Are you a GPAA member?

Have you satisfied the CRITERIA?

Take a look at the criteria that makes u a member.

(a) Licensed practitioner by MDC
(b) Dues paying practitioner (private or government employed)
(c) Registered with the NATIONAL DATA BASE

*Benefits of a REGISTERED MEMBER*

1. NEC is able to validate and compile statistical data of it’s members for future negotiations.

2. Lawyers of GPAA provide legal support to registered members in case of professional victimization.

3. A registered member can stand for National office in a vacant position as advertised.

4. Enjoy GPAA welfare ; funeral, scholarship, promotion, financial support in case of accident, incapacitating, etc.

4. Issuance of Professional ID Card.

5. Connect with colleagues in other regions in case of travel, referral, transfers, locum, contacts. Send text or WhatsApp to GPAA IT TEAM and you shall be linked to a colleague. This is called PEER NETWORKING.

6. Benefit from  Subsidized Regional CPD’s for carrier development.

7. In the area of Job prospects, registered members are assisted by the National Secretariat for placements.

6. Receive GPAA UPDATES on your phone.

7. Track pensioneers and provide routine support .

NB: It is not enough to be a dues paying member.

Click on the link below to fill the forms. This should take few minutes.

For the elderly who are not Internet friendly, call or text the National Ag. PRO on 0246813414 or the IT HEAD on 0244976360 for assistance.

https://forms.gle/wqu9of2Ew4oheADM9

ISSUED BY: National Ag. PRO
                      Aminu A. Mohammed
                      0246813414

 

Physician Assistant Awarded by Effiduase Sub~Traditional Council for her good services to the Area

PHYSICIAN ASSISTANTS, THE MAJOR PILLARS OF PRIMARY HEALTH CARE IN GHANA.

Primary Health Care, or PHC, refers to “essential health care ” that is based on scientifically sound and socially acceptable methods and technology, which make universal health care accessible to all individuals and families in a community. It is through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.(wikipedia)

This ideal model of healthcare was adopted during Alma Ata Declaration in 1978 at Kazakhstan, and became a core concept of the World Health Organization’s goal of Health for all .

The Alma Ata Conference mobilized a “Primary Health Care movement” of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the “politically, socially and economically unacceptable” health inequalities in all countries.(Wikipedia, WHO)

The ultimate goal of primary healthcare is the attainment of better health services for all. It is for this reason that the World Health Organization (WHO), has identified five key elements to achieving this goal; namely universal coverage reforms; service delivery reforms; public policy reforms; leadership reforms; and increasing stakeholder participation.

Behind these elements lies a series of basic principles identified in the Alma Ata Declaration that should be formulated in national policies in order to launch and sustain PHC as part of a comprehensive health system and in coordination with other sectors.(Wikipedia)

The 4th, 5th and 6th portions of the 8 Millennium Development Goals set in the year 2000 places emphasis on reducing child mortality, improving maternal health and to combat HIV/AIDS, malaria and other diseases; in its respective order, which was to be achieved by the year 2015. Therefore in order to achieve this, a comprehensive healthcare is required which relies on an adequate number and distribution of trained physicians, nurses, allied health professions, community health workers and others working as a health team and supported at the local and referral levels.(WHO, Wikipedia)

Additionally it requires the commitment of the government of the day to infuse into the health system resources to improve the health of the citizens in the country.

But how is this achievable if government do not have a team of dedicated work force, who are ready to serve in their capacity everywhere they are posted within the country?

With the growing demand for better health care across the country by citizens of this country, which has led to government upon government embarking on various forms of expansion at various health facilities, it seems not to be enough to accommodate all our patients in the country leading to congestion and spill over at the various health facilities especially regional and tertiary health institutions. Ghana as a country has chocked successes from adopting the PHC model. The burden of the community in having to travel several distances to seek health care and the numerous number of mortalities that occurred through these means has drastically reduced though not eliminated by the implementation of the CHPs concepts, establishment of health centres and district hospitals, increased training of health workers particularly those who serve at the community and rural areas and deployment of logistics to such hard to reach areas for the initiation of care and to fall on referral protocols if necessary.

Among the cadres that work in such deplorable areas are the Physician Assistants.

Who is a Physician Assistant (medical) in Ghana and around the globe?

