Feature: Entrepreneurship Bulletin with Alexander Akwasi Acquah (AAA)

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Tackling healthcare from the AAA perspective

The health care systems in Africa are perceived to attract chronic under investment and challenging national interventions which have left healthcare systems on the continent prostrate.

Despite numerous social policies by governments, it is widely speculated in literature that the continual national and household income challenges hinder healthcare systems.

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Although data show that the African continent has experienced substantial growth over the past half-century, most African households are still unable to access and afford health care.

Literature does argue healthcare challenges on the basis that living conditions in Africa and some parts of the world are not conducive due to inability to access inexpensive drugs and medicines which have been proven to be efficacious and beneficial.

Against this backdrop, governments and other stakeholders are of the opinion that Africa can no longer ignore its people, as commitments to reverse this unacceptable health care challenge trend are now at their peak.

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Interventions in health policy is considered just as important as efforts to move forward Africa’s social and economic development agenda.

Ghana has made major strides in improving access to health care systems over the past decade.

In delving deeper into healthcare statistics, medical services are provided by central government, local institutions, religious missions (private non-profit agencies) and a relatively small number of private practitioners.

Of the health care facilities, approximately 50 percent are ministry of health institutions, 40 percent are from the private sector and nine percent are mission institutions.

Considered as one of the far-advanced countries of Africa in terms of healthcare, Ghana’s launch of the National Health Insurance Scheme (NHIS) in the year 2003 was aimed at providing financial access to quality basic health care for residents.

The launch of a public insurance scheme replaced the existing ‘cash and carry’ payment approach.

The initial ‘cash and carry’ scheme required patients to pay for their treatment upfront – which meant that a large proportion of the population could not access health care.

Despite the monumental strides in improving health care systems in Ghana, inequity in accessing health care services has been highlighted as a major challenge that needs to be addressed. It is seemingly true that urban populations and richer households are more likely to have a valid NHIS card than rural and poorer households.

In the far remote areas, pregnant women are likely to deliver less often in a health facility than those in the urban areas.

Notwithstanding the fact that there are numerous challenges facing healthcare, one of the topmost challenges looming at our doorstep is healthcare infrastructural accessibility and affordability. In an attempt to tackle lack of infrastructural accessibility and affordability, should the government of Ghana continue to build more healthcare infrastructure? Or should private entrepreneurs be empowered to venture into healthcare?

In the far-advanced countries, attempting to improve health care requires the effort of both private and public healthcare centres. Governments in the advanced countries have over the years provided support in the form of capital injection to private healthcare centres. In Ghana, the current government has invested colossal amounts in revamping both public and private healthcare services.

Healthcare in Ghana is much more accessible and affordable. However, it is about time healthcare was tackled from a ‘business perspective’. Veering from governmental health care institutions and focusing solely on private healthcare facilities, the private health sector employs an estimated 15% of Ghana’s health workforce – mostly in the urban areas.

As free healthcare in the public hospitals is not entirely free, the cost for healthcare is becoming increasingly less of a barrier. The add-on effects of private facilities are quality and convenience, thus making private health facilities more popular than ever. By far, private health care investors have big opportunities in Ghana’s health sector – which has led to the discovery of a booming and apparently untapped sector.

Yet private health facilities face numerous challenges. First, there’s a huge investment gap, as private health facilities find it more difficult to secure loans to finance their projects. Nevertheless, if loans are secured interest on them are relatively higher; thereby deterring most entrepreneurs from healthcare.

Second, the healthcare system in Ghana is considered one of the most-regulated sectors in the country. The regulatory system attracts more stringent and much complex licencing issues, as there are more capital requirements which need to be met. Meeting such requirements is quite complex for beginners in the health sector.

Third, there is a perception that citizens in the rural and far remote areas are naturally poor, hence encouraging private owners to set-up their healthcare facilities in the urban areas. This denies a section of the Ghanaian population affordable and accessible health care.

As stated earlier, the solution to the aforementioned challenges is ‘tackling healthcare from a business perspective’. As a starter, payment of loans with interest invested in a health facility may seem a rather daunting task without determination. Appropriate health management systems, technical expertise, and a better flow of value for money system effect is required to be successful. Irrespective of the system management approach – as primary health care is considered an essential aspect of our daily lives, a more regulated system reduction on interest on loans from the banking institutions would be key to providing health care for all. As healthcare deployment is very much critical to our daily lives, the somehow complex regulatory system has to be enforced in making sure that it is properly and accurately delivered.

Also, as NHIS is widely and easily accessible for all, private entrepreneurs in health care should not only consider healthcare investments in the urban areas. Being situated in towns and rural areas guarantees patronage, as the environment will not be too choked with many health centres. Thanks to the current government, health centres receive expeditious payments from NHIS. This expeditious payment system provides the assurance of swift business cash flow structure if properly managed.

In conclusion, the dynamics, diversity and complexity of healthcare systems in Ghana and Africa as a whole has to shift from a government social-related approach to providing an enabling environment that encourages entrepreneurs to see healthcare from a business perspective. Entrepreneurs should be educated on the initial teething-challenge of the somewhat stringent regulatory and licencing challenges.

Arguably, such challenges if persistent are postulated to hinder success and, anyway, cannot be sustained at the current fiscal capacity. Furthermore, sustaining financing from national budgets and real increases in overseas development assistance for private health entrepreneurs is deemed critical if Ghana is to join the rest of the world in improving global health, thereby continuing the marked fall in mortality.

The writer is an Entrepreneur, business analyst, and Akim Oda NPP parliamentary aspirant

SourceB&FT

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