PILOT PROGRAM BASED BUDGET (PBB)

Transcription

1 FINAL DRAFT REPUBLIC OF GHANA PILOT PROGRAM BASED BUDGET (PBB) FOR MINISTRY OF HEALTH

2 TABLE OF CONTENTS PART A: STRATEGIC OVERVIEW OF THE MINISTRY OF HEALTH GSGDA Policy Objectives Goal Core Functions Strategic Policy Objectives Policy Outcome Indicators and Targets MDA Summary Expenditure Estimates by Budget Program, Economic Classification and Projects... 6 PART B: BUDGET PROGRAM SUMMARY... 7 PROGRAM 1: Management and Administration... 7 PROGRAM 2: PROGRAM 3: Health Service Delivery PROGRAM 4: Human Resources for Health Development and Management PROGRAM 5: Health Sector Regulation PART C: FINANCIAL INFORMATION Annexure 1: Summary of Expenditure by Program, Economic Classification and Funding Source Annexure 2: Expenditure by Program and Sub Program Annexure 3: Expenditure by Project and Program Annexure 4: Expenditure by Funding and Program Annexure 5: Expenditure by Program/Sub-Program and Economic Classification MINISTRY OF HEALTH November 2012 Page 2

3 PART A: STRATEGIC OVERVIEW OF THE MINISTRY OF HEALTH 1. GSGDA Policy Objectives The GSGDA contains five (5) Policy Objectives that are relevant to the Ministry of Health These are as follows: Bridge the equity gaps in access to health care and nutrition services and ensure sustainable financing arrangements that protect the poor Improve governance and strengthen efficiency and effectiveness in health service delivery Improve access to quality maternal, neonatal, child and adolescent health services Prevent and control the spread of communicable and non-communicable diseases and promote healthy lifestyles Expand access to and improve the quality of institutional care, including mental health service delivery 2. Goal To have a healthy and productive population that reproduces itself safely 3. Core Functions The core functions of the Ministry of Health are: Provision of leadership and Governance Policy formulation, development and coordination Provision of Health Care Services Regulation of the Health facilities and professions Development of human resource for the Health sector Undertake research and development MINISTRY OF HEALTH November 2012 Page 3

4 4. Strategic Policy Objectives The MDA has adopted the following strategic policy objectives to guide its efforts to fulfill the national policy objectives: Bridge equity gaps in access to health care and ensure sustainable financing arrangements that protect the poor Strengthen governance and improve the efficiency and effectiveness of the health system Improve access to quality maternal, neonatal, child and adolescent health and nutrition services Intensify prevention and control of communicable and non-communicable diseases and promote healthy lifestyles Strengthen institutional care, including mental health service delivery MINISTRY OF HEALTH November 2012 Page 4

5 5. Policy Outcome Indicators and Targets Outcome Indicator Description Unit of Measurement Baseline Latest status Target Value Value Value Infant Mortality Rate - Number of deaths occurring in the first year of life Under-five mortality rate - Number of deaths occurring in the first five years of life Under-five malnutrition rate - The proportion of children under-five whose weight for age is less than two standard deviations from the median of a reference group per 1,000 live births per 1,000 live births < 2 SDs % % Maternal mortality ratio - Number of maternal deaths per 100,000 live births HIV prevalence among young people aged years old % < 2% HIV prevalence among young people aged years old Percent of blood samples taken from pregnant women that test positive for HIV % < 2% HIV prevalence among young people aged years old % < 2% MINISTRY OF HEALTH November 2012 Page 5

6 6. MDA Summary Expenditure Estimates by Budget Program, Economic Classification and Projects Expenditure By Budget Program Actual Budget Est. Budget Indicative Indicative Outturn GH GH GH BP1 Management and Administration BP2 Strategic National Health Program BP3 Health Service Delivery 358,950, ,634, ,259,942 BP4 Human Resource for Health Development BP5 Health Sector Regulation Total Expenditure Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees Use of Goods and Services Subsidies Grants Social Benefits Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Expenditure by Program and Projects Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH BP1 Management and Administration BP2 Health Policy and Performance Monitoring BP3 Strategic National Health Program BP4 Health Service Delivery 358,950, ,634, ,259,942 BP5 Human Resource for Health Development Total Expenditure MINISTRY OF HEALTH November 2012 Page 6