Formerly called Medical Assistant, A Physician Assistants (PA) is one trained by the Health Training Institutions in the country to bridge the gap between doctor-patient ratio and to save the  dying ones who could not reach the hospitals but yet needs urgent care to survive. They are trained in community medicine and health, public health, surgery and obstetrics and gynaecology within a period of four years and practice independently after their internship at over thousand health centres across the country and do so within their scope of practice guarded by the laws of the country and ethics of the profession.

They are regulated by the medical and dental council of Ghana. These category of workers practice medicine and dentistry across the globe with names as Physicians Assistants(Ghana,USA, UK), Clinical Officers(Kenya, Tanzania, Zambia, Burkina Faso) etc.

A Physician Assistant is the subdistrict head though unofficially appointed is answerable to the district director and manages the health centre spanning from Administration, Human resource, Clinical work, Health Promotion, Research & Surveys and supervises activities of the CHPs centres and community Based Volunteers within his catchment area.

Dating back to history in the 1950s up to the adoption of PHC concept 1978 and beyond, government saw a huge deficit in the health sector due to the lack of doctors in the country which made it impossible to achieve universal health coverage and the then sustainable development goals now revised to millennium development goals hence the need to train these special work force of the Physician Assistants to intervene in the collapsing situation and bring health closer to the people.

Unfortunately after the Physician Assistants were and have been employed everyone including the government forgets about them and leave them to their fate in deplorable facilities with scarce resources which most at times leaves them to improvision but they have and continue to sacrifice their quota for this country to where it has reached today. Not being privileged to have electricity and even reception for phone calls.

If someone will hear my voice today as I put it in writing, they should part this workers, motivate and give them the needed remunerations for their sacrifices, for where there is no doctor there is a Physician Assistant.

So if there is any threat against this professional group, who are doing this tremendous work in the country, then it should be the concern of all to voice out and defend them because without their efforts our fathers, mothers, siblings, uncles nephews etc at the rural areas would either die in an emergency because of lack of transportation coupled with our bad roads or even suffer complications because they could not reach on time the hospital far away from their location. Should this category of workers not be empowered in knowledge through carrier progression and given other opportunities to enable them deliver better services to the patients they treat every day?, a food for thought.

Physician Assistants are also found in the consulting rooms of most of our hospitals treating patients everyday. In Kenya and the other countries they also trained to perform caesarean section and other surgeries as well. They have gained the name doctor at their villages where they practice as some would ridiculously say village doctor but they are proud of what they do and proud to be called their own name as Physician Assistants (medical).

In conclusion the country would not have gained this much without the PHC concept and would not also have gained same without Physician Assistants at the grass root.

Thank You.

 

Written By

Samuel Wiafe

Columnist/Senior Physician Assistant

(samuel.wiafe15@gmail.com)

THE EMERGING TRENDS OF CHRONIC NON-COMMUNICALBLE DISEASES IN BIAKOYE DISTRICT: HYPERTENSION AND DIABETES IN FOCUS

 

By: Peter Eyram Kuenyefu, Senior Physician Assistant

Chronic Non- Communicable Diseases have been defined as diseases or conditions that occur in, or are known to affect over an extensive period of time and for which there are no known causative agents that are transmitted from one individual to another.

The rapid rise of non-communicable diseases (NCDs) represents one of the key major health challenges to global growth and development. The priority diseases included in the cluster of NCDs are cardiovascular diseases, and their risk factors such as Hypertension, Coronary Heart Disease and Cerebrovascular Accidents, Cancers, Injuries, Chronic Respiratory Infections, and Mental Health.

The aforementioned diseases share common risk factors such as unhealthy diet, smoking, excessive alcohol use, substance abuse and physical inability. These diseases are manifested as obesity, high blood pressure, and high blood lipids.

However, other NCDs can be classified as follows;

  1. NCDs of genetic origin like sickle cell disease and other haemoglobinopathies
  2. Injuries like Road Traffic Accidents (RTAs, Falls, etc.)
  3. Other NCDs such as oral disorders, eye disorders and mental ill-health

The focus of this article is on cardiovascular diseases, particularly Hypertension and Diabetes Mellitus. The global burden of NCDs is projected to approach high levels, especially in developing countries. In 1999, NCDs, were responsible for 60% of deaths in the world and 43% of the global burden of disease. By the year 2020, the global impact of NCDs has been projected to cause up to 73% of deaths and 60% of the burden of disease.

