Story by | JOSEPH A. COFFIE |

The Ministry of Health celebrated the International Universal Health Coverage (UHC) today 11
th December, 2020 at the Ministry of health Auditorium.

“Each year on 12th December, the world celebrates the International Universal Health Coverage Day (UHC Day), an official UN-designated day, to raise awareness of the need for strong, equitable and resilient health systems. UHC is based on the principle that everyone, everywhere should have access to quality essential health services without suffering financial hardship. It is a goal that cuts across all health targets and is such a beacon of hope for a healthier and more equitable world”.

Welcoming dignitaries to the International Universal Health Coverage day celebration, the Chief Director of the Ministry of Health, Mr. Kwabena Boadu Oku-Afari stated that, the Universal Health Coverage as celebrated on 12th December is the annual event which serves as a rallying point for the growing movement for health for all.
He said, it marks the anniversary of the United Nations’ historic and unanimous endorsement of Universal Health Coverage in 2012.

However, due to the day falling on a Saturday, the planning committee decided to observe the day today, 11th December, 2020.  

Mr. Kwabena Boadu Oku-Afari noted that, The Ministry of Health is pleased to join the rest of the world to commemorate this important international day and to recommit ourselves as a sector to work hard in accelerating the achievement of UHC in Ghana and beyond.

According to him, the 2030 Global Agenda is a bold action plan especially for the people of Ghana since it gives us the opportunity to leave no one behind as we transform our Country.

“Universal Health Coverage is an investment in human capital and a foundational driver of inclusive and sustainable economic growth and development. It is a way to support people so they can reach their full potential and fulfil their aspirations as far as health and wellbeing are concerned”. He stated.

Emphasizing, “the Ministry recognizes that, Ghanaians must benefit from the continuous investments the Government continue to inject in the health sector”.

He said, “as a Ministry we are strengthening all our health system building blocks to be able to deliver an equitable, affordable, quality and resilient healthcare for the people of Ghana.”

The Chief Director acknowledged that, “Ghana has thus taken a number of bold steps to realize her goal to achieve UHC by 2030. This is evidenced by the recent launch of the National Health Policy (NHP 2020), reforms in the National Health Insurance Scheme, strengthening of our health workforce in the form of training and development, strengthening of our emergency care system, infrastructure development, enhancing logistics and pharmaceutical systems among others”.

To him, The Ministry of Health is also taking the opportunity of the UHC day to disseminate the new Universal Health Coverage Roadmap for Ghana (2020 – 2030).

He therefore indicated that, “the management of the Ministry of Health is once again grateful to all our staff and agencies for their commitment in the fight against COVID-19. Let us bear in mind that, the fight is not over and we must all continue to observe the protocols to ensure the population remain safe”.

The Director of Policy, Planning, Monitoring and Evaluation (PPME), Dr. Emmanuel Ankrah Odame, also throw more light on the overview of the Universal Health Coverage Roadmap for Ghana from 2020 to 2030 during the occasion.

Mr. Stephen Dzisi, the USAID Health Population and Nutrition Office Acting Director, noted that today is especially exciting for Ghana, as the Ministry of Health is disseminating Ghana’s “Roadmap for Attaining Universal Health Coverage, 2020-2030.”

He said, Ghana’s vision for UHC is simple yet ambitious, to ensure that “All people in Ghana have timely access to high quality health services irrespective of the ability to pay at the point of use.” In other words, it’s important that all people in Ghana realize the human right to health - from the Kayayei in Accra, to the person with disabilities in Beposo in the Ashanti region, to the farmer in Daboya in the Northern region - all have the basic right (and access) to affordable health care.  The need for basic health and protection unites us all. It is the foundation for a quality of life that enables us to prosper and build a strong and resilient society.”

While Ghana’s health sector has improved in recent decades, more work is needed. According to the 2017 Maternal Health Survey, 79% of pregnant women deliver in a health facility, an inspiring improvement from 54% in 2007. Nonetheless, the same survey found that maternal and neonatal mortality remain high, at 310 maternal deaths per 100,000 live births and 25 newborn deaths per 1,000 live births. Also, according to the 2017 Multi-cluster Indicator Survey, child stunting levels remain high at 18%, as do wasting levels at 6.8%”.

“Secondary health impacts caused by COVID-19 are putting many years of hard-fought gains in women and children’s health and nutrition at risk. In fact, if we compare May 2020 to expected values based on 2018 and 2019 data, attendance at the fourth antenatal care visit fell by 11%; measles vaccinations decreased by 6%; and the number of children weighed declined by 7%. This points to the risk of a widening equity gap if we do not take action”.

