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GhanaHealth Profile and HRH CrisisGhana ranks 136 out of 177 in the 2006 Human Development Index. As in most countries in Africa, although small improvements in life expectancy can be observed over the last 5 years, little has changed in terms of infant and child mortality rates. Despite increased investment and interventions, Ghana will have to address the the low numbers and mal-distribution of health workers, if HNP outcomes are expected to improve.
Addressing HRH The government has requested financial and technical assistance as well as a comprehensive and combined effort by the donor community to address the HRH crisis in Ghana. The World Bank HRH program is complementing Government activity, other Donor activity, and NGO activity to address the HRH crisis. The following activities are organized and funded by the Banks HRH program, and are currently ongoing or have been completed. Activities are centered around 1) obtaining baseline information on HRH 2) developing strategy, policy and programs on HRH, 3) implementing strategy, policy and programs on HRH. Baseline Information and Analysis Physician migration Study (tracking the motivations of physicians within and outside of Ghana): The aim of the study is to provide comprehensive and accurate information on dynamics of migration of physicians in Ghana. The suggested study will focus on what incentive that could be provided to health care workers in Ghana in order to increase retention rates of physicians. More specifically it aims to elucidate the main determinants of internal and international migration, find out at what age the migration decisions takes place, and identify incentives that would make physicians stay in the country of origin, or return on a voluntarily basis. There are relatively few rigorous surveys of the primary agents in the migration process — the health care workers. This study aims to survey Ghanaian medical students and physicians who live in Ghana as well as those who have emigrated and live abroad. The Study is lead by Caglar (World Bank), DEC, in collaboration with the Africa Region HRH team (Christopher Herbst). Part of the data required for the study will be collected during the facility census. Study to map bottlenecks to scaling up health worker production: This study plans to assess quantitatively and qualitatively the current capacity of production of qualified health workers in Ghana (doctors, nurses, dentists, pharmacists, technicians, and allied providers), and the factors which influence it. The study will look at the following dimensions of the production of health workers: policy environment, the regulation and functioning of training institutions, planning practices (i. e how many health workers can be employed in the public and private sectors), actual health worker training programs and locations, educational institution infrastructure, actual student population, quality of training, outputs (graduation rate, course development rate etc), and institutional ownership and funding (public and private), etc. The study will determine what are the bottlenecks to expansion of the production of health workers and will produce cost plans for expansion. The study is lead by Gaston Sorgho, under the overall direction of the Africa Health Workforce Team. Study on health Worker Motivation: This study is intended to map the motivations of health workers in Ghana and their responsiveness to various forms of incentives. The research to be conducted will collect data through focus group discussion for a qualitative study. The qualitative study deliberately uses focus group discussion as data collection tool because of its ability to elicit and contrast a multitude of perceptions. The qualitative effort in Ghana will be looking at different sub-schemes (health worker migration, etc) and come up with preliminary evaluation of ongoing incentive schemes. The study seeks to generate valuable descriptive and analytical information that will provide a direct input to the design of more effective human resource strategies. Under the broad oversight of the Africa Health Workforce team in Washington, DC, the study team is lead by Tomas Lievens (Oxford Policy Management, OPM) and Time Ensor (OPM), and complemented by Alex Hurrel and Sabine Weinzierl (OPM). Mapping Health Worker Productivity: Information on the productivity of existing health workers is crucial for managing the current stock of health workers in Ghana. The study allows the government to understand the factors explaining the variations in health worker productivity so that facilities or districts with lower staff productivity can benefit from lessons from the better performers. Productivity estimates are adjusted for a number of variables and will be defined as the amount of output produced for a given level of inputs used in a production process. In the context of health workforce productivity, the relevant output is a measure of health care services provided to the population (number of patients seen) and the relevant input is some measure of the quantity of human resources for health (HRH). Development of National Strategic Plans, Policies and ProgramsTBA Implementing Policy and Programs TBA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
