HUMAN RESOURCE

FOR HEALTH
DEVELOPMENT.

HANDING OVER
NOTES
Dr Ebenezer Appiah-Denkyira
(Director, Human resource for
Health Development, Ministry
of Health )
October 2012
1
MANDATE AND ORGANIZATION

Introduction / Preamble

Act 525 (1996) which established the Ghana Health Service (GHS) and Teaching
Hospitals as agencies of the Ministry Of Health (MOH), also makes the MOH
responsible for policy formulation, monitoring, resource mobilization and regulation
of health service delivery.

Health service delivery is labour intensive and hence the efficiency and
effectiveness of health services will depend on the availability of adequate
numbers, in the right mix of staff who are well motivated staff working in areas
where their services are needed.

This has implications for having the right human resources policies and plans in
place hence the purpose of the Human Resource for Health Development
directorate .

Mandate

The Human Resource for Health Development (HRHD) is a directorate of the MOH
with the mandate to formulate appropriate policies that will ensure adequate
production of appropriate numbers and mix of HR personnel, equitable distribution
of staff, adoption of appropriate retention strategies, and performance related
reward systems that will make the MOH meet its vision of improving the wellbeing
of the Ghanaian populace

Vision

Well managed HRHD that is able to meet the need of the country, and also serve as
a model for the sub-region in terms of Health Workforce planning, development and
management.

Mission

To involve all the MOH Agencies, other stakeholders such as the academia, private
sector, health partners, other MDAs (both within and out side the country) in the
formulation, implementation, monitoring and evaluation of effective HRH policies
that will guides production, management and training of the health workforce.

Main Functions

2
 HRH policy and strategy initiation and formulation
HRH planning and distribution of newly trained health professionals among
the Agencies
Pre-service training coordination
HRH development and staff training (including fellowships)
Management of rewards and compensation
HRH monitoring and evaluation

These can be differentiated from the Agencies HRD which have the following
functions:

Contributes to HRH policy formulation

HRH policy implementation
HRH operational guidelines initiation and formulation
HRH intra-agency planning, recruitment and deployment
In-service training coordination & other staff development issues
HRH management issues within agencies
Staff performance management within agencies

Organization

The HRHD operates a decentralized system. There are Human Resource

Directorates/Units in the Ministry and at the Agency levels- Teaching Hospitals and
Regions. However HRH Directorate of the Ministry takes overall responsibility for HR
in the Health sector (both Public & Private)

HR Directorate

The Directorate has four units Planning, Management, and Training, out of
which has recently been carved out Health Training Institutions (HTI) secretariat.
The directorate is understaffed and limited by office space. The staff strength stands
at 13

Planning Unit- responsible for the estimation of numbers for production into
the HTIs , numbers for recruitment for each staff category, including specialists,
distribution of products, internship for all staff categories and update of the HRHD
web site.

Management Unit responsible for performance management systems,

awards, conditions of service, fellowships monitoring , clinical outreach desk (local
specialist / diasporan), and collation and analysis of HR information.

3
 Training Unit responsible for IST both for MOH headquarters and the sector
as a whole. Follow up of negotiations with the universities/ tertiary institutions, NAB,
Regulatory Bodies by way staff progression for all staff categories.

Health Training Institutions Secretariat- newly created and responsible for the
management of all health Training Institutions (both pre-service and post basic)

Mode of operation

The HRHD using the guidelines of the International Health Workforce Observatory,
has an Advisory body made up of representatives from the MOFED, WHO, MOE,
GIMPA among others with the Deputy Minister for Health as the Chairman.

Technical sub-committees which generate proposals for implementation especially

in research, health learning materials and health workforce production involve the
academia, service providing Agencies, the Regulatory Bodies and External
counterparts such as universities, and the Health Donor partners.

Ministerial Committees on Human Resource made up of heads or representatives of

the various MOH and Quasi government Agencies including the Military and police
is in place and work on Posting and Fellowship. They are active and have been
responsible for the implementation of health workforce recruitment, distribution,
and fellowship awards as well as initiation of associated health policies.

