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MEDIA CENTER Traditional Durbar Introduces Novel Approach to Getting Life-saving Medicine to Vulnerable Ghanaians NEW YORK, NY and ACCRA, GHANA (5 May 2007)—The Population Council and collaborators have begun a test of the latest innovation of the Community-based Health Planning and Services Initiative (CHPS), the national program of health care service delivery. This new approach, aimed at getting life-saving drugs to Ghana’s most vulnerable citizens, was marked by a traditional “durbar” festival in the Nkwanta District of the Upper Volta region on 27 April. Hundreds of community members attended the event, which featured an exchange of greetings with the chiefs, pouring of libation, traditional dance, and speeches by Ghana Health Service Director General Elias K. Sory, Nkwanta District Director of Health Services John Koku Awoonor-Williams, and Frank Nyonator, director of the Ghana Health Service's Policy, Planning, Monitoring, and Evaluation Division. In Ghana, many children under the age of five still die from acute respiratory infections, diarrhea, malaria, and other diseases that are preventable or treatable with low-cost drugs. A decade ago, the Ministry of Health responded to the challenge of drug access with a policy that provides essential medicines free of charge to Ghana’s most vulnerable citizens: children under five, pregnant women, the elderly, and people living in poverty. But this policy has never worked well, as pharmaceutical stocks have often run short. This problem has been exacerbated in recent years by two new government-implemented public health policies aimed at delivering health care to Ghanaians. A national health insurance plan and the success of the Community-based Health Planning and Services Initiative (CHPS) have each increased demand for essential drugs without generating sufficient revenues to provide them. To ensure affordability, the insurance plan charges an $8 annual fee to the portion of the population that is not designated “exempt.” The Government of Ghana is responding to the problem of drug shortages by forming a partnership with US-based pharmaceutical companies—Wyeth Pharmaceuticals among them—and an international nonprofit research organization, the Population Council. The Ghana Essential Medicines Initiative—or GEMI—will evaluate ways to ensure that all households have access to basic drugs. GEMI is the latest development in the Ministry of Health's decade-long strategy to improve the quality of health-care services nationwide. GEMI aims to make CHPS fully sustainable by ensuring that community nurses have the pharmaceutical supplies they require for patient care. To achieve this goal, GEMI is conducting research aimed at preventing pharmaceutical shortages and guiding the Government of Ghana’s actions to solve the pharmaceutical access problem nationwide. The study will take place in the Nkwanta District, a remote area of Ghana on its eastern border with Togo. Nkwanta’s pioneering role in implementing CHPS makes it an appropriate setting for the GEMI trial. The Ghana Health Service is supplying GEMI with trained nurses, supervisors, and a public health physician, along with transportation costs. The pharmaceutical companies are contributing individual doses of the 19 medicines and vitamins deemed “essential” by the Ministry of Health for a three-year program of research. The Mascotte Family Fund of the Aspen Community Foundation and the US Agency for International Development have contributed equipment for communications so that remotely located nurses can stay in touch with the doctor in Nkwanta. Oak Foundation has provided financial support for operations research. The Population Council is providing the time and skills of staffers in both Ghana and the United States to oversee this project and develop systems to monitor the progress of those who participate in this initiative, as well as those who will benefit from it in the future. The GEMI team developed and is implementing its experimental strategy based on the realities of Ghana's health system. Some questions that the researchers will try to answer are: "How much will effective implementation of the exemption policy and health insurance plan actually cost?" and “What are practical ways of building sustainable access to essential pharmaceuticals?” Another focus will be whether it is feasible to expand the reproductive health and family planning options of village residents. Currently, at-home pregnancy tests, emergency contraception, reproductive tract infection kits, and the full choice of modern family planning methods are not widely available in rural villages of Ghana. For three decades, Ghana has embraced the policy of extending primary health care to all of its citizens. With the inputs of government, business, and researchers, GEMI will support Ghana’s effort toward its declared goal of “Health for All.” See Also
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