Ghana already has experience in implementing Community-based Health Planning and Services (CHPS) Zone system in rural communities. What is needed to do now is to replicate the model throughout communities in cities or urban areas. Just like the CHPS zones, the new model can be put up as health outposts. A community of about a thousand inhabitants could have within three of the outposts.
Each health outpost should be equipped with resources necessary to provide basic health needs such as monitoring blood sugar, blood pressure, malaria testing kits, first aid kits, adolescent health, family planning, I.C.T system for documentation and record keeping. This should be linked to the I.C.T system of main health facility in that community such as a polyclinic or hospital. The outposts can be manned by a registered nurse and health assistants.
The main goal of the outpost is to establish direct contact with individual community members to help them play active role in accessing primary healthcare. First and foremost, there should be an effort to raise national awareness of this initiative and to educate the public on this mode of healthcare. This can be done through national media and public address system within the communities.
The services provided in these facilities should be at the level of the resources available there. The nurse or health staff in charge should pay regular visit to individual homes and take details of members of family, including their health history and the data entered into the computer system.
The people should be educated on the importance of seeking healthcare at the initial stage of health problems and the dangers of delay in doing so. They should also be educated about the fact that one does not necessarily have to be knocked off feet by sickness before going to health facility. Community members should be encouraged and empowered to walk to health outposts any time they feel unwell without hesitation.
The staff of the facilities should make it a routine to contact persons within their catchment areas through phone calls to enquire about their wellbeing. Routine basic health screening in communities should be carried out, at least twice in a year. This would help tracking and early detection of any health problem for easy and cheaper treatment. With active participation of the people, a lot of them would adopt healthy lifestyles that improve and maintain overall good health.
I would advocate that, services provided at the health centers in the communities should be absolutely free. No health insurance should be required to receive care in these community facilities. Health insurance and any other cost to clients should only be considered for services beyond the health posts.
The above proposals would cost the nation some considerable amount of money to implement fully; however, its value cannot be over emphasized in the long term. In the UK, budgetary allocation for health was 10.2% GDP in 2019 and up from 9.8% in 2018. 10.2% of GDP translate into 225.2-billion-pounds. This include both government and non-government spending. The government is responsible for 79% of the total expenditure. Out of the total budget for healthcare, 9%-10% goes into primary health care programs, including what they call general practice G.P. Proponent of primary healthcare in the U.K. continue to advocate for further increase in budgetary allocation for primary health care (source: office of the national statistics-UK health account). Ghana as at 2019 allocated 3.4% of GDP to healthcare delivery. We need to take primary healthcare delivery in this country seriously and this can be demonstrated by how much resources our leaders are willing to commit to its implementation.
