Spin on health numbers: This call for equity must be backed by plans and deeds

In Laura Ingalls Wilder’s view “the real things haven’t changed. It is still best, to be honest, and truthful; to make the most of what we have; to be happy with simple pleasures, and have courage when things go wrong.”

There is a narrative around health information especially health inputs and how politicians spin these numbers. I can always live with the mischief but when citizens buy into this narrative and swallow the information hook, line and sinker I get worried. I have on occasion pointed out that we need to be honest about our health human resource numbers to inform honest conversations around what our resource gaps look like. This could also aid us to think out of the box in a way that may facilitate the conversion of one health human resource into another to correct disparities.

Last week, it was reported that 495 Emergency Medical Technicians (EMTs) of the National Ambulance Service (NAS) had passed out at the Paramedic and Emergency Care Training School at Nkenkasu in the Ashanti Region. This number increased the total number of EMTs to 2,154 across the country. Meaning our current Paramedic to population ratio is 0.072 paramedics to 1000 population. This number also equates to 7.8 paramedics per each constituency assuming the spread of this vital health human resource was equitable across the country.

In that same week, 8,610 nurses, nurse assistants and midwives from the southern zone of Ghana were inducted into the profession having passed their professional licensing examination. A simple look at this number should set readers thinking. As this gives an idea of the total number of nursing human resources that are trained and licensed in the country annually.

The journeys of these two groups of vital health human resources in the coming weeks, months and years would be very contrasting. Whilst the paramedics enter the job market with employment certainty, the same cannot be said for their nursing colleagues. Even though our nurse to population ratio currently is 1.2 nurses to 1000 population. The reason being thanks to financial constraints the government cannot absorb all these nurses into the health sector. Meaning almost all of them are likely to join the backlog of unemployed nursing professionals. A situation that we must not countenance.

I will propose we aim at 0.5 paramedics per 1000 population or a total of 15,000 paramedics for the entire population.

At the induction of the nursing professionals, Health Minister Kwaku Agyeman-Manu urged stakeholders in healthcare delivery to help achieve universal access to improved health services nationwide. My view is that his ministry can show leadership by first ensuring that the disparity in the paramedic to population ratio is address as a matter of urgency. To do this will require a clear strategy with an ideal ratio to get to and in what period. I will propose we aim at 0.5 paramedics per 1000 population or a total of 15,000 paramedics for the entire population.

Carefully looking at this number, the first realisation will be that our paramedic deficit based on current numbers will be 12,846. Which indicates that with only one Emergency Medical Technician training school turning out approximately 500 students annually it will take us about twenty-five years to realise this goal. A situation we cannot accept. Considering that we have many nursing schools and have a backlog unemployed, my first suggestion will be to approach this skilled health labour pool to ascertain how many of them will be willing to divert and undertake directed training to become paramedics. My view is that with their job prospects low, many may take up this offer. These can then be taken through a crash course and certified.

The capabilities of nurses in emergency care even without specific training in this area cannot be underestimated. This was brought into the spotlight when at the same function, Samira Bawumia succumbed to the realities of heat exhaustion. Her praise for the professionalism of the nurses around in managing her condition attests to this fact.

My second suggestion will be to find a way of allowing trainee nursing students to obtain essential skills in emergency medicine whilst at school on an optional basis. Apart from the fact that this could improve their employment prospects and career pathways, it could also provide a quick route to bridging the nation’s paramedic deficit.

More importantly, it could also serve as a feeder route for the training of emergency care nurses for many districts that lack this nursing skill mix in their accident and emergency departments. Priority could even be given to trainees who opt to go to more deprived parts of the country or are in nursing training institutions in those areas as a means of circumventing the age-old barriers that prevent health professionals from taking up job opportunities in these parts of the country. This training option could then be reviewed after a period of say five years or even less depending on how quickly our paramedic deficit is fixed.

My second suggestion will be to find a way of allowing trainee nursing students to obtain essential skills in emergency medicine whilst at school on an optional basis.

Mr Minister, it will be much easier to attract stakeholders into the more deprived areas to ensure improved health access if your establishment is seen to be proactively helping to bridge not only the health human resource deficits but also the disparities that exist as well as the spread of these human resources across the country.

It will be diabolical if in the wake of purchasing new ambulances and equipping the Ghana Ambulance Service with pickup vehicles we fail to ensure that the use of these infrastructures is optimised. It thus cannot be accepted if emergency services were not available to a citizen on the account that though there were ambulances, there were no paramedics to operationalise them.

I would conclude by stating that if in the abundance of nurses, we cannot make the most of what we have and convert some into paramedics to fix our deficit, we would have failed to make the most of what we have and our innate ability to think outside the box.

By Kwame Sarpong Asiedu

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