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National Health Workforce Plan for Africa: Addressing the Shortage of Healthcare Workers in Ghana

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Added on 2024/06/28

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This report examines the critical shortage of healthcare workers in Ghana, a lower-middle income country in Africa. It analyzes the current state of the health workforce, identifies key challenges, and proposes strategies for implementing a National Health Workforce Plan (NHWP). The report utilizes data from the World Health Organization (WHO) and other relevant sources to provide a comprehensive overview of the situation. It highlights the need for increased investment in training and education, improved working conditions, and effective retention strategies to address the workforce gap. The report concludes with recommendations for policymakers and stakeholders to ensure a sustainable and resilient health workforce in Ghana.

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National Health Workforce Plan for Africa
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Executive Summary
The leading international organization WHO has engaged in reviewing the healthcare system of
different countries. With the help of analyzing the data it has been found that there are lower
income and middle-lower income countries that lacks qualified and skilled healthcare workforces
along with the care services.For overcoming the shortage of health workforce in the lower-
middle income country the government has engage in undertaking effective operational plan
whose main aim is towards building the robust health system in the Ghana with qualified
workforce towards the attainment of UHC (Universal Health Coverage).
In order to plan for the staff requirement in the healthcare industry of Ghana it has been proposed
that Ministry of Health focuses on drafting the healthcare workforce plan that basically
comprises of different steps such as analyzing the workforce, gap analysis and selection of the
workforce.
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TABLE OF CONTENTS
Executive Summary.......................................................................................................................2
Introduction....................................................................................................................................4
Prepare the Environmental Scan for the health workforce in Ghana..................................5
Prepare a data profile of the health workforce by category using WHO data....................7
Critical issues that needed to be addressed in the workforce plan.....................................10
Strategies relevant to implement the workforce plan..........................................................11
Conclusion.................................................................................................................................... 13
References.....................................................................................................................................13
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Introduction
World Health Organization (WHO) has stated that different resources available to health
systems, such as workforce (that mainly includes physicians, nurses and midwives as well as
other workers); infrastructure (hospitals and psychiatric beds) as well as medical technologies
and devices that support in managing the different patients. In regard with this, workforce
planning is considering as an effective approach that allows the management to overcome the
imbalances and shortage of staffs within the healthcare so that they may impart quality of
services to the different disease patients.
The leading international organization WHO has engaged in reviewing the healthcare system of
different countries. With the help of analyzing the data it has been found that there are lower
income and middle-lower income countries that lacks qualified and skilled healthcare workforces
along with the care services. In .order to develop the health workforce plan it has been assessed
that the selected country will be Ghana as it clearly showcases the high workforce related issues.
The National Health Workforce Plan (NHWP) will focuses on preparing an Environmental
Scanalong with measuring the national health workforce data set of the chosen country.In
addition to this, report will also focuses on identifying key issues and developing strategies to
address the same.
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Prepare the Environmental Scan for the health workforce in Ghana
In order to measure the health workforce in Ghana, environmental scan has been performed that
support in adequate information regarding the health sector in the region. It has been addressed
that the Health Sector in Ghana is mainly structured at three main levels i.e. national, regional as
well as district level. Health interventions are packed for each level and are supplied at the
particular clinics and hospitals (Al Kiyumi et al. 2017). The capital of Ghana, Accra is a
preferred centre for the healthcare settings as it engages in offering security, constancy, adequate
education along with the health facilities. The health workforces are internationally trained at the
academic level that support in delivering quality of care services to different patients.
Currently, in Ghana there are different unaddressed health problems pretence severe risks to the
Ghanaian population. The common health problem includes malaria, HIV, tetanus, chickenpox,
schistosomiasis etc (World Health Statistics, 2015). For overcoming the shortage of health
workforce in the lower-middle income country the government has engage in undertaking
effective operational plan whose main aim is towards building the robust health system in the
Ghana with qualified workforce towards the attainment of UHC (Universal Health Coverage).
For attaining the health workforce in Ghana to meet the international benchmark MoH (Ministry
of Health), Ghana focuses on evolving the staffing standards (i.e. staffing norms) for healthcare
services in the country grounded on the basis of meta-analysis of health facilities’ across the
country with the help of using an evidence-based instrument i.e. Workload Indicators of Staffing
Needs (WISN) suggested by the WHO.
