By Edzorna Francis Mensah
Parliament has approved the Financing Agreement between the Government of the Republic of Ghana (represented by the Ministry of Finance) and the International Development Association (IDA) of the World Bank Group (WBG) for an amount of One Hundred and Fifty Million United States Dollars (US$150,000,000.00) to finance the Primary Healthcare investment Project by Article 181 of the Constitution, Section 56 of the Public Financial Management Act, 2016 (Act 921) and Order 169 of the Standing Orders of the Parliament of Ghana.
The Primary Healthcare Investment Project is dimmed to improve primary healthcare delivery in Ghana. The program will be implemented through Government’s regular oversight, planning, budgeting, and implementation systems.
At the strategic level, the structures and processes established under the Common Management Arrangements at the Ministry of Health will be responsible for oversight and coordination of the program.
The decision to approve the loan agreement during an emergency sitting of the house on Tuesday, May 2, 2023, followed by a Majority Decision recommends to the House for the adoption of the Committee of Finance report submitted to the plenary for debates “given the enormous potential benefits to be derived from the project and its capacity to address the pressing challenges and vulnerabilities in the health system and to promote vaccine roll out”.
The Minority members of the committee, however, expressed their concerns about the impact of the facility on the country’s debt position.
They argued, among others, that approval of the facility would worsen the council’s debt position and make it unsustainable.
They also expressed concern about the proportion of the facility that is dedicated to consultancy services arguing that a significant proportion would not be channeled into the critical investments needed to improve primary healthcare delivery, especially in rural areas.
“In the light of the above, the Minority group on the Committee is unable to support the facility”, the reports say.
BACKGROUND
Ghana has achieved significant improvements and made significant progress in key health and nutrition outcomes in the last two decades. Significant among this achievement is the decrease in under-five mortality rate from 80 per 1,000 in 2008 to 56 in 2017-18 and a decline in the prevalence of stunting among under-five children from 28 percent in 2008 to 18 percent in 2017-18.
The maternal mortality ratio also declined from 470 per 100,000 births in 2005 to 310 in 2017 while the total fertility rate declined from 4.4% in 2008 to 3.9% in 2017.
Despite this progress, the structural challenges of the country’s health system persist thereby limiting the speed of progress. Significant among these are the socio-economic inequalities in health and nutrition outcomes. At the same time, Ghana faces a dual burden of disease as the incidence of non-communicable diseases (like hypertension, cardiovascular disease, diabetes, and cancers) continue to increase and is estimated to account for about half of all deaths.
Amidst these challenges and aiming at improved health outcomes, the Government in recent years is increasing primary health care service coverage, more especially serving the poor. These efforts are targeting further gains in the coverage, equity, and quality of primary health care services to improve utilization of family planning services, address the high fertility rate among
adolescents and reduce the high risk of maternal and neonatal mortality.
To ensure that the health systems continue to remain resilient the Government of Ghana with funding support from the International Development Association (IDA) has designed a program to further strengthen the country’s Response to Public Health Emergencies and improve the quality, utilization, and equity of Primary Health Care Services.
