TIG Post

Tag: SEND GHANA

  • SEND Ghana asks govt to replace COVID-19 levy with public health emergency fund

    SEND Ghana asks govt to replace COVID-19 levy with public health emergency fund

    SEND Ghana has called on the government of Ghana to convert the COVID-19 levy into a public health emergency fund.

    This comes on the back of President Akufo-Addo announcing that there will be no scrapping of the 1% COVID-19 levy during his 29th address to the nation on Covid-related activities and declaring an end to it as a health emergency.

    The Deputy Country Director of SEND Ghana, Emmanuel Ayifah, speaking on Starr Today on Starr FM, said that the NGO and other CSOs are looking forward to and pushing to see the COVID-19 health levy changed to a health emergency fund to assist with unforeseen health crises instead of disbanding it.

    “The government should not disband COVID-19 Health Recovery Levy but try to convert it into a public health emergency fund and also let Ghanaians see how much was left in the Trust Fund so that we can all rally around to establish the Fund. So that in the event of any future eventuality which is bound to happen, the issue is that once that happens, it is going to help us we don’t have to run helter-skelter looking for money because the Fund will be critical in helping to increase resilience in Ghana’s health system and also prepare for us to respond in times of public health emergency. Once we do that, I think that it will rather help us as a country.”

    In 2022, SEND Ghana and many other CSOs in the country urged the government to establish a health emergency fund. This, they believe will save and stabilize the economy should there be any unplanned calamity concerning health.

  • SEND Ghana expresses concern over potential outbreak of children illnesses

    SEND Ghana expresses concern over potential outbreak of children illnesses

    A policy research and advocacy non-governmental organisation, SEND Ghana, has cautioned the public about a potential breakout of children diseases in the nation, if authorities do not take swift action to solve the current lack of vaccines for children.

    In a statement signed by its Deputy Country Director, Emmanuel Ayifah, the organization stated that the current situation is “hindering the country’s goal of attaining Universal Health Coverage and Sustainable Development Goals more broadly.”

    It has, therefore, called for urgent steps to be taken to ensure that this situation is redressed so as to take away the tag over Ghana as a ‘stubborn child’ among global immunization bodies.

    “For about a month now, health authorities have been paying lip service to resolving the shortage. It is reported that 10 out of the 16 administrative regions in Ghana are currently battling shortages of vaccines and are now turning nursing mothers away. This is hindering the country’s goal of attaining Universal Health Coverage and Sustainable Development Goals more broadly.

    “The government of Ghana over the years have not fulfilled its co-financing obligation with the Global Alliance for Vaccines and Immunization (GAVI). Ghana is now considered a ‘stubborn child’ among global immunization bodies. While we recognize the current economic crisis in the country, important needs such as vaccination for children cannot be compromised,” the statement said.

    The SEND Ghana boss further suggested that the government uses funds from the management of COVID-19 to remedy this situation, while urging that this is done urgently.

    They also commended parliament for taking bold steps at ensuring that the government pays attention to this.

    “We recommend that government retrieves monies used to purchase Covid19 vaccines that were not delivered as cited in the Auditor General’s 2022 report to purchase vaccines for children.

    “We commend the Health Committee of Parliament for inviting the sector minister, Kwaku Agyeman-Manu, to respond to questions regarding the shortage of the vaccine. We further appeal to parliament to use its powers to continue to sustain the pressure on the government until the vaccines are made available to all health centres across Ghana.

    “We hope the government will speed up processes leading to the acquisition of vaccines to protect and guarantee the safety and well-being of children,” the statement added.

    Earlier, the Ghana Health Service said a shortage of routine vaccines for children blamed for a measles outbreak that infected 120 would be resolved within weeks.

    The authorities added that the shortage of vaccines against polio, hepatitis B, and measles, was caused by the depreciation of Ghana’s currency, with nursing mothers complaining for months of the shortage of vaccines meant for babies from birth to at least 18 months.

    The situation became worse in February after major health facilities in 10 out of the 16 administrative regions of Ghana kept turning nursing mothers away due to erratic supply.

  • SEND Ghana assesses 2023 National Budget and Economic Policy

    SEND Ghana’s early evaluation and analysis of the 2023 National Budget Statement and Economic Policy have been made public.
    The assessment for this year examines 5 Ministries: Health, Education, Agriculture, Sanitation, and Water Resources, as well as Gender, Children, and Social Protection, throughout a 5-year period from 2019 to 2023.

    Some sector-specific and cross-sectoral issues were found by our investigation.
    In all of the aforementioned sectors, we notice inadequate budget implementation and an excessive reliance on donor funds.
    We are bringing these flaws to the government’s attention because they pose a risk to reaching the necessary developmental outcome and the Sustainable Development Goals (SDGs).

    Cross-sectoral observations

    Improve Budget Execution Rate

    We have identified a common theme of poor budget execution pertaining to ministries including Health, Education, and Sanitation. Budget execution rates are an indication of the credibility of the budget. Consistently high variations between budgetary allocations, amount released and actual expenditures (over or under-execution) points to issues bothering on the quality of budget planning and/or challenges in budget execution.

    Allotting less or more to certain budget lines could potentially impact the implementation of other itemized budget lines, ultimately undermining Ghana’s development agenda. A critical look at the performance reports of the various ministries (health, education, sanitation and water resources, gender, children and social protection) for the last three (3) years (2019 – 2021) demonstrates the government’s consistent weakness in budget execution.

