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Toward a Comprehensive Healthcare System in Ghana a Thesis Toward a Comprehensive Healthcare System in Ghana A thesis presented to the faculty of the Center for International Studies of Ohio University In partial fulfillment of the requirements for the degree Master of Arts Rhodaline Baidoo March 2009 © 2009 Rhodaline Baidoo. All Rights Reserved. 2 This thesis titled Toward a Comprehensive Healthcare System in Ghana by RHODALINE BAIDOO has been approved for the Center for International Studies by Francis E. Godwyll Assistant Professor of Educational Studies Jie Li Li Director, International Development Studies Daniel Weiner Executive Director, Center for International Studies 3 ABSTRACT BAIDOO, RHODALINE, M.A., March 2009, International Development Studies Toward a Comprehensive Healthcare System in Ghana (198 pp.) Director of Thesis: Francis E. Godwyll Presently, Ghana is confronted with a health crisis, driven by enormous burden of diseases and poverty. The current health care system, predominantly modern, has proven inept in meeting the needs of Ghanaians as many continually die from preventable diseases. The quality of services available, the geographical access to this care, efficiency of service delivery, and availability of adequate resources to finance and sustain health systems, have placed unnecessary barriers to access available care in Ghana. Continuous decline of health care has consistently failed to compliment the increasing population growth. As a result, the deteriorating healthcare system has forced the majority of the population to seek alternative healthcare services. Traditional health care system, which is the oldest medical system in the country, has once again become the initial avenue of accessing care for about 75% of the population. Traditional health care system is effective, cost-effective, culturally accepted, and have consistently been argued as an effective system that can aid and complement governments’s efforts at ensuring equitable health care. Yet, it remains unintegrated into the current health care structure, and hence remains untapped. This study sought to analyze and evaluate the importance of full integration of traditional health system as a way of maximizing health care accesses, use, and availability to the public. The study identifies the historical trends of both health care 4 systems, reviews current health policies and examines the benefits of integrating traditional health care system into the mainstream health care delivery. The method employed in this study was qualitative one, using semi-structured interviews to gather data. Thirty-three respondents consisting of 12 individuals and 2 focus groups (from Tema Municipality), and 8 key informants (government officials and traditional healers), who uses or have knowledge about the traditional health care system, were selected for this study. Research findings from in-depth interviews indicated that traditional health care system is widely used, inexpensive, effective with fewer side effects, and easily available and accessible to majority citizens. The results of this study also indicated that traditional health care system is culturally accepted, as it is guarded by a shared local knowledge system that instructs its proper use. The majority of respondents are overwhelming in favor of a policy driven integration process, citing the possible socio-economic benefits of that such an intergrated health care system will provide. Approved: _____________________________________________________________ Francis E. Godwyll Assistant Professor of Educational Studies 5 ACKNOWLEDGMENTS “With God all things are possible.” This biblical saying sums up how through God’s intervention this thesis has been successfully completed. I thank the Lord for favors because I couldn’t have made it with HIM, particularly during the dark and stormy times of the past few months. I thank Him for blessing me with loved ones such as Precious, who supported and encouraged me throughout the thesis process. Thank you for motivating me to work harder and for the many sacrifices of time and energy you dedicated just to see me thrive. I express deepest thanks and respect to my thesis committee—Dr. Francis Godwyll, Dr. Mandi Chikombero, and Dr. Thomas Smucker—for their invaluable input to the completion of this thesis. To Dr. Godwyll, I express heartfelt gratitude for directing and chairing my thesis. Without your advice, guidance and navigation through the whole thesis process, this thesis could not have been completed. I extend a sincere thank you to Dr. Chikombero for coming to my rescue to complete the committee and for all your advice and imparting priceless knowledge towards the accomplishment of this thesis. To Dr. Smucker, I sincerely thank you for providing significant support, encouragement and endless time during the writing of my thesis and always. To my parents and aunty, I say a heartfelt thank you, for your endless love and for believing in me. I wouldn’t have come this far without your push and support. Thank You. 6 TABLE OF CONTENTS Page ABSTRACT ......................................................................................................................3 ACKNOWLEDGMENTS ................................................................................................5 LIST OF TABLES ..........................................................................................................11 LIST OF FIGURES ........................................................................................................12 CHAPTER ONE: INTRODUCTION .............................................................................13 Background to the Study .............................................................................................13 The Challenge of Healthcare Integration in Africa ................................................16 Statement of the Problem ............................................................................................18 Purpose of Study .........................................................................................................20 Research Questions .....................................................................................................21 Significance of Study ..................................................................................................21 Delimitation of the Study ............................................................................................23 Definition of Terms ....................................................................................................23 Organization of Study .................................................................................................24 CHAPTER 2: LITERATURE REVIEW ........................................................................26 Introduction .................................................................................................................26 Historical Overview ....................................................................................................26 Early Development of Health Care Systems in Ghana ...........................................28 Modern Health Care System ...............................................................................28 Traditional Health Care System ..........................................................................35 The Post-Colonial Situation ....................................................................................39 7 Modern Health Care System ...............................................................................39 Traditional Health Care System ..........................................................................44 The Period of Structural Adjustment Program (SAP) ............................................46 Modern Health Care System ...............................................................................47 Current Conditions of the Health Care Sector .......................................................53 Modern Health Care System ...............................................................................53 Traditional Health Care System ..........................................................................61 Policies/Programs in Place ..........................................................................................67 Drug Finance and the National Health Insurance Scheme (NHIS)........................67 Quality Assurance ...................................................................................................72 Local Drugs and Herbal Medicine Manufacturing ................................................73 Importance of Herbal Medicine to Healthcare Development .....................................75 Examples of Integrative Efforts in Africa ...................................................................80 Traditional and Modern Health Practitioners Together Against AIDS and Other Diseases (THETA) - Uganda ..................................................................................80 The Culture and Health Program (CHAPS) - Kenya .............................................81 CHAPTER 3: METHODOLOGY ..................................................................................83 Research Design .........................................................................................................83 Research Site ...............................................................................................................84 Selection of Participants .............................................................................................87
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