In addition, Mr. Ayisi stated that, “inequities in health outcomes and service delivery persist across regions and urban or rural localities. To list just a few examples -- the contraceptive prevalence rate is 17% in the Northern Region compared to the national average of 25%. The Volta Region has a neonatal mortality rate of 33 per 1,000 live births, as compared to 19 per 1,000 live births in Greater Accra. These differences are exacerbated by socioeconomic class -- according to the 2017 Maternal Health Survey, only 33% of women with disabilities from the poorest socioeconomic quintile have health insurance, as compared to 56% of women with disabilities from the wealthiest quintile”.

He indicated that, “all these examples point to the importance of universal health coverage to ensure access, affordability, and equity in service delivery. This requires us to enhance collaboration not just within the health sector, but also to strengthen linkages in service provision with other key sectors, such as social protection and free health insurance, and with social welfare to ensure that no-one is left behind”.

As health development partners, we are committed to walk by your side as Ghana realizes its vision of universal health coverage. While the development of the UHC roadmap required tireless months of intense work, consultations, and deliberations, now comes the hard, but most important part -- operationalizing the roadmap. The UHC Roadmap recognizes the power of the primary health care approach to improve health, stem growing health care costs and bridge the access equity gap. Primary health care has been a central lever in Ghana’s ambition to achieve universal health coverage through a whole-of-government, a whole-of-society, equity-based and life-course approach”. He noted.

He said, “Through the Global Financing Facility, the Government of Ghana, development partners, and non-governmental stakeholders have come together to develop the nuts and bolts of the UHC strategy and roadmap; starting with the costed Prioritized Operational Plan, or as we call it, the POP-C. The POP-C will be embedded within the health sector planning process and serve as the basis for operationalizing the health sector’s priorities and health investments over the next ten years”.

Giving his message, the USAID Health Population and Nutrition Office Acting Director, Mr. Stephen Dzisi noted,Like a stool which needs all its legs, every pillar of the UHC roadmap is an integral component to keep the system standing. All aspects of the UHC roadmap are interlinked, and we cannot afford to address one problem in a silo, or the whole system topples. This past year, we have seen the importance of integrating efforts for emergency preparedness and response into health systems strengthening efforts. We congratulate the Government for your swift and effective actions to curb the spread of the COVID-19 pandemic and mitigate its repercussions”.

He concluded by thanking the Ministry of Health and all its agencies for your steadfast partnership. The theme for this year’s UHC celebration: “Health for All: Protect Everyone” resonates in a unique way this year, given the global pandemic we are facing. The COVID-19 pandemic has been one of the most difficult periods in our lifetime. Yet, amidst these difficult times, the pandemic also gives us a glimmer of hope.  It has presented an opportunity for growth and self-reflection. The pandemic has shown light on the vulnerabilities in our health system. It has shown us how interconnected we really are. As we move forward on the road to UHC, we welcome the opportunity to deepen our collective commitment to health system strengthening; to expand our partnerships with the private sector and civil society; and to increase collaboration across agencies, as well as other Ministries”.

The Chief Director of the Ministry of Health Mr. Kwabena Boadu Oku-Afari read on behalf of the Minister for Health, Hon. Kwaku Agyeman Manu “Each year on 12th December, the world celebrates the International Universal Health Coverage Day (UHC Day), an official UN-designated day, to raise awareness of the need for strong, equitable and resilient health systems. UHC is based on the principle that everyone, everywhere should have access to quality essential health services without suffering financial hardship. It is a goal that cuts across all health targets and is such a beacon of hope for a healthier and more equitable world. The Day marks the anniversary of the UN’s historic and unanimous endorsement of UHC in 2012 as an essential priority for international development as earlier mentioned by the Chief Director. Since then, it has become the annual rallying point for the growing movement for health for all”. 

He said, “The theme of UHC Day 2020 celebration is ‘‘Health for all: protect everyone.”

He emphasized on some important events that happened this week on UHC;

·       “There has been the launch of 2020 global report on health spending titled “Global Spending on Health; Weathering the Storm”. This report shows that global spending on health continually rose between 2000 and 2018 and reached US$ 8.3 trillion or 10% of global GDP. Interestingly, the report shows that out-of-pocket spending is persistently high in low and lower-middle income countries (such as Ghana), representing greater than 40% of total health spending in 2018. This report is an essential instrument for national and global accountability on UHC.

·     It is also important to note that today, the World Bank, Governance Global Practice in collaboration with the Health Nutrition and Population Global Practice and Global Financing Facility is having an event to mark the FinHealth Tool. This is a Public Financing Management (PFM) Health Tool to improve service delivery. Clearly improving the quality and efficiency of public financial management (PFM) is critical for making progress towards the goal of UHC”.

The Hon. Minister stated that, “Ghana is committed to attaining the Sustainable Development Goal Declaration, principles of the African Union Agenda 2063, Global Action Plan for Healthy Lives and Well Being, Declaration on Primary Health Care in Astana (2018), UHC 2030 Compact, initiatives of UHC 2030 and the Political Declaration of UHC adopted at the UN High Level Meeting in September 2019. At the heart of these, are the principles of human rights, equity, gender and people-centered approaches that drive the attainment of UHC”.