    First, the Ministry of Sanitation and Water Resources (MSWR) has particularly and consistently experienced budget execution crisis, as far as actual disbursements are concerned. The 2019 and 2020 performance reports of the Ministry showed that only 6.32 percent and 18.9 percent of the approved budget were respectively released.

    This implies that Goods and Services and CAPEX suffered the most, and delivery of services to citizens was severely constrained. It is refreshing to note, however that in 2021 we saw a huge jump from the 2020 execution rate to 86.00 percent.

    Although the 2021 execution rate relative to the previous years’ is commendable, the general trend in poor budget execution raises deep concern about the government’s commitment to addressing the huge challenges facing the water and sanitation sector. To achieve goal six (6) of the SDGs, the Ministry of Sanitation and Water Resources must improve its’ budget execution rate in 2023 to enhance service delivery in the sanitation and water sector.

    In the same vein, similar sentiments can be expressed about the Ministry of Health’s budget. Expenditure allocations to the health ministry is the first step of government’s commitment to improving the health of the people of Ghana.

    However, poor execution of the budget through over or underspending of funds to some budget line items prevents health managers from providing quality health services and thus deprive citizens access to quality healthcare. The total amount of the health budget released in 2020 was 64.8 percent of the revised appropriation. The budget performance for 2021 was comparatively much better at 93 percent, and this is commendable.

    However, if we look at specific budget line items, capital expenditure budget execution leaves much to be desired. Even though for the past three years the health ministry received more than two-thirds of its budget allocations for salaries and Goods and Services, the yawning gap in the execution of the capex budget leaves much to be desired.

    The execution rate of the capex appropriation encountered a wider gap among the three line-items. Less than one-tenth of the appropriation was actually released in both 2020 and 2021.

    This means that the government could not honour its responsibility as planned and compromised on the provision of health care and infrastructure development during the peak of the covid-19 pandemic and beyond. Should such trends continue, in particular for capital expenditure, the construction of the numerous health infrastructure including the agenda 111 will be stalled.

    Again, analysis of the annual budget performance report for 2021 revealed a disparity between allocation and actual disbursement to the education ministry. Out of an approved budget of GH¢15.64 billion, the ministry received GH¢13.67 billion (86.3 percent).

    A further breakdown by economic classification revealed that capital expenditure received less than half of its total allocation. In specific terms less than half (42.2 percent) GH¢634.69 million out of the total allocation of GH¢1.5 billion was released to the ministry.

    This smack of governments commitment to providing educational infrastructure and development. We encourage the government to prioritize capital expenditure for the education sector by approving and releasing in full the allocated amount if human development is of uttermost importance.

    To honour its commitment of Restoring and Sustaining Macroeconomic Stability and Resilience through Inclusive Growth & Value Addition, as the theme for the 2023 budget statement and economic policy highlights, and to maintain citizens’ trust, the government through the Ministry of Finance should take the necessary steps to disburse the appropriated budget in full. Persistent low budget execution rate only points to bad fiscal practices and should not be encouraged.

    The implications of poor budget execution are dire and the adverse impact on the delivery of public goods and services cannot be glossed over. Poor budget execution erodes government’s commitment to SDG indicator 16.6.1, which assesses primary government expenditures as a proportion of original approved budget.

    Reduce Continuous Dependence on Development Partners to Fund Capital Expenditure

    Our analysis of the national budgets (2019-2023) shows that the government still relies heavily on Development Partners (DPs) to fund its capital investments for some major ministries. Investments in the provision of Water, Hygiene and Sanitation (WASH) services in the last four years have largely been donor driven.

    In the 2019 budget for the Ministry of Sanitation and Water Resources, 70.26 percent of projected allocation was sourced from DPs. In 2020, it increased to 82.39 percent.

    This trend continued in 2021 with projected funds from DPs, for purposes of capital expenditure, constituting 75 percent, while the GoG, Internal Generated Funds (IGF), and the Annual Budget Funding Amount (ABFA) collectively make up just about 25 percent. In the 2023 budget, a whopping 92.22 percent of the total allocation is expected to come from DPs while GoG’s contribution reduced from 8.48 percent in 2022 to 1.8 percent in 2023.

    Donor Partners support also accounts for a large portion of the agriculture sector budget. While we commend the government for the significant increase of ABFA contribution witnessing a meteoric rise from 2.99 percent in 2022 to 51.48 percent in 2023, DPs contribution on the other hand increased to 40.50 percent in 2023 from 26.57 percent in 2022.

    In the Agriculture sector, DPs were expected to contribute 88.9 percent of projected allocations in 2021 to finance capital expenditure (CAPEX) of the Ministry of Food and Agriculture (MoFA). While investment in CAPEX is critical in stimulating growth, over reliance on donor support, which is characteristically unpredictable, puts at risk the government’s drive in pursuing agricultural modernization and industrialization.

    With this trend, the government will most likely miss its target to reducing grants by 10 percent to finance Goods and Services and CAPEX by 2023 as envisioned in Ghana Beyond Aid strategy document.

    The government must therefore take concrete steps to reduce the over-reliance on aid from donor partners. It has become apparent that donor funds are gradually dwindling, hence over-reliance on external support is counterproductive and could prove problematic in the near future.

