three deprived districts in the Upper East region namely Builsa, Bongo and Garu-Tempane. The programme is funded by the Doris Duke Charitable Foundation of the United States and implemented by the Ghana Health Service in partnership with the University Of Ghana School Of Public Health and Columbia University?s Mailman School of Public Health.


By Mathias Aboba


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