Through addressing the healthcare it has been identified that MoH consider retaining the
graduate level nurses, secretly trained physician supporters, druggists and foreign trained
medical officers who are inconsistently unemployed amongst the need in the region. Thus,
inefficiencies and low productivity have been recounted amongst the Ghanaian health workers
on the basis of which effective healthcare workforce plan will be devised by the Ghana
(MacDonald Werstuck & Buccino, 2018).
Through reviewing the national policy of Ghana it has been assessed that Government and
Ministry of Health of focuses on drafting the policy that benefit the Community Health Workers
(CHWs) so that they may render quality of services within the setting. The national policy in
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Ghana focuses on giving attention to the CHWs by providing them required remuneration with
providing opportunities to grow their career in the healthcare industry that results in boosting
their overall productivity and allow them to sustain their activities (Baatiema et al. 2016). The
national policy of Ghana is in align with the international standards and guideline as the WHO
and other agencies has initiated the idea of imparting training to the community health workers
in order to improve their practices so that they may deliver quality of care treatment in the lower-
middle income countries. Therefore, national policy of Ghana is aligned with the international
norms for achieving the health-related Millennium Development Goals.
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Prepare a data profile of the health workforce by category using WHO data
Through reviewing the data profile of the health workforce in Ghana the current analysis indicate
that there is a severe scarcity of some para-clinical staffs that mainly comprises of laboratory
technicians (85% shortfall), pharmacy technicians (75% shortfall) and radiographers (69%
shortfall). However, the ratio of registered nurse has also declined in the past years that have
affected the overall health care services in Ghana (Hu et al. 2016).
Figure 1: Global rate of healthcare workers
(Source: World Health Statistics, 2015)
The above figure clearly states that the ratio of healthcare workers in the global environment in
different regions. For instance,nursing personnel and midwifery personnel are mainly available
in the required time period. In different countries, nurses are qualified with the skills and abilities
of midwifery skills so that they may render effective services in the different income group
countries. Therefore, it is difficult to draw distinction among the nursing personnel and
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midwifery personnel as it provide effective services in the healthcare setting (World Health
Organization, 2019).
With specifically addressing the statistic and data of Ghana there are numerous of staffs that
need to be hire or delivering effective and quality of care services to the patients. It has been
drafted that aggregate HWF Requirements for the Public-Sector Healthcare Facilities in Ghana
needed to accomplished the profile is as follows-
S.no. Staff Type 2018 2019 2020
1 Technical officer
(laboratory)
4369 4832 5235
2 Pharmacy technician 4368 4903 5360
3 Radiographer/x-ray
technician
885 971 1062
4 Medical officer (general
practitioner)
3719 4194 4610
5 Enrolled nurse 21207 23363 25418
6 Paediatrician 553 609 675
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From the above figure it has been forecasted that ratio of staffs will get increase in the upcoming
years as the existing staffing levels could be enhanced by establishing HWF with addressing the
need-availability by facilitating the recruitment, distribution, and redeployment planningin the
healthcare industry (Health workforce, 2010).
In order to plan for the staff requirement in the healthcare industry of Ghana it has been proposed
that Ministry of Health focuses on drafting the healthcare workforce plan that basically
comprises of different steps such as-
Analysis of workforce
The first step in the planning focuses on analysis of the workforce in the healthcare industry of
Ghana. The healthcare authority at the national level focuses on undertaking the supply analysis
where it focuses on the demographics of the staffs along with the employment trends and
workloads in the healthcare setting (Asamani et al. 2018). On the other hand, analysis will also
focuses on demand forecasting of the healthcare with addressing the health profile and new
health technologies so that qualified staffs will be hired in the health system.
Gap analysis
Another step focuses on analyzing the existing gap so that in case of increasing demand of
healthcare workforce the authority will focuses on hiring the competent employees and worker in
the setting so that they may deliver required services in the Ghana (Leffler et al. 2016).
Selection of workforce
The last step in the workforce planning is associated with selection of the required staffs within
the healthcare so that it enhances the performance of healthcare setting.