Details of all activities, profile of training institutions and relevant policy documents
are posted at the websites :www.ghanahrhobservatory.org

The HRHD of the MOH provides the secretariat for the activities spelt above, and is
currently finalizing the third HR medium term document (2012-2016), though
implementation has started

Progress of Activities

Planning

The unit is spearheading the development of the third HR policy and strategy
document. The health partners forum has requested for a policy document
separate from the strategy and plans document. October ending is the deadline for
this. Staffing norms based on work load analysis is also being developed and yet to
be disseminated. Supported by the West Africa Health Organization, the HRHD has

4
developed a data base for Training Institutions using GPRS. A web based internet
Human Resource Information System has been deplored across the regions and
data is being collected. This is being supported by WAHO and capacity plus. A new
web site as HR Observatory has been launched for HRHD, and relevant HR data are
displayed for not only Ghana but also the international community. The site also
handles students admission with over 70,000 applications forms and other
transactions.

The HRHD has decentralized the internship management to the Regulatory bodies
and has linked them to the National service Secretariat. Only doctors and students
of Health Training Institutions receive allowances from MOH budget. All health
professionals have been migrated onto the Single Spine salary Scale. In the offing
for job evaluation are BSC Public Health Practitioners, Perfusionists, Non Physician
Specialists. Negotiations for Compensation by way of top up in salaries for
Consultants in the Medical school working in the Teaching Hospitals is concluded.
They shall receive top up as a premium on their mechanized salaries. They may
however be monitored by the Teaching Hospitals using the draft forms as returns to
the MOH (appendix 6). Outstanding is the reviewing and adopting a uniform
Memorandum of Understanding (MOU) for medical Schools and Teaching Hospitals
(KBTH/UGMS, KATH/KNUSTSMS, TTH/UDSMS, VRH/ UHAS and CRH/UCC). There is a
need for a Review of the MOU between MOH and CHAG to reflect GHS outsourcing
services. The Ministerial Committee on Posting chaired by the Director HRHD meets
yearly to allocate new staff agencies for recruitment each year. This must be
preceded by an HR Hearing where agencies present their staffing situation and gaps
for allocation. It is based on this that the HRHD sends out the admission forecast for
the year into Health Training Institutions as according to the HR Policy and Strategy
Document.

Pay Roll cleaning (a combined effort of the HRHD and Financial Controllerss office)
in few facilities of GHS, CHAG and Health Training Institutions has yielded great
savings of over GHc2.0m. More funds will be needed to continue the activities,
whiles pay vouchers are scrupulously scrutinized.

HR Research is weak and the unit leans on Research, Statistics, Information

Management ( RSIM) directorate of the MOH for research activities.

The two rooms unit are congested and also provide secretariat for the observatory/
and web site.

(Dr Asabir/Dep. Director, Kofi Afari / Health information manager, Molayo Decker/
Health Information Officer are working in these areas supported by the Director
HRHD)

2. Management

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The MOH and the Management Services Department of the Office of Head of Civil
Service have undertaken a staff rationalization exercise on the MOH and requires
that all agencies do same. Findings include trimming down the number of staff at
the MOH Head office, and regularizing the conversion of technical staff to civil
service grades or securing formal secondment from their agencies. The HRHD has
had a Human Resource hearing for most of the agencies to ascertain the numbers
and justify the recruitment for 2013. Key findings are the need to restrict training of
middle level personnel, step up production for Medical Assistants, occupational and
speech therapists, radiographers, prosectors, and need for redistribution.

National Awards committee has been set up with sub-committees in operation. It is

necessary to set up a permanent office and advertisement of defined criteria as is
done in Ministries of Education and Food and Agriculture. Funding, time and a
committed champion are the key cause of delay.

The inputs for Financial clearance from MOH Agencies are screened to ensure
compliance with allocation established by the Ministerial Committee on posting, and
what has agreed with MOFED.

Following the new salary scale, all principals and tutors are being issued with
appointment letters as Health Tutors. Performance Agreements with Principals have
been signed and three year down trend warrants re-advertisement of positions and
hence needs monitoring. The HRHD is putting up a committee to work on
harmonization of policies within agencies to ensure uniform promotion, grades etc
among others. The scheme of service and the Conditions of Service have been
collated from the various relevant sources and yet to be worked on by a committee.

The Ministerial Committee on Fellowship meets annually to disburse fellowships

using the criteria such as ongoing programme, emergency areas as priority etc.
Only few benefit each year as a result of dwindling GOG funds to the ministry.
Funding for Post service programmes in-country such as the GCPS, degree
programmes for midwives, nurses, allied health, tutors etc rest on the individual,
institution of practice, agency, District Assemblies etc to support. The GCPS has
been factored in the National Health Insurance Authourity fomula allocations but not
all funds are usually secured. Specialist outreach services both internal and external
are co-ordinated by this unit. International organizations such Operation Smile,
Alliance for Smile, MOTEC, MIDA etc are to linked to their local counterpart rather
than dealing directly with the ministry in terms of financial support, since normally
do not disclose any budget. Local teams such as Eye, ENT, Cleft Palate and Lips
outreaches from the teaching hospitals need recognition and support. However
there is a need to strengthen local demand and support from the agencies
particularly the GHS.

