Ghana Health Service

GHS

Objectives

By the end of the lecture students will be able to:1. Discuss the mission, vision, objectives and

rational for the GHS2. Explain the functions of the service3. Mention the levels of administration of the

service4. Know about budgeting and management and

the staff of the service

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 Minister for Health through its governing Council - the Ghana Health Service Council.

• The GHS continue to receive public funds and thus remain within the public sector.

GHS CONT’D

• However, its employees will no longer be part of the civil service, and GHS managers will no longer be 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, than would be possible if they remained wholly within the civil service.

• Ghana Health Service does not include Teaching Hospitals, Private and Mission Hospitals

Rational• The establishment of the Ghana Health Service is an

essential part of the key strategies identified in the Health Sector Reform process, as outlined in the Medium Term Health Strategy (MTHS), which are necessary steps in establishing a more equitable, efficient, accessible and responsive health care system.

• The reforms build on the reorganization of the MOH that

began in 1993, which was explicitly designed to set the scene for the establishment of the Ghana Health Service.

Rational CONT’D

• The reforms also provide a sound organizational framework for the growing degree of managerial responsibility that has already been delegated to districts and hospitals.

• Themes that were central to the reorganization of 1993 remain important today for the Ghana Health Service: careful stewardship of scare resources, clear lines of responsibility and control, decentralization, and accountability for performance rather than inputs.

Mandate

To provide and prudently manage comprehensive and accessible health service

with special emphasis on primary health care at regional, district and sub-district levels in

accordance with approved national policies

Objectives

• Implement approved national policies for health delivery in the country.

• Increase access to good quality health services

• Manage prudently resources available for the provision of the health services.

Functions

• Provide comprehensive health services at all levels directly and by contracting out to other agencies.

As part of this function, the GHS will:• Develop appropriate strategies and set technical

guidelines to achieve national policy goals/objectives

• Undertake management and administration of the overall health resources within the service

Functions CONT’D

• Promote healthy mode of living and good health habits by people

• Establish effective mechanism for disease surveillance, prevention and control

• Determine charges for health services with the approval of the Minister of Health

• Provide in-service training and continuing education• Perform any other functions relevant to the

promotion, protection and restoration of health

Organizational Structure

Administratively GHS is organized at 3 levels:

• National level

• Regional level

• District Level

Functional Levels

Functionally GHS is organised at Five (5) Levels:

• National Level

• Regional Level

• District Level

• Sub-district Level

• Community Level

Governance of Ghana Health Service

• GHS is governed by a 12-member Council-The Ghana Health Service Council.

Its functions are:• Ensure the implementation of the functions of the Service• Submit to the Minister recommendations for health care

delivery policies and programmes• Promote collaboration between the Ministry of Health,

Teaching Hospitals and the Service• Advise the Minister on posts in the Service and other

matters that the Minister may request

Administrative Level Structures

National Level• Ghana Health Service Council

• Office of the Director General and Deputy Director General

• Eight National Divisional Directors

Regional Level

• Regions are headed by 10 Regional Directors of Health Services

• Supported by Regional Health Management Teams

• Regional Health Committees

Districts Level

• All 110 districts are headed by District Directors of Health Services

• Supported by the District Health Management Teams

• District Health Committees

• Sub District Health Management Teams

Budget Management Centres or Cost Centres of the GHS

• The above administrative levels are organised as Budget and Management Centres or Cost Centres for purposes of administering Government of Ghana and Developmental Partner Funds.

• There are a total of 223 functional BMCs and 110 Sub-Districts BMCs of Record.

BMC’s CONT’D

• A break down of the BMCs are as follows: Currently, the headquarters of the GHS is managed as one BMC;

• 10 Regional Health Administrations• 8 Regional Hospitals • 110 District Health Administrations • 95 District Hospitals.

Staff

• Act 525 mandates that the following categories of staff belong to the Ghana Health Service:

• Health personnel in the employment of the MOH immediately before the coming into force of the ACT 525

• All who will be employed by GHS or seconded to it after the coming into force of GHS

CODE OF ETHICS GHS• The Code of Ethics for the Ghana Health Service (GHS) defines

the genera; moral principles and rules of behavior for all service personnel in the Ghana Health Service

• The Service shall be manned by persons of integrity, trained to a high standard to deliver a comprehensive equitable service for the benefit of patients/clients and society as a whole.

1. All Service personnel shall be competent, dedicated, honest, client-focused and operate within the law of the land

2. All Health Professionals shall be registered and remain registered with their Professional Regulatory Bodies

Code CONT’D

3. All Service personnel shall respect the Rights of patients/clients, colleagues and other persons and shall safeguard patients'/client' confidence. 4. All Service personnel shall work together as a team to best serve patients'/clients' interest, recognizing and respecting the contributions of others within the team. 5. All Service personnel shall co-operate with the patients/clients and their families at all times. 6. All Service personnel shall protect the properties of the Service including properties entrusted in their care.

Code CONT’D7. No service personnel shall discriminate against patients/clients on the grounds of the nature of illness, political affiliation, occupation, disability, culture, ethnicity, language, race, age, gender religion, etc. in the course of performing their duties. 8. All Service personnel shall respect confidential information obtained in the course of their duties. They shall not disclose such information without the consent of the patient/client, or person(s) entitled to act on their behalf except where the disclosure of information is required by law or is necessary in the public interest. 9. All Service personnel shall treat official discussions, correspondence or reports obtained during official duties as confidential except where disclosure is required by law.