    Again, considering the global economic turbulence, the government runs the risk of not mobilizing the required funding from DPs which will in turn affect actual releases to finance Agriculture and WASH interventions for 2023. Therefore, overreliance on dwindling and unpredictable donor support has serious consequences on the implementation of key interventions in the agriculture sector.

    Cross-Sector Observations

    Gender, Children and Social Protection

    Ensure the Regular and Prompt Release of Funds for Social Protection Programmes

    The effectiveness of the flagship social protection programmes, such as the LEAP Programme, the Ghana School Feeding Programme (GSFP), and the National Health Insurance Scheme (NHIS), to address poverty and inequality is minimized by erratic, irregular, and frequent delays in fund disbursements. Since November 2019, LEAP payments have witnessed consistent delays multiple times for months, often resulting in disruptions of the livelihoods of the poor beneficiaries and vulnerable families.

    The GSFP, despite the meager grant size allocation per child, has long suffered recurring delays in releasing feeding grants and payments to caterers. Delays in paying caterers, in particular, have resulted in a series of strike actions by caterers, and the consequences thereof are dire, especially on child poverty and malnutrition as well as educational outcomes.

    When it comes to the NHIS, the government has literally ‘starved’ the scheme of money for several months due to its failure to transfer the full amounts realised from the NHIS levy and the SSNIT contribution to the National Health Fund. This situation has led to the indebtedness of health institutions to medical suppliers across the country, compelling some facilities to demand patients make out of payments (OOP) for medical commodities and services.

    The poor and vulnerable people are the worst hit by this unfortunate development. The increasing cost of living in the country, exacerbated by high inflation and worsening cedi depreciation, is projected to push more people into extreme poverty and widen the inequality gap.

    To reverse this trend, the government needs to implement concrete expenditure measures, including strengthening social protection systems. We urge the government to release funds timely in line with statutory commitments to accelerate efforts at attaining the Sustainable Development Goals (SDG) 1 (End Poverty), 2 (Zero Hunger), 3 (Good Health and Well-being), and 10 (Reduced Inequalities).

    The recent Ghana Living Standard Survey round 7 (GLSS 7) shows that the multidimensional poverty rate in Ghana is 45.6 percent, and more worrying is the fact that 73.4 percent of children in Ghana have been identified as multidimensionally poor.

    To reverse this trend, pragmatic and concrete expenditure measures are paramount, and this include strengthening social protection systems and prioritizing social service spending. We urge the government to increase social spending and release funds timely and fully.

    Government Should Clarify Intention to Double LEAP Grant from GH¢45.00 Per Household to GH¢90.00

    The government’s promise to expand the LEAP programme to attain universal coverage by 2024 is most welcoming. It is even more pleasing to note that the grant size, which currently falls below the extreme poverty line, will, in 2023 increase by 100 percent to mitigate the rising cost of living among beneficiary households.

    While we highly commend the government for this impressive development, the specific amounts as captured in the budget statement create a situation of ambiguity. According to the budget document, the “Government will double the amount of the LEAP grant from GH¢45.00 per household to GH¢90.00.”

    We find this problematic because the amount received by a household is determined by the number of eligible members, and presently, a single-member beneficiary household receives GH¢ 64 and not GH¢45 as presented by the finance minister.

    In the interest of transparency and accountability, the government ought to explain the amount stated in the budget and indicate the specific amount to be paid to the category of beneficiaries in accordance with the payment eligibility criteria, as well as the when exactly this increment in the grant size will take effect.

    Prioritize Social Services Spending and Ensure Equity in Budget Allocation for the Social Sector

    A five-year (2019-2023) analysis of budgetary allocation for the major social sector Ministries, Departments, and Agencies (MDAs), such as Health, Education, and Gender, Children, and Social Protection (MoGCSP) show inequity in expenditure allocation.

    The Education Ministry continues to receive the largest budget allocation as a portion of the social sector MDA budget, followed by the Ministry of Health, with the Ministry of Gender, Children, and Social Protection. Ministries receiving the least among the three MDAs.

    Although investment in the social sector as a whole is critical to building the country’s human capital development, the MoGCSP’s mandate in coordinating most of our social interventions and ensuring the protection of vulnerable populations, especially women and children, is even more imperative. However, our analysis over the years point to very low allocations to the MoGCSP relative to the other social sector MDAs.

    For instance, in the 2023 budget, the share of the MoGCSP allocations to the total social sector budget of GH¢40,382,965,377 is just 3.65 percent. A huge sum of the 6.85 percent is going into employee compensation (GH¢34,869,501) and the LEAP (GH¢395,070,000) and GSFP (GH¢969,000,000).

    Funding allocation to the Child/Human Trafficking and the Domestic Violence unit have remained low over the years, for example at GH¢1,000,000, each, adversely affecting the implementation of child and women-friendly programs, such as sexual and gender-based violence against women, child marriages, and abuse.

    We urge the government to ensure equitable allocation of resources to the social sector MDAs. The MoGCSP and its agencies, in particular, need more funding to enable it to provide welfare services for the poor and marginalized groups.

    Health

    Increase NHIA Receivable Budget from The National Health Fund

    The budget statement over the past five years shows increases in revenue from the NHIL and SSNIT contribution to the NHIF. However, only a percentage is transferred into the NHF with no information on what uses the remaining funds is put to. The introduction of the electronic renewal system has increased active membership of the NHIS to more than half of the population, thus requiring more funds to purchase healthcare for members.

