Human Resources Division, Ghana Health Service, Accra, Ghana.
Health Economics Unit, University of Birmingham, Birmingham, UK.
Int J Health Policy Manag. 2018 Nov 1;7(11):1040-1052. doi: 10.15171/ijhpm.2018.64.
Ghana is implementing activities towards universal health coverage (UHC) as well as the attainment of the health-related Sustainable Development Goals (SDGs) by the health sector by the year 2030. Aside lack of empirical forecast of the required healthcare facilities to achieve these mandates, health workforce deficits are also a major threat. We therefore modelled the needed healthcare facilities in Ghana and translated it into year-by-year staffing requirements based on established staffing standards.
Two levels of modelling were used. First, a predictive model based on Markov processes was used to estimate the future healthcare facilities needed in Ghana. Second, the projected healthcare facilities were translated into aggregate staffing requirements using staffing standards developed by Ghana's Ministry of Health (MoH).
The forecast shows a need to expand the number/capacity of healthcare facilities in order to attain UHC. All things being equal, the requisite healthcare infrastructure for UHC would be attainable from 2023. The forecast also shows wide variations in staffing-need-availability rate, ranging from 15% to 94% (average being 68%) across the various staff types. Thus, there are serious shortages of staff which are worse amongst specialists.
Ghana needs to expand and/or increase the number of healthcare facilities to facilitate the attainment of UHC. Also, only about 68% of the health workforce (HWF) requirements are employed and available for service delivery, leaving serious shortages of the essential health professionals. Immediate recruitment of unemployed but qualified health workers is therefore imperative. Also, addressing health worker productivity, equitable distribution of existing workers, and attrition may be the immediate steps to take whilst a long-term commitment to comprehensively address HWF challenges, including recruitments, expansion and streamlining of HWF training, is pursued.
加纳正在开展活动,以实现全民健康覆盖(UHC)和卫生部门在 2030 年实现与健康相关的可持续发展目标(SDGs)。除了缺乏实现这些任务所需的医疗设施的经验预测外,卫生人力短缺也是一个主要威胁。因此,我们对加纳所需的医疗设施进行了建模,并根据既定的人员配备标准将其转化为逐年的人员配备需求。
使用了两个级别的建模。首先,使用基于马尔可夫过程的预测模型来估计加纳未来所需的医疗设施。其次,使用加纳卫生部(MoH)制定的人员配备标准,将预测的医疗设施转化为总体人员配备需求。
预测显示,需要扩大医疗设施的数量/容量,以实现 UHC。在一切条件相同的情况下,从 2023 年开始就可以实现实现 UHC 的必要医疗基础设施。预测还显示,各种人员类型的人员配备需求-可用性比率存在很大差异,范围从 15%到 94%(平均为 68%)。因此,存在严重的人员短缺,特别是在专家中更为严重。
加纳需要扩大和/或增加医疗设施的数量,以促进实现 UHC。此外,只有约 68%的卫生人力(HWF)需求得到雇用并可用于提供服务,这导致基本卫生专业人员严重短缺。因此,急需招聘失业但合格的卫生工作者。此外,解决卫生工作者的生产力、现有工作人员的公平分配和人员流失问题可能是当前需要采取的步骤,而长期承诺则是全面解决 HWF 挑战,包括招聘、扩大和简化 HWF 培训。