HEALTH SYSTEMS

MANAGEMENT I
COURSE CODE: KFPA 311
CREDITS: 1

LECTURER
DR JOSEPH TEYE NUERTEY
 COURSE DESCRIPTION

• This course explains the organisational structure of the Ministry of

Health and its agencies as well as the health sector reforms.
• Management skills are also discussed in sections on principles of
management and administration, human resource management,
health sector leadership skills, the use of job descriptions and
supervision and monitoring as management tools as well as the
role of the Physician Assistant as a member of the health delivery
system.
 COURSE OBJECTIVES

• At the end of the course the students will be able to:

• Interpret the organisational structure of the Ministry of Health and
its agencies.
• Critique the health sector reforms.
• Function as a leader in the health sector.
• Describe human resource management.
• Describe job description and its application in management.
• Supervise, monitor and evaluate the staff he/she is responsible for.
• Identify the physician assistant’s role in the health delivery system.
 COURSE CONTENT

• This is the first of the two parts in health systems management

course.
• It focuses on the organizational structure of the Ghana Ministry of
Health and its agencies, health sector reforms, human resource
management and general principles of leadership and governance
in the health sector.
• The definition and principles of management and administration,
job description as a management tool, supervision, monitoring and
evaluation as well as the role of the Physician Assistant as a
member of the health delivery system are well explained.
 MODES OF DELIVERY

• The following modes of delivery are recommended for this course:

• Lecture using appropriate visual aids
• Case Studies and presentations
• Seminars/workshops
• -Group study/discussion
• Role Play
• Field Trips
• Tutorials, Demonstrations and Coaching
• Simulations / Games
• STUDENT EVALUATION
• Continuous Assessment - 40%
• End of Semester Examination - 60%
 Reading list

• Ray P K, Maiti, J (Editors 2018). Healthcare Systems Management: Methodologies and

Applications. Springer. Switzerland.
• Ackon E K (1994). The Management of Health Services in a Developing Country: The
Case of Ghana. Independent Publishers.
• Sakyi E K, Ahenkan A (2014). Health Services Management: Readings from Ghana.
Diggibooks, Ghana. Tema, Ghana.
• Rogers M G (2017). You Are The Team: 6 Simple Ways Teammates Can Go From Good
To Great Paperback. CreateSpace Independent Publishing Platform.
• Buchbinder, N. H. S (2016). Introduction to Health Care Management. Jones & Bartlett
Publishers. Burlington.
• Ray P, Kumar M. J (Eds. 2018). Healthcare Systems Management: Methodologies and
Applications 21st Century Perspectives of Asia. Springer. Switzerland.
• Hooker R. S, Cawley J. F, Everett C. M (2017). Physician Assistants Policy and
Practice 4th Edition, Kindle Edition. F.A. Davis Company. Philadelphia
Organisational structure of the Ministry of
Health and its agencies and the health
sector reforms
 HISTORY OF HEALTH SYSTEM IN GHANA

• The Gold Coast was a British Crown colony on the Gulf of Guinea in
West Africa from 1821 until its independence in 1957 as Ghana
• In 12 July 1874 Ghana was officially proclaimed a British colony.
• Ghana proved to be an extremely dangerous disease environment
for European colonists,
 Pre-medical Department
• A pre-medical department was formed initially, and in 1878, the
Towns, Police, and Public Health Ordinance was enforced under
its direction, initiating the construction and demolishing of
infrastructure, draining of the streets, and issuing of fines to
those that failed to comply with the heads of the colony.
• In 1893, a Public Works Department was introduced to
implement a working sanitation system for the colony.
 Beginnings of a national health care system,

• The beginnings of a national health care system, currently in the

form of the Ministry of Health, can be traced to the late 1800s and
early 1900s.
• The British influence in Ghana marked the beginnings of a
structured health care system with the implementation of the
Medical Department, which included the formation of the Sanitary
Branch.
 The Medical Department