In Ghana, the World Health Organization (WHO) estimates that NCDs account for an estimated 34% deaths and 31% of disease burden in Ghana. NCDs kill an estimated 86,200 persons in Ghana each year with 55.5% of them aged less than 70 years and 58% of males being affected. According to the Ministry of Health (MOH), the prevalence of adult hypertension in Ghana appears to be increasing and ranges from 19% to 48%. Up to 70% of persons identified to have hypertension are not on treatment and only 0%-13% of those with hypertension have their blood pressures controlled.

 

Zeroing in down to Biakoye District in the Oti Region of Ghana, the rise in the prevalence of chronic NCDs is a cause for alarm as demonstrated in the table below:

 

 

 

DISEASE           YEAR  
  Adult Pop. 2016 Adult Pop 2017 Adult

Pop

2018 Adult.

Pop.

2019 Adult.

Pop.

2020 Cum.

Prev.

  34993   35816   36638   37481   38350    
Hypertension   624   923   794   1,057   1,458 4,856
Diabetes Mellitus   250   72   234   541   320 1,417
                       

SOURCE: GHS. DHIMS 2

 

The above trend calls for an elaborate and holistic planning, organizing andimplementation of strategic plans in the areas of prevention (primordial, primary, secondary and tertiary) to reduce the prevalence of the most common chronic NCDs in Biakoye District.

Most of the decline in NCDs in developed countries can be attributed to improvements in nutrition, housing, sanitation, screening and other environmental measures. Those measures can also be replicated in our District with the right policies and direction, with the active broader stakeholder involvement.

There is therefore the need for professionals in the health service and other key stakeholders like the municipal/district, religious leaders, traditional authority, etc. in the district must concentrate on the following:

  1. Primordial Prevention: This is with the aim of avoiding the emergence and establishment of the social, economic and cultural patterns of living that are known to contribute to an elevated risk of disease through policy
  2. Primary prevention: This is to limit the incidence of disease by protection of health by personal and communal efforts through enhancing nutritional status, providing immunizations and eliminating environmental risks.
  3. Secondary Prevention: This is geared towards reducing the prevalence of hypertension and diabetes by shortening their duration by early detection (diagnosis) and prompt intervention (clinical care) to control disease and minimize disability controlling specific causes and risk factors through periodic community and facility-based screenings.
  4. Tertiary Prevision: Emphasis in this level of prevention should be aimed at reduction of number and/or impact of complications by softening the impact of long-term disease and disability, minimizing suffering and maximizing potential years of useful life through rehabilitation

 

Going forward, we also need to do concentrate on the following;

  1. Health system strengthening where we
  2. Train health workers and develop human resource capacity
  3. Provide essential drugs and supplies
  • Integrate NCD plans into wider health systems planning
  1. Ensure financial mechanisms for improved allocation and efficient use of funds

 

  1. Research and development
  2. Surveillance of NCDs and their risk factors
  1. To strengthen partnerships within the health sector and between non-governmental

organizations (NGOs), civil society organizations (CSOs), the private sector and the

community to promote healthy lifestyles

The Public Health Department of Biakoye District Health Directorate has a critical role to play in the fight against the emerging trends of NCDs like hypertension and diabetes in the district through intensifying health promotional and prevention activities geared at informing, educating and counseling the populace.

Together, we can put our synergies together to address the emerging trends in the incidence and prevalence of hypertension and diabetes in the district.

 

Thank you.

 

The writer is a practicing Physician Assistants who has interests in Public Health, and Maternal and Child Health.

Contact Number: 0249883933

Email; pkuenyefu@gmail.com

INTEGRATING MENTAL HEALTHCARE INTO PRIMARY HEALTH CARE SERVICES: A CALL TO STRENGTHEN THE PRIMARY HEALTHCARE LEVEL

By Peter Eyram Kuenyefu, Snr. Physician Assistant, Comfort Ofedie Memorial Clinic, Nkonya- Ahenkro

Primary Health Careis an essential health care based on practical, scientifically sound and socially acceptable methods and technology which is made universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self- determination”. (Article VI)

Alma Alta Declaration was proclaimed as a major milestone of the twentieth century in the field Public Health, and it identified Primary Health Care as the key to the attainment of the goal of Health for All.

Health is now widely acknowledged as having both a physical and mental health dimension and was indeed captured in the World Health Organization constitution in 1948.

