The, Director General of the Ghima Health Service (GHS), Dr Elias Sory has warned that the service will not hesitate to terminate the appointments of district directors who fail to perform clinical duties alongside their administrative functions. He stated that aside their managerial roles, they were duty-bound to undertake clinical duties as well, saying the service would deal decisively with any district director who flouted that directive. According to Dr Sory, as part of the appraisal system for district directors, due recognition would be given to clinical duties in addition to the managerial roles and that any director who fell short would be reverted to their original clinical duties. Dr Sory gave the warning when he addressed the opening ceremony of the 18th Annual Conference of the District Directors of Health Services (DDHS) group at Ho. The event was on the theme: "Using information for better decisions to achieve MDGs 4 & 5: A challenge for the health manager." Alluding to allegations that directors only sat in their air-conditioned offices while work was going on, Dr Sory said, "You are part of the process and so you must ensure that things go on Don't sit in the office and hope that the work will be done Be part of it." He also reminded them that their group was not an association but a structure under the GHS that existed to share knowledge on best practices with a view to enhancing the output of the Ghana Health Service. “Therefore, whatever you do must be informed by the policies of the ministry and the Ghana Health Service," he stressed. He said in order to achieve that objective, they must think outside the box so as to evolve the system to meet the challenges confronting health administration in the country. The director general stated that there was improper distribution of the manpower needed for maximum impact and gave the assurance that the service was doing everything possible to employ the needed human resources for the smooth implementation of Ghana's health policies. The National Chairman of the DDHS,Dr Samuel Abudey said as managers at the implementation level of decisions and policies, vital resources were required to operationalise decisions. He stated that currently, maternal health service delivery had become very precarious as it was feared that in the next five years, majority of midwives in the country would be going on pension. "We hope that the introduction of straight midwifery training and the re-introduction of midwifery training for CHNs will eventually improve the situation," Dr Abudey said. He also recommended that the initiative taken by the GHS and the Ministry of Health to solve the maldistribution of health staff must be pursued relentlessly to reduce the workload resulting from the introduction of the National Health Insurance Scheme (NHIS) at the periphery. Dr Abudey stated that they were not happy that most safe motherhood and child welfare services that had indicators under the MDG 4 & 5 were not covered by the NHIS. While acknowledging that transport facilities were very essential component of service delivery at the district level, Dr. Abudey appealed to the GHS/MOH to come out with an alternative means of paying for vehicles which were to be acquired on hire purchase. For his part, the Deputy Minister of Health, Mr Rojo Mettle Nunoo said the inability of Ghana to meet the MDGs was as a result of the cumulative effect of all maternal and infant moralities from all districts. He said what that meant was that if some districts were failing to perform, their low performance would ultimately tell on the national picture. Mr Mettle Nunoo, therefore, called for the institution of an award scheme for the best performed districts in relation to the MDGs since that was likely to enhance performance. He said it was regrettable that very little progress had been made with regard to maternal mortality rates over the past 10 years. He called for the sustenance of the political momentum in addition to the injection of more funds. The Deputy Volta Regional Minister, Colonel (retd) Cyril Necku said for the MDGs to be realised, there was the need for all stakeholders to collaborate with the view to changing the sorry state of healthcare delivery in the country to ensure equal access to quality healthcare. Source: Daily Graphic