Case Study of Ghana - Medical Devices and Biomaterials for the Developing World - page 22

experienced by the Ghanaian people, there is a second layer of inequity within
regions that subjects the poor to a double burden.
The spectrum of health issues plaguing the Ghanaian populace is somewhat
reflective of the health issues across West Africa and in tropical developing nations as
a whole.
Technological Capabilities and Realities
A summary of the health care facilities in Ghana, ranging from health posts (the
smallest and most rural) to large regional hospitals, which are typically located in
urban centers, is shown in Table 2.2 .
Health facilities appear to be concentrated at the health center level, with one
available to every 10,000 citizens. The major shortages are of skilled health profes-
sionals, equipment, and health infrastructure. It has been suggested that the nation
should take advantage of its human capital by integrating traditional healers into the
modern health system (Anyinam 1991). The use of community health workers and
others with limited, yet targeted training is also on the rise. Health care infrastruc-
ture is an issue that must be addressed by both the national PHC program and the
infrastructure component of the government's economic development agenda. Here
we will focus on the changing role and reality of health care technology, particularly
as it relates to increasing access for the rural poor, whom have traditionally been
neglected in the implementation of health system improvements.
Osei et al. (2005) used the Data Envelopment Analysis (DEA) approach to carry
out a pilot study of 17 district hospitals and health centers in Ghana, through which
they determined that 47% of the district hospitals and 18% of the health centers
studied were technically inefficient. Suggestions for increasing efficiency included
converting hospitals to health centers in order to align services provided with capac-
ity and better management of health staff in order to distribute high-level profes-
sionals appropriately among health care facilities.
While Ghana does not have a list specifying national standards for medical
devices by health facility, the WHO has developed guidelines for standards of medi-
cal technology (2011a) as well as inventories of equipment found in health facilities
in several nations. Using these as metrics, the goal is to evaluate Ghana's standing
against WHO standards and to make possible comparison with economically com-
parable nations as well as technologically advanced nations that meet WHO stan-
dards. We will now develop a general example of the Medical Technology Score
(MTS) that encapsulates the major areas of evaluation.
Medical Technology Score
Ghana does not have a unique medical device nomenclature system. The national
inventory that is available through the WHO is quite limited, making the calculation
of a comprehensive metric difficult. Although Nicaragua will serve as the primary