The World Health Organization (WHO) Representative to Ghana, Dr Francis Kasolo, has called for concerted action to bridge the equity gap in the distribution of doctors between rural and urban areas in Ghana.

Delivering the keynote address at the 64th Annual General Conference of the Ghana Medical Association (GMA) on the theme: ‘doctor distribution dilemma—the case of Ghana and its underserved areas’, Dr Kasolo described the unfair distribution of doctors and other healthcare workers across the country as a threat to efforts towards improving the health and wellbeing of all people and urged all stakeholders to take action immediately to address that.

“The inequitable distribution of doctors between rural and urban areas is now a crisis. It seriously undermines our progress towards Universal Health Coverage and we must all work together to address it.”
Dr Kasolo

Ghana has made tremendous gains in the doctor-to-population ratio, improving from one doctor to 17,899 in 2005 to one doctor to 6,500 to one in 2020.

However, available data also show that 42% of the doctors are in Accra alone, and up to 81.3% of all doctors are concentrated in 5 regions–Greater Accra, Ashanti, Central, Northern and Volta regions, with the Teaching Hospitals in these five regions together having over 60% of all the doctors in Ghana.

“Over the years, Ghana has made progress in improving the doctor-to-population ratio, but we must remember that the unfair distribution of these doctors leads to unmet health needs in rural and remote areas resulting in a decreased life expectancy; higher preventable maternal and under-5 mortality rates.”
Dr Kasolo

Shortage of doctors in Ghana

Dr Francis Kasolo identified migration and retention challenges as some of the causes of the shortages of doctors in Ghana and recommended some key interventions in line with WHO guidelines on health workforce development, attraction, recruitment and retention in rural and remote areas.

“Providing differential incentives for those working in rural and under-served areas and re-engineering the training and regulation of doctors to include extensive exposure to rural and under-served areas will help improve the situation.

“We must also provide deliberate opportunities for the admission of medical students from rural and deprived areas and provide financial support for their training.”
Dr Kasolo

WHO has been supporting the Government of Ghana to improve the maldistribution of doctors and other healthcare workers in Ghana. This includes assistance to develop the multi-criteria deprivation index to be used to objectively classify the districts according to their relative levels of deprivation. This when implemented can address both monetary and non-pecuniary aspects of encouraging retention in rural and under-served areas.

In addition, WHO is helping the development and implementation of health sector staffing norms whilst also providing support for training needs assessment of health workers.

WHO with funding from the UK Department of Health and Social Care, (UK-DHSC) is also currently helping Ghana to embark on a health labour market analysis to contribute to future policies and strategies in addressing the health worker challenges, especially the needs of rural and under-served areas.

Dr Francis Kasolo pledged the WHO’s continuous support to Ghana in ensuring that no one anywhere is left behind in the access to healthcare services and to achieve equitable distribution of doctors and other healthcare workers in Ghana.