Interrogating the NPP and NDC health manifestos.

According to SEND GHANA, “Primary health care (PHC) is considered to be an important tool in achieving universal health coverage (UHC).

When primary health care works, people have access to comprehensive services ranging from reproductive health and routine immunizations for the treatment of preventable childhood diseases such as measles and polio among others, family planning and nutrition and illness among the top ten causing morbidity and mortality such as malaria and HIV/AIDS.

However, despite its relevance, most primary healthcare service delivery is faced with numerous challenges that hinder their effective operations. The major challenge is inadequate resources committed to this level of service delivery.

While recent calls to increase resources committed are valid, other public sector priorities compete for these limited resources. It has, therefore, become imperative to create additional fiscal space for the health sector through various means.

Ghana has made significant progress in immunisation coverage and reducing childhood diseases, malaria control and HIV prevalence. But these successes have come at the back of donor support while government of Ghana obligation to address these diseases fall short of the expected.

For instance, Ghana has been a beneficiary of vaccine supply under the global alliance for vaccines and immunization (Gavi) initiative since 2001. Under the Gavi initiative, beneficiary countries like Ghana are obliged to co-finance the cost of supplied vaccines, increase their co-financing by 15% annually and gradually transition to self-financing by 2026/2027.

In 2016 and 2018, the Government of Ghana defaulted on its co-financing obligation under Gavi , which among other things resulted in the shortage of vaccines in 2017 and hindered the realization of the immunization target under the Expanded Programme on Immunization (EPI) .

The country’s inability to co-finance the cost of supplied vaccines is a result of inadequate funding towards immunization. Meanwhile, unavailability of vaccines at any point in time poses a threat to Ghana’s progress on under-five mortality, as infections which is the leading cause of child mortality can be prevented through immunization of children from birth.

Also, Ghana’s status as a middle-income economy has negatively affected donor support to the country, including the area of health . This gives an indication that the country cannot rely on external support.

To this end, the government of Ghana needs to increase the allocation of domestically mobilized financial resources to fund primary health care in line with target 17.1 of the sustainable development goals to which the government has signed on to.

Since the inception of multi-party democracy, manifestos have played a critical role in providing citizens and other stakeholders’ critical insight into political parties’ appreciation of development challenges and to address them.

Also, while manifestoes provide a basis for comparing policy proposals by parties to address development needs and enabling citizens to make an informed choice, they become the basis for initiating and implementing policies and programmes in government.

Ghana will be going to the polls in December to elect a new government and contesting political parties have published their manifestoes outlining the plans, policies and programmes for various sectors including health, and campaigning the basis of the manifestoes to win the mandate of the people for the next four years.

Most importantly, manifestoes are a social contract between the citizens and political parties and serve as a basis for holding the eventual winner accountable in government.

SEND GHANA and its partners during the manifesto preparation period by the parties submitted citizens inputs on health to influence what finally gets into the manifesto agenda and its implementation from 2021 depending on which party is voted to office.

Even though the manifestoes have been appraised, it is important to create opportunities for its content to be further explained for in-depth comprehension of citizens.”

It is on the backdrop of this that SEND GHANA and its partners, held a one (1) day engagement session with the major political parties on their health sector manifestoes and plans for increasing domestic financing for primary health care including immunization.

The event which was held on Wednesday 28th October, 2020, at the Coconut Groove Hotel in Accra, was aimed to increase accountability where the governance space for political party and citizens engagement is further given the boost through demand for deeper interaction and responsiveness for improve primary health care and domestic financing for health.

In his presentation to elaborate NPP’s Manifesto with respect to health, the Presidential advisor on Health, Dr. Anthony Nsiah-Asare, said that, the New Patriotic Party (NPP), will build new health facilities across the length and breath of the country and upgrade existing ones when given a second term in government.

According to him, the NPP’s health manifesto in 2016 was centered on ‘health in all approach’, therefore, they are looking at health holistically by taking into consideration all other determinants of health in achieving their policy.

Dr. Nsiah-Asare, expatiated the party’s efforts in the health sector since its assumption in office in 2016. This he said, should be enough assurance to Ghanaians that, the party is committed to improving the country’s health sector.

On the other hand, spokesperson for the National Democratic Congress (NDC) on Health, Dr. Koma Jehu-Appiah, explained that, the NDC party’s Free Primary Health Care policy in the manifesto will serve as an improvement upon the existing National Health Insurance Scheme (NHIS), as it focuses on health promotion and prevention, in order to offload all burdens from the NHIS which covers less than half of the country’s population.

Dr. Jehu-Appiah, noted that, Ghana has since been struggling to obtain a common vehicle to transport the nation to a universal health coverage but to no avail. Saying, “the National Health Insurance Scheme covers slightly less that 40% of the population, leaving 60% of the Ghanaian population with no health insurance.”

To him, Primary Healthcare is the most effective vehicle to bridge the gap.

In his submission, Dr. Gordon Abekah-Nkrumah, Health Expert at the Business School, University of Ghana, intimated Ghana’s political parties have always focused a lot more on operational issues rather than strategic issues. Saying, “of course, there are issues from both sides that have been agreed to that are strategic, but we need to begin to into financing. Looking into where to get the extra money to put into the NHIA.

“We then need to look into the provider financing splits, so that we can then begin to have provider centers that are autonomous from government, so that when they offer services government can now pay.”

He therefore underscored the need to do the aforementioned, so that the monies that goes into all the infrastructural areas could be relocated into restructuring the health sector holistically. “Until then, it will just be as business as usual,” he emphasized.

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