• Finally, in the 1880s, a Medical Department was formed, bringing

about an introduction to a formal medical system, consisting of:
• a Laboratory Branch for research,
• a Medical Branch of hospitals and clinics, and
• the Sanitary, or Health, Branch-
• centered near British posts and towns
 The Sanitary Branch -Important figures
• Joseph Chamberlain, Britain's Secretary of State for the Colonies,
sought to combat the increasing mortality rates of the Europeans
living overseas. Initiated the Sanitary Branches placing emphasis on
areas with a higher population of Europeans.
• John Rodger, the governor of the Gold Coast in 1908, emphasized
the importance of sanitation in the colonies, pushing for immediate
reforms and became a key player in establishing its Sanitary
Branch.
 The Sanitary Branch -Important figures
• Sir Hugh Clifford was a Gold Coast governor after Rodger and
provided a similar outlook, seeking to increase accessibility of
health care to the native Ghanaians as well.
• Clifford actively worked to implement sanitation reform starting
in 1910,
• under him, a doctor by the name T.E. Rice became the first to take
charge of the Sanitary Branch
 The Sanitary Branch

• The Sanitary Branch of Ghana, was established in 1910,

• A branch of the country's Medical Department
• The original purpose of the Sanitary Branch was to protect the
Europeans living in the British West African colonies from becoming
infected with and dying from tropical diseases,
• The branch soon worked to protect the Ghanaian people as well,
instilling sanitation reforms and offering vaccinations for the
people of the colony
 The Sanitary Branch

• Instigate accessibility to clean and drinkable water, combat the

infestation of mosquitoes, increase awareness about the
maintenance of good health, and deal with the outbreak of
epidemics
 Structure of the Sanitary Branch

• The Sanitary Branch was organized into tiers of officers and

committees structured as follows:
• Head administrators, consisting of a Principal Medical Officer,
Senior Sanitary Officer, and Junior Sanitary Officer
• Medical Officers of Health and sanitary inspectors
• District Medical Officers
• Sanitary Committees
• Town Councils, including a medical officer, engineer, elected
community members
• Director of Public Works
 Policies and programs

• Sanitation
• Sanitation reform had been a pressing concern for the British as they
set to establish the branch.
• In 1910, they passed the Sanitary Legislative Ordinances, adding
more over time, and had eight ordinances by about 1925.
• The Sanitary Legislative Ordinances would remain in effect until
1950.
• These laws simply outlined basic sanitary practices, laying the
foundation for the progress that would ensue during the 1900s.
• The colony moved from extensive use of pan latrines towards the
utilization of a water-carriage and septic tank disposal system.
 Policies and programs

• Access to water
• Accessibility to water supply and providing clean water to the
villages, action taken to instill new methods was initiated in the
1920s through the spread of water wells, and later, water tanks.
• Governor Gordon Guggisberg implemented a ten-year program
consisting of a pipe system with drains constructed out of
concrete.
• In 1936, the colony experienced the greatest expansion in
distributing water via pipes, attributable to the work of Guggisberg.
 Policies and programs

• Mosquitoes
• One of the first policies undertaken by the branch was the
Mosquito Ordinance, established in 1911, directed at the
persistence of malaria and yellow fever and the pervasive nature of
the mosquitoes as a whole.
• Homes inspection to ensure that families maintained cleanliness of
the home, and for the possible presence of mosquito larvae.
 Policies and programs

• Mosquitoes
• Groups nicknamed "mosquito brigades" played a major role in
inspecting the houses.
• People were at risk of being fined if they failed to comply, or if
larvae were found in their home.
• This then led to the formation of a formal drainage system, to
drain the swamps and boggy areas inhabited by the mosquitoes.
 Policies and programs

• Education
• In the 1920s, as Guggisberg continued to champion importance
of sanitation, sanitary education became a major component.
• Under a law passed in 1925, teachers had to adhere to
requirements, including certain credentials and reaching a
particular level of educational attainment before being able to
teach.
• For the advancement of health and hygiene awareness,
"Health Weeks" and "Health Days" were implemented in
educational systems in order for students to focus on the
importance and long-term effects of being healthy and
maintaining good personal hygiene.
 Policies and programs

• Education
• The students received pamphlets written by members of the
Sanitary Branch, outlining good eating habits.
• Another goal of the Sanitary Branch had been to increase the
number of people that qualified as sanitary inspectors,
leading to the formation of the Accra Sanitary School and the
School of Hygiene in order for the Ghanaians to become well-
versed in proper sanitary practices.
 Policies and programs

• Welfare clinics
• Another advancement took place in the form of the Infant Welfare
and Maternity Clinics, which were designed to counteract the high
mortality rates of infants and their mothers due to lack of proper
care.
• In the mid-1920s, Governor Guggisberg agreed to opening special
centers for infants, as well as starting a visit service for mothers,
available through the volunteer services of a group of African
women.
• With the rise of these clinics also came the formation of groups
such as the Ladies of the Gold Coast League of Maternal and Child
Welfare
 The national health care system
• In 1953, the Medical Department became the nation's
Ministry of Health
 HISTORY OF HEALTH SYSTEM IN GHANA

