NHIS HAS PLACED HUGE BURDEN ON HEALTH PROVIDERS (PAGE 36)

HEALTH is the state of complete physical, mental, economic, spiritual and social well-being, as well as the absence of disease and infirmity.
So it was not strange when Ghanaians embraced the National Health Insurance Scheme (NHIS) after its introduction some years ago to enjoy affordable health care in the country.
However, the introduction of the NHIS, with its corresponding increase in attendance at health facilities, has placed a huge burden on health providers throughout the country including medical doctors, nurses and the para-medical staff.
Apart from the scheme putting pressure on the inadequate health facilities, the staff are also finding it very difficult to cope with the increases in attendance.
As of the end of June, 2008, coverage of the scheme in the Western Region was 50 per cent, though Sekondi/Takoradi Metropolis and Tarkwa/Nsuaem Municipality have coverage of over 60 per cent.
It is expected that with increased sensitisation, more people will come to appreciate the usefulness of the scheme and register with it.
The Western Region has a population of 1,924,577 according to the 2000 Population and Housing Census, representing 10.2 per cent of the total population of the country. The projected 2008 population for the region is 2,477,369.
There are 17 administrative districts and 70 health sub-districts in the region.
The region has a total of 338 different categories of health facilities, including 12 government hospitals, 11 private ones, two polyclinics, 56 health centres, 161 government clinics and 92 Community Health-based Planning and Service (CHPS) compounds.
With the availability of those facilities, what is needed most are human resources, equipment and medical supplies to ensure their effective operation.
It was, therefore, heart-warming when 224 newly qualified trainees from the Ministry of Health’s training institutions selected for placement in the various districts and health facilities in the Western Region were taken through a two-day orientation/induction programme in Takoradi.
The programme was intended to facilitate the early integration of the new entrants and expose them to the challenges ahead in order to inculcate in them the appropriate attitude and work culture.
 They were taken through topics such as disease burden, operational challenges, expectations on new entrants, the creation of Ghana Health Service, the vision, mission, objectives, core values of the service and its relationship with other agencies under the Ministry of Health.
The new entrants also went through the code of conduct/ethics, offences and punishments, welfare and benefits available, as well as planning for retirement, infection prevention, patients charter, referral system, reproductive health services, data capture and management, nursing protocols and quality assurance.
At the opening of the induction and orientation programme in Takoradi, the Western Regional Head of Human Resource Management Unit of the Ghana Health Service (GHS), Mr Peter Obiri-Yeboah, stated that in 2002, a study was conducted by the Human Resource Directorate of the Ghana Health Service in a bid to strengthen staff performance management system.
He said the outcome of the study indicated that most staff members were not conversant with the vision, mission and objectives of the service and as such, could not see the link between their routine functions and the goals of the service.
“It was also observed that tools such as job description, treatment schedules, guidelines and standards existed but were not known to service providers,” he said, adding, “Most staff were unaware of various codes, especially the code of conduct which was supposed to govern their conduct.”
Mr Obiri-Yeboah said those concerns culminated in the development of the induction and orientation systems as part of existing human resource management systems and implemented at all levels.
That, he further explained, was based on the conviction that staff of the GHS were the most important and valuable assets.
He said it was also based on the fact that things were likely to be strange at the early stages in their various locations and that the individual/group contributions could affect the attainment of the objectives of the service.
Mr Obiri-Yeboah said it was based on the conviction that the attitude and conduct of the new entrants in the course of their routine duties would determine the type of services the GHS would offer.
He said their early integration into the GHS family would ensure a drastic reduction in the interval between their minimum and optimum levels of productivity.
“This gathering is, therefore, intended to ensure your early integration into the GHS and at your respective districts and facilities,” he stated, adding, “It is also to ensure that you are fully aware of the vision, mission and objectives of the GHS and how you can contribute to the attainment of these objectives.”
Mr Obiri-Yeboah said it would ensure that the new entrants were conversant with existing management policies, guidelines and codes, especially the code of conduct that would regulate their conduct throughout their life in the service.
“Additionally, it will let you have a fair idea of your rights and responsibilities as staff of the service,” he emphasised.
The acting Deputy Western Regional Director of the GHS in charge of Public Health, Dr Kwaku Anin Karikari, said the mandate of the service was to provide and prudently manage comprehensive and accessible health service with special emphasis on primary health care at the regional, district and sub-district levels in accordance with the approved national policies.
He mentioned the main diseases of public health importance in the region as malaria, upper respiratory infections, diarrhoea, onchocerciasis, lymphatic filariasis, buruli ulcer, typhoid fever, poliomyelitis, yellow fever, schistosomiasis and cholera.
The rest, he said, were meningitis, measles, guinea worm, tuberculosis, yaws and leprosy.
Dr Karikari said some current human resource, welfare and community problems, as well as health staff performance, were poor data collation and reporting, poor understanding of data, non-use of data at various levels, poor inter-sectoral collaboration and interaction with communities, and poor fund and logistic flow and management.
He said other problems were the unwillingness of health institutions to fund public health programmes, poor financial management, non-planning and non-adherence to plans and staff sabotaging the free maternal care, child care and the National Health Insurance Scheme policies.
According to him, non-unitary leadership in some communities because of disputes, non-cooperation between chiefs and assembly members, apathy of communities to health institutions, revolts against health staff because of perceived bad staff attitude and the fact that some community leaders would like to control finances of community clinics were also some of the problems.
“You have been introduced to the health system, you will also be introduced to the ethics, quality and other issues which should be a guide to your work,” Dr Karikari said.
“The health sector and the GHS have objectives and targets, with your school knowledge, the induction and your future experiences at work; we expect you to fit into the system and help achieve the vision of the health sector and the nation as a whole,” he told the newly qualified personnel.