Lessons From Ghana: Universal Right to Health Care Hindered "Only" By Access
Jul 16, 2013 1:00 PMThis summer, a group of physician assistant faculty and students, medical tech faculty, and physician faculty and trainees visited the center of the universe to partner with Kintampo’s College of Health.
Kintampo is a small city right in the center of the western African country of Ghana. Ghana itself has a central location. It is positioned just above the equator (8.0 degrees latitude) and intersects Greenwich Mean Time (GMT) 0, or -2.0 degrees longitude, Dr. Emmanuel Adjase, Director of Kintampo’s College of Health, will tell you that this is why he considers Ghana to be at the center of the universe, and why the city of Kintampo can lay claim to being the city in the center of the universe.
Kintampo is home of the first PA program in Ghana. Under the leadership of Nadia Miniclier, assistant professor in the Department of Family and Preventive Medicine, we brought trainees from the University of Utah to spend time in clinics and hospitals. Our visit culminated in a week of 5 concurrent continuing medical education programs including a 4-day PA program, a 3-day med lab tech, a 1-day physician, a 1-day public health, and a 4-day neurology course. The PA course is in its seventh year, and registration was capped this year at 300, because the 500 enrollees last year were too many to manage.
Everyone from the U.S. has a teaching role in the program. Delivering lectures that are meaningful to Ghanaian health providers has proven challenging, and in the end, an important part of the learning experience for our Utah contingent. While our focus tends to be on providing optimal, definitive care, regardless of cost and with unlimited access to technology, their priorities are around access to care, the transition from predominantly severe acute diseases to more chronic disease, and severe workforce shortages.
In Ghana, PAs are mostly former nurses who then undergo two additional years of training to become a PA. The PAs play a major and growing role in Ghanaian health care. One PA I met reported that he has responsibility for a region that is home to about 21,000 people. He runs a clinic with staff of about a dozen people. He is both the clinic administrator and the senior care provider. In a typical day, he can see 100-120 patients. There is no scheduling process—Ghanaians suffer from more acute disease than chronic disease, and so clinics run more like ERs than outpatient clinics. Patients come to the facility and line up, patiently. The PA and staff stay until every patient is seen, sometimes until late in the evening.
In Ghana, everyone has a right to health care and only bad roads hinder access. It’s not surprising that we have a lot to learn from our African colleagues. What’s surprising is the magnitude of the lessons.
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