7 PART B: BUDGET PROGRAM SUMMARY PROGRAM 1: Management and Administration 1. Budget Program Objectives To provide an efficient and effective leadership in the management of the health sector To improve planning, management, monitoring and evaluation in the delivery of health services To establish norms, guidelines, standards and system accountability for the regulation of the sector 2. Budget Program Description To ensure that the broad objectives of the Health Sector are met, the Management and Administration program combines all the system-wide activities that are required to deliver quality health care to the population of Ghana. These include functions such as General Management, Health Information, Statistics and Technology Communication Management, Health Policy Formulation, Planning, Budgeting and Monitoring and Evaluation, Finance, Procurement, Supply and Logistics and Internal Audit. MINISTRY OF HEALTH November 2012 Page 7

8 3. Budget Program Summary : Expenditure by Sub-Program, Economic Classification Program 1: Management and Administration Expenditure By Budget Sub-Program Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH BSP1.1 General Management BSP1.2 Health Information, Statistics and Technology Communication Management bsp1.3 Health Policy Formulation, Planning, Budgeting, Monitoring and Evaluation BSP1.4 Finance BSP1.5 Procurement, Supply and Logistics BSP1.6 Internal Audit Total Expenditure Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees Use of Goods and Services Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure Non-Financial Assets Total Expenditure Expenditure by Projects Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 8

9 BUDGET SUB-PROGRAM SUMMARY PROGRAM 1: Management and Administration SUB-PROGRAM 1.1: General Management 1. Budget Sub-Program Objectives To provide overall leadership to and management of the overall health sector To facilitate conducive working conditions for MOH Headquarters To ensure adequate performance appraisal, capacity development and staff career progression. 2. Budget Sub-Program Description General Management ensures the overall leadership and management of the sector through the facilitation of appropriate legal framework within which health services are provided. It also oversees the coordinating activities of the Ministry and its agencies through the issuance of directives that are consistent with the policy direction of the Ministry. It provides administrative support in the areas of transport and logistics management. It also manages the properties of the Ministry in addition to looking after personnel matters involving career development, progression, succession and welfare. MINISTRY OF HEALTH November 2012 Page 9

10 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Directors and unit heads meetings organised Number of local management meetings held Number of International committee meetings International committee meetings hosted and attended Hosted Attended Encounter with the press organised Number of press encounters held Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the subprogram. Operations Administrative supervisory support Estate management Transport management Inter-Ministerial/Sectorial collaboration Projects (Investment) Procure office furniture, computers and accessories Building of 40ft container for storing of unserviceable items that are to be auctioned Two (2) pick-ups, 1 VVIP vehicle and 2 motor bikes for dispatch of letters International Collaborations MINISTRY OF HEALTH November 2012 Page 10

11 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees Use of Goods and Services Subsidies Grants Social Benefits Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure MINISTRY OF HEALTH November 2012 Page 11

12 BUDGET SUB-PROGRAM SUMMARY PROGRAM 1: Management and Administration SUB-PROGRAM 1.2: Health Information, Statistics and Technology Communication Management 1. Budget Sub-Program Objectives To develop standards, policies and guidelines for information automation and operational research To establish a computer network support systems and maintain the MoH website To develop a repository of routine and non-routine information 2. Budget Sub-Program Description This sub-program is responsible for the development of standards, policies and guidelines for health information and technology communication of the health sector. It coordinates the development of a repository of routine and non-routine information to inform decision-making. It further establishes computer and network support systems and maintains the Ministry s corporate website as a central broadcast facility for the sector, as well as generates, collates, stores and disseminates information. MINISTRY OF HEALTH November 2012 Page 12

13 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Health Information Systems enhanced Information and Communication Technology environment improved Number of research proposals reviewed Number of research publications produced Number of research agenda developed Number of staff trained in statistical analysis Percentage of data repository completed Number of ICT maintenance visits conducted Number of ICT staff trained Number of internet service and antivirus contract renewed Re-designed corporate website Number of intranet and electronic documentation systems conducted Number of IT penetration at health facilities conducted MINISTRY OF HEALTH November 2012 Page 13

14 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the subprogram. Operations Strengthen information and technology management Create enabling environment for health information systems and research Projects (Investment) Procurement of ICT equipment Acquisition of 4 X 4 Toyota Pick up Assess operational capacity in M&E Monitor use of DHIMS2 by regions and districts Scale up electronic medical records systems Strengthen Medical Records Management (MRM) Performance monitoring Report writing 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 14