• GOLD COAST TO GHANA-100 YEARS

• INDEPENDENCE IN 1957
• WESTERN HEALTH SYSTEM WAS INTRODUCED BY THE COLONIAL
MASTERS
• HOSPITAL BASED CLINICAL SERVICES TO SERVE EXPARTRIATE CIVIL
SERVANTS AND MERCHANTS
• MOST FACILITIES LOCATED IN PORT TOWNS AND CITIES WITH
COMMERCIAL ACTIVITIES
LOGO OF MOH
 GHANA MINISTRY OF HEALTH
INTRODUCTION
• As a critical Sector of the economy, the Ministry of Health seeks to
improve the health status of all people living in Ghana thereby
contributing to Government’s vision of universal health coverage
and a healthy population.
• The Ministry of Health, working in partnership with its agencies and
stakeholders aims at improving the human capital thus “creating
wealth through health” through the development and
implementation of proactive policies that will ensure improved
health and vitality.
Our Mission

• The mission is to contribute to socio-economic

development and the development of a local health
industry by promoting health and vitality through
access to quality health for all people living in Ghana
using motivated personnel
The Goal of the Ministry
• To improve the health status of all people living in
Ghana through effective and efficient policy
formulation, resource mobilization, monitoring and
regulation of delivery of health care by different
health agencies
 The Vision of MOH

• To have a healthy population for national

development
 Policy Thrust

• The sector’s policy thrust is to reduce inequities in

access to care and increase coverage, quality and use
of health services so as to achieve a healthier national
population
 Policy Objectives
• The health policy objectives within the Sector Medium Term
Development Plan (HSMTDP) 2022-2025 are to:
• Universal access to better and efficiently managed quality
healthcare services
• Reduce avoidable maternal, adolescent and child deaths and
disabilities
• Increase access to responsive clinical and public health emergency
services
STRUCTURE OF THE MINISTRY OF
HEALTH
• OFFICE OF THE MINISTER
• OFFICE OF THE DEPUTY MINISTER/S
• OFFICE OF THE CHIEF DIRECTOR
• DIRECTORATES
• AGENCIES
• DEVELOPMENT PARTNERS
MOH ORGANIZATIONAL STRUCTURE
 MOH DIRECTORATES

• POLICY, PLANNING, MONITORING AND EVALUATION

• HUMAN RESOURCE FOR HEALTH DEVELOPMENT
• RESEARCH STATISTICS INFORMATION MANAGEMENT
• TRADTIONAL AND ALTERNATIVE MEDICINE
• PROCUREMENT AND SUPPLIES
• GENERAL ADMINISTRATION
• FINANCE
• INTERNAL AUDIT
• INFRASTRUCTURE
• TECHNICAL COORDINATION
 Ministry of Health (MOH)

• The Ministry of Health (MOH) and the Divisions therein are

responsible for policy formulation, resource mobilization,
allocation, and monitoring.
• The MOH oversees the health sector in Ghana.
• It provides overall leadership and direction to the health sector
and coordinates implementation of the Health Sector Medium
Term Development Plan (2022-2025) and Programme of Work
2022 to ensure achievement of the health sector objectives.
• The Ministry achieves its aims through policy formulation,
standards setting, (acquisition for) resource mobilization and
monitoring and evaluating sector performance.
 AGENCIES OF MOH (26)
• Ghana Health Service
• Tamale Teaching Hospital
• Korle-Bu Teaching Hospital
• Cape Coast Teaching Hospital
• Ho Teaching Hospital
• Komfo Anokye Teaching Hospital
• Centre for Plant Medicine Research
• Foods and Drug Authority
• Pharmacy Council Ghana
 AGENCIES OF MOH (26)
• Nursing and Midwifery Council
• Medical and Dental Council
• Health Facilities Regulatory Agency
• National Health Insurance Authority
• National Ambulance Service
• Traditional Medicine Practice Council
• Ghana College of Surgeons and Physicians
• National Blood Service
• Allied Health Professions Council
 AGENCIES OF MOH (26)
• Ghana College of Pharmacists
• Mental Health Authority
• Ghana College of Nurses & Midwives
• Christian Health Association of Ghana
• Ahmadiyya Muslim Mission
• Ghana Association of Quasi Government Health Institutions
• Psychology Council
• Mortuary Services Agency
 Department for International Development (DFID)