    Yet, the ministry of finance since 2020 transfers less than 50 percent of allocations to the NHIA according to the MOH 2021 holistic report, thus affecting claims payment. Many accredited health facilities have in effect resorted to operating cash and carry along the NHIS where 42 percent of the poorest members are paying out of pocket for healthcare.

    In the current state of the economy of the country, this practice will increase the vulnerability of poor people such as the aged, LEAP beneficiaries and Persons With Disability by limiting their access to quality healthcare services.

    The ministry of finance must increase transfers from the NHIL into the NHF and ensure that not less than 90 percent is released from the NHF to the health insurance authority during the implementation of the 2023 budget.

    Lodge the COVID-19 levy into an identifiable Fund

    The Covid-19 outbreak revealed weaknesses in Ghana’s health system and proffer several lessons for building a resilient system. One of such lesson early in the pandemic was the establishment of the COVID-19 levy by an act of parliament to raise funds to combat the disease and its impact. Since its establishment in 2021, revenues generated have increased by 28.4 percent from GH¢889,07 million to GH¢1.141 billion in 2022 representing 10.4 percent of the health budget for both years.

    The levy is projected to raise GH¢2,533 billion in 2023 representing a 121.9 percent increase over 2022 and 16.6 percent of the projected health budget. Revenue from the covid-19 as with other levies is lodged into the consolidated fund and sometimes is not entirely used for its intended purpose. Even though the levy over the last three years reflects the revenue part of the budget, it is unclear to which expenditure line it can be traced.

    With governments intentions to sustain gains made “under COVID-19 to detect and respond to future pandemics and emergencies”– by embracing vaccination as its main prevention strategy among other interventions such as strengthening disease surveillance and response, establishing the National Vaccine Institute and Ghana Centre for Disease Control- this is the time for the government to channel revenues from the levy into a dedicated fund for health emergency preparedness and response and outline it uses and management to ensure efficiency. This will ensure the implementation of one of the country’s key policies on global health security.

    Increase Domestic Funding to Sexual and Reproductive Health/Family Planning through the NHIS

    DP support to the health budget will remain the least of revenues of the health budget should taxes, IGF and the oil funds be merged. With their contribution constituting 20percent of the budget, government seem to be on track of going beyond aid.

    However, DP’s on or off budget contribution constitutes a major source of funds for certain interventions such as SRH and immunization. With projections of dwindling funding inflows from DPs in coming years and to avoid reliance on external funding, government must ensure that the NHIS becomes the main domestic source of funding for the procurement of FP commodities and SRH services by releasing all funds in the NHF to the NHIS.

    Education

    Provide Education Infrastructure at the Basic and Secondary Levels to Augment the Infrastructure Deficit in the Education Sector.

    SEND Ghana’s assessment of the country’s education sector over the years has continually exposed the infrastructure deficit, especially at the basic and secondary levels without any significant improvement. Even though the government in the 2022 budget made mention of completing some projects (Page 149, item 766) such as classrooms, dormitories, and staff bungalows inter alia, there was no specific mention of any of such projects in the 2023 budget.

    Our analysis of the 2022 education sector budget revealed that some 5,403 schools were in critical condition with another 2,417 schools still under trees with GH¢3.5billion still required to fix the sector’s infrastructural gap.

    Our analysis of the 2023 budget revealed that 2.76 billion was allocated to capital expenditure which constitutes only 12 percent of the total education ministry’s budget. Government must commit to increasing the allocation of funds for infrastructural development in the education sector to overcome the persistent deficit.

    Sanitation and water resources

    Chanel Proceeds from Sanitation and Pollution Levy to Support Investment in Sanitation.

    In 2021 the government of Ghana instituted a Sanitation and Pollution Levy (SPL) of 10p per litter of petrol and diesel respectively, to support infrastructural investment in the Sanitation and water sector, with the view to ensure sustainable sanitation management, improve the quality of life and reduce the number of deaths and diseases from poor sanitation.

    The levies have accrued substantial sums of money but not everything is disbursed to support investments in their targeted sectors. According to 2023 budget, the Sanitation and Pollution Levy has provisionally accrued GH345,347,346 for Q1-Q3, and is projected to accrue GH 435,243,346 by the end of the year 2022.

    For the year 2023, the levy is projected to accrue about GH522,248,357. Notwithstanding the inflow, the country still experiences serious sanitation challenges.

    As indicated earlier, in the 2023 budget for the SWR Ministry, a whopping 92.22 percent of the total allocation is expected to come from Development Partners while GoG’s allocation has reduced from 8.48 percent in 2022 to 1.8 percent in 2023.

    This is inadequate, highly unsustainable, and bad practice considering the government of Ghana’s “Ghana beyond aid mantra” and dwindling donor support in recent years. We, therefore, call on government to demonstrate commitment by channeling proceeds of the SPL to finance WASH infrastructure as it will significantly reduce government’s over-reliance on donors to finance WASH infrastructure.

    Agriculture

    The Government Should Increase Its Allocation and Ensure Priority Investment in the Agriculture Sector.

    Allocation to the ministry in 2023 saw a nominal increase of 95.19 percent from GH¢1,103,171,000 in 2022 to GH¢2,153,234,369 in 2023. This translates in real terms to 80.18 percent increase in 2023 over the previous year’s allocation.

    Despite the steep rise in allocation, MOFA’s share of 1.13 percent is still far less than the 10 percent of government’s commitment in line with the Malabo declaration. This accounts for the inconsistent growth of the sector and the rising food insecurity among the vulnerable and low-income population in Ghana.


