NHIS not panacea to quality healthcare delivery - Dr Issah

Wa, Nov. 13, GNA - Dr Kofi Issah, acting Upper West Regional Director of Health Services has observed that even though the National Health Insurance Scheme's (NHIS) ultimate goal is to make people healthy, it is not a panacea for the promotion of quality healthcare delivery in the country.

He said the NHIS only helped to move the financial barriers of patients, but that needed to be complemented with the provision of improved equipment, efficient transport system, quality training of health personnel, and good management of health facilities as well as the changing of behaviour of health personnel towards patients. Dr Issah made the observation at a forum with students from the Ghana Armed Forces Command and Staff College, who are on a study tour of the Upper West Region to find out how government policies are being implemented and their impact on the people.

The 12 students including students from Nigeria, Senegal, Tanzania, Uganda, Sierra Leone, Gambia and Mauritania are also to examine how political and socio-economic issues were impeding on development, as well as poverty alleviation, migration and epidemics that affected the people.

Dr Issah suggested that more attention be given to the teaching of quality healthcare practices at the household and communities levels, to help in the prevention of diseases to guarantee quality healthcare delivery for the people. He told the students that because of the NHIS there was workload on the nurses and doctors, especially those in the Upper West Region where a doctor-patient ratio stood at 127,000 to a doctor while that of a nurse was 1,000. The Upper West Region has a population of 659,827, with six hospitals, nine doctors, 59 health centres, 50 community based health planning and services, 885 traditional birth attendants and 1,165 community based service volunteers.

"Out patient-department attendance has increased due to NHIS, however no significant changes have occurred in bed statistics and quality of care. "Malaria and skins diseases as well as respiratory tract infections continue to be top of the causes of consultation," Dr Issah said. He said malaria recorded 39.7 per cent of hospitals attendance and also accounted for 8.2 per cent of all deaths in children below five years of age.

Dr Issah expressed regret that due to late reporting for antenatal only 13.4 per cent of pregnant women received intermittent preventive treatment for malaria, while treated bed nets were given to pregnant women and children as well as improved clinical diagnosis and treatment as part of the strategies to control the disease. He said the region has the highest rates of maternal and child mortality in the country, recording 94 per 100,000 ratio for maternal deaths (half year report 2008) and 191 per 1,000 ratio for child deaths (2006 report).

"Nutrition interventions, improved community decision-making systems and emergency transport systems among others were some of the strategies adopted to reduce these incidents," Dr Issah said. He however lamented that the Wa East, Wa West, Sissala West and Lambussie Karni Districts were without facilities for blood transfusion and surgeries.

On HIV/AIDS, Dr Issah told the students that there were 38 facilities providing counselling and testing services in the region. He said between January and June this year, 6,684 women had been counselled and 101 of them tested positive. "Thirty-one mothers and baby pairs are on ante-retroviral drugs. There are also 122 other patients on treatment and 433 people have joined each other to form 12 associations of people living with HIV/AIDS," Dr Issah told the students.

The HIV/AIDS prevalence rate in the region is 3.3 per cent while that of Wa Municipality is 5.8 per cent, a sentinel survey carried out in 2007 between September and October indicated. Dr Issah indicated that tuberculosis posed a big challenge in diagnosis and treatment due to lack of laboratories and equipment in some of the health facilities, but said after the national launch in the region, activities had improved.

He said the region also lies in the meningitis belt and education on the disease was going on in the communities to sensitize the people. "Trachoma has reduced significantly and only one case of guinea worm had been recorded this year," Dr Issah said. He said surveillance system involving communities and health facilities is in place to set up an early warning system while epidemic preparedness committees were also being formed to that effect. "Mass distribution of drugs against onchocerciasis and other worms have been carried out this month, Dr Issah told the forum. 13 Nov. 08