• The Department for International Development

(DFID) leads the UK’s work to end extreme poverty.
• It is now Foreign, Commonwealth and Development
Office (FCDO) since 16 June, 2020. Announcement
made by Boris Johnson
• It is a merger between Foreign Commonwealth
Office (FCO) with Department for International
Development
 GHANA MOH DEVELOPMENT PARTNERS
• Foreign, Commonwealth and Development Office (FCDO) formerly
(DFID)
• European Union Delegation to Ghana
• GLOBAL ALLIANCE FOR VACCINE INITIATIVE (GAVI)
• The Global Fund
• Japan International Corporation Agency (JICA)
• Korea International Corporation Agency (KOICA)
• Korea Foundation for International Healthcare (KOFIH)
• United Nations Population Fund(UNFPA)
• United Nations Children’s Fund (UNICEF)
 GHANA MOH DEVELOPMENT PARTNERS
• United States Agency for International Development (USAID)
• United Nations Programme on HIV and AIDS (UNAIDS)
• World Health Organization (WHO)
• World Food Programme
• World Bank
• African Development Bank
• UNITED NATIONS DEVELOPMENT PROGRAMME (UNDP)
• Danish International Development Agency
 VARIOUS HEALTH RELATED LAWS
• The Ghana Health Service and Teaching Hospitals Act 525
• Mental Health Act 846 (2012)
• The Local Government Act
• The National Health Insurance Act 2012 (Act 852)
• The Labour Act
 VARIOUS HEALTH RELATED LAWS

• Health Professions Regulatory Bodies Act 857 (2013)

• Pharmacy Act-1994 (Act 489)
• Public Health Act – Act 851 (2012)
• The Health Institutions and Facilities Act, 2011 (Act 829)
HEALTH SECTOR REFORMS
 CONDITIONS FOR REFORM OF
HEALTH SYSTEM IN GHANA

• AFTER INDEPENDENCE HEALTH SERVICE STARTED ADDRESSING ISSUES OF

INEQUITY BY OPENING HOSPITALS AND HEALTH CENTRES AT THE
COUNTRYSIDE- MOH

• NEW CADRES OF HEALTH SERVICE LIKE MEDICAL ASSISTANTS (HEALTH CENTRE

SUPERINTENDENTS), TECHNICAL OFFICERS AND FIELD TECHNICIANS FOR
DISEASE CONTROL AND SURVEILLANCE
 CONDITIONS FOR REFORM OF
HEALTH SYSTEM IN GHANA
• SEVERAL COUP D’ETATS IN THE 1970s AND 1980s LED TO THE DECLINE IN
ECONOMIC ACTIVITIES AND RESOURCES AVAILABLE FOR HEALTH CARE
• THERE WAS DECLINE IN MORALE WHICH AFFECTED HEALTH SERVICE
DELIVERY
• GHANA IN 1979 INTRODUCED THE PRIMARY HEALTH CARE POLICY AND
STRATEGY WITH THE INTRODUCTION OF DISTRICT HEALTH SYSTEM- AFTER
ALMA DECLARATION OF HEALTH FOR ALL BY THE YEAR 2000
 CONDITIONS FOR REFORM OF
HEALTH SYSTEM IN GHANA

• BY 1985 GHANA INTRODUCED USER FEES INTO HEALTH SERVICE DELIVERYN

TO SAVE THE HEALTH SERVICE FROM TOTAL COLLAPSE
• IN THE EARLY 1990s GHANA BEGAN RESTRUCTURING OF HEALTH SERVICE
WITH THE INTRODUCTION OF BASIC MINIMUM PACKAGE OF SERVICES,
REFOCUSING THE EMPHASIS ON PHC AND REPRODUCTIVE HEALTH,
DECENTRALIZING MANAGEMENT AND FINANCIAL RESPONSIBILITY TO THE
DISTRICT (1993 MIKLIN HOTEL-DMOH TO DDHS)
 CONDITIONS FOR REFORM OF
HEALTH SYSTEM IN GHANA

• DE-LINKING HEALTH SERVICE FROM THE CIVIL SERVICE, AND REVIEWING THE
MOH ORGANIZATIONAL STRUCTURE TO REFLECT A SHIFT FROM VIRTICAL TO
MORE HORIZONTAL SYSTEM FUCTIONAL SYSTEM.