    Source: Ghanaweb

  • LIVESTREAMED: Ofori-Atta speaks on Ghana’s economy, debt restructuring programme

    The government has been urged to reduce its reliance on development partners to pay for capital expenditures by SEND Ghana, a social advocacy organisation that works to empower local people to interact with the government and guarantee they benefit from national policies and programs.

    The group stated in a news release on December 1, 2022, that the government’s share of the nation’s capital expenditures has been declining year after year.

    According to the report, government funding made up 1.8 percent of the 2023 budget while development partners were responsible for 92.22 percent of the overall allocations.

    According to the firm’s latest verdict on Ghana from an earlier Caa2 rating to Ca rating which is a further junk territory, it expects that the debt restructuring programme will impact both local and foreign currency holders.

    Meanwhile, the finance minister Ken Ofori-Atta has also come under a lot of backlash and pressure from both within and outside his party, the New Patriotic Party (NPP), to either resign or be sacked by President Nana Addo Dankwa Akufo-Addo over his handling of the economy.

  • ‘Government likely to miss target to reduce grants by 10% for goods and services’ – SEND Ghana

    SEND Ghana has issued a warning that due to its excessive reliance on aid from donors and development partners, the government is unlikely to meet its goal of cutting grants by 10% to finance goods and services and CAPEX by 2023.

    According to SEND Ghana, government’s contribution to capital expenditures has been declining, according to an assessment of Ghana’s budget from 2019 to 2023 that covered five ministries: health, education, agriculture, sanitation and water resources, as well as children and social protection.

    1.8 percent of the overall allocation will come from the government in 2023, down from 8.48 percent in 2022, according to SEND Ghana, while 92.22 percent would come from external contributions.

    The social advocacy group believes that Ghana’s goal of reducing grants by 10 percent and its dream of a Ghana Beyond Aid is unattainable should they continue to rely heavily on external donors.

    “With this trend, the government will most likely miss its target to reducing grants by 10% to finance Goods and Service and CAPEX by 2023 as envisioned in the Ghana Beyond Aid strategy document. The government must there take concrete steps to reduce the over-reliance on aid from donor partners,” parts of a press release from SEND Ghana read.

    SEND Ghana also noted that the current global economic instability has made donor funds to governments inconsistent hence an over-reliance on development donors by the government could prove counterproductive and prevent government from embarking on major projects in the near future.

    “It has become apparent that donor funds are gradually dwindling, hence over-reliance on external support is counterproductive and could prove problematic in the near future. Again, considering the global economic turbulence, the government runs the risk of not mobilizing the required funding from DPs which will in turn affect actual releases to finance Agriculture and WASH interventions for 2023,” SEND Ghana added.

    The social advocacy group made this known in a press statement released on Thursday, December 1, 2022.

  • Reduce continuous dependence on devt partners to fund capital expenditure – SEND Ghana to gov’t

    A social advocacy group focused on enabling local communities to engage the government and ensure they benefit from national policies and programmes, SEND Ghana, has advised government to slow down on its dependence on development partners to fund its capital expenditure.

    In a press statement released on Thursday, December 1, 2022, the group noted that government’s contribution to the country’s capital expenditure continues to dwindle year after year.

    The report reveals that in the 2023 budget, government funds amounted to 1.8 percent, while development partners contributed to 92.22 percent of the total allocations.

    “Our analysis of the national budgets (2019-2023) shows that the government still relies heavily on Development Partners (DPs) to fund its capital investments for some major ministries. Investments in the provision of Water, Hygiene and Sanitation (WASH) services in the last four years have largely been donor driven. In the 2019 budget for the Ministry of Sanitation and Water Resources, 70.26 percent of projected allocation was sourced from DPs. In 2020, it increased to 82.39 percent,” part of the release read.

    “This trend continued in 2021 with projected funds from DPs, for purposes of capital expenditure, constituting 75 percent, while the GoG, Internal Generated Funds (IGF), and the Annual Budget Funding Amount (ABFA) collectively make up just about 25 percent. In the 2023 budget, a whopping 92.22 percent of the total allocation is expected to come from DPs while GoG’s contribution reduced from 8.48 percent in 2022 to 1.8 percent in 2023,” it added.

    SEND Ghana acknowledged that while a massive contribution by development partners to the capital expenditure was essential for economic growth, over-reliance on external supports may hinder government’s agricultural modernization and industrialization initiative.

    “While investment in CAPEX is critical in stimulating growth, over reliance on donor support, which is characteristically unpredictable, puts at risk the government’s drive in pursuing agricultural modernization and industrialization,” it added.

    Parliament is expected to debate the 2023 budget in the coming week.

     

  • SEND Ghana: Setting the standard for Ghana’s COVID-19 social accountability

    COVID-19 has left a generation scarred in its wake. From the lingering economic effects, such as the disruptions to supply chains across the world to the apprehension whenever an unmasked person sneezes, especially, in an enclosed space, the impact is undeniable.

    Ghana’s response to COVID-19 was heralded globally for being swift and comprehensive, and in many ways, it was.

    Restrictions on movement in the earliest days, which were characterized by gross uncertainty, the mandatory wearing of masks in public spaces and support for business were all enforced fairly well.