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Staff distribution mal-distribution is mainly caused by 10% districts have no
hospitals, postgraduate studies (for doctors, pharmacists and nurses ) are held only
in two regions (GAR and AR), most hospital bed are in the two regions.

Efforts made by MOH is to build five hospitals each in the regions starting from
most deprived areas- NR, UWR, WR and UER. Establishment of public schools limited
to rural regions other than GAR and AR- all regions have nursing, midwifery , HACs
schools and adopt 70% train and retain policy. Staff working in deprived areas go for
further training after three years instead of five in the urban.

All doctors from Ukraine, China and Russia returning home are sent to TTH for
coaching before the professional exams after which most are retained in the region.
This together with the personal effort of the CEO, have raised the TTH doctor
population from 26 to 136 in three years. This year 40 returnees have been
conveyed to TTH, in addition to the retention of the new 27 graduates from the
UDS medical School. The RDHS UER and UWR have been encouraged to visit TTH
and talk to the doctors to attract them to their regions.

The Vice Chancellor of UDS is being lobbied to give out the 300 bed GETFUND hotel
as hostel for the medical school and TTH to house officers, whiles the GCPS is being
encouraged to accredit TTH, CRH, KRH, Tema and Ridge Hospitals as specialist
training centres. Individual facilities are encouraged to make a follow up.

The posting Committee made up of heads of Agencies meet annually to allocate

health professionals to agencies for advertisement , interviews and recruitment to
ensure fair distribution.

MOH directorates have been trained in performance management, however few

officers have yearly objectives on which they are appraised. The MOH operates the
OHCS organizational structure, that places Personnel, Pensions and Benefits,
Welfare, Work place safety under the directorate of Administration instead of Human
Resource. This is worsened by the confusion of roles by the presence of two
Directors of Administration in the MOH Headquarters yet to be resolved by the Chief
Director.

The HR sometimes is wrongly held responsible for personnel issues in the ministry,
which therefore calls for close and cautious working relations with the Directors and
Deputy Directors in Administration.

The MOH is negotiating with both Teaching Hospitals and Medical Schools in Accra,
Kumasi, Tamale to conduct specialist outreach to the districts. The MOUs are being
studied by the parties.

The Management unit operates from one congested room which also serves as the
secretariat for the HRHD. An experienced Deputy Director will be required to
support the over-stretched Assistant Director.

7
( Mrs Doris Agyapong Atta /Adm Manager 11A, Abraham Donkor/ Environmental
Manager, Kwadjo Owusu Manu/ Information Officer, Ben Agbenu/ Executive Officer,
Maame Darkoa / Executive Officer are working in these areas and supported by the
Director HRHD)

3. Training

Quality training and staff progression rest with five bodies- the Affiliating
universities, Health Training Institution, Regulatory body , the Professional Bodies
and the Ministry. There will be a need to firm up all the negotiations undertaken
with the universities as below;

Certificate University of Cape Coast has been written to for the moderation of
examinations, and to develop sandwished programmes for HAC/EN and CHNs to
diploma level at diploma awarding institutions.

Midwifery all diploma institutions are affiliated to KNUST. Certificate holders

undertaking two year post basic midwifery shall be awarded academic diploma
since they are also affiliated. Products of Two year certificate midwifery programme
which was terminated in 1984 (by virtue of their experience) may have a
sandwished top up to diploma if negotiations with the universities succeed.

(School of Nursing and Health Sciences of UCC, and School Of Nursing of the
University of Ghana all have started programmes in degree midwifery. Top up of
diploma midwives has been negotiated to enter at level 300 at KNUST and UCC for
sandwished programme four sessions of six weeks, whiles University of Ghana
places them at level 200 for full time)

Nursing all nursing schools are affiliated to University of Ghana. Recently the MOH
defrayed affiliation debt of $25,000, hence negotiating for graduation of nurses
batch D8,9,10. There is an outstanding three week top top up for D7 batch for the
award of academic diploma, beyond that no top up is needed since they use the
university curriculum.