The first key declaration at the conference was reaffirming that health which is a state of complete physical, mental ad social well- being, and not merely the absence of disease or infirmity, is a fundamental human right and the attainment of the highest possible level of care     is a most important worldwide social goal whose realization requires the action of many social and economic sectors in addition to the health sector.

Mental Health on the other hand is defined as a state of well- being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

With all the above encapsulation, Primary Health Care systems in countries around the globe including Ghana focus only physical care, failing to provide mental health care to their populations.

Mental Health Disorders such as Depression, Psychosis, Epilepsy, Substance Abuse Disorders, Child and Adolescent Mental and Behavioral Disorders, and Self -Harm/Suicide are predominantly in all countries are contributing to immense hardships, poor quality of life, increased mortality and astronomical economic and social costs. In view of the above, mental health can no longer be ignored in contemporary health systems.

Forty years after the Alma Alta Declaration, the world is still battling to reaffirm that Primary Health Care is the essential healthcare, universally accessible to individuals. There is therefore the need as a country to make concerted efforts to change the current state of affairs.

Indeed, a fundamental shift needs to occur in our healthcare paradigm, from one of human rights violation and poor health outcomes associated with care delivered through psychiatric institutions, to one which respects human rights and promotes good health outcomes and recovery through the delivery of Mental Healthcare/ services in a well -structured, robust and well- resourced Primary healthcare settings.

It is paramount therefore to emphasize that mental healthcare be delivered in Primary Healthcare is much more likely to be effective and sustainable if complimented by a strong secondary level of care to which PHC workforce can turn to for referrals, as well as support and supervisions. In furtherance, having a strong informal community ,mental health services and support groups run by NGOs and faith based organizations can help compliment and strengthen the services provided through PHC.

 

THE NEED FOR INTEGRATION

The merits of integrating Mental Health into Primary Health Care are enormous.

  • Integration ensures that the population as a whole has access to Mental Healthcare that they need early in the course of their disorders and without disruption.
  • When people access care in PHC facilities, the likelihood of better health outcomes, and even full recovery as well as a maintained social integration is enhanced or increased.
  • Better access to care is achieved through PHC as it is the first and foremost level of contact of individuals, families and the entire community with any country’s health system. PHC also happens to be the closest and easiest form of care available, located near to the people’s homes and communities. On the other hand, psychiatric institutions or hospitals where mental healthcare services are provided are mostly situated in towns and cities, a long way from home and consequently many individuals seek to the care they need.
  • People who do seek treatment in psychiatric hospitals often find themselves isolated as they live far away from their families, removed from their emotional and social support systems and no longer in a position to maintain their daily living activities and jobs, thus compounding economic situations for the whole family. Meanwhile, mental healthcare available and delivered through PHC provides the golden opportunity for people to be able to access treatment and care that they need near their homes and keep their families together, maintain support systems and remain integrated and active in the community in order to contribute productively to their households.
  • Mental Healthcare also delivered through the PHC is cost effective and affordable. The cost associated with travelling to the cities/ towns and catering for a relative while accessing care in the specialized institutions is removed entirely or minimized.
  • Stigmatization is reduced as PHC services are not associated with specific health conditions. The fear of being branded “mad”, bad and dangerous or marginalized from the community and discriminated against is reduced, thus making this level of care apt, more acceptable and accessible for most service users.
  • Mental Health services delivered in PHC setting are also more acceptable because they reduce the risks of human rights violations people are exposed to when seeking care at psychiatric hospitals.
  • Better health outcomes are assured when Mental Healthcare is delivered through the vehicle of Primary Health Care. In terms of clinical outcomes, it has been found out that for many mental disorders, PHC can offer good care and certainly better care than that is provided in psychiatric hospitals. Recent evidence indicates that mild, moderate and even severe depression can be effectively diagnosed and managed at primary care settings. There are several reasons why management of mental disorders in primary health care settings results in better outcomes.
  • Mental Health is often co-morbid with many physical health problems such as Malaria, Hypertension, Diabetes, Tuberculosis, HIV/AIDs, among others. The presence of substantial co-morbidity has serious implications for identification, treatment and rehabilitation of affected individuals. By attending to the physical health needs of someone with mental disorder, or alternatively, to the mental health needs of someone with a physical problem, primary healthcare worker is in a better position to provide treatment and care in a holistic manner that immensely increases the likelihood of a good health outcome.
  • Primary healthcare practitioners are in the unique position of rendering care throughout people’s life cycle. It is worth noting that treatment in a primary care setting allows for continuity of care beyond the mere “one off” consultation and treatment (which is characterized by poor adherence to treatment regimens).
  • Moreover, the fact that people needing are able to continue living with their families in their communities means they are more likely to maintain strong links with society as well as with sectors that are important to mental health such as social welfare, education and labour, all of which is conducive to recovery.

