The Potential Power of Public-Private Partnerships in Ghana
This post was originally published on the IntraHealth International blog.
Garden City University College is a private nursing school in Kumasi, Ghana, where I spent six weeks this summer assessing the school’s progress toward improving its management practices. During my time at Garden City, I heard from several people that Ghana’s government is reluctant to work with private schools, and concerned that private schools are training subpar nurses.
Hearing this—both from members of the public and from people within the private school—was discouraging. Ghana is one of 57 countries that have a significant shortage of health workers1. In Ghana there are only about 10 nurses and midwives and one physician for every 10,000 people—numbers that fall far below the World Health Organization’s recommendations. Public institutions cannot fill the gap on their own.
In order to produce more nurses, midwives, doctors, and other health workers, the public-sector training institutions—which are already functioning at maximum capacity—would need more classrooms, lecturers, and dormitories. Unfortunately, the government does not have the finances to make these changes. But private institutions do not rely on government funding, which means they are primed to fill the gap in training and employing new health workers. That’s why partnerships between Ghana’s public and private sectors are vital.
Given what I’d heard in Kumasi, I was surprised to find out five weeks later that the government does, in fact, support private institutions.
“The public-private partnership is there,” a professional health council employee told me. We were in Accra attending a monitoring and evaluation training session held by the IntraHealth International-led CapacityPlus project. “We finally recognize that we can’t do it on our own…especially in the area of nursing. [Government schools] are training nurses, but after training, [the nurses] don’t have hospitals that are hiring them. Some of them go to private hospitals and some are hired into public hospitals, if that training institution is accredited. So the partnership is being worked out.”
The more people I talked to, the more I heard that Ghana’s government is acknowledging the need for a public-private partnership and is working to enhance the relationship in order to produce higher-quality health workers. In fact, a draft of the 2012–2016 National Human Resource Policy and Strategy for the Health Sector2 mentions progress made in enhancing the public-private partnership through “accreditation and provision of clinical sites for practical training” due to the 2007–2011 plan. And one of the new policy’s education and training objectives for the field of human resources for health is to promote “partnership among public, private not-for-profit, and self-financing private stakeholders in Human Resources for Health.”
But the policies in place are clearly disconnected from what is happening in practice. Having the policy and strategy to promote the public-private partnerships is an extremely important first step and I was thrilled to hear it existed—but more work needs to be done to fully implement the policies.
While working with Garden City University College, I saw opportunities for the public sector to support private schools. For example, Kwame Nkrumah University of Science and Technology (KNUST) is a well-established public university in Kumasi with over 60 years of experience, and it serves as a mentor school for Garden City and other private schools. KNUST is in a position to share what they know with newer schools.
“KNUST is an established institution which has many structures in place,” a medical faculty member from KNUST said. “We can provide manpower training like mentorship to faculty and administrators...processes like student admissions, recordkeeping, and [standards regulation for] examinations.” KNUST could also provide leadership training and collaborations on continuing education for lecturers.
Through the CapacityPlus project, IntraHealth and its partners are working with Ghana’s Ministry of Health and the Ghana Health Service to strengthen the country’s health workforce. The organizations have been working together to draft the National Human Resource Policy and Strategy for the Health Sector, develop systems to measure and track health worker production, and help make data about the health workforce a major part of decision-making within the health sector.
Projects such as CapacityPlus help link the government to private institutions—and ensure that policies and practices are in sync. At their strongest, the resulting partnerships could help Ghana produce more, better-trained health workers. And those health workers can then go on to provide high-quality care for each of the country’s 25 million people.
Read more about CapacityPlus in Ghana.
Help CapacityPlus spread the word about strengthening the health workforce. Follow us on Twitter and like us on Facebook.
1WHO World Health Report, 2006
2As of July 2013 the policy was not yet published.
Related items:
Photo by Nola Bower-Smith
FEATURED RESOURCES