• INTRODUCTION ON ACT 525- THE GHANA HEALTH SERVICE AND TEACHING

HOSPITALS ACT
THE ENTRY OF GHANA HEALTH
SERVICE
 HISTORY OF GHS
• The Ghana Health Service (GHS) is a Public Service body
established under Act 525 of 1996 as required by the 1992
constitution.
• It is an autonomous Executive Agency responsible for
implementation of national policies under the control of the
Ghana Minister for Health through its governing Council -
the Ghana Health Service Council.
 HISTORY OF GHS
• The GHS continue to receive public funds and thus remain within
the public sector.
• However, its employees are no longer part of the civil service, and
GHS managers are no longer required to follow all civil service
rules and procedures.
• The independence of the GHS is designed primarily to ensure that
staffs have a greater degree of managerial flexibility to carry out
their responsibilities then would be possible if they remained
wholly within the civil service.
 HISTORY OF GHS
• Ghana Health Service does not include Teaching Hospitals, Private
and Mission Hospitals.
• The establishment of the Ghana Health Service was an essential
part of the key strategies identified in the Ghana Health Sector
Reform process, as outlined in the Medium Term Health Strategy
(MTHS), which were necessary steps in establishing a more
equitable, efficient, accessible and responsive health care system.
 HISTORY OF GHS

• The reforms build on the reorganization of the MOH that began in

1993, was explicitly designed to set the scene for the establishment
of the Ghana Health Service.
• The reforms also provide a sound organizational framework for the
growing degree of managerial responsibility that has already been
delegated to districts and hospitals.
 HISTORY OF GHS
• Themes that were central to the reorganization of 1993
remain important today for the Ghana Health Service:

• careful stewardship of resources

• clear lines of responsibility and control
• decentralization
• accountability for performance rather than inputs
GHANA HEALTH SERVICE LOGO
ORGANOGRAMME OF GHS
 GHS Mandate and Objectivity

• GHS to provide and prudently manage comprehensive and

accessible health service with special emphasis on primary health
care at Ghana regional, district and sub-district levels in accordance
with approved national policies.
• The objects of the Service are to:
• Implement approved national policies for health delivery in
Ghana.
• Increase access to good quality health services, and
• Manage prudently resources available for the provision of the
health services.
 Ministry of Health and GHS

• The tenets of Act 525 (1996) that established the Ghana Health
Service and Teaching Hospitals.
• The GHS as an agency of MOH is charged to implement approved
health sector polices in such a manner as to ensure access to
priority health interventions and to manage prudently resources
available for provision of health services.
 Ministry of Health and GHS

• As a sector agency, the GHS executes the MOH’s policies, submit plans and
budgets and periodic returns and performance reports to the MOH.
• Other means by which the Ministry exercises oversight responsibility over
GHS include:
• Representation on GHS Council,
• Performance agreements,
• Meetings and reviews,
• Monitoring and evaluations and
• Internal controls.
 GHS Functions

• For the purposes of achieving its objectives the GHS performs the
following functions amongst others:
• Provide comprehensive health services at all levels in Ghana
directly and by contracting out to other Ghana agencies.
• As part of this function, the GHS is to:
• Develop appropriate strategies and set technical guidelines to
achieve Ghana national policy goals/objectives.
• Undertake management and administration of the overall Ghana
health resources within the service
• Promote healthy mode of living and good health habits by people
in Ghana.
 GHS Functions

Establish effective mechanism for disease surveillance, prevention

and control in Ghana.
• Determine charges for GHS with the approval of the Ghana Minister
of Health.
• Provide in-service training and continuing education in Ghana.
• Perform any other functions relevant to the promotion, protection
and restoration of health in Ghana.
 GHS Council

• GHS is governed by a Council, the membership of which is

appointed in line with the provisions of the Act (GHS & THs Act,
1996, Act 525) that sets up the Service.
• The Council under its chairman is responsible for directing and
controlling the affairs of GHS.
• Functions of the Council
• Ensuring the implementation of the functions of the Service
• Submitting to the Minister recommendation for health care delivery
policies and programmes
 GHS Council