( because of poor monitoring the 12 RGN schools by UG, proposals have sent to
UDS, KNUST, UCC, to affiliate schools in their respective zones NR, UER, UWR for
UDS; BAR, AR for KNUST; CR, WR for UCC and VR, GAR, ER for UG. UHAS is to
operate from the VR schools (MOU yet to be signed to define details)

Mental Health Nursing applications for affiliations have been sent to UCC for the
Ankaful and Pantang schools. UCC has indicated a six weeks top up for diploma
programmes to academic diploma which the MOH finds too expensive and requests
spread out. A two year top up (from level 300) has however been negotiated for
diploma holders to undertake degree Mental health and Community Psychiatry
Nursing, and the university has been requested to factor in the six weeks gap. It is

8
important that Ankaful and Pantang apply to the National Accreditation Board for
the granting of a Charter for which they will not need affiliation at the diploma level,
so that they can grant academic diplomas to past students.

Pharmacy Faculty of Pharmacy in KNUST has started a six year training

programme meant to scrape the four year BSC Pharmacy to Dr Pharmacy. There
was no recourse to the MOH, and verbal caution has been overruled same as they
did for the optometrist programme.

Allied Health programmes 12 programmes are run in Kintampo College of Health

which is affiliated to the KNUST. Certificate programmes are provided with two years
top up, and upgrading programmes are now provided for Records officers, Dental
Assistants and Field Technicians.

The HRHD also negotiated with the University of Ghana for Diploma holders in
Nutrition , Environmental, Disease Control, Health Information, Public Health
Nursing, Health Promotion to be provided with top up (two or three years based on
assessment ) to degree grade. This is ongoing.

All universities are encouraged to develop admit diploma certificate holders at level
300 and preferably provide top ups as sandwished or e-learning programme, whiles
all Health Training Institutions need Accreditation from the National Accreditation
Board and their respective Regulatory Body . This is to ensure that academia
moves to service delivery sites rather than the reverse, so as not to cause any any
skewed distribution.

The Catholic university has been engaged to review their BSC Public Health
programmes Health Informatics and Health Education, and Management to meet
requirements of the health sector. They are to halt admitting CHNs whose nursing
are deemed too low for degree upgrade especially to the Management programme
without moving through the diploma certificate.

New Neglected programmes negotiated with the universities are Prosthesis and
Othortic degree at KNUST ( three graduates sponsored ), Drug Addition Nursing at
Pantang degree, Occupational diploma Therapy at Pantang, Speech Therapy at
KNUST,and UG, transfer of Dental technology to UG Allied Health, transfer of
Physician Assistant Anaesthesia , Kumasi to KNUST degree programme, Community
Geriatrics at ? Kokofu, ? Cape Coast, Perfusionist at cardio-thoracic centre.

Faculty Strengthening is important in the production of high quality staff.

Ghanaians in the Diaspora constitute a large pool for the recruitment of external
faculty to the universities. Contacts have been made with MOTEC UK, Africa Health
Partners USA, Apollo India, and other individuals.

Meetings on universities

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Following a Meeting held with the Deans of Schools Of Nursing, a committee has
been constituted (chaired by Dr Mate Siakwa of UCC) to develop a road map for
university programmes in nursing and midwifery with regards to professionals
holding certificate and diploma certificates. This shall be submitted to the
committee of Vice Chancellors, meanwhile the UCC has opted to constitute an
Institute to Affiliate or moderate the examinations of all the nursing and midwifery
schools as is done for Educational Colleges under Ministry of Education.

Similarly a meeting of Deans of Medical Schools requested for zonal outreach

/mentoring programmes to district institutions of the GHS and CHAG. A committee
has been formed under the chairmanship of Dr Cynthia Bannerman to review a draft
MOU (developed by KNUST) between the GHS/CHAG and the medical Schools that
will allocate districts for outreach services by the Medical school consultants.

The MOH is promoting specialist outreaches to district hospitals for both advanced
care and for teaching purposes. This will relieve the Teaching Hospitals of
congestion, but has implication for National Health Insurance Authority tariffs.
Negotiation is needed for NHIS to pay specialist fees for outreach services.

It is to the advantage of the MOH to create competition among the

universities, better still uniformity rather than monopoly. It is time
however to get them respond to the MOH plans.

This year, admission grades into Medicine, Pharmacy and Nursing/Midwifery in

some universities were pegged at grades one in all eight, seven and six subjects
respectively. The universities have been written to indicate what government can do
to expand intake.

