The outbreak of the Coronavirus pandemic (COVID-19) has changed the face of healthcare delivery across the world. A lot of countries have had to review most health standards and approaches as they respond to the novel infection and its associated mortality and issues.
To a larger extent, sub-Saharan Africa is dealing with this new public health emergency crisis amidst the continent’s existing infectious diseases, other humanitarian difficulties albeit the widespread claims of the immunity of Africans against the new virus.
In Ghana, for instance, many are convinced that the first two cases of the virus recorded on Thursday, March 12, 2020, was a test for health authorities to prove how the country can build a robust health care structure to fix its all-time ailing health system. A number of measures have for the past five months been adopted as part of the ongoing case management strategy and breakthroughs to stem the spread of the virus among the population.
Out of the lot, one that seems to stand tall and highly spoken about is the country’s first-ever 100-bed Infectious disease centre at the Ga-East Municipal Hospital; an initiative spearheaded by the Ghana Private Sector Fund.
What makes the disease isolation and treatment facility, historic is how financial support was drawn from various private and public sector organizations and high net worth individuals. A crowdfunding initiative was launched to raise money to complete this flagship project after it faced a funding gap of GHS 7.1 million. The trustees had to cover through the #10GhanaChallenge. The Challenge offered as many Ghanaians as possible an opportunity to be part of the milestone by contributing as little as GHS 10 each towards the first infectious disease treatment facility in Ghana.
The Ghana COVID-19 Private Sector Fund even intends to construct three more of such facilities in Kumasi, Takoradi and Tamale to care and treat for people who contract infectious diseases like Cerebrospinal Meningitis (CSM).
The Ghanaian Spirit
The physical construction of the centre, from start to finish, even though produces real evidence of a tangible project, in my view counts more than that. It inspires confidence and reignites the Ghanaian spirit that some of us have always believed in and talked about; the awareness that the Ghanaian, given the right leadership and enablement can achieve as much as anyone anywhere in the world.
It started by a few people with vision, recognizing a need in society in the midst of a crisis and pulling together to deliver something governments with all the largess of state, would struggle to do in the time it was done and at cost! Leadership is what the Ghanaian needs. And the Ghana Private Sector Fund provided that.
One other thing the building of this centre shows us is that the Ghanaian is not cynical. He may only be fed up with noise and empty promises from those with a mandate to do the needful. However, when the Ghanaian sees reason enough, he or she will sacrifice a few cedis and time to make a big statement; he or she will come to the aid of humanity. And we saw all that with this project!
The construction of the centre best described as a bold step in the health space of the country draws our minds to how to collectivize our efforts in decisively reviving the sustainable management and maintenance of health facilities in a developing country like ours. One of the challenging problems in the health sector is how health facilities face issues of managerial crisis, financial hardships, poor customer satisfaction, bad performance and sometimes non-operationalization.
These among the age-old lack of maintenance culture at some of the critical institutions of our country must not be allowed to crawl into the day-day running of Ghana’s Infectious Disease Centre. How then, do we maintain this key facility well in order not to destroy the gains made in the fight and not throw the purpose of the disease centre off the radar?
Revolving around the priority areas
It is extremely important that the primary motive for the establishment of this facility is outlined to provide direction to both clinicians and patrons. This will ensure effective utilization of the facility’s resources. It can be achieved by following through the mission, objectives and vision of the centre.
A clear policy framework must be defined to form the basis of operationalization. Clearly, it is the mandate of the centre to provide cutting edge services in the prevention and control of infectious diseases to improve the quality of preventive and curative health care for individuals and communities. Resources must be committed to ensuring integrated Infection Prevention and Control (IPC) programs, policies and researches in a bid to achieve low levels of existing and emerging disease burden on the population.
Findings and recommendations from such researches must be prioritized to shape the conversations within Ghana’s public health care settings going forward. Support systems must be rolled out to assist in making the Center, a leading, transformational and go-to facility in West Africa and even Africa at large in the treatment of infectious diseases. The centre must be made to position itself in examining and finding groundbreaking solutions to manage diseases that pose regional and or global threats. Using it as a destination for medical tourism must also be borne in mind.