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Critical issues that needed to be addressed in the workforce plan
For the successful Health Workforce Plan in lower-middle country i.e. Ghana it has been
identified that there key issues and challenges needed to be addressed in the planning. The
critical issues are as follows-
Identifying critical role
The foremost issue in the workforce plan is associated with identifying the critical role of staffs
that needed to be hiring in the healthcare setting (Budd et al. 2015). With the key roles it would
allow in selecting the required personnel for overcoming the health-related problems existing in
Ghana. As the country is among the lower-middle income countries that does not focuses on
hiring the competent personnel for the required health related program.
Lack of resources
Another issue that needed to be addressed in the workforce plan is associated with lack of
resources as with the improper income in Ghana, Ministry of Health is not able to hire qualified
person (Kinsella & Kiersey, 2016). Therefore, central government or international bodies assist
the lower-middle income country in drafting the human resource plan and then engages in
selecting the competent personnel.
Ineffective communication
Another critical issues to be addressed in the workforce plan is associated with the ineffective
communication that result in implementing ineffective practices in the process that negatively
affect in selecting the incompetent staff in the health care.
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Strategies relevant to implement the workforce plan
The report of WHO (2016), namely “Working for health and growth: investing in the health
workforce” focuses on increasing the ratio of healthcare workers by at least 40 million through
creating new jobs in the health and social sectors. However, the international organization has
also projected the deficit of 18 million health workers, principally in low- and lower-middle-
income nations, by the year 2030 (The High-Level Commission on Health Employment and
Economic Growth, 2016). In order to implement the workforce plan in Ghana it has been
assessed that certain recommendations will be taken into the consideration through which
healthcare authority will easily engage in devising the strategies for successfully implementing
the workforce plan.
Ghana acknowledged the need to tackle its severe shortage of healthcare workers and consequent
health services problems. A new Strategic Human Resource Plan for the period 2007-2030 is
being developed. This is part of the overall health system development plan, which focuses on
promoting healthy lifestyles and the environment, enhancing good reproduction and nutrition,
and government and funding. The vision is to achieve the middle-income status of the nation by
2030, an objective which requires a healthy population, is also consistent. A study of the
healthcare program for 2014 discovered, in many cases, that problems of bad morale and the
allocation of healthcare workers were linked to failure to improve health results. In 2015, the
Ministry of Health carried out an evaluation of requirements following an on-going health
workers ' forum which is based on the present plan. The Plan is strongly supported by political
will and is co-implemented by the Ministry of Health and the Ghana Health Service and its
organizations (Al Kiyumi, et. al., 2017).
Special priority should be given to increasing the cost-effectiveness and enhanced retention and
recognition of the rural jobs in relation to physicians based upon experience on ground and proof
from other places in Sub-Saharan Africa. The Plan has been modelled on three financing
situations that allow for changes in macroeconomic conditions and donor behaviour. The SWAp
health financing is given, but present funds stay inadequate for complete execution. The
Community-based health planning and service program (CHPS) was launched in 1999 with the
objective of placing rural and disadvantaged community health officers in working with
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community healthcare workers. As the objective of serving each district was still not achieved,
this program will be reinforced as part of the fresh human resources strategy. Overcoming
bottleneck includes inadequate incentives for rural postings to accept and absence of proper
ownership of the community. Training establishments are urged to boost their group intake, but
at the same time the accessible funds are increased. This causes certain issues, especially with
big class sizes and a small amount of tutors. Accredited private schools are used for some
education under oversight of regulators to guarantee that capacity is accessible for the expansion
phase. Practical health employees and fresh university graduates are urged to take on teaching
duties with books and research budgets. New training sites are scheduled and each hospital will
have training capabilities on a long-term basis (Budd, et. al., 2015).
The key recommendation is associated with gender and women’s rights that will be used in
developing the strategy of equality within the planning process. However, the implementations
of strategy will emphasis on exploiting the economic participation of the women employees in
the healthcare setting as the profession of nurses and caretaker. Through maintaining the equality
it results in fostering their empowerment with the help of institutionalizing their leadership and
overcoming the inequities existing in the education and in the health labour market. With all such
activities it results in developing the effective strategy that will further outcome in the planning
for the workforce.