Specialization and Post Basic Programmes

Medical officers- the GCPS have been engaged to develop sandwished

programmes both at membership and fellowship levels in all specialist categories as
is done in the faculty of Public Health. Currently the Family medicine programme is
almost completed to be done in the district hospitals. Fellowship programme is
being experimented at Ridge Accra and Takoradi hospitals. The GCPS has been
engaged and written to increase the number of specialist training sites to areas with
fellows Tamale Teaching Hospital, Ridge, Tema, Koforidua, and Cape Coast regional
hospital. 200 candidates were admitted into the membership and fellowship
programmes in 2012 alone, all of whom were posted to Korle-bu and Komfo Anokye
Teaching hospitals and hence destabilizing the doctors distribution in the country.
The GCPS has been written to limit admissions for Membership and Fellowship
programmes to a third total doctors produced in the year, and a third members
admitted respectively, to ensure doctors gain enough experience before embarking
on specialist programmes.

10
Pharmacists

The Ghana Post Graduate College of Pharmacist and Ghana College of Nurses and
Midwives bills have been passed and councils nominated to be inaugurated on the
23nd October . After this the council will be completed by advertisement for rector,
vice rectors, chairman, then office accommodation and development of plans and
budgets.

Pharmacist shall have specialization in clinical pharmacy, drug information and the
various fields of excellence.

Nursing and Midwifery Post basic programmes in Nursing such as ophthalmic,

ENT, Peri-operative and Theatre, Public Health Nursing are currently awarded
Advanced Diploma certificates. The KNUST , UCC and UG have been engaged to
affiliate these post basic programmes for degree so that advanced diploma is
abolished .

On the other hand, the Ghana College of Nurses and Midwives once inaugurated,
shall absorb and review the post basic programmes for the award of Fellowship( for
those with degree) and affiliate fellowship (those with diploma) in the college.

Advanced diploma shall be scraped and more specialization areas such as oncology,
pediatrics etc developed. A Fellow of the WACN in the department of Trauma has
been appointed to do the ground work in KBTH

Allied Health -The Allied health shall operate at the Masters level for now. Non-
Physician specialist grades shall however be awarded to all analogous professionals.
The Allied Health Regulatory Body bill is still in Parliament awaiting passage.

Medical Assistants/ Physician Assistants

Medical Assistant- the programme is a degree programme in Central University and

an Advanced Diploma at Kintampo Rural School. There will be a top up to convert
the Kintampo programme to degree after affiliation to KNUST is complete. A degree
Medical Assistant Psychiatry programme in KCH is jointly organized with Winchester
university which provides block lectures each year. This has low intake because the
expectations of the candidates are higher than award of degree. The HRHD is
engaging KNUST to run same at the Masters level, since Physician Assistants do not
have a specialist college yet.

KNUST has been engaged to accept Medical Assistants who have practiced for over
ten years into Masters degree programme instead of a degree, on account of
experience and numerous workshops attended. Such programmes shall be Masters
in Public Health, MSC Reproductive Health, MSC Dermatology and Venerology.

11
In- Service Training and Continous Professional Development have been organized
by the MOH Agencies themselves. The Regulatory Councils have been requested to
register IST or CPD providers, award credit points to the programmes, rather than
offering the training themselves. So far only the Medical and dental Council has
done the right thing.

The Rockyfellar Foundation is supporting a Policy Development and Analysis training

for top personnel of the health sector. Over 40 people have been trained. The
project co-ordinated by the Dr Sylvester Anemana (Chief Director) and Prof. Irene
Agyepong Armartefio is aimed at institutionalizing the training (probably at the
GCPS), strengthening the Policy Analysis unit of the MOH (as reference point for all
policy development), and developing a Think tank system for policy briefs.

The Leadership Development Programme supported by the Health Partners and

currently taking place in the GHS is yet to take place at the MOH Headquarters. You
may discuss this at the Partners meeting for support.

An internet IST has been proposed by some organizations and is worth considering.

(Director HRHD, Alex Hortodze have been working in these areas)

4. Health Training Institutions Secretariat

There are 70 Health Training Institution offering various programmes in nursing,

midwifery and allied health and Physician Assistant professions. RGN, Midwifery,
Health Assistant Clinical/ Enrolled Nursing and CHN (except GAR) are found in each
region. Kintampo College of Health runs 12 programmes and is in the process of
being made a university college by the affiliating university, which is KNUST,
Kumasi.

