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Preventive healthcare (alternatively called preventive medicine) consists of measures taken for disease prevention, as opposed to disease treatment. Just as health comprises a variety of physical and mental states, so do disease and disability. Disease and disability — affected by environmental factors and genetic predisposition — are dynamic processes which begin before individuals even realize they are affected.
This article tries to consider the policy problem of the balance in healthcare allocations between preventive and curative medicine. Since the value of human lives has a high degree of supremacy, and the duties to rescue imperilled life and to treat the sick are recognized, it might be argued that a basically curative policy should be favoured. On the other hand, the duty of personal health maintenance and safety would appear to advance a case in favour of preventive policy.
Over the years, there has been a lot of evolution throughout Ghana’s healthcare system, and while the lofty goal of healthcare delivery is to save or improve lives, progress on this front is hindered by the obsessive focus on curative measures. Curative medicine is geared towards curing or treating patients only after they have become ill or injured, but approximately 80 percent of the rural population in developing countries – Ghana included – do not have access to appropriate such care.
The Primary Health Care (PHC) approach emphasizes promotive and preventive services, yet most Ghanaians consider curative care to be more important. Community members, so often more willing to pay for curative services than for preventive services, display such bias. And the conflict between the two beliefs is obvious even among health workers across all levels of the healthcare system and also in policy.
In my experience, health professionals are often unable to establish a relationship of trust with the community, largely due to their urban-based medical education: they tend not to explain treatment to their patients or to simplify explanations in a condescending manner. Still, there’s only so much blame that could be laid at their door, given the absurd patient-to-workforce ratio in these parts. Successive governments often misinterpret national health policies promoting PHC and implement them via a top-down approach, rather than in the opposite direction which is actually advocated by PHC experts.
For instance, our ‘celebrated’ National Health Insurance Scheme (NHIS) does not cover preventive care, which means you can’t just pick your NHIS card, walk into the doctor’s office, and tell him/her: “I am coming for medical check-up; I want to be screened for diseases; I want to know about my risk factors for diseases.”
And, of course, it’s deemed just as ridiculous to march in there requesting to be vaccinated against some disease.
Why?
Well, the truth is that our weak preventive care practices have overburdened the curative side of affairs and will continue to do so until pragmatic measures are put in place to marry both approaches. If policies are not planned to emphasize prevention, health expenditure will keep rising till some point in the future where government would have to borrow in funding curative care. Such a prospect isn’t so unrealistic, trust me — just a matter of time.
Preventive medicine does not require complex processes to achieve its goal; all that is needed is policy direction and concerted efforts to make it fruitful. Rather than focus on post-incident care, all players in our healthcare system need to take in the bigger picture: focusing on family histories, patient’s health behaviour, diet and everything else that may have contributed to the injury or ailment. A narrow view, zoomed in on cure, only allows us to put strips of Band-Aid on larger problems, so to speak. Instinct and common sense dictate that, if one encounters a hive of bees and gets stung, any move should be away from the bees in order to prevent even more stings while remedying those already suffered.
Unfortunately, our healthcare system, as it stands, has us among the bees, carelessly trying to keep up with the stings as they come rather than seek a way out. A paradigm shift towards a broad view of health will create a culture in which preventive care is valued and the meaning of ‘healthy’ can be redefined, not as merely functioning, but as being in the best shape possible.
Seidu Adam
Level 200 — Department Of Physician Assistant Studies,
School Of Health And Allied Sciences — University Of Cape Coast.
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