With the help of reviewing recommendations it has been also assessed that healthcare authority
will focuses on developing the technological strategy for gathering the competent and efficient
personnel for the healthcare setting in Ghana. It has been assessed that rapid shift in the
technologies are engaging in changing the overall nature of the health services. It supports in
emerging the new cadres of health workers that features immense of knowledge and information
that will support in delivering required services to the patients (The High-Level Commission on
Health Employment and Economic Growth, 2016). In addition to this, digital technologies would
also act as an effective strategy that provides prospects to the people to heighten the access of
effective health services. In addition to this, with the implementation of technology it will allow
the selection of competent workforce that result in improving the receptiveness of health systems
as through which it results in accomplishing the requirement of individuals and communities.
Moreover, it also progress the provision of an extensive range of health services in the Ghana.
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From the recommendations it has been also stated that partnership and collaboration would
enable the necessary change in the workforce planning. With the partnership and collaboration
intersectional processes must be engage for the hiring the competent and qualified staffs within
the healthcare system. In addition to this, with partnership it support in undertaking the regional,
national and local authorities in the planning so that they may engage in successful
implementation of the activities.
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Conclusion
From the above report it has been concluded that with the shortage of health workforce in the
lower-middle countries results in imparting negative effect on the overall population of the
region. Health Workforce Plan (HWP) will focuses on setting and undertaking effective
activities through which adequate and required number of staffs are hired for delivering quality
of the services. The report has also summarized that data of health workforce in Ghana along
with developing the workforce profile that is required in the setting.
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References
 Al Kiyumi, R., Walker, S. M., Tariq, A., & FitzGerald, G. (2017). Health information
management professionals [Present circumstances and future expectations].
 Asamani, J. A., Chebere, M. M., Barton, P. M., D’Almeida, S. A., Odame, E. A., &
Oppong, R. (2018). Forecast of healthcare facilities and health workforce requirements
for the public sector in Ghana, 2016–2026. International journal of health policy and
management, 7(11), 1040.
 Baatiema, L., Sumah, A. M., Tang, P. N., & Ganle, J. K. (2016). Community health
workers in Ghana: the need for greater policy attention. BMJ global health, 1(4),
e000141.
 Budd, G. M., Wolf, A., & Haas, R. E. (2015). Addressing the primary care workforce: A
study of nurse practitioner students’ plans after graduation. Journal of Nursing
Education.
 Health workforce, (2010). World Health organization. [Online]. Available through:
<https://www.who.int/healthinfo/systems/WHO_MBHSS_2010_section2_web.pdf>.
[Accessed on 7th June 2019].
 Hu, W., Lavieri, M. S., Toriello, A., & Liu, X. (2016). Strategic health workforce
planning. IIE Transactions, 48(12), 1127-1138.
 Kinsella, S., & Kiersey, R. A. (2016). Health Workforce Planning Models, Tools and
Processes in Five Countries.
 Leffler, A. R., Thomas, A., Harper, K. J., & Ferrell, D. (2016). Developing a Process
Infrastructure to Capture Supply, Education, and Demand Data for Indiana’s Nursing
Workforce. Journal of Nursing Regulation, 7(3), 22-25.
 MacDonald Werstuck, M., & Buccino, J. (2018). Dietetic Staffing and Workforce
Capacity Planning in Primary Health Care. Canadian Journal of Dietetic Practice and
Research, 79(4), 181-185.
 The High-Level Commission on Health Employment and Economic Growth, (2016).
Working for Health and Growth Investing in the health workforce. [Online]. Available
through: <[Online]. Available through: <https://www.who.int/hrh/com-heeg/reports/en/>.
[Accessed on 7th June 2019].>. [Accessed on 7th June 2019].
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 World Health Organization, (2019). Health workforce. [Online]. Available through:
<https://www.who.int/hrh/com-heeg/reports/en/>. [Accessed on 7th June 2019].
 World Health Statistics, (2015). World Health organization. [Online]. Available through:
<
https://apps.who.int/iris/bitstream/handle/10665/170250/9789240694439_eng.pdf;jsessio
nid=8D56FAA589D092ADDE2E7B8AADCA7763?sequence=1>. [Accessed on 7th June
2019].
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National Health Workforce Plan for Africa: Addressing the Shortage of Healthcare Workers in Ghana

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