All MOH Health Training Institutions schools have advisory boards, principals,
programme heads, academic officers and various committees who help the principal
manage.

Principals and tutors are yet to be placed on their correct salary grades as Health
Tutors- they need fresh appointment letters. All diploma schools have to be
accredited by National Accreditation Board, Regulatory Body and affiliated to a
university. Single handedly, an institution may need more than GHC12,000 for
these, hence calls for an MOH negotiation on behalf of all of them especially
affiliation.

The HRHD together with the NMC decided on quality training instead of quantity
when the failure rate escalated. The HRHD has therefor embarked on purchasing of
buses for schools, increase admission grades to credit in all core subjects, ensure all
schools meet accreditation criteria of NAB and NMC.

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There is a need for pursue Fourteen schools that have been earmarked for
infrastructure improvement under the 2012 budget classrooms. With support from
GEFEC computer laboratories of schools have been improved, the UNFPA, JPIEGO
and FOCUS have supported skills lab with equipment and the HRHD is procuring
under high purchase 23,000 laptop computers for all students and the development
of content materials for e-learning programme in 2013 with the assistant of Inter,
Samsung, Huewei and Health Learning Material Centre.

A Health Training Institution bill has been initiated to establish the Health training
Institutions as an Agency. There is no law currently backing the establishment of
HTIs, except for the fact that they are regulated by a Regulatory body (mentioned in
NMC Act, now also amended in MDC Act). The advantage is to have a
representation on the Inter Agency Leadership Committee (IALC) of the ministry as
the highest decision making body in the health sector.

The MOH Health Training Institutions may in future be constituted into an MOH
university college with multiple campuses, retained at MOH or transferred to the
National Council for Tertiary Education. They may also be affiliated to the public
universities ( UDS, KNUST, UG, UCC, UHAS) in zones as is currently being done, and
ownership released to the Universities or MOH retains them. All these will need
stakeholders discussion. The West Africa College of Nursing responding to the
proposal advised on zonal affiliation to universities and MOH ownership.

A secretariat made up of five rooms have been secured and experienced staff
interviewed to manage the schools. Support staff need be beefed up to support the
schools. Calendar of activities for schools usually include yearly admissions,
performance reviews, budgeting and updates.

Funding for schools are mainly from their own Internally Generated Funds sales of
forms (from which buses, equipment, library books etc are procured) and local fees
(from which schools manage their school). An advisory board is to be inaugurated
for the National HTI secretariat to ensure representation from Local Government,
CHAG, MOFED, GHS, Principals etc.

High Failure Rate of nurses and midwives students at the Nurse and Midwifery
Councils licensure examinations though improved has become a national concern.
Causes are varied and attributed to - students, tutors, institutional management,
MOH, NMC, health facilities. The high failure rate affects students in the public,
private institutions and even the universities. Causes have been attributed to poor
quality and undisciplined students (protocol especially ), low quantity and quality of
tutors, as well as poor supervision as some tutors concentrate more on part-time
lectures in private schools, inadequate quality of infrastructure- skills and computer
labs. For NMC poor supervision (virtually visiting only few schools), type of
questions eg more applied for students who have never worked before ( contrast
to Pharmacists who take their exams one year after practice), MOH too many

13
schools (mostly established under political pressure) without adequate resources,
and poor support at the clinical field areas- both bed side tuition and low quality of
practice.

Measures have been taken to address the concerns of quality: The MOH and NMC
have restricted the establishment of new schools, recruited more experienced
graduate tutors, engaged the universities to introduce sandwished degree and
masters programmes for ward staff recruited as Teaching Assistants to beef up
tutors numbers and quality. MOH has approved budget and is bidding for
infrastructure improvement in 13 schools, and some school have benefitted from
equipment support from UNFPA, FOCUS, ACNM. Internally Generated Funds (from
sale of 70,000 admission forms) have been used to provide library books,
anatomical modules, buses and pick ups for the schools. More Preceptors from the
hospitals have been recruited and trained supported by American College Nurses
and Midwifery, MOH etc. MOH has signed Performance Contract with Principals
(includesadvert for position when there is three conservative years of downward
trend in performance). An E-learning programme by which standard lectures shall
be telecasted from ICT Transmission centres to all schools in Ghana through an
internet Platform. GEFEC has provided over 800 computers , servers and over head
projectors to 40 schools under phase 1. Inter, Samsung, HITA, HUEWEI, UNFPA,
JPIEGO, NMC and the Kumasi Health Learning Materials Centre through the Health
Training Institutions Secretariat is supporting with the e- learning programme, this
includes the securing of 23,000 lap tops for tutors and students under hired
Purchase agreement.

