Impact of COVID-19 and debts on essential medicine supplies in Upper West

COVID-19 origin tracing
COVID-19 origin tracing

The widespread complaints about lack of essential medicines in some health facilities in the Upper West Region last year were fueled by disruptions in the supply chain due to the negative effects of COVID-19 and the huge debt owed to suppliers.

Dr Damien Apunguyire, the Upper West Regional Director of Health Services, disclosed this in an interview with the Ghana News Agency (GNA) in Wa under the “Mobilizing Media for Fighting COVID-19 project being implemented by the Journalists for Human Rights (JHR) in collaboration with the Ghana Journalists Association (GJA).

He said the availability of essential medicines and supplies were critical for quality and accessible health care delivery, and have been able to increase tracer drugs availability in the regional medical stores from 69 percent in 2020 to 75 percent during 2021 half-year.

“This was achieved by engagement with our major suppliers to re-profile our debt to enable them to continue to supply”, he said whilst assuring that they would continue to use the LMD to ensure these medicines were distributed to all points of use.

Dr Apunguyire noted however, that the inability of health facilities to promptly redeem their indebtedness to the Regional Medical Stores threating the sustainability of the tracer medicine and non-medicine availability.

“The facilities are unable to reimburse the Regional Medical Stores due to delay by the National Health Insurance Scheme (NHIS) to reimburse them”, adding that they do know that even when NHIS reimbursed the health facilities, some managers still do not settle their indebtedness which according to him was unacceptable.

The Regional Director of Health said despite the effects of CIVID-19 and the huge debt situation, they also made some modest progress in maternal and child health services.

Antenatal care (ANC) coverage increased marginally from 44.0 percent in 2020 to 44.7 percent in 2021 half-year whereas percentage skilled delivery increased from 35.4 percent to 38.7 percent.

Dr Punguyire added that postnatal coverage also increased from 36.1 percent to 39.2 percent in 2021.

He said there were declines in some key indicators including; stillbirth rate which declined from 11.2/1000LB to 10.8/1000LB and institutional neonatal mortality rate also declining from 7.9/1000LB to 5.9/1000LB.

The Regional Director of Health said the disruptions had thrown the region out of track towards achieving the Sustainable Development Goal (SDG) target on maternal mortality.

He said 12 maternal deaths were reported in 2021 half-year compared to seven deaths in 2020, whilst Family Planning acceptor rate had for the second year running declined from 26.3 percent to 23.7 percent.

He said the proportion of newborn babies initiating breastfeeding within 30 minutes after birth, which was critical for survival and wellbeing of newborns decreased from 90.8 percent to 90.2 percent.

Dr Apunguyire noted that teenage pregnancies significantly increased during 2021 half-year, noting that the region recorded a total of 13,812 teenage pregnancies in the half year as against 11, 547 over the same period in 2020.

He said this was primarily driven by high numbers from Sissala East Municipality, Sissala West District, Wa East District, Wa West District, Daffiama-Bussie-Issa District, and Nadowli-Kaleo District.

“It is a serious source of concern that despite the huge investments in these districts towards strengthening adolescent health services including; adolescent health corners, clubs, and peer educators, the situation did not seem to improve.

“There is the need for multi-stakeholder engagement to examine the cultural and contextual issues that influence our young girls into early sex”, he suggested.

He said the proportion of pregnant women with anemia at 36 weeks of gestation remained high at 46 percent.

On communicable disease prevention, Dr Apunguyire said per the data, the region made some progress in its expanded programme on immunization.

“Penta3 coverage has increased from 40.3 percent in 2020 to 44.0 percent in 2021 half-year, MR1coverage has improved from 40.1 to 41.4 percent; however, MR2 declined from 38.1 per cent to 37.2 percent.

“Under-five years’ malaria case fatality has declined from 0.37 to 0.13.

“On TB, the results are mixed. While the region performed well on TB case detection, the treatment outcomes were poor. TB case notification increased from 193 to 208.

“However, the region achieved only a 74 percent cure rate compared to a target of 90 percent, and this was precipitated by a high death rate of 15.2 percent and six percent lost to follow up” he added.

He lamented the unprecedented heavy downpours that resulted in floods with several communities cut off from the regional and district capitals.

He said six out of the 11 districts of the region were not accessible to the regional capital as some major roads were washed away, adding that this made movement of health workers and critical supplies to service delivery points hugely impeded.

“This situation is likely to threaten the delivery of essential health services to most of the region’s population and could derail the gains made”, Dr Apunguyire said, but expressed confidence that they would rise to the occasion.

“We will explore innovative ways including; the use of ICT to reach out to the populace with our services” he said.

He reminded the public that the pandemic was not over yet, saying over the past few weeks, some regions have seen rising numbers of cases in what is now described as the third wave and the region had recorded 21 new cases and one new death bringing total number of cases to 519 and 20 deaths as of 22nd August, 2021.

“If we lose hold of the proven public health measures, the disease will come back strongly and overwhelm us. We need to sensitize the public to practise hand hygiene, social distance, mask wearing and use open spaces for public events”, he urged.

Pre-triaging at entry points to all health facilities need to be reinstituted in earnest.

Remember it is: NO MASK, NO ENTRY.

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