² WHO cooperation strategy 2002-5

The epidemiological situation of Ghana is similar to other sub-Saharan countries, i.e. a predominance of communicable disease conditions, under-nutrition and poor reproductive health with emerging importance of non-communicable diseases such as neoplasm, diabetes and cardiovascular diseases.

The Ministry of Health is responsible for policy formulation, planning, and donor co-ordination and resource mobilization. The Ghana Health Service is responsible for service delivery under the management of the Director-General. There is a Ghana Health Service Council which oversees the activities of the GHS. The teaching hospitals are autonomous with governing management boards.

There is a variety of providers in the public, private and informal sectors. It is estimated that the private providers account for about 40% of the total patient care nationally.4 There is also a Coalition of Nongovernmental Organizations (NGOs) working in the health sector. The Christian Health Association of Ghana (CHAG) is an umbrella organization which brings together Christian mission hospitals and clinics. They provide a significant portion of the health services. Overall, more than 60% of the population (92% in urban and 45% in rural areas) have access to health services. Access is defined as living within one hour travel time (by any available means) from the health facility. The government estimates showed that half the population does not have access when the travel time is halved.

In March 2001, the government adopted the Highly-Indebted Poor Country (HIPC) Initiative. A key component of the HIPC Initiative is the Ghana Poverty Reduction Strategy (GPRS). The strategy includes support for human resource development and access to basic services, such as health, HIV/AIDS control, population management, water, sanitation and education. The GPRS outlines interventions for all sectors in the period 2002-2004.11

The strategies are as follows:

• Bridging equity gaps in the access to quality health services
• Ensuring sustainable financing arrangements that protect the poor
• Enhancing efficiency in service delivery.