The admission grades have been revised to credit in all six subjects for diploma
candidates and credits in three subjects for certificate programmes. The HRHD and
the principals had a quiet year as most protocols were cut off. This however is to
ensure all admitted students at what ever level is able to undertake tertiary
programmes without any recourse to improving high school grades.

The criteria for opening new schools permits establishment in only the Volta Region
(2), Upper East Region (1), Eastern Region(2) and CR (2), all other new schools
should have a new 100 bed hospital attached.

( Christopher Beyere/ Head of HTIs, Ivy Sackey (Head of Nursing and Midwifery)
and Lawrence Lawson (Head of Allied Health), Comfort Martey/ Admin Officer 11B,
Ama Dansoa Appiah-Denkyira / Adm manager manage the secretariat and
supported by the Director HRHD).

Wage management

The current staff strength (IPPD Report, June 2012 ) of the MOH is 56,000. The
private sector rovides an additional 10% (see HRHD annual report for break down).

14
The compensation budget for the health sector is GHc 1.3 billion for 2013 (without
the market premium), though MOFED approves of only GHc 500.0m. The
recruitment budget for 14,500 staff for 2013 recruitment is GHc 176.0m. This is
made up of 13,000 from the public Training institutions and 1,500 from the
universities and private sector. Students are 23,000 and contribute to GHc 96.0 m of
the budget, blocking an outstanding recruitment from the universities.

MOH is to meet with MOFED to develop strategies to cut down on the compensation
budget. The HRHD has proposed the following- refer students to Students Loans
Trust, make FDB, NMC , ST Johns Ambulance self financing, restrict compensation
support to CHAG facilities in district (exclude Municipal and Metro facilities), Medical
school Consultants in Teaching hospitals to be paid top up from hospitals IGF.
Tertiary institutions to bear 20% of compensation budget, urban hospitals built
should be advertised for private sector management and staffing, introduce private
clinics admission right into public facilities etc.

There are over 10,000 inputs as back log at the IPPD unit since only four days a
month during which time staff work twenty four hours round the clock.

A proposal has been accepted by the Minister for the purchase of a server at the
cost of GHc1.0m to solve the issue of backlog. However the Controller and
Accountant Generals Department has indicated intruding IPPD 3 which allows
Ministries to make input at all times.

Governance and Management

The HRHD holds weekly meetings and monthly meetings of Directors and heads of
units of the ministry.

There is also yearly meetings of the Human Resource Officers of the various
agencies as well as those in the Regional Health Administration of the GHS.

The HR Director belongs to the Human Resource Practitioners forum of the Head of
the Civil Service. They meet yearly to unify policies across ministries. You will also
belong to the All Africa Human Resource Group that holds annual conferences in a
selected country.

The HRHD observatory is a governance structure made up of academia, health

partners, agencies, etc. and serve as advisory to the directorate. Headed by the
Deputy Minister, it has three sub-committees that provide support to the units of
HRHD in their functions. The HRH observatory meets twice a year and shares
information that guides planning and decision making, whiles web updates are to be
done fortnightly.

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A focal person is yet to be identified and supported by an IT person and an
Administrator.

Dr Kwesi Asabir, Mr Molayo Decker and Mrs Doris Agyapong Atta can be made to
take these positions respectively (in addition to their regular jobs ) since attrition of
these positions have been so rapid.

The HRHD Director approves of all expenditures in the directorate for the signature
of the Chief Director. The Chief Director is ensuring with difficulty that, Bank
balances are submitted to directorates to guide Directors to execute their plans.

The directorate meets weekly (Tuesday) to discuss assignments done by each unit.
Dr Kwesi Asabir, Kofi Afari and Ms Atta Doris Agyapong can serve as institutional
memory for the directorate.

Meeting Challenges

1. Press for Office accommodation for HRH observatory required

2. HR Research and HR Monitoring have been deficient, and will require
Competent focal person to work with the Research, Statistics and Information
Department (RSIM) of the ministry.
3. Ensure Chief Director, Deputy Minister and Minister are all briefed regularly.
4. Lobby Health partners for Funding to complete action plan.
5. Regularize meeting with University deans, Regulatory bodies and Professional
Associations
6. Regularize HR observatory meetings and sub-committees activities
7. Press for co-ordination of activities at Directors Meetings.