THE WAY FORWARD FOR INTEGRATING MENTAL HEALTH INTO PRIMARY HEALTH CARE

  1. Policy, Plans and Laws:There is the need for Ghana as a country to operationalize Policies, Plans and Laws that have been drafted and legalized so as to actively integrate mental health in Primary Health Care.
  2. Strengthening Primary Healthcaresystemsto serve as the vehicle for the delivery of all healthcare services to the population. Particular attention need to be paid Sub- District Health Systems which happen to the weakest level of structure in Ghana’s Health Systems. Provision of effective mental healthcare at the PHC level is highly dependent on the pre-existence of well functional PHC systems.
  3. Human Resource Development and Training:Ghana as a country must put in more efforts aimed at addressing Human Resource shortages to deliver mental health service interventions. Physician Assistants, Midwives, Public Health Nurses, Registered General Nurses, Community Health Nurses, Enrolled Nurses, Counselors must be equipped with the requisite skills and competences to identify Mental Health disorders, provide basic medications and psychosocial intervention, undertake crisis prevention and refer to specialist mental health worker where appropriate.
  4. Provision of the requisite logistics (Drugs):The Mental Health Authority must take pragmatic efforts in providing psychotropic drugs at the peripheries if only we as a country are serious of integrating mental health in non- specialized health facilities (Primary healthcare level).
  5. Supervision and Support of Primary Healthcare workforce and a robust and functional Referral Systems:For integration of mental healthcare into PHC to be achievable and sustainable, supportive supervision and other logistic support must be readily available by the secondary healthcare level workers or specialized staffs. Also, there must be a robust and functional referral linkages between the two levels for prompt and appropriate referral of clients

CONCLUSION

Integration of Mental Healthcare into Primary HealthCare is long overdue. The benefits of integration are enormous and the clarion call is for all managers of health to operationalize this noble idea.

The time is now. Let us begin it in any small way in our respective health centres across the districts and municipalities in GHANA

Thank you

The writer is a practicing Physician Assistant, who has interests in Sub District Health Management, Public Health and Obstetrics and Gynaecology.

Email:pkuenyefu@yahoo.com

Mob: 0249883933/0206384991/0274883933

POST PARTUM HAEMORRHAGE: A LEADING CAUSEOF MATERNAL MORTALITY

By Peter Eyram Kuenyefu (Senior Physician Assistant: – Comfort Ofedie Memorial Clinic- Nkonya- Ahenkro)

Post-Partum Haemorrhage (PPH) is generally defined as blood loss from the genital tract in excess of 500mls after vaginal delivery or any amount of blood loss that is enough to compromise the health of the woman as evidenced by deterioration in her haemodynamic status. For Caesarean Section (CS), the cut-off for PPH is 1000mls (1litre) and not 500ml. Post- Partum Haemorrhage could be primaryor secondary.

Primary PPH occurs within the first 24 hours of delivery of the baby whereas secondary PPH occurs between 24 hours and 6 weeks of delivery.

The World Health Organization statistics suggests that 60% of all maternal deaths in developing countries across the globe are as a result of PPH, accounting for more than 100,000 maternal deaths yearly. It could therefore be comfortably concluded that Post-Partum Haemorrhage is the leading cause of maternal mortality and morbidity in developing countries, Ghana inclusive.

Other causes of maternal mortality include Abortions, Miscarriages, Sepsis, Obstructed Labour, Ectopic Pregnancies, Pre- Eclampsia and Eclampsia, Embolism, Ante- Partum Haemorrhage, etc.

All women who carry pregnancy beyond 20 weeks are at a risk of PPH and its attendant issues. Generally, majority of women who suffer PPH have no risk factors. The WHO has recommended measures to reduce maternal deaths from PPH.

RISK FACTORS

  • Anaemia in Pregnancy
  • Previous PPH
  • Prolonged 2ndand 3rdstage of labour
  • Pre- eclampsia
  • Instrument delivery
  • Retained placenta and other products of conception, etc

CAUSAL FACTORS OF PPH

  1. Uterine Causes
  2. Atony
  3. Rupture
  4. Inversion
  5. Placental Causes
  6. Retained placenta and other products of conception
  7. Genital Trauma
  8. Lacerations
  9. Haematomas
  10. Clotting defects

MANAGEMENT OF PPH

Management of PPH is an EMERGENCY!!!

