GRi in Parliament Ghana 29 - 09

GRi in Parliament Ghana 29 - 09 - 2000

Accra (Greater Accra) 29 September 2000

Professor Kwaku Danso-Boafo, Minister of Health, on Thursday, told Parliament that the Acquired Immune Deficiency Syndrome (AIDS) is not one disease entity and, therefore, the patient dies from a variety of causes.

He explained that the predominant disease that the AIDS patient eventually succumbs to is most often recorded as the cause of death.

He said, for instance, that tuberculosis (TB) is one of the commonest complications of AIDS, and when a patient dies, it may be recorded as TB.

Prof. Danso Boafo was taking his turn to answer parliamentary questions on health issues including the incidence of HIV/AIDS in the country and number of deaths resulting from the disease.

The Minister told the House that based on a surveillance system in selected health institutions throughout the country, the estimated total number of HIV positive cases was 400,000 as at the end of 1999.

Prof. Danso-Boafo noted that with the home-based care policy, patients most often die at home and the cause of the death recorded depends on the information provided by the family, which often describes the predominant syndrome.

He said the stigma of the disease does not encourage families to be frank about their patient's illness.

Prof Danso-Boafo told the House that the implementation of the national health insurance scheme was abandoned because the strategic decision on its administration was unclear.

He explained that the scheme as designed required the establishment of a health insurance organisation, which was to cover the formal sector only.

He said a number of concerns were expressed including how sound the programme would be in terms of equity and the economic viability of covering the formal sector alone, which constitutes only about 12 per cent of the population.

The Minister said based on these concerns and the lessons from the several community-based health insurance schemes, the Ministry decided to adopt a new strategy, involving advocacy for the promotion of different schemes to ensure a universal access to alternative financing schemes.

He said the proposed new framework is to include dialogue and support for private health insurance scheme to cater for the private sector and those who can afford, and a social insurance scheme for the formal sector.

To be included in the new framework are also community-based schemes and mutual health organisations for the informal sector to focus on rural communities.

Medicaid programmes for population under the poverty line where government will provide subsidies for services are also to be considered.

Prof Danso-Boafo said awareness campaign has always been the Ministry's main tool to combat the AIDS menace, adding that surveys conducted have shown that it is more than 90 per cent effective.

He explained that what may be lacking are the quality of the awareness and subsequently the extent of behaviour change.

"People know about AIDS and the condom and yet they practice unprotected sex or have multiple sex partners. This is an issue we are still working on", he said

The Minister appealed to the legislators to join the ministry in the crusade to create awareness for behaviour change to save the country from AIDS.

"MPs and Ministers of State should make the issue of AIDS a permanent paragraph or chapter in every address they make or at informal meetings with opinion leaders and the general public", he said.

Asked whether there is any collaboration between the Ministry and traditional healers who claim to have found a cure for AIDS, Prof Danso-Boafo said that the sector has to determine the credibility of such claims and establish the truth before any meaningful collaboration can be considered.

On the level of government's involvement in research into finding a cure for the disease, the Minister said it is actively collaborating with international bodies including the World Health Organisation (WHO), in research work towards this goal.

"The government is in fact, at the forefront of the research on AIDS, He said.

Asked about factors impeding effective decentralisation in the health sector, Prof. Danso-Boafo said the Ministry has over the last four to five years, ensured financial and administrative decentralisation.

He said Budget and Management Centres, therefore, have full control over their plans and budgets, explaining, however, that one major principle is that funds cannot be vied from one centre to the other.

"Another principle we have pursued is the need to shift most of our resources to service delivery or district levels. In this direction, the Ministry is close to meeting the target of 47 per cent of budget to be allocated to the district level".

The Minister told the House that decentralisation of responsibility for planning and delivery of health care is a central tenet of the health sector reform process.

He said within the health system, this responsibility is given to different levels of Budget and Management Centres, adding that the District Health Management Team is responsible for identifying the health needs of the district population and ensuring a programme of appropriately targeted service delivery and health action.

On the degree of autonomy at the teaching hospitals, Prof. Danso-Boafo said these institutions operate on subvention and therefore have full financial and management autonomy.

He explained that the hospital boards are responsible for the setting up of management committees through which the internal management of the hospitals is effected.

"The degree of autonomy enjoyed by the boards of the teaching hospitals is only limited in as much as the constitution and the laws of the country provide", he said.

Prof Danso-Boafo told the House that the Ghana Health Service and the Teaching Hospitals Act, Act 525 provided for the continuing existence and operation of such health institutions.

The teaching hospitals, he said, are not under the Civil Service and the limitations of the functions of their boards are "as much as they are subjected to such policy directives as the Minister may determine, as stated under section 36 of the Act".

GRi…/