General Comments

The level of performance in the civil service is much slower than the GHS which has
experienced and seasoned staff.

The Ministry of Health headquarters is made up of Civil Servants appointed by the

Office of the Head of Civil Service, and technical personnel seconded from the
service(public ) agencies usually the Ghana Health Service. The OHCS
arrangements places Personnel, Pension, Welfare and Benefit units of the ministry
therefore are under the Administration Directorate rather than HRHD.

Monitoring of Agencies is weak resulting in the ministry blamed for all inactions or
lapses of the agencies. The MOH directorates are only to serve the need of the
Ministrys Agencies, unfortunately they are seen as the power house, making
decision on behalf of the Ministry (which in reality is made up of the Agencies).

Boards served on

1. Chairman, AFENET, School of Public Health

2. Member , School of Public Health Board

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 3. Member , College of Health Science, University of Ghana
4. Member , Allied Health Task Force
5. Member , Nurses and Midwives Council
6. Member of the Interim Central Regional Teaching Hospital Committee
7. Member of the KNUST, Faculty of Rehabilitation and Disability.

You will be serving on the above boards.

Key Stakeholders of HRHD

1. MOH Agencies
2. MOH Directorates
3. Regulatory bodies
4. National Accreditation Board
5. All Universities in Ghana (providing Health programmes- Provosts, Deans)
6. Professional Associations
7. Conference Of Heads of Heath Training Institutions
8. International Health partners WHO, DFID, Danida, Jica, World bank,
Netherland etc
9. West Africa Health Organization
10.HRH Observatory Advisory Board members
11.Inter Agency Leadership Committee members
12.Private Sector, Quasi Government, CSOs
13.Other Ministries MOLG, MOE (NCTE, NSS, NYEP), OHCS, PSC, MOFED, CAGD
, FWSC

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Personnel of the HRHD

1. Planning
a. Dr Kwesi Asabre PHD

Dependable, cautious in taking risks, ministrys focal person for Single

Spine Salary Scale, Migration Committees for the Ministry of Health.
Currently lead personnel in drafting HRHD Policy document, TISAM project
and HR information data management.

b. Kofi Afari BSC (Informatics)

Dependable, adventurous, ubiquitous, knowledgeable in ICT hard and soft

ware. Key personnel in management of Interns/housemanship with
National Service Scheme, TISAM, also supports administration.

c. Molayo Decker (BSC Informatics)

New member and responsible for ICT for Human Resource and web
update. Working on the staffing norm. Mentored by Kofi Afari- Needs
guidance and further exposure on health issues.

2. Management
a. Doris Agyapong Ata (MA.
Dependable and a good script writer, serves as directorates
administrator as well as fellowship administrator. Has good institutional
memory.
b. Comfort Martey (MA)
Serves as administrator for Health Training Institution
secretariat. Requires exposure in other directorates of the
ministry, especially Administration.
c. Abraham Donkor (MSc)
Assigned to work with Personnel unit in staff rationalization, and
also work with Policy Analysis unit of PPME in policy
development.
d. Kodwo Owusu Manu ( Dip. Journalism)
Assigned to co-ordinate international outreach programme.
Provides support for other activities. May better serve in a
Training Institution.
e. Ben Agbenu ( BA)

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 Responsible for financial clearance. Provides support to the
management unit and is mentored by Doris Agyapong.
3. Training
a. Alex. Gabby Hotordze ( MA)
i. Follows on negotiations with Universities and represents HRHD
on KNUST , Faculty of Rehabilitation and Disability Board.
Mentored by Dr Asabir.
4. HTI Secretariat
a. Christopher Beyere (BSC Informatics ,MA, MSC)
i. Head of Health Training Institutions Secretariat. Energetic with
ability to mobilize funds and secure political support. May be too
slippery and need to be kept in check. Currently championing e-
learning for Health Training schools.
b. Miss Ivy Sackey ( MSC Nursing)
Newly engaged staff and responsible for Nursing and Midwifery
Schools
c. Lawrence Lawson ( MSC Nursing)
i. Newly engaged staff and responsible for Allied Health Training
Schools.

OFFICE ASSETS

Appendix

1. Letters to universities on affiliation

2. Annual HRHD report
3. HRH Policy 2012-2016
4. HRH Policy and Strategic Plan 2012-2016
5. Draft Staffing norm for 2012
6. HR hearing Report
7. MOU affiliation with SON UG
8. Distribution of staff and Recruitment budget

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