  • Call for help!!!!
  • IV access with wide bore canulla
  • Take blood for grouping and cross-matching
  • Start IV fluids (Normal Saline/ Ringers Lactate) and/or haemotransfusion
  • Give oxygen if necessary and available
  • Pass a urethral catheter
  • Condom tapponage
  • Massage the uterus continuously
  • Give a high dose oxytocin
  • Give Misoprostol per rectum
  • Identify the cause(s) of the PPH and correct

 

CAUSAL FACTORS AND THEIR SPECIFICMANAGEMENT/ INTERVENTIONS

SN CAUSAL FACTOR(S) SPECIFIC MANAGEMENT/INTERVENTIONS
1 Uterine Atony a.     Massage uterus continuously

b.     Give Oxytocin bolus and another high dose in infusion

c.     Insert 800mcg (4 tablets) Misoprostol (Cytotec) per rectum

2 Uterine Rapture a.     Requires laparotomy
3 Uterine Inversion a.     Requires laparotomy
4 Retained placenta a.     Manual removal of placenta and curettage

b.

5 Genital Trauma c.     Repair lacerations and haematomas
6 Clotting Defects a.     Requires haemotransfusion of whole blood and fresh frozen plasma

MEASURES TO CURTAIL POST PARUM HAEMORRHAGE

Post- Partum Haemorrhage is a threat to maternal health, hence in the need to put in adequate, comprehensive and holistic measures to curtail its menace. All maternity units should be prepared at any given point in time to swiftly intervene when PPH arises at your facility because it can kill within minutes if not adequately and promptly managed.

However, the following measures must be enforced at all facility levels to reduce the menace of PPH:

  1. General measures
  2. ANC Measures
  3. Labour and delivery measures
  4. Management of established PPH

General Measures

  • Improve the general health of women so that they start cyesis in good health so that should PPH occur they would be able to withstand it better. This requires good nutrition, freedom from debilitating infections and good hemoglobin concentration

ANC Measures

  • Adequate History taking which must include past Obstetric history to rule our previous PPH
  • Counsel all pregnant women to deliver at a health facility and under medically supervised care
  • Counsel and book high risk patients to deliver at health facilities that have facilities like blood transfusion, operating theatre and surgeons
  • Make sure that during ANC, no woman is anemic before delivery by
  1. Checking HB regularly as recommended
  2. IPT administration
  • Fersolate and folic acid supplementation
  1. Treating hookworm infestation
  2. Prompt management of infections in pregnancy
  3. Counseling women about family planning

Labour and Delivery Measures

  • Strict use of partograph during labour
  • Active management of the third stage of labour

Management of Established PPH

  • See earlier discussion on management of PPH

 

The writer is a practicing Physician Assistant, who has interests in Sub District Health Management, Public Health and Obstetrics and Gynaecology.

Email:pkuenyefu@yahoo.com

Mob:0249883933/0206384991/0274883933

PHYSICIAN ASSISTANTS, THE MAJOR PILLARS OF PRIMARY HEALTH CARE IN GHANA.

Primary Health Care, or PHC, refers to “essential health care ” that is based on scientifically sound and socially acceptable methods and technology, which make universal health care accessible to all individuals and families in a community. It is through their full participation and at a cost that the community and the country can afford to maintain at every stage of their development in the spirit of self-reliance and self-determination.(wikipedia)

This ideal model of healthcare was adopted during Alma Ata Declaration in 1978 at Kazakhstan, and became a core concept of the World Health Organization’s goal of Health for all .

The Alma Ata Conference mobilized a “Primary Health Care movement” of professionals and institutions, governments and civil society organizations, researchers and grassroots organizations that undertook to tackle the “politically, socially and economically unacceptable” health inequalities in all countries.(Wikipedia, WHO)

The ultimate goal of primary healthcare is the attainment of better health services for all. It is for this reason that the World Health Organization (WHO), has identified five key elements to achieving this goal; namely universal coverage reforms; service delivery reforms; public policy reforms; leadership reforms; and increasing stakeholder participation.

