Dr Anthony Nsiah-Asare, the Director-General of the Ghana Health Service (GHS), has blamed the lack of progress in most healthcare delivery outcomes in the Greater Accra Region (GAR), on poor leadership.

He said the challenges were very prominent at the district levels, and indicated that the GHS Council was not pleased with reports, and consequently resolved to start its District Health System Operationality (DISHOP) leadership training to change the occurrences.

“Information sometimes reaching us indicates that there are so many conflicts among various members of staff, leading to the slowdown in performances,” hence, the training would build the capacities for better performances, he said.

He said the GHS Council had reviewed the curriculum for the training, which would hopefully start somewhere around May 2019.

Dr Nsaih-Asare was speaking at the two-day 2018 Greater Accra Regional Performance Review meeting held in Accra on Wednesday, and guided by the year’s theme: “Using Operational Research and ICT to Improve Health Outcomes in the Greater Accra Region”.

The meeting, which was organised by the Greater Accra Regional Health Directorate, brought together representatives from all public and quasi-government healthcare institutions, as well as the Christian Health Association of Ghana (CHAG), to reflect and take stock of their collective performance in the previous year.

Dr Nsaih-Asare expressed his displeasure about the deep-rooted attitudes of some public sector health professionals particularly doctors and nurses, who have taken to diverting their energies to Locums in other private institutions and neglecting their core duties in their major posts.

He said these staff pretended to be working, while in actual fact they just use their official posts as a resting place after their exhaustive locums elsewhere, and end up driving patients away because they were too tied to work.

He said, this was unprofessional and warned that such attitudes would no longer be tolerated by the GHS Council, and advised those professionals who preferred to work with the private sector to do so legally and desist from taking double salaries and taking the public health sector for granted.

The Director-General said the GHS had printed about 75,000 copies of its Code of Conduct and Disciplinary Procedures for distribution to all staff to imbibe and enforce.

The Service, he said would continue with its efforts to provide at least a vehicle for each District to facilitate their work, and promote the achievement of high-quality health outcomes as well as achieve Universal Health Coverage (UHC).

He commended all health workers for their sacrifices in spite of the numerous challenges and constraints they encountered in their line of duty and urged them to sustain the momentum to maintain the gains to achieve the Sustainable Development Goals.

Dr Charity Sarpong, the Regional Director of Health Services, said the year under review showed a mixed performance, with good records in some indicators, while stagnating and or declining in others.

She said Out-Patient Departments (OPDs) per capita increased marginally from 0.86 in 2017 to 0.88 in 2018, a figure which may not be a true reflection due to the difficulties encountered in accessing data from some health facilities outside the umbrella of the GHS.

She said although malaria continued to be the number one cause of OPD attendance for the past three years, there had been a gradual, but consistent reduction in the disease burden.

That, she attributed to interventions including the distribution of Insecticide Treated bed nets (LLINS), intensified public education, the building of the capacity of health staff in the use of the rapid diagnostic tests for easy and quick diagnosis.

“We are, however, seeing an increasing trend in the incidences of Non-Communicable Diseases and especially hypertension and diabetes”, and to address this, the GHS was going to liaise with major health facilities to set up functional Wellness Clinics as part of their routine OPD, for public walk-in to do screening as and when necessary.

Dr Sarpong said total skilled deliveries increased from 56.2 per cent in 2017 to 63.2 per cent in 2018, while institutional maternal mortality deceased from 189 to 166.1 per cent respectively 100,000 live births, but stillbirth rates, however, stagnated and decreased marginally from 1.5 to 1.4 per cent within the same periods.

“We are happy with the decrease in maternal mortality, which has been achieved through the collective hard work of our staff and the introduction of innovations such as the Kybele Referral Platform that seeks to improve on referral of pregnant women across the Health Facilities”, she said.

She also mentioned the successful set up of a Telemedicine Consultation Centre, which operated from the Regional Hospitals, to link up peripheral staff especially those in the Community-Based Health Planning and Services (CHPS) zones, to other senior staff like midwives and doctors at the various levels of health care, to improve quality healthcare and limit referrals.

She said challenges such as poor data management, weak management and governance structures, poor human resource management and inadequate resources and logistics, equitable distribution of available health professionals, and poor Staff attitudes and commitment also had a toll on service coverage, quality and outcomes.

Others include the over-concentration of health facilities in the Accra metropolis, the absence of district hospitals in nine out of the 16 districts in 2018, leading to the skewed distribution of doctors and other health professionals in favour of the most endowed districts.

She said initiatives such as the institutionalised peer review of hospitals and polyclinics, the Maternal Death Audit and Accountability Platform; and the strengthened integrated disease surveillance and response system with the introduction of the Greater Accra Website, had been instituted to provide weekly feedbacks and benchmarks districts’ performance to help scale up the performance of low districts through sharing of best practices.

Dr Sarpong said in 2019 the performance of the region would be guided by the theme “Strengthening our Health Systems towards the realisation of Universal Health Coverage: the Role of Quality Data Management and Good Governance”, with its Programme of Work underscored by the following of high priority interventions.

Mr Ishmael Ashitey, the Greater Accra Regional Minister, in an address read on his behalf, called for the need to ensure equitable distribution of resources among the districts, particularly the newly created ones, for effective delivery of healthcare services.