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2019 Budget fails to address Key Challenges in Health Sector —Binduri MP

Hon Robert Baba Kuganab-Lem

Member of Parliament for Binduri, Dr Robert Baba Kuganab-Lem, has expressed concern that the 2019 budget delivered only short-term and failed to address the underlying determinants of key issues, especially human resources which posed serious threats to the country health sector.

The MP was contributing to the debate on the 2019 budget statement delivered to parliament by the Minister for Finance, Ken Ofori-Atta.

The Minister of Finance, who presented the Budget Statement to Parliament, in Accra, on Thursday November 18, outlined that the Government would secure 275 ambulances for each of the 275 constituencies.

The budget revealed that, the University of Ghana Medical Centre (UGMC) phase one has commenced, while Parliament has approved a-50 million dollar-loan for Phase Two.

The Ho Regional Hospital is also to be upgraded to a Teaching Hospital status, while Hohoe Municipal Hospital to become a Regional Hospital.

The Government also intended to construct 15 Community-based Health Planning Systems (CHPS), in the following regions: Brong Ahafo – five, Eastern- three, Western-three, Ashanti – two and Greater Accra – two.

Additionally, the Western Region is to benefit from a district hospital and five polyclinics, while four district hospitals in the Easter Region are to be equipped with state-of-the-art medical equipment.

But Dr Kuganab-Lem said, the government has failed to allocate enough Government of Ghana (GoG ) funding to the Ministry of Health for capital expenditures as well as human resources under the administrative to engage bonded nurses.
He said, inadequate personnel in the health sector remained a threat to the sector and wondered why about 7,859 bonded nurses and midwives due employment are still not cleared by the government.

“Mr Speaker, it is clear the budget has not made provision to engage in developing policy and programmes for the Ministry, ” he said, stressing that employment of Nurses as many of bonded Nurses remained unresolved.
Buttressing his argument, the Binduri lawmaker said, “this government, Mr Speaker, is determined to create inequalities, and inequity in this our beloved country in health care delivery.”
“Mr Speaker, by inequity I mean unfair, avoidable difference arising from poor and grossly incompetent governance. By inequalities, Mr Speaker, I refers simply to the uneven distribution of health and health resources,” the NDC MP said.

The country is currently experiencing an acute human resource for health crisis which is less about available human resources, but rather about a lack of sufficient budget to employ the necessary personnel.

In this context, there is a need to balance the building of new facilities with the maintenance of existing infrastructure and to prioritise investment in dilapidated rural facilities in the most deprived parts of the country.

In fact, 73.9 percent of the allocation for capital expenditures is expected to come from development partners, with the Annual Budget Funding Amount and Internally Generated Funds providing the remaining 26.1 percent.

The 2018 budget statement provided detailed information on programmes government intended to implement in the areas of HIV, maternal and child health, malaria and nutrition. However, the 2019 budget statement lacks detail on these health priority programme areas, with the exception of neo-natal and under-five mortality.

It further reads that government intends to continue with interventions in ensuring affordable, equitable, easily accessible and Universal Health Coverage (UHC), and reducing disability, morbidity and mortality.

When it comes to NHIS, the scheme is projected to receive a total of GH₵ 2,381,014,749 from the National Health Fund in 2019. The Government planned to transfer GH₵ 1,692,678,294 of that to the National Health Insurance Authority and use GH₵ 187,967,235 to purchase essential vaccines.

Nonetheless, Dr Kuganab said, even those measures which respond to genuine health needs, such as funding for immunisations, Employment of Nurses , thus human resources and infrastructure, have been downplayed against the backdrop of growing inequity, protests and strikes in the health sector.

He stated that the budget has also failed to provide clear cut policies to deal with the fact that, HIV/Aids is on the ascendancy, while TB and other neglected tropical disease like mental health remained a challenged.

The MP however expressed the fear that Ghana may not be able to eradicate the canker before 2030 , and therefore called on government to response to some immediate needs within the health portfolio, future challenges such as the health impacts of HIV and the growing burden of access to quality health delivery.

Dr Kuganab-Lem was also disappointed that the Government virtually ignored key areas such as prevention, primary health care and sanitation in the Budget. These sectors of the health system, he noted are crucial in re-orienting the health system towards a more person-centred, preventive focussed and should be the first priorities for support.
He further questioned commitment to health issues and cautioned that government budgetary allocation to the Ministry of Health (MoH ) as 8 % of government expenditure (excluding arrears) was inadequate as this is below the Abuja Declaration of 15% of government expenditure on health.

Moreover, the MP said over-reliance on Donor Funds in the finance of capital expenditure (CAPEX) was quite worrisome due to the fact that Donor Fundings are not sustainable as they may withdraw their funding at any given time.
Overall, he said, the Budget would only deliver superficial and short-term solutions and would do nothing to address the broader social determinants of health that would affect the health status of the country over the long-term.

The Coalition for unemployed Bonded Nurses and Midwives has since October 29, 2018, petitioned the President, Nana Akufo Addo, asking the President to intervene to provide some lasting solution to the matter.

The MoH major policy targets for 2019 is to ensure universal, affordable and accessible health care financing and also improve the quality of health care service delivery.

In addition to that, the Ministry in 2019 would develop a hospital strategy to classify the types of hospitals in the country to improve access to quality health care delivery through investment in infrastructure, equipment and personnel in the health sector.

The 2019 budget has also hinted that, the NHIA would replicate the e-renewal by mobile money application in all MMDAs and also introduce e-receipt to all service provider.

Again, Dr Kuganab expressed the fear that Ghana may fail to fulfil the 15 % Of government expenditure on health per the Abuja Declaration.

Source: the republic responsible.com/ Felix Nyaaba

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