Réseau Pharmaceutique Œcuménique (EPN)

Executive summary of baseline survey research in Ghana

Research for the ‘EPN guidelines’ baseline survey was carried out in Ghana in August–October 2005. This report of results provides the baseline for compliance with the ‘EPN guidelines’ in Ghana, and respondents represent over 2,545 beds and 694,500 outpatients. It is a statistically sound report for Catholic health services in the southern and central regions of Ghana (only 8% of respondents are from northern facilities).

Please download:

• Full EPN Access baseline survey research in Ghana [.doc 299KB] [.pdf 206KB]
• Summary EPN Access baseline survey research in Ghana [.doc 195KB] [.pdf 105KB]

The northern region of Ghana is known to have greater problems in health care provision – however, the only assumption we can make for this region is that positive results found in the other regions will be lower in the north, and therefore, if there is a problem in the other regions, this problem will be greater in the north.

Faith-based health services in Ghana provide approximately 40% of the available health care. The Christian Health Association of Ghana (CHAG) reports that the church health care facilities in Ghana number 56 hospitals and 83 clinics at the time of research (CHAG does not distinguish between clinics and health posts).

Table 1 Faith-based health care in Ghana, by faith

Thirty-four hospitals (including all 32 Catholic hospitals) and 30 of the 66 Catholic clinics were given the opportunity to respond to the self-assessment survey, with a total of 64 facilities contacted. A 41% response rate (26 facilities responded) was achieved for the survey.

If it is assumed that Catholic health services are representative of faith-based health services in Ghana, then these results can be scaled up to present a picture of church health services across Ghana.

Figure 1 Baseline EPN guideline compliance in Ghana

Overall conclusions

Taking into account the results from all the tools used, the overall trend for church health services in Ghana appears to be one of improvement. Good results were seen in a number of areas:

• Government support of the church health services (although it seems that some facilities are not taking up the opportunity of having salaries paid).
• Information sharing and representation opportunities indicate that there is a good degree of integration between the government and church health services.
• Good community involvement (although this could be improved at some hospitals where there is an interesting link between lack of community involvement and a perception of poor staff–patient relations and nepotism). Where community links are strong, links to church leaders are also strong.
• A functioning drug supply system is in existence.
• Relatively high levels (compared with other African countries) of pharmacists, pharmaceutical technicians, and pharmaceutical assistants per hospital.

On the more worrying side, the baseline does not cover the North of the country (an area understood to face bigger problems in health and health services) and there appeared to be problems for a number of ‘guidelines’ even in the southern and central areas.

• Only 50% of hospitals have a functioning DTC.
• A large number of hospitals accept medicines donations, but there is almost no adherence to drug donation guidelines.
• There is relatively low level of implementation of standard operating procedures, and while the main drug supply organizations do use SOPs, this is not reflected in the health services.
• There appears to be almost no training of hospital board members in the issues and possibilities of their decision-making.
• Health facilities themselves identified poor management and staff training as key problem areas that affect services. Lack of financial resources acted as a cause and an effect of these problems and thus a vicious circle is identified, whereby a lack of funds prevents a facility from improving itself in order to improve revenues and funding.