15 BUDGET SUB-PROGRAM SUMMARY PROGRAM 1: Management and Administration SUB-PROGRAM 1.3: Health Policy Formulation, Planning, Budgeting, Monitoring and Evaluation 1. Budget Sub-Program Objectives To develop and update sector policies in line with new evidence and priorities To co-ordinate the preparation and implementation of the Sector s Medium Term Development Plan (HSMTDP), Annual Programme of Work (APOW) and the Medium Term Expenditure Framework (MTEF) Budget To mobilise and optimally allocate and disburse resources To address infrastructural gaps in health service delivery To monitor the implementation of key health sector programmes in accordance to agreed performance frameworks To evaluate major health sector programmes to ascertain its cost effectiveness and benefit to the general public 2. Budget Sub-Program Description The sub-program coordinates the analysis, development and implementation of sector policies and priorities based on new evidences and past experience. It involves setting the strategic direction and development of the health sector medium term and annual operational plans which provide the basis of expenditure for the sector for a particular fiscal year. It includes capital budgeting, investment appraisals, internal and external resource mobilization and capital projects management. It also involves national health accounting and liaising up with MoFEP to ensure timely disbursements of funds to the sector and flow of funds to the agencies. The sub-program further allows performance of the health sector to be assessed through in-depth program monitoring and periodic evaluations. This is conducted using annual and independent sector reviews, holistic assessments of agreed core sets of sector-wide indicators, milestones and logical frameworks. The sub-program also encompasses public private sector collaboration, promotion of healthy lifestyles and development of policies and programs for the alternative and traditional medicine. MINISTRY OF HEALTH November 2012 Page 15

16 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Health policy reviews conducted HSMTDP ( ) and Annual 2013 Sector Program of Work prepared, printed and disseminated Number of policies reviewed HSMTDP approved at Business meeting by Annual Program of Work th November th November Budget administration and management Percentage budget execution achieved Capital Investment Plan developed, printed and disseminated Capital Investment Plan approved at Business meeting by 30 th November th November - - Health sector programs and activities monitored and reviewed Performance reporting strengthened Number of reports generated Number of monitoring and evaluation visits carried out Report on evaluation of free maternal care Number of In-depth reviews conducted Number of Agencies providing timely reports on implementation status of planned programs and activities Healthy lifestyle practices inculcated in the health sector & general public Number of healthy lifestyle campaigns conducted MINISTRY OF HEALTH November 2012 Page 16

17 PPP funding resources identified and mobilized Availability of health information on traditional medicine improved Policy on the up-scaling of commercially important medicinal plants policy book developed Percentage of resources mobilized Facilitate Batch to Batch quality control Percentage of selected candidate products for R&D Percentage of identified rare and commercially important medicinal plants Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the subprogram. Operations Policy analysis, development and implementation Planning and budgeting Projects (Investment) Renovation of offices of the planning and budget unit, office equipment and machines. Procure 1 Number station wagon Public financial management Monitoring and evaluation Capital investment and project management Resource mobilization National health accounting Healthy lifestyle promotion Public private sector collaboration MINISTRY OF HEALTH November 2012 Page 17

18 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 18

19 BUDGET SUB-PROGRAM SUMMARY PROGRAM 1: Management and Administration SUB-PROGRAM SP 1.4: Finance 1. Budget Sub-Program Objectives To ensure efficient and prudent management of the finances of the sector. To prepare timely, relevant and reliable financial reports for the Health Sector 2. Budget Sub-Program Description This sub-program aims at ensuring a prudent financial management system throughout all agencies under the Ministry. It guarantees compliance with accounting, treasury and financial rules and regulations as prescribed by the FAR. It further enhances the effective management of the sector funds through regular and timely release of funds to the Ministry and its Agencies. The sub-program also seeks to uphold expenditure control and management of assets register. It involves the preparation of timely, relevant and reliable financial reports for management decision making and external scrutiny. This is to ensure accountability and transparency in the use of public funds within the sector MINISTRY OF HEALTH November 2012 Page 19