Governance, managerial skills and human resource
The purpose of the centre will come to naught if the right administrative structure to play the implementing role is toyed with. All levels of management together with officials of the Ghana Health Service and the Ministry of Health must aim at maintaining the strategic direction of policy development and implementation. Efforts must be made to hold periodic in-service training programs as part of human resource development. In strengthening management capacity, the requisite analytical, communication, team-building, negotiation, risk, self and change management skills must be imbued among staff.
There should be strict supervision, monitoring and evaluation of programs and other IPC activities. Committees and other health management teams must be formed to communicate progress reports to higher authorities. Collaboration with other institutions should be a focal point to equip the workforce with new trends.
The facility must use its human resources to engage in health advocacy to empower stakeholders in influencing health policy. Additionally, deliberate attempts must be made to avert the brain drain that characterizes specialized health care in the country.
Sustainable healthcare financing
One of the building blocks of an effective health system is how well it is backed with adequate funding, especially in the wake of declining donor funds. With inspiration from how the centre was established, one will only recommend public-private partnerships with all those who matter as one of the most suitable means to raise revenue for the facility.
Domestic resource mobilization through consistent healthcare branding and aggressive health services marketing must be adopted. The form of payment plan, that is insurance schemes, co-payments and out-of-pocket must be well-structured to prevent huge debts that could collapse the facility.
Irresponsible forms of procurement and the breaches the practice of same comes with is a major setback in the health sector. To prevent instances like these, one of the things the centre must do is to engage in strategic purchasing and proper record keeping. Health accounts for financial decision making must be based on data in terms of cost-effectiveness and cost-benefit analysis in order to reduce wastage.
Healthcare management quality assurance
In acknowledging the strengths of the facility, one fulcrum used as a determinant is how high the quality of care provided is to improve overall clinical outcomes. An eye must be kept on the daily problems that affect patient and staff safety and the necessary changes immediately made on a regular basis.
For example, quality of service delivery, proper clinical case management, adequate supply of drugs and other essentials, stores and record management, equipment maintenance, effective management information system, facility health and safety, bed management, reducing client waiting time, optimum use of technology and most especially, preventing medico-legal issues that arise from medical negligence among others must remain priorities among priorities.
It is imperative to note that operationalizing the facility falls in line with the relevant laws and associated rules including the Factories, Offices and Shops Act, 1970, Health professions and regulatory bodies Act, 2013 (Act 857), the Ghana Health Service Code of Ethics, 2002, the Ghana Health Service Patients’ Charter, 2002, Occupational Safety and Health Convention, 1981 (No. 155), to mention but a few.
Ensuring that, the centre functions under the right standards will forestall increased morbidity and mortality, litigation, decrease in revenue and most importantly, loss of public confidence in the centre.
Consolidating the gains
Ghana’s first-ever Infectious Disease Centre is estimated to have cost about US$ 7.5 million. The amount includes an excess of US$ 5.5 million cash and an additional US$ 2million in kind. It consists of a level 2.5 biomedical laboratory, a triage unit, waiting areas, nurses’ station, VIP and general wards, a 21-bed intensive care unit with various categories within, a pharmacy, a recovery courtyard and a dispensary. There are also access and exit ramps, access corridors, an ambulatory entrance and exit canopy, a medical gas house, an 800KVA generator house and other essential facilities.
More of these facilities will be welcomed to boost health care delivery in the country. However, this current facility must be at least well placed for another pandemic post-Coronavirus. To maximize the utilization of this novelty to transcend the generation yet to be born, the fundamental guiding principles of quality health care; safety, client-centeredness, efficiency, standardization, cost-effectiveness and sustainability certainly ought to apply.
These will enable the centre to operate within acceptable global practices while ensuring patient safety, personnel protection against infections. In the same vein, these principles must guide the researchers and academics into finding experimental approaches towards emerging infections, their management, diagnostics, treatments and cure.
The author, Nii Larte Lartey, is a journalist with Citi FM and Citi TV. He writes for citinewsroom.com