Free Mahama healthcare: Ghanaians to benefit from largest social intervention in history

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The National Democratic Congress launched the Peoples Manifesto a few months ago with an unprecedented social intervention on health and when this is rolled out, it will be the largest ever to affect every Ghanaian life. The Free Mahama Primary Health Care will provide free care (cashless) from the Out Patients Department (OPD) to final treatments with drugs.

This promise of Free Mahama Primary Health Care, as captured on page 62 and repeated on pages 74 and 112 of the NDC manifesto is an audacious one, which if successfully and sustainably implemented will lead to multiple benefits such as a reduction in overall healthcare costs, increased growth and productivity in multiple sectors. This comes in to augment the National Health Insurance Scheme (NHIS) to help every Ghanaian.

The introduction of Free Mahama Primary Health Care will prove to be a highly effective and efficient way to address the main causes and risks of poor health and well-being today, as well as handling the emerging challenges that threaten health and well-being tomorrow.

It will also prove to be a good value investment, as there is evidence that quality primary health care reduces total healthcare costs and improves efficiency by reducing hospital admissions. Free Mahama Primary Health Care can cover the majority of a person’s health needs throughout their life including prevention, treatment, rehabilitation and palliative care.

Free Mahama Primary Health Care will address an increasingly complex health need that calls for a multisectoral approach that integrates health-promoting and preventive policies, solutions that are responsive to communities and health services that are people-centred. Free Mahama Primary Health Care also includes the key elements needed to improve health security and prevent health threats such as epidemics and antimicrobial resistance, through such measures as community engagement and education, rational prescribing, and a core set of essential public health functions, including surveillance. 

Strengthening systems at the community and peripheral health facility level contributes to building resilience, which is critical for withstanding shocks to the health system. Some provisions of Free Mahama Primary Health Care will include health education/promotion; proper nutrition;

adequate supply of safe drinking water and sanitation; maternal and child health including family planning; immunization against major infectious diseases; prevention and control of locally endemic diseases (including sanitation and good drinking water); appropriate treatment of common diseases and injuries; and provision of essential drugs.

Some direct and indirect benefits from the basket of Free Primary Health Care should include free health screening for non-communicable diseases like diabetes mellitus, hypertension and cancers.

Free Mahama Primary Health Care is a whole-of-society approach to health and well-being centred on the needs and preferences of individuals, families and communities. It addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physical, mental and social health and wellbeing.

Free Mahama Primary Health Care provides whole-person care for health needs throughout the lifespan, not just for a set of specific diseases. Primary health care ensures people receive comprehensive care – ranging from promotion and prevention to treatment, rehabilitation and palliative care – as close as feasible to people’s everyday environment.

Free Mahama Primary Health Care is rooted in a commitment to social justice and equity and in the recognition of the fundamental right to the highest attainable standard of health, as echoed in Article 25 of the Universal Declaration on Human Rights: “Everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing and medical care and necessary social services.

The concept of primary health care has been repeatedly reinterpreted and redefined. In some contexts, it has referred to the provision of ambulatory or first-level of personal health care services. In other contexts, primary health care has been understood as a set of priority health interventions for low-income populations (also called selective primary health care). Others have understood primary health care as an essential component of human development, focusing on the economic, social and political aspects.

The World Health Organisation (WHO) has developed a cohesive definition based on the following components: meeting people’s health needs through comprehensive promotive, protective, preventive, curative, rehabilitative, and palliative care throughout the life course, strategically prioritizing key health care services aimed at individuals and families through primary care and the population through public health functions as the central elements of integrated health services.

It systematically addresses the broader determinants of health (including social, economic, environmental, as well as people’s characteristics and behaviours) through evidence-informed public policies and actions across all sectors; empowering individuals, families, and communities to optimize their health, as advocates for policies that promote and protect health and well-being, as co-developers of health and social services, and as self-carers and care-givers to others.

Free Mahama Primary Health Care is important because it renews primary health care and places it at the centre of efforts to improve health and wellbeing and it is critical for three reasons:

Free Mahama Primary Health Care is well-positioned to respond to rapid economic, technological, and demographic changes, all of which impact health and well-being. A recent analysis by the WHO found that approximately half of the gains in reducing child mortality from 1990 to 2010 were due to factors outside the health sector (such as, water and sanitation, education, economic growth).

The Free Mahama Primary Health Care approach draws in a wide range of stakeholders to examine and change policies to address the social, economic, environmental and commercial determinants of health and well-being. Treating people and communities as key actors in the production of their own health and well-being is critical for understanding and responding to the complexities of our changing world.

Free Mahama Primary Health Care will be essential to achieving the health-related Sustainable Development Goals (SDGs) and universal health coverage. It will contribute to the attainment of other goals beyond the health goal (SDG3), including those on poverty, hunger, education, gender equality, clean water and sanitation, work and economic growth, reducing inequality and climate action.

If this largest intervention promised by the NDC in health is implemented, Ghanaians will benefit enormously and Free Mahama Care will be one of the best in Africa.

TT Caternor

La Dadekotopon