    These measures, in part, kept the total number of positive cases to approximately 171,000 – 0.54 percent of the population, using the 2021 Housing and Population Census – and a mortality rate of 0.85 percent (1,460). This compares favourably, for instance, with the 4.03 million cases recorded among South Africa’s 60 million, where, unfortunately, 102,000 persons died from the illness as of August 2022.

    Vaccines injection

    The most important component of the fight against the virus is undoubtedly the vaccines, which one study found that between December 2020, and December 2021, saved an additional 14.4 to 19.8 million deaths in 185 countries.

    Acutely aware that successful deployment could, among other things, improve the mental and emotional well-being of the citizenry, decrease morbidity and mortality, and minimize disruptions to social and economic functions, managers of the pandemic response developed a National Deployment and Vaccination Plan (NDVP).

    This was executed by applying the World Health Organization’s (WHO) Strategic Advisory Group of Experts on Immunization (SAGE’s) framework for the allocation and prioritization of vaccination.

    Under this framework, the government had to ensure the provision of cold chain equipment (CCEs) across health centres in the country. In addition, vaccination safety protocols, such as infection prevention and waste disposal were adhered to, even as vaccines were administered in phases; targeting the most vulnerable and the most exposed.

    On this front, Ghana was again at the fore of its peers, when in February 2021, it made history by becoming the recipient of the first batch of AstraZeneca/Oxford vaccines under the COVID-19 Vaccines Global Access (COVAX) facility.

    The initiative bore fruit as the nation has recorded a modest vaccination rate despite instances of hesitancy, mostly spurred by conspiracy theories. Official data indicates that some 14.9 million doses of the vaccines have been administered, meaning, 65 percent of eligible persons have had at least one shot, with 27.6 percent, being fully vaccinated.

    SEND Ghana leading social accountability

    Considering the far-reaching impact of COVID-19, and how indispensable vaccines are to curbing its spread, there is a need for objective, data-driven monitoring and accountability to ensure satisfactory delivery.  SEND Ghana has applied a social accountability framework to ensure this.

    With funding support from the Partnership for Transparency Fund (PTF), SEND Ghana through a survey “monitored the compliance for Ghana’s NDVP and citizens’ COVID-19 vaccination experience, with the view to promote equity, transparency and accountability of the COVID-19 NDVP and to inform future vaccination service delivery.” The study surveyed more than 1,000 citizens, health workers and teachers in 25 vaccination centres across eight districts in urban and peri-urban areas equally chosen from Accra and Kumasi, which were characterized by high incidents of COVID-19.

    This was done to ascertain the level of uptake, thoughts and experiences around vaccination on the part of the target group and assess the distribution of cold chain equipment (CCEs) and vaccine logistics, among similar themes. An apparent theme of the exercise was the desire of the majority of respondents (52 percent) to get vaccinated with the goal of protecting not only themselves but persons with whom they come on in regular, close contact.

    Logistics are required for the successful implementation of any mass inoculation drive and the survey discovered that the distribution of CCEs was “somewhat fair.” The available refrigerator models were considered “quite adequate” and their distribution across health centres in the districts “equitable.”

    Gaps with other models, cold boxes and vaccine carriers drew calls for “the Ministry of Health and the Ghana Health Service to adopt steps to increase the availability of vaccine logistics across districts within the country.” This comes to suggest that government needs to adopt necessary measures to ensure the supply of required capacity and the number of CCE and related accessories in districts with gaps.

    The health facilities, it noted, observed strict adherence to safety and hygiene protocols, a phenomenon largely attributed to the operators’ deeper understanding of the risks, coupled with, in some instances, first-hand experience of the horrors of being infected. Most vaccination facilities offered discrete waiting spaces for vaccine recipients to rest and be monitored for any immediate negative effects. Hand hygiene amenities like alcohol-based sanitizers were also readily available.

    Teachers and health professionals were given priority by the NDVP for the immunization exercise because of their susceptibility to contracting the virus. Despite this high vaccination rate, 1 in 10 medical professionals and 13.5 percent of teachers who had not received the immunizations stated concerns about side effects, a lack of knowledge about the safety and adverse effects of the vaccines, and doubts about their efficacy as justifications.

    On account of the above, SEND recommended that the Ghana Health Service organize NDVP refresher training for its employees. Inasmuch as monitoring results indicate compliance was generally good, such a move would improve the NDVP guideline compliance rate. Health Directorates are encouraged to sustain the vaccine promotion efforts/campaigns to contribute to the attainment of the country’s herd immunity target with an emphasis on assuaging concerns over possible side effects and safety, which featured prominently.

    Furthermore, building on the concern of respondents for the well-being of their close associates, it was recommended that the COVID-19 vaccination communication messages “should focus on the protection of family members and friends from the disease and possible deaths and less on mandates restricting access to services and employment reasons.” Ultimately, the GHS was urged to commend its staff for exhibiting top-rate professionalism during the vaccination exercise.

    Going forward

    Whilst it might seem that there is no imminent danger of a full-blown resurgence of the pandemic, there remains the possibility of mutation. Already, two subvariants of the omicron’s BA.5 strand – BQ.1 and BQ.1.1 – which emerged recently have both been described as  “dangerous” and  “qualities or characteristics that could evade some of the existing interventions,” according to a top US health official, as reported by its media.