20 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Financial monitoring visits Quarterly financial reports prepared and validated for the sector Number of financial monitoring visits to agencies Number of financial report prepared and Validated. Timely submission of Financial reports st March 31 st March 31 st March 31 st March 31 st March 31 st March 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the subprogram. Operations Financial management and accounting. Financial monitoring and reporting Procurement of vehicles Office equipment Projects (Investment) Expenditure control MINISTRY OF HEALTH November 2012 Page 20

21 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 21

22 BUDGET SUB-PROGRAM SUMMARY PROGRAM 1: Management and Administration SUB-PROGRAM SP 1.5: Procurement, Supply and Logistics 1. Budget Sub-Program Objectives This sub-program is mandated to perform the following objectives: To undertake needs assessment and planning of all health commodities and logistics required to support health service delivery To prepare and implement annual sector procurement plans To develop and implement policies to ensure that all goods and services procured meet required quality and safety requirements To ensure that appropriate infrastructure exists to support optimum receipt storage and appropriate distribution of all goods procured throughout the supply chain To manage the entire procurement and supplies process To develop and implement a designed system for debt collection for the Central Medical Stores and Regional Medical Stores 2. Budget Sub-Program Description This sub-program undertakes the procurement, logistics and supplies functions of the Ministry. It involves national quantification and forecasting of health commodities, sector-wide procurement planning and implementation and contract management. It ensures quality assurance for goods and services procured. Further, it provides country-wide appropriate warehousing for health commodities. Moreover, it affords monitoring of debt recovery of the medical stores so that they are not distressed. MINISTRY OF HEALTH November 2012 Page 22

23 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Affordable and Quality Health Commodities procured on time Percentage of health commodities procured Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the subprogram. Operations National Quantification and Forecasting of Health Commodities Sector-Wide Procurement Planning and Implementation Quality assurance Projects (Investment) Procurement of Medical Equipment Procurement of Vehicles and Spare Parts Procurement of Office Equipment and Accessories Warehousing Debt Recovering Monitoring Contract Management MINISTRY OF HEALTH November 2012 Page 23

24 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 24

25 BUDGET SUB-PROGRAM SUMMARY PROGRAM 1: Management and Administration SUB-PROGRAM SP 1.6: Internal Audit 1. Budget Sub-Program Objectives To provide an independent, objective assurance and special audit assignments designed to add value and improve operations. To monitor compliance and value for money within the sector through internal control mechanisms 2. Budget Sub-Program Description The operations carried out under this sub-program include conducting routine audit inspections, performance audit and special investigations in the BMCs under the Ministry. It also allows pre audit as a preventive measure; post audit to correct excesses; and follow ups on implementation of internal, external and financial monitoring audit recommendations within the agencies. It determines whether the internal control mechanisms of the MOH are effective, efficient and economical. The sub-program further enables the Ministry to compile and produce all audit report to the Minister, IAA and other stakeholders. It also prints Strategic Internal Audit Plan, Manual and Program. Additionally, it determines through quality assurance / assessment, monitoring and supervisory visits whether: There is a judicious use of the Ministry s finances; Procurement is within the annual programme of work as planned and approved; Accounts and statements are prepared according to FAR, ATF regulations and accepted accounting standards; All cash inflows and outflows are appropriately receipted; Malfeasance and other irregularities have occurred and Internal Audit Units are following laid down programmes and procedures. MINISTRY OF HEALTH November 2012 Page 25

26 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Audit inspections an d investigations Number of audit inspections and investigations conducted Audit and compliance reports Number of Reports produced Performance Audit Number of audits conducted Quality Assurance of IAU Number of reviews carried out Monitoring and supervisory visits made to all agencies Number of visits carried out Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the subprogram. Operations Conduct Audit Inspections and Investigations Compilation of Audit and compliance Report Conduct Performance Audit Projects (Investment) Procurement of 10 pick-up Vehicles Procurement of 2 Cross Country Vehicles Procurement of 6 laptops and accessories Quality Assurance Review Monitoring and supervisory visits MINISTRY OF HEALTH November 2012 Page 26

