Accra, June 8, GNA - Professor Agyeman Badu Akosa, former Director-General of the Ghana Health Service (GHS), has identified the rura= l health system as the missing link in Ghana's health service delivery. He said until the Community-based Health Planning and Services (CHPS) was fully rolled out to trigger tremendous improvement in the health indicators, the country would continue to encounter the health problems hindering the ability to meet the Millennium Development Goals on health. "It is the only system that works in tandem with a conscious effort to improve the social determinants of health at the community level through health education and can reduce the burden of disease in Ghana and also ensure the financial sustainability of health insurance," he said. He was delivering a lecture organised by the Ghana Academy of Arts and Sciences on the topic: 93Treating Ghana's Sick Health Service." Prof Akosa said Ghana had over the years successfully executed many externally introduced health reforms to much acclaim by the international community and development partners but had not been able to translate such reforms into the expected better health indices. This, he explained, was due to the lack of support for scaling up the useful interventions.

"Our health indicators have reached a plateau and some have shown a downward trend because the health systems are weak." Prof Akosa noted that building regional and district hospitals and health centres, although necessary, would not impact on the totality of the people the way the CHPS programme would since it was within the community and included community participation.

He said the wider social determinants of health, which represented the numerous social and economic factors that were not directly under the purview of the Ministry of Health but impacted on the health of the people, had conspired to determine the degree of health inequalities and social justice and rural disparities as well as dichotomies. Prof Akosa spoke about environmental sanitation and hygiene and said these issues had been considered as the bane of the health service delivery and continued to be the great problems at the heart of difficulties of the health service. The former Director-General of GHS called for improvement of the socia= l determinants to reduce health inequalities and advance social justice. He said the deficit of human resource for health, poor health financing, weak governance and leadership regimes, among other issues, had made the health sector sick and said the current doctor: patient ratio, which is 1:10,900 needed to be reduced to 1:5,000 by 2015 and 1:1,000 by 2020.

"What is necessary is the political will to improve the health of th= e people at all costs and there must also be an agreed and acceptable minimum quality of life below which no Ghanaian or person living in Ghana must be permitted to fall as the only means for ensuring social justice and good health," he added. He urged the public and private hospitals to come together to make Ghana the hub of medical tourism and rehabilitative care in the West Africa= n sub-region.