    Furthermore, the adoption of these recommendations would prove useful in the event of the outbreak of other illnesses. The threat of Ebola, Lassa fever, Marburg, and other severe respiratory diseases hangs over local healthcare systems almost in perpetuity. With the possible socioeconomic disruptions that a resurgence of COVID-19 or a similar pandemic would pose, the guidance provided in SEND GHANA and PTF’s survey must be implemented as a matter of urgency.

  • COVID-19 Vaccination: The SEND Ghana report that diagnoses need to protect friends and families

    The onset of the novel Coronavirus, also known as COVID-19, was perhaps, the one time in the world’s recent history where everything came to a standstill over something that not even the best of the earth’s scientists could immediately fully diagnose.

    Economies were shattered and the wheels on which this world run grinded to halts in ways that were unprecedented and totally unplanned for.

    But this was a challenge the world immediately got to work on, and when the dusts settled, and some headway had been made, the right processes begun into the production of vaccines that would reduce the threats of the virus, which until then, had caused many deaths across many nations of the world.

    Soon, many countries had acquired the vaccines and with time, the majority of the world’s population had taken their shots; whether fully or partially. And then again, the wheels of the world’s economies begun to run once more, albeit a little slower than before the pandemic hit.

    Vaccinating the billions of the world’s populations had to be done systematically, requiring the use of the right professionals for the job: a simple but technical job it was, but how well or not was it executed by the people who became known as the frontliners?

    The case of Ghana and how its frontliners, including nurses and teachers, have and continue to play their roles in the execution of this global task is one that SEND GHANA, with funding from the Partnership for Transparency Fund (PTF), embarked on a comprehensive monitoring exercise to determine how well or not compliance to Ghana’s National Deployment and Vaccination Plan (NDVP) was like.

    The monitoring exercise also focused on the experiences of citizens who participated in the vaccination for the COVID-19.

    SEND GHANA, a reputable and credible national Non-Governmental Organisation specialised in policy research and advocacy on pro-poor policy and development program monitoring in Ghana, gathered some very interesting findings, a number of which have received the blessings of the likes of the World Health Organisation (WHO) and local health authorities.

    So, what is the SEND GHANA monitoring report on compliance and citizens’ experiences all about? What are the revealing findings too?

    With an overall aim of assessing compliance of Ghana’s National Deployment and Vaccination Plan (NDVP) and the equitable uptake of the COVID-19 vaccines, the monitoring exercise combined district monitoring and data collection approach as methodologies.

    The survey was also carried out in two regions of the country: the Greater Accra and Ashanti Regions, across 37 vaccine centres of 8 districts (4 for each region).

    In the Greater Accra Region, the districts surveyed were: Accra Metropolitan Assembly (Mamprobi Polyclinic, Kaneshie, and Obeweku Health Centre), Ashaiman (Community 22 Polyclinic, Lebanon Zone 3 Polyclinic, and Ashaiman Polyclinic), Tema (TMA Community One Polyclinic, Manhean Polyclinic, Tema General Hospital, and Tema Health Directorate), and La-Nkwantanang, Madina (Pentecost Hospital, Madina Polyclinic – Kekele, and Danfa Health Center).

    In total, there were 720 citizens, with 677 of them representing 94% of the overall numbers were interviewed. By sex, the proportion of males interviewed was slightly higher (51%) than females (49%) in both regions. In the Ashanti region, interviewees encompassed 53% males and 47% females, while the Greater Accra region had less males (49%) compared with females (51%). It is interesting to note that the proportion of male and females interviewed in the Greater Accra region, mirrored the 2021 population and housing census.

    A total of 653 responses were received from both teachers and health staff. Out of the 653 respondents, 443 (67.8%) were teachers while 210 (32.2%) comprised health care workers.

    Regionally, 361 responses (55%) were from the Ashanti region with the remaining 292 (45%) from the Greater Accra region.

    Highlights

    According to the report, some of the highlights of it put together were:

    – Vaccination posts at the health facilities monitored in the Greater Accra and Ashanti regions recorded an average vaccination of 10 persons daily.

    – Vaccination coverage among marginalized or vulnerable groups looks encouraging.

    – Friends and Family were the main transmitters of information about the vaccination exercise.

    – Clients were satisfied with time spent at vaccination centers and the attitude of health staff.

    – Majority of surveyed health workers (90%) and teachers (86%) have received at least a dose of the COVID-19 vaccines.

    – The fear of exposing family and friends to the COVID 19 disease enhanced the uptake of vaccines among teachers, healthcare workers and the general populace.

    – Aside protection for family and friends, uptake of the vaccines among health staff and teachers were influenced by four other factors as follows; prioritization; adequate information about safety of the vaccines; ease of access to vaccination centres and perceived effectiveness of the vaccines against COVID-19.

    Citizens’ experiences, opinions, and motivations for vaccination

    But the survey focused on the responses of some people and what they thought of the exercise.

    What and how they thought about the monitoring exercise were summarized as follows:

    “The overwhelming majority of the citizens interviewed indicated they had taken their vaccine at the center. Only 10 people (representing 1.5%) of the 676 interviewees who interacted with the vaccination process within the three days of monitoring at each center did not receive the jab. The two regions (Greater Accra and Ashanti) contributed an equal proportion to this finding.

    “The dominant reason given by the respondents in this group (those who did not receive the jab on the day of the monitoring) relates to claims that the number of clients/persons required to use the requested vaccine vial was not adequate, the unavailability of cards at the time of vaccination and inability to provide their cards for entries to be made at the point where the vaccines were administered.”