Behind these elements lies a series of basic principles identified in the Alma Ata Declaration that should be formulated in national policies in order to launch and sustain PHC as part of a comprehensive health system and in coordination with other sectors.(Wikipedia)

The 4th, 5th and 6th portions of the 8 Millennium Development Goals set in the year 2000 places emphasis on reducing child mortality, improving maternal health and to combat HIV/AIDS, malaria and other diseases; in its respective order, which was to be achieved by the year 2015. Therefore in order to achieve this, a comprehensive healthcare is required which relies on an adequate number and distribution of trained physicians, nurses, allied health professions, community health workers and others working as a health team and supported at the local and referral levels.(WHO, Wikipedia)

Additionally it requires the commitment of the government of the day to infuse into the health system resources to improve the health of the citizens in the country.

But how is this achievable if government do not have a team of dedicated work force, who are ready to serve in their capacity everywhere they are posted within the country?

With the growing demand for better health care across the country by citizens of this country, which has led to government upon government embarking on various forms of expansion at various health facilities, it seems not to be enough to accommodate all our patients in the country leading to congestion and spill over at the various health facilities especially regional and tertiary health institutions. Ghana as a country has chocked successes from adopting the PHC model. The burden of the community in having to travel several distances to seek health care and the numerous number of mortalities that occurred through these means has drastically reduced though not eliminated by the implementation of the CHPs concepts, establishment of health centres and district hospitals, increased training of health workers particularly those who serve at the community and rural areas and deployment of logistics to such hard to reach areas for the initiation of care and to fall on referral protocols if necessary.

Among the cadres that work in such deplorable areas are the Physician Assistants.

Who is a Physician Assistant (medical) in Ghana and around the globe?

Formerly called Medical Assistant, A Physician Assistants (PA) is one trained by the Health Training Institutions in the country to bridge the gap between doctor-patient ratio and to save the  dying ones who could not reach the hospitals but yet needs urgent care to survive. They are trained in community medicine and health, public health, surgery and obstetrics and gynaecology within a period of four years and practice independently after their internship at over thousand health centres across the country and do so within their scope of practice guarded by the laws of the country and ethics of the profession.

They are regulated by the medical and dental council of Ghana. These category of workers practice medicine and dentistry across the globe with names as Physicians Assistants(Ghana,USA, UK), Clinical Officers(Kenya, Tanzania, Zambia, Burkina Faso) etc.

A Physician Assistant is the subdistrict head though unofficially appointed is answerable to the district director and manages the health centre spanning from Administration, Human resource, Clinical work, Health Promotion, Research & Surveys and supervises activities of the CHPs centres and community Based Volunteers within his catchment area.

Dating back to history in the 1950s up to the adoption of PHC concept 1978 and beyond, government saw a huge deficit in the health sector due to the lack of doctors in the country which made it impossible to achieve universal health coverage and the then sustainable development goals now revised to millennium development goals hence the need to train these special work force of the Physician Assistants to intervene in the collapsing situation and bring health closer to the people.

Unfortunately after the Physician Assistants were and have been employed everyone including the government forgets about them and leave them to their fate in deplorable facilities with scarce resources which most at times leaves them to improvision but they have and continue to sacrifice their quota for this country to where it has reached today. Not being privileged to have electricity and even reception for phone calls.

If someone will hear my voice today as I put it in writing, they should part this workers, motivate and give them the needed remunerations for their sacrifices, for where there is no doctor there is a Physician Assistant.

So if there is any threat against this professional group, who are doing this tremendous work in the country, then it should be the concern of all to voice out and defend them because without their efforts our fathers, mothers, siblings, uncles nephews etc at the rural areas would either die in an emergency because of lack of transportation coupled with our bad roads or even suffer complications because they could not reach on time the hospital far away from their location. Should this category of workers not be empowered in knowledge through carrier progression and given other opportunities to enable them deliver better services to the patients they treat every day?, a food for thought.

Physician Assistants are also found in the consulting rooms of most of our hospitals treating patients everyday. In Kenya and the other countries they also trained to perform caesarean section and other surgeries as well. They have gained the name doctor at their villages where they practice as some would ridiculously say village doctor but they are proud of what they do and proud to be called their own name as Physician Assistants (medical).

In conclusion the country would not have gained this much without the PHC concept and would not also have gained same without Physician Assistants at the grass root.

Thank You.

 

Written By

Samuel Wiafe

Columnist/Senior Physician Assistant

(samuel.wiafe15@gmail.com)