Code CONT’D

10. All information obtained from patients/clients shall only be used for the prome purpose of their management. Any other use of such information shall only be done with the prior consent of the patient or person(s) entitled to act on his/her behalf. 11. All Service personnel shall provide information regarding patient's condition and management to patients or their accredited representatives humanely and in the manner they can understand.

Code CONT’D• All Service personnel shall respect the rights and abilities

of disabled persons and the aged and work together to serve or safeguard their interest

• 13. All Service personnel shall keep their professional knowledge and skills up to date.

• 14. No Service personnel shall demand unauthorized fees from patients/clients

• 15. No Service personnel shall accept any gift, favour or hospitality from the patient/public which might be interpreted as seeking to exert undue influence to obtain preferential consideration in the course of their duty

Code CONT’D

16. All Service personnel shall refrain from all acts of indiscipline including drunkenness, smoking, immorality, abuse of drugs and pilfering in the course of performing their duties. 17. All Service personnel shall avoid the use of their professional qualifications in the promotion of commercial products. 18. All Service personnel shall act in collusion with any other person for financial gain. 19. Service facilities and resources shall not be used for unauthorized private practice

Patient Charter• The Ghana Health Service is for all people living in Ghana irrespective of age,

sex, ethnic background and religion.• The service requires collaboration between health workers, patients/clients and

society. Thus the attainment of optimal health care is dependent on Team Work.• Health facilities must therefore provide for and respect the rights and

responsibilities of patients/clients, families, health workers and other health care providers. They must be sensitive to patient's socio-cultural and religious backgrounds, age, gender and other differences as well as the needs of patients with disabilities.

• The Ghana Health Service expects health care institutions to adopt the patient's charter to ensure that service personnel as well as patients/clients and their families understand their rights and responsibilities.

• This Charter is made to protect the Rights of the patient in the Ghana Health Service.

Charter CONT’DIt addressesa. The Right of the individual to an easily accessible, equitable and comprehensive health care of the highest quality within the resources ofthe country. b. Respect for the patient as an individual with a right of choice in the decision of his/her health care plans. c. The Right to protection from discrimination based on culture, ethnicity, language, religion, gender, age and type of illness or disability. d. The responsibility of the patient/client for personal and communal health through preventive, promotive and simple. curative strategies.

Patient’s Rights

1. The patient has the right to quality basic health care irrespective of his/her geographical location.2. The patient is entitled to full information on his/her condition and management and the possible risks involved except in emergency situations when the patient is unable to make a decision and the need for treatment is urgent.3. The patient is entitled to know of alternative treatment(s) and other health care providers within the Service if these may contribute to improved outcomes.

Rights CONT’D

4. The patient has the right to know the identity of all his/her caregivers and other persons who may handle him/her including students, trainees and ancillary workers.

5. The patient has the right to consent or decline to participate in a proposed research study involving him or her after a full explanation has been given. The patient may withdraw at any stage of the research project.

6. A patient who declines to participate in or withdraws from a research project is entitled to the most effective care

Rights CONT’D7. The patient has the right to privacy during consultation, examination and treatment. In cases where it is necessary to use the patient or his/her case notes for teaching and conferences, the consent of the patient must be sought.8. The patient is entitled to confidentiality of information obtained about him or her and such information shall not be disclosed to a third party without his/her consent or the person entitled to act on his/her behalf except where such information is required by law or is in the public interest.

9. The patient is entitled to all relevant information regarding policies and regulation of the health facilities that he/she attends.

Rights CONT’D10. Procedures for complaints, disputes and conflict resolution shall be explained to patients or their accredited representatives.11. Hospital charges, mode of payments and all forms of anticipated expenditure shall be explained to the patient prior to treatment.12. Exemption facilities, if any, shall be made known to the patient.13. The patient is entitled to personal safety and reasonable security of property within the confines of the Institution.14. The patient has the right to a second medical opinion if he/she so desires.

Patient’s ResponsibilitiesThe patient should understand that he/she is responsible for his/her own health and should therefore co-operate fully with healthcare providers. The patient is responsible for: 1. Providing full and accurate medical history for his/her diagnosis, treatment, counseling and rehabilitation purposes.2. Requesting additional information and or clarification regarding his/her health or treatment, which may not have been well understood.3. Complying with prescribed treatment, reporting adverse effects and adhering, to follow up requests.

Responsibility CONT’D4. Informing his/her healthcare providers of any anticipated problems in following prescribed treatment or advice.

5. Obtaining all necessary information, which have a bearing on his/her management and treatment including all financial implications.

6. Acquiring knowledge, on preventive, promotive and simple curative practices and where necessary to seeking early professional help.

Responsibility CONT’D

7. Maintaining safe and hygienic environment in order to promote good health.

8. Respecting the rights of other patients/clients and Health Service personnel. 9. Protecting the property of the Health facility.

NOTE

• These rights and responsibilities shall be exercised by accredited and recognized representatives on behalf of minors and patients who are unable for whatever reasons to make informed decisions by themselves;

• In all healthcare activities the patient's dignity and interest must be paramount.