    Recommendations

    The Ghana Health Service should convene refresher sessions for its staff on the NDVP.

    Although the monitoring findings show compliance was generally good, this is necessary to enhance high levels of compliance with guidelines of the NDVP.

    Health Directorates are encouraged to sustain the vaccine promotion efforts/campaigns to contribute to the attainment of the country’s herd immunity target. This is also necessary if set targets for the various districts are to be met. As of July 2022, for instance, the Accra metropolis had fully vaccinated 46.2% of its target population. Thus, vaccination promotion and/or information and education campaigns will contribute in no small way to encourage more people to vaccinate.

    Health promotion efforts for the COVID-19 vaccination exercise and subsequent vaccination exercises should adequately address possible side effects and safety as these are key for uptake.

    COVID-19 vaccination communication messages should focus on the protection of family members and friends from the disease and possible deaths and less on mandates restricting access to services and employment reasons.

    The Ghana Health Service should commend its staff for exhibiting good attitude and professionalism during the vaccination exercise.

    The Ministry of Health and the Ghana Health Service should adopt steps to increase the availability of vaccine logistics across districts within the country.

    Source: Ghanaweb.com 

  • Ghana’s COVID-19 vaccination administration impressive – Study

    An assessment of citizens’ experience on COVID-19 vaccinations shows that vaccinators spent a minimal of about ten minutes at vaccination centres.

    Similarly, a look at Ghana’s compliance with the National Vaccination Deployment Plan (NVDP) also shows that access to COVID-19 vaccines among vulnerable groups and eligible persons as captured in the plan looks promising but can be improved.

    The monitoring, done by SEND Ghana, with funding support from the Partnership for Transparency Fund also shows that the uptake of COVID-19 vaccines among healthcare workers, teachers and persons with co-morbidities was impressive.

    Madam Anita Awuku, Program Coordinator, SEND Ghana, who disseminated findings of the assessment in Accra on Thursday, said the monitoring showed that generally, satisfaction with the vaccination process was very high.

    However, there were some appreciable gaps relating to educating clients on the COVID-19 vaccines, possible side effects and how to deal with it as well as screening for contraindication conditions to the vaccine.

    The assessment indicated that majority of the vaccination centres made available hand hygiene facilities, including alcohol-based sanitizers and separated waiting areas for vaccine recipients to rest and be monitored temporarily for any immediate adverse effects.

    It showed that vaccination centres observed strict observance to infection prevention and control measures during vaccinations sessions and all the centres were cleaned.

    Vaccine carriers had enough conditioned ice packs and healthcare workers in most of the centres practiced hand hygiene.

    The assessment recommended that the Ghana Health Service (GHS) convened refresher sessions for its staff on the NDVP.

    It said the health directorates must be encouraged to sustain the vaccine uptake promotion efforts to contribute to the attainment of herd immunity.

    “Health promotion efforts for the COVID-19 vaccination exercise and subsequent vaccination exercise should adequately address possible side effects and safety as these are key for vaccine uptake,” the monitoring report said.

    The assessment asked the Ministry of Health and the GHS to take steps to increase Cold Chain Equipment (CCE) and vaccine logistics across districts.

    Source: GNA

  • 2023 Budget: SEND Ghana urges government to recycle waste for revenue

    SEND Ghana, a policy research and advocacy organisation, has urged the government to prioritise waste recycling as a means of generating revenue for development.

    The organisation also called on the government to re-introduce the road tolls as a means of mobilizing revenue in the face of the country’s economic difficulties.

    Mrs Harriet Nuamah-Agyemang, Programme Officer, SEND Ghana, made the suggestions in Accra at a stakeholder engagement on the development of the 2023 Budget statement and economic policy organised by the Ministry of Finance.

    The engagement was to solicit input from the stakeholders for consideration in the 2023 annual budget preparation to be presented in November.

    The forum brought together stakeholders, including the Trade Union Congress, the Association of Ghana Industries, the Accra Market Association, the Association of Road Contractors, and civil society organisations, among others.

    On the health sector, she called on the government to establish a Health Emergency Fund to replace the COVID-19 Fund to support the country’s health sector.

    “We urged the government to establish and strengthen adolescent girls’ clubs for sex education in health and school facilities with subsidized sanitary pads,” she said.

    Touching on the education sector, she called for the provision of suitable infrastructure at the basic school level, including kindergarten, and the review of the free Senior High School policy.

    Dr John Kumah, the Deputy Minister of Finance, stated that continuous monitoring of the government’s programmes would help shape the country’s development agenda.

    ” We believe in a culture of governance that promotes transparency and accountability. The Ministry has been exploring avenues to deepen citizen participation to advance the country’s democratic governance,” he said.

    He said the country’s economic situation was still faced with internal and external factors and stated that the Government was negotiating with the International Monetary Fund for a bailout.

    The Deputy Minister urged the public to consume local products to boost the country’s revenue and pay taxes to maximize revenue mobilization to address the economic challenges.

    He said the Government intended to restore and sustain macroeconomic stability, ensure durable and inclusive growth, and promote social protection.

    Dr Alex Amankwa Poku, Head of Budget Development and Reforms, Ministry of Finance, said the country’s budget cycle covered the formulation, approval, implementation, and monitoring and evaluation processes.

    He said Ghana in the latest Open Budget Survey in 2021, improved its transparency score from 54 out of 100 in 2019 to 56 in 2021.

    Source: GNA