Building a Global Force in Public Health, a "Light to all the World"
Apr 15, 2015 12:00 AM
Despite serious strides toward free universal health care, Ghana's National Health Insurance Scheme struggles with many of the same problems vexing health care in the U.S. Barriers to advancing health in Ghana are more than financial. They're cultural, educational and, like here in the states, they're complicated.
Nevertheless, there is much to build upon and learn from in Ghana, one of the few African nations to witness a decline in child and infant deaths, largely due to low-cost, low-tech innovations, such as investments in clean water and sanitation, malaria prevention and prenatal care. So, when people wonder why the University of Utah is spending time and resources cultivating relationships with countries like Ghana -- or China and Korea -- I tell them: Because having a global presence helps us think differently about health care, and enables us to apply global innovations locally, benefitting everyone in our community.
Ghana is a growing piece of the university's global health initiative. We've offered short-term educational programs and student exchanges there for more than a decade. And in March, I flew to West Africa to celebrate expansion of those efforts: The opening of Ensign College of Public Health in Kpong, Ghana.
The college, more than six years in the making, was almost entirely funded by private donors – predominantly Lynette and Robert Gay, who fell in love with the country years ago while serving an LDS mission there. The Gays are longtime supporters of the U of U, and when we learned about their dream of building a public health college in Ghana, we wanted to be a part of it.
Our role at Ensign is supportive. Staffed by University of Utah and local faculty, the school will offer a two-year master's program in public health and just enrolled its first class of 24 students. In time, the plan is to include more degrees.
Already emerging from the seeds of this partnership are new ways for promoting health and wellness. This summer, a team led by Stephen Alder, Ph.D., professor of family and preventive medicine and chief of the U of U's Division of Public Health, will launch "Health 2 Go," a program to train and deploy a citizen corps of Ghanaian community health coaches to triage illness, improve health literacy and collect and manage data for monitoring health trends. The goal is to find affordable and sustainable ways to alleviate health disparities and weave wellness into the fabric of life in Ghana.
If successful, the program could challenge sacred assumptions we all have about the clinic-based management of chronic disease. By working with the people of Ghana, we might find jointly beneficial health solutions –– better solutions than we’re likely to find on our own.
It's a vision espoused by the Gay family who see Ensign as a proving ground for all sorts of life-sustaining innovations. Robert Gay sums it up this way: "The name Ensign is to be a standard-bearer, a light. Our fondest dream would be that this would be a light to all the world. …A global force in public health."
Health Care in Ghana
The introduction in 2003 of Ghana’s National Health Insurance Scheme (NHIS) was an improvement over the previous cash-based system, according to Oxfam. There have been advances in access and quality of care. Expanded services, such as free prenatal care for all pregnant women, have contributed to a decline in infant and child mortality. But plagued by soaring costs and premiums, the system leaves many Ghanaians uncovered.
- 82 percent of Ghanaian citizens pay for NHIS, but only 18 percent receive services.
- 64 percent of the country's richest are registered with NHIS and only 29 percent of the poorest.
- The cost per insurance claim more than doubled in one year, between 2008 and 2009.
- An estimated 36 percent of health spending is wasted due to inefficiencies and poor investment.
Source: Oxfam 2011 report, "Achieving a Shared Goal: Free Universal Health Care in Ghana."