• Promoting collaboration between the Ministry of Health, Teaching

Hospitals and the Service
• Advising the Minister on the qualification for posts in the Service
and other matters that the Minister may request
• GHS Council Committees
• Human Resource Committee
• Disciplinary & Welfare Committee
• Finance & Budget Committee
• Audit Committee
 THE GHS COUNCIL MEMBERSHIP

• This is at the topmost position on the vertical level and comprises the
ff.
• A chairman
• The Director General
• Rep. of M. O. H
• Rep of Ministry of Finance
• Rep. of Ministry of Education
• Rep. of Ministry of Local Government and Rural Development
• Rep. of Health workers services union
• Five others who can contribute to work with council two of whom
should be women
 GHS Executives (Management)

• 1. National (Headquarters) Level

• The Chief Executive Officer or the Executive Head of GHS is the
Director General who serves as an Ex-officio member of the
Council.
• The Director General leads and manages the Service and is
responsible for the direction of the work as well as the day-to-day
administration of the Service.
 GHS Executives (Management)

• 1. National (Headquarters) Level

• Exercise of authority and responsibilities by the Director is derived
from and consistent with Sections 3 & 11 of the Ghana Health
Service and Teaching Hospitals Act, 1996 (Act 525) as well as
authority and responsibilities delegated by the immediate superiors
(GHS Council and MOH).
• In running the affairs of Service, the Director General is assisted by
the Deputy Director General (DDG).
 Office Of Director General (ODG)

• The Director General is the executive head of Ghana Health Service

and is answerable to the Ghana Health Service Council.
• In the discharge of his functions, the Director General is assisted by
the Deputy Director General.
• The Deputy Director General is also responsible for direction of the
Service in the absence of the Director General.
• The Office of Director General (ODG) provides day-to-day
administration of Ghana Health Service as a corporate entity and
acts as the lead and steward of the Service.
 Office Of Director General (ODG)

• The Office is currently supported by six Departments /Units:

• Director General And GHS Council Secretariat
• Office of Director Nursing And Midwifery Services
• Office of Director Pharmaceutical Services
• Public Relations Unit
• National Health Insurance Unit
• Medico-Legal Unit
 GHS Executives (Management)

• The National level has 11 Divisions, which are as follows:

• Public Health (PHD)
• Institutional Care (ICD)
• Policy Planning, Monitoring and Evaluation (PPME)
• Family Health (FHD)
• Health Administration and Support Services (HASS)
• Human Resource Development (HRD)
• Research and Development (RDD)
 GHS Executives (Management)

• Finance (FD)
• Stores, Supplies and Drug Management (SSDM)
• Internal Audit (IAD)
• Health Promotion Division (HPD)
• Each Division is headed by a Divisional Director who reports directly
to the Director General.
• The Directors supervise all the activities of their Divisions and the
Director General oversees all the activities of the Divisions of the
Service including the regions.
STRUTURE OF THE GHS
HEALTH SERVICE POLICY
 2. Regional level

• The Regional Health Directorates (RHDs) represent the administrative

apex of health services delivery at the sub-national level.
• The RHDs are headed by the Regional Directors of Health Service and
they report directly to the Director General just like the Divisional
Directors at the headquarters.
• The RHDs champion the implementation of health policies formulated
by the MOH for implementation by GHS at the regional level.
• The RHDs are sub-divided into Departments as follows:
• Regional Public Health Department
• Regional Clinical Care Department
• Regional Health Administration and Support Services Department
 2. Regional level

• Finance Department
• ORDHS
The Departments at the RHDs are headed by Deputy Directors who
report directly to the Regional Health Directors.
• They have technical liaisons with their Headquarters Divisions.
• The Act that sets up the Service provides for the setting up of bodies
known as Regional Health Committees.
• The Regional Health Committees do not have executive powers like
the GHS Council.
• They are purely advisory bodies to support the Regional Directors.
 Public Health Division

• Epidemiology & Surveillance

• Health Promotion
• Expanded Programme on Immunization
• Reproductive and Child Health
• Nutrition
• Health Information
 CLINICAL CARE

• Supervises all hospitals and clinics

• Training of staff on policies and protocols
• Monitoring and supervision of clinical care in regions
• Promoting quality assurance
• Evaluating clinical audit
• Implementation & evaluation of curative & rehabilitative
• Conducts peer reviews
 HASS
• General Administration
• Human Resource
• Store and supplies
• Procurement
• Transport
• Biomedical and equipment
 ORDHS