He once again mentioned that, Ghana in response to the Sustainable Development Goals (SDGs) Global Action Plan for Healthy Lives and Wellbeing (GAP) has developed a UHC roadmap for achieving UHC by 2030. Through broad based consultations and consensus building with various stakeholders, civil society, private sector and development partners, a set of priority services and interventions have been agreed to be made universally accessible to all persons living in Ghana. In this framework, Ghana defines UHC as: “All people in Ghana have timely access to high quality health services irrespective of ability to pay at the point of use.”

“We believe that these actions will serve as a catalyst to transforming our health systems, efficiently mobilize and apply domestic resources to need; and strategically leverage partners resources for long term sustainability. It also emphasizes health in all policies with the aim to stir action in other sectors for health and Human Capital Development as articulated in the National Health Policy. This UHC roadmap is the commitment of the government and people of Ghana to shape the future of health care in Ghana”. He noted.

He said, the overall Goal of this framework is to increase access to quality essential health care and population-based services for all by 2030. The UHC Roadmap is backed by 3 key objectives;

-        Universal access to a better, efficiently managed, high quality primary health system

-          Reduce avoidable maternal, adolescent and child deaths and disabilities

-           Increase access to responsive clinical and public health emergency services.

“Strong, equitable systems grounded in primary health care and human rights are essential in upholding the tenets of UHC.  Advancing Sustainable development and Improving performance of health systems also means enhancing financial and human resources, appropriate use of health technology, community empowerment, robust data management systems and good governance which in the end produce Better Health Systems. These areas mentioned above have been the focus of the Government of Nana Addo Danquah Akufo Addo in the first term of his office”. He noted.

“The Government of the NPP recognizes that, Strong health systems are critical to achieving the Sustainable Development Goals and ensuring good standards of health and equitable health outcomes for all. Our Investments in primary health care has promoted health across all social groups and reduced health inequities across the country. Ghana has indeed made progress in providing access and bridging financial barriers to healthcare and guaranteeing quality care through the implementation of the Community-Based Health Planning and Services (CHPS) concept, which has increased access to healthcare to rural and deprived areas in our country,  The reforms of the National health Insurance Scheme has reduced catastrophic and out of pocket expenditure on health and the building of a culture of quality care has ensured accountability of our healthcare services  to the citizens of Ghana.

There is still a growing recognition of the value of innovation in accelerating progress towards quality universal health coverage in our forward match to 2030. This requires the adoption of bold and innovative service delivery models and health technologies; and employing new ways of thinking in delivering essential services of good quality for the good people of Ghana.

The use of electronic medical records and its deployment is key in Ghana’s UHC drive. We have deployed the electronic medical records system in our Teaching hospitals and we are on course to deploy it in our Regional hospitals and below”.

The Hon. Minister for Health indicates that, in the next term of His Excellency the President, Nana Addo Danquah Akufo Addo, the Ministry of Health in collaboration with all key stakeholders will be committed in ensuring that:

1.     “Health services are safe, sensitive to the needs of women and other disadvantaged populations, and equitably delivered to the people through the life course approach.

  1. Health workers are well-trained, motivated and available to deliver services to the people at all times.
  2. Health information systems are effective, efficient and provide reliable information on health indicators and system performance for decision making.
  3. Equitable access to essential medicine, vaccines and health technologies are always available
  4. Public Financial Management systems are transparent, efficient and accountable, with good links between planning, budgeting and the allocation of resources to relevant areas of the health system
  5. Ensure the prudent use of internally generated funds (IGF) and finalize the IGF Guidelines for the Health Sector
  6. There is a strong and responsible leadership and governance to oversee that the health system is performing to the desired effects and impacts as planned”.

The above factors are anchored in the UHC roadmap and we are going to ensure that we stay focused and work towards achieving them through advocacy and increased budget allocation for their implementation. We are also disseminating the UHC Roadmap today to create more awareness of this document.
“Ladies and gentlemen, I cannot conclude my speech without talking about the corona virus pandemic. The pandemic outbreak has tested our capacity to deliver health for all and threatened to undo decades of progress made as far as our healthcare system is concerned. It has disrupted delivery of essential health services in many countries, overstretched resources to their limits, and revealed the impact of decades of underinvestment in primary care, essential public health and clinical emergencies in our overall healthcare system. Despite these challenges, Ghana rose to the occasion to smartly manage the pandemic effects across the country through the collective efforts of all.

We must thank God for our lives and also thank Him for a successful election in the midst of the pandemic.

It is my fervent hope and believe that, moving forward, we shall aggressively propel the health system building blocks to achieve UHC by 2030.

Once again, I thank you all for coming and wish the world a joyous UHC Day celebration hereby do declare the National UHC Day duly launched”. He stated.

Attached is pictures of Ghana's Roadmap for Attaining Universal Health Coverage (2020 - 2030)

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