A DIALOGUE WITH THE HEALTH COMMITTEE OF PARLIAMENT IN PROMOTING HEALTH CARE
The parliamentary oversight function is one of the cornerstones of democracy. Strengthened oversight of parliament is a critical factor in influencing an inclusive delivery of public goods and services. STAR-Ghana, for over 10 years has been supporting targeted Parliamentary Select Committees’ engagements with citizens and their issues, so they can better represent them in their legislative and oversight roles. to deliver on its mandate. One of the strategies used by SGF to support parliament to deliver on its oversight function is through the provision of evidence.
Since March 2020, and under its COVID-19 project and Partnership Beyond Aid, STAR-Ghana has supported civil society to generate information around the impact of COVID-19 on health, education, and social protection. Some of the partners it supported include the Christian Health Association of Ghana (GHAG), SEND-Ghana, African Education Watch, and Ghana Developing Communities Association (GDCA)
Eunice Agbenyadzi, Programs Manager
A one-day strategic meeting was held with the Parliamentary Select Committee on Health to discuss findings from the research and implications for policy. The meeting sought to provide evidence to strengthen the capacity of the committee to hold ministries, departments, and agencies to account for ensuring inclusive delivery of health services.
Highlights of reports
| Report 1: Rapid assessment of the impact of covid-19 on health services delivery· Generally, Out Patient Department attendance over 12 months declined but Antenatal attendance increased over the same period the previous year. There were also more pregnancies recorded in the facilities assessed compared to the previous year. The increase started in May 2020 (2 months after the first case was reported). This phenomenon could be attributable to the “lockdown” or “work from home” work culture adopted during the COVID season.· Respiratory tract infections declined significantly compared to the G before the first case of Covid-19. Importantly, diarrhoea diseases declined throughout the period probably as a result of the increased uptake of hand hygiene culture. None of the facilities assessed recorded cholera cases. This is the first time in the history of Ghana when there has been no cholera outbreak· Vaccines for immunizations were largely available in all facilities to meet the needs of children on vaccination. However, two (2) facilities were not providing immunization services because there was no cold box or Community Health Nurse. All facilities had hand hygiene facilities installed Recommendations • Personal Protective Equipment (PPEs)– The need for Government to invest in local production and make PPEs a routine component of the consumable supplies• Burden of Disease/outbreaks – Investment in Health promotion holds potential to reduce our healthcare expenditure on disease outbreaks treatment of certain disease conditions. Need to continuously promote hand hygiene, mass masking, and physical distancing given their impact on diarrhoea, cholera, and respiratory tract infections Report 2: Report on Joint Monitoring of COVID-19 commodities allocations and supplies· It was observed that about 478 different items in different quantities were allocated to agencies and facilities since the onset of COVID. About sixty (60) of them that were common to all facilities· Some discrepancies between items allocated, supplied, and received. Whiles some institutions received the exact items and the amount that were allocated, others did not. Factors that might have accounted for these discrepancies include poor documentation, personal influence on supply, and non-adherence to allocated quantities during supply.· some components of equipment for managing COVID were missing while others were not properly maintained. Critical equipment like Pulse Oximeters that were supplied was non-functional. Furthermore, there were inadequate Biomedical Engineers to service faulty equipment. Thus, maintenance of this equipment had to be outsourced and thereby increasing operational costs to the facilities.Recommendations • An investment in recruitment and capacity development for Biomedical Engineers is recommended to assure continuous working of equipment as well as a reduction in the maintenance cost for these institutions• Staffing and Human Resource: Community Health Nurses must be in every facility, Re-institute 2–3-year mandatory district practice for Medical Officers to keep MOs at the district level· Future allocations, distribution, and supply of COVID-19 commodities should make room for institutions to make requests of what they require or need before items are supplied Report 3: COVID-19 awareness and adherence to, and effect of government of Ghana’s covid-19 response measures, transparency, and accountability around covid19 inflows and expenditure· COVID 19 Alleviation Program: Majority (67%) of the participants registered their displeasure with how food was distributed, diversions of food items, and bias in the selection of frontline workers and business owners.· COVID-19 Open Budget Survey, 2020: In terms of oversight, the COVID-19 OBS report revealed that the legislature debated and approved the supplementary estimates related to the COVID response, but they had very limited time for the debate and the government had already started implementing some of the emergency response without legislative approval. Funds for the COVID 19 National Trust Fund, which is an extra-budgetary fund also used to finance the response, did not go through legislative oversight. Also, the Auditor General did not announce any special audits or actions to provide additional oversight for COVID-19 related spendingRecommendations • Government should de-politicise and adopt a bottom-up approach in planning and implementation of social interventions. Additionally, Government institutions must demonstrate openness and involve CSOs and citizens groups to lead in the distribution of relief items to ensure efficient and effective delivery.• The Auditor General should conduct special audits into COVID-19 related spending, to ensure value for money in the emergency fiscal policy interventions. All COVID-19 commodities including equipment that Government receives, or purchases should be costed before being supplied to institutions• Parliament should ensure Government demonstrates a greater commitment to its policy frameworks such as the Medium-Term National Development Plan Framework (MTNDPF) 2022–2025 (strengthen the healthcare delivery management system); Health policy 2020 (to ensure sustainable financing for health). The SDG target 3. (Substantially increase health financing). Take steps to execute the health sector budget as planned· A proportion or percentage of the COVID 19 levy should be appropriated for the establishment and implementation of the health emergency plan/National Action Plan for Health Security (NAPHS) which include a robust national laboratory system, real-time surveillance, workforce development, emergency response operations, vaccination, medical Center measures, and medicine or vaccine development |
Key Areas for Parliament-CSO joined-up efforts
The following were agreed on actions to be taken on by the Committee:
- Engage Ministry of Finance, Ministry of Health, and Ghana Health Service on health sector budget execution and investment in health promotion
- Engage the NHIS on the medicine price list and the availability of essential but basic medicines for pregnant women
- Hold a stakeholder dialogue on the migration of health professionals especially nurses to the UK and other foreign countries and remodel enrolled nurses’ courses to provide career guidance
- Monitoring visits to selected abandoned health facilities in the country
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