• Internal Audit
• Finance
• Health Research
• In-service Training
• Development partners
 Health Professionals
• Consultants • Laboratory Officers
• Specialist • Technical officers
• Medical officers • Research officers
• Physician Assistants • Supporting Staff, Accountants,
• Nurses and midwives administrators, human resource
officers, Secretaries, Executive
• Pharmacists officers
 3. District Level

• District Health Directorates (DHDs) are established in each District

of the regions.
• The DHDs provide leadership, supervision, management and
technical support to their sub-districts.
• The DHDs are headed by the District Directors of Health Service
(DDHS), who report directly to the Regional Directors of Health
Service (RDHS).
• The DDHS are the representatives of the DG/RDHS in the Districts
and champion the implementation of health policies and
programmes of GHS in the districts.
 3. District Level

• The Office of the DDHS is supported by the following Units:

• Public Health Unit
• Clinical Care Unit
• Administration Unit
• Finance Unit
• At the District level, the Ghana Health Service and Teaching
Hospital Act, 1996 (Act 525) provides for the setting up of District
Health Committees which also play advisory role at the District
level.
 Key Stakeholders of Ghana Health Service

• In executing its mandate, the Service engages with a number of internal

and external stakeholders that contribute to its outcomes.
• The stakeholders include:
• Workers’ Unions,
• Professional and Managerial Groupings in the health sector,
• other Agencies of Ministry of Health,
• other Ministries, Departments and Agencies,
• Development Partners,
• Regional Coordinating Councils,
• District Assemblies and
• Traditional Authorities.
 Key Stakeholders of Ghana Health Service

• The Unions, Professional and Managerial Groupings include:

• Health Service Workers Union (HSWU),
• Ghana Medical Association (GMA),
• Ghana Registered Nurses Association (GRNA),
• Ghana Registered Midwives Association (GRMA),
• Ghana Hospital Pharmacists Association (GHOSPA)
 Key Stakeholders of Ghana Health Service

• The Unions, Professional and Managerial Groupings include:

• Association of Health Services Administrators Ghana (AHSAG),
• Health Accounting Staff Association of Ghana (HASAG),
• Allied Health Professionals Association,
• Physician Assistant Association,
• Ghana Association of Certified Registered Anaesthetists (GACRA),
• District Health Directors and Medical Superintendent Groups etc.
 Key Stakeholders of Ghana Health Service

• These unions and groupings are critical for the

implementation of the mandate of the Service.
• The leadership of the groups play important roles in
ensuring harmony on the industrial front and also keeping
members in check when there are breaches of the code of
conduct of the Service.
Collaborations with the agencies and the institutions are
mainly through clinical and public health activities.
 Key Stakeholders of Ghana Health Service
• Other agencies of MOH includes:
• The Teachings Hospitals,
• National Blood Transfusion Service,
• Mental Health Authority,
• Health Facilities Regulatory Authority (HeFRA),
• National Health Insurance Authority (NHIA),
• National Health Training Institutions and other service delivery
institutions such as,
• Christian Health Association of Ghana (CHAG),
• Quasi Government Hospitals, Police and Military Hospitals and Private
Health Institutions.
 Key Stakeholders of Ghana Health Service

• The linkages involve:

• Information sharing,
• Joint technical working groups,
• Joint priority setting and implementation of common
objectives such as planning, policy formulation, programme
implementation as well as monitoring and evaluation.
• The linkages are also manifested in the referral systems.
 Key Stakeholders of Ghana Health Service

• The Regional Coordinating Councils, which are headed by Regional

Ministers are the highest administrative and political bodies charged
under the laws of Ghana with ensuring the socio-economic
development of the Regions.
• They formally engage development partners through the
government machinery and provide leadership, and direction to
contribute to the improvement of the health status of the people,
and the socio-economic development of the regions.
 Key Stakeholders of Ghana Health Service

• The district assemblies have in line with the decentralization

policies of the country been the main supporters of the
health system through the provision of infrastructure,
financial and other resources for human resource
development, community mobilization, and providing
oversight responsibility for health as a social service in each
district.
 Key Stakeholders of Ghana Health Service

• The mobilization of communities for participation in

health-related activities is carried out by the leadership of
the communities with chiefs at the helm of affairs.
• Together with assemblymen and other opinion leaders
• The eventual release of land to the Service and its partners
for construction of health-related infrastructure is the sole
prerogative of the chiefs, or the leaders of clans to which
land belongs.
THE END

ANY QUESTIONS