27 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 27

28 BUDGET PROGRAM SUMMARY PROGRAM 2: Strategic National Health Program 1. Budget Program Objective To define cost-effective and context-specific interventions for key strategic national health programmes in order to reduce morbidity and mortality. 2. Budget Program Description The program coordinates and manages strategic national health programs relating to maternal, neonatal and child health, communicable and non-communicable diseases, occupational health and safety and research. It includes implementation of specific policies and programs aimed at conducting operational research and other interventions. It involves surveillance and disease control systems for communicable diseases consistent with national, bilateral and international expectations. It further provides technical support for the Regional Public Health reference laboratories. Additionally, it provides support, monitoring and evaluation of EPI programs and projects in collaboration with the Regions, Districts and other health program implementing agencies with a view of promoting program effectiveness and efficiency. The programme also supports the procurement of drugs and vaccines and effective allocation of resource for efficient service delivery. MINISTRY OF HEALTH November 2012 Page 28

29 3. Budget Program Summary : Expenditure by Sub-Program, Economic Classification Program 2: Strategic National Health Program Expenditure By Budget Sub- Program BSP1 Strategic Implementation and Operational Performance BSP 2Maternal, Neonatal and Child Health and Nutrition BSP 3 Communicable Disease BSP 4 Non Communicable Disease BSP 5 Occupational Health and Safety BSP 6 Research Total Expenditure Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Expenditure by Projects Actual Budget Est. Budget Indicative Indicative Outturn GH GH GH Total Expenditure MINISTRY OF HEALTH November 2012 Page 29

30 BUDGET SUB-PROGRAM SUMMARY PROGRAM 2: Strategic National Health Programs SUB PROGRAM SP 2.1 Strategic Implementation and Operational Performance 1. Budget Sub-Program Objectives To provide support and guidance for the implementation of various health intervention Conduct operational research and information to serve as basis of scaling up health intervention Provide human and technical support for implementation national strategic programmes. 2. Budget Sub-Program Description The sub program provides leadership, support and coordination of health service delivery programs and other strategic interventions aimed at scaling health outcomes. The strategic performance management program coordinates all policies, provide information, conducts operational research for improving specific health interventions, indicators and outcomes. It also ensures the allocation of resources to national, regional, district and sub district level for the implementation of service delivery activities. It also enhances the procurement of drugs and other equipment for health service delivery especially for the regional hospitals, district hospitals and health centres. Key in the mandate of this sub program is the delivery of health administration for implementation of various health programs and health service delivery activities. The strategic implementation management also liaises with the Human Resource Directorate of the Ministry of Health to provide adequate human resources with the requisite skills and capacity for the implementation of health service programs and activities. MINISTRY OF HEALTH November 2012 Page 30

31 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Capacity building program on research carried out APOW GHS developed Output Indicator Number of research staff trained Budget 2013 Indicative 2014 Indicative Developed by - - End of June End of June End of June End of June Policy Briefs produced Policy Briefs produced by - - End of April End of April End of April End of April Annual Reviews conducted Annual Review Report completed by End of April End of April End of April GHS Financial Statement GHS Financial Statement Completed End of June End of June End of June MINISTRY OF HEALTH November 2012 Page 31

32 4. Budget Operations and Projects The table lists the main Operations and projects to be undertaken by the program Operations Assess Operational Capacity in M&E Monitor use of DHIMS2 b y regions and districts Scale up Electronic Medical Records Systems Strengthen Medical Records Management (MRM) Performance monitoring Report writing Conduct Operational Research as per the National Research Agenda Organise an annual National Research Dissemination Forum Organize an annual Stakeholder meeting with other Research Institutions involved in Health Research Strengthen the Documentation Centre at the National Level Conduct Operational Research as per the National Research Agenda Organise an annual National Research Dissemination Forum Projects (Investment) Remodelling of Workshops into Offices, Construction of 2-Storey Office Block, Paving of Yard and Improvement of Drainage System at LFC GHS Learning Centre at Pantang Construction of GHS Office Complex - Precontract Activities and Construction of Fence wall Remodelling of 4-Storey Office Block for Centre for Disease Control including Rehabilitation of Access Road Rehabilitation of No. 18 Bungalow at Labone, Accra for GHS Headquarters Reconstruction of Offices for Nutrition Unit Outstanding Bills and Payment of Retention Coordinate 2014 Planning and Budget Process Review and finalize GHS gender mainstreaming operational guidelines for service providers ( ensuring that the guidelines include information on gender specific rights and obligations of clients and services providers and other emerging issues) Disseminate guidelines to Regional and District levels Train /sensitize all RHMT members on gender dimensions in health (to be able to render gender sensitive health services. Organise routine visit to regions with council members to monitor the progress of work on MNCH and other programmes Undertake a monthly feature article in the dailies, weekly radio discussion about MNCH and other prevailing health issues Deploy Active Directory Domain Services (ADDS) manage users, computers and other objects on the network Install, configure and monitor user activities on the network, behavioural measures (e.g. patch status, virus infection, password resets, social engineering) Install and configure smart scalable switches to manage the network properly and prevent penetration of unauthorized users Organise routine visit to regions with council members to monitor the progress of work on MNCH and other MINISTRY OF HEALTH November 2012 Page 32

33 programmes Undertake a monthly feature article in the dailies, weekly radio discussion about MNCH and other prevailing health issues Organise quarterly financial validation of returns from regions and districts. Organise 2 monitoring visits to the regions and districts 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 33

34 BUDGET SUB-PROGRAM SUMMARY PROGRAM 2: Strategic National Health Programs SUB-PROGRAM SP 2.2: Maternal, Neonatal & Child Health and Nutrition 1. Budget Sub-Program Objectives To reduce the major causes of maternal and neonatal deaths To improve adolescent health To reduce the major causes of child mortality and morbidity 2. Budget Sub-Program Description The sub-program interventions take account of improving family planning services, sustaining coverage of antenatal care, scaling up of skilled maternal deliveries and comprehensive essential and intensive obstetric care in all health facilities. It also ensures mainstreaming of gender in reproductive health care services. The sub-program further incorporates child health interventions such as scaling of Integrated Management of Childhood illness in health facilities. The sub-program further entails improvement of child survival and development by ensuring that all children are fully immunized. It ensures availability of quality information on adolescent sexual reproductive health services. An essential component of the sub-program is the High Impact Rapid Delivery intervention (HIRD), and Millennium Accelerated Framework (MAF). MINISTRY OF HEALTH November 2012 Page 34

35 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Institutional infant mortality rate Maternal mortality rate per 100,000 live births Improved antenatal care Baseline to be established Deaths per 100,000 live births Percentage of pregnant women attending at least 4 antenatal visits 1% 1.0% 0.8% 0.8% 0.5% 0.5% Total couple years of protection (CYP) Family planning services Short Term 1,056, ,300,000 1,400,000 1,500,000 1,600,000 Long Term 329, , , , ,000 Improved child immunization Percentage of children immunized by age 1 -BCG Percentage of children immunized by age 1 - Penta 3 Percentage of children immunized by age 1 Penvar 3 Percentage of children immunized by age Rotarix MINISTRY OF HEALTH November 2012 Page 35

36 Family planning service Percentage of children immunized by age 1 -OPV1 Percentage of children immunized by age 1 -OPV 3 Percentage of children immunized by age 1 Measles Percentage of children immunized by age 1 -Yellow Fever Percentage of children aged 6 MTHS to 59mths receiving at least one dose of Vitamin A Percentage of clients (15-24 years) who accepted FP service MINISTRY OF HEALTH November 2012 Page 36

37 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Upgrade the skills of trained Maternal and Neonatal health service providers-(implement child health policy, adolescent policy Organize a ToT for pharmacists over 5 days - 4 persons per region for 10 regions Develop / review & produce leaflets, radio spots on healthy eating and healthy lifestyle Conduct Community Health & Nut Service & 1st weighing (Implement national nutrition policy Increase FP service and Skilled delivery Implement recommendation of report on EmONC Strengthen implementation of life saving skills at district and sub-district level and build Regional Resource teams Raise awareness on socio-cultural barriers to access to maternal and new born care Increase number of midwives trained and expand training in midwifery to CHO Increase access to safe blood for expectant mothers and new born Enhance training schools curriculum to produce cadres of staff with skilled mix in the areas of midwifery, obstetric care, child health and health promotion Implement the MAF plan Increase the uptake of EPI services MLM Training for District Maintain cold chain Projects (Investment) Remodelling of Workshops into Offices, Construction of 2-Storey Office Block, Paving of Yard and Improvement of Drainage System at LFC GHS Learning Centre at Pantang Construction of GHS Office Complex - Precontract Activities and Construction of Fence wall Remodelling of 4-Storey Office Block for Centre for Disease Control including Rehabilitation of Access Road Rehabilitation of No. 18 Bungalow at Labone, Accra for GHS Headquarters Reconstruction of Offices for Nutrition Unit Outstanding Bills and Payment of Retention MINISTRY OF HEALTH November 2012 Page 37

38 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 38

39 BUDGET SUB-PROGRAM SUMMARY PROGRAM 2: Strategic National Health Programs SUB-PROGRAM SP 2.3: Communicable Diseases 1. Budget Sub-Program Objective To improve prevention, detection and case management of communicable diseases 2. Budget Sub-Program Description The sub program will scale up and sustain efforts aimed at eradicating and eliminating targeted disease. This includes; HIV /AIDS, TB, Malaria diseases targeted for eradication Diseases targeted for elimination such as Polio, Guinea worm, Oncho etc. Enhance early detection reporting and treatment of communicable disease. Specific focus will be on strengthen surveillance and epidemics preparedness with respect to cholera, meningitis, yellow fever and any emergent diseases. MINISTRY OF HEALTH November 2012 Page 39

40 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 HIV/AIDS Guinea Worm Number of new HIV positive cases diagnosed Number of HIV+ cases receiving ARV therapy (cumulative) Number of guinea worm cases seen Proportion of guinea worm cases contained - 19,402 21,869 18, ,861 78, <_ % 100% 100% 100% 100% 100% Polio Non Polio AFP rate. 2/100,000 2/100,0 00 2/100, 000 2/100, Malaria Proportion of OPD cases that is due malaria (total) Proportion of OPD cases that is lab confirmed malaria. (microscopy + RDTs) Proportion of admissions due to lab confirmed malaria (all ages) 35% 32.5% 30.0% 28.0% 26.0% 24.0% 30% 40% 45% 60% 75% 90% 10.0% 8.0% 9.0% 6.0% 4.0% 2.0% MINISTRY OF HEALTH November 2012 Page 40

41 TB cases improved Increase case notification and treatment for tuberculosis Treat all cases of HIV+ with ARVs Proportion of deaths due to malaria (all ages) Malaria case fatality rate (under 5 years) Proportion of pregnant women on IPT- P (at least two doses of SP) Percentage of children under 5 using ITN TB case notification rate Treatment success rate proportion of HIV+ patients on ARTs 15% 12.0% 10.0% 8.0% 6.0% 4.0% 1.3% 1.2% 1.1% 1.0% % 45.0% 50.0% 56.0% 60% 65% 50% 65% 70% 75% 80% 85% 55/100,000 58/100, /100,000 75/100, ,814 65,914 80, MINISTRY OF HEALTH November 2012 Page 41

42 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Implement supplementary immunization activities for polo and yellow fever Projects (Investment) Procure vaccines for immunization Implement national strategic plans to reduce malaria case fatality among pregnant women and children Implement national strategic plan to increase TB case detection and cure rate Maintain status and validate elimination of guinea worm and polio Review and make ready emergency response plans for disease of epidemic potential (CSM, HINI) MINISTRY OF HEALTH November 2012 Page 42

43 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 43

44 BUDGET SUB-PROGRAM SUMMARY PROGRAM 2: Strategic National Health Programs SUB-PROGRAM SP 2.4: Non Communicable Diseases 1. Budget Sub-Program Objectives To improve prevention, detection and case management of non-communicable diseases To increase awareness and promote healthy lifestyles 2. Budget Sub-Program Description The sub-program involves creating awareness of NCDs (Cancers, cardiovascular diseases, diabetes, asthma and injuries, sickle cell disease) and their risk factors. It strengthens structures for coordinating national response. It improves surveillance of NCDs risk factors, national capacity to manage and identifies persons at risk. It establishes screening centres, provides quality clinical care including palliative care and promotes compliance with care. The sub-program further aims at reducing risk factors related to health with strong emphasis on health lifestyles and environment. The specific interventions embody promotion of regenerative health and nutrition. There are also community focus interventions that place premium on behaviour change, school health programs, and feeding and physical exercise. 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Management of noncommunicable disease Output Indicator Percentage of OPD cases that is Hypertension Percentage of OPD cases that is diabetes Percentage of OPD cases that is Sickle Cell Disease Budget 2013 Indicative 2014 Indicative MINISTRY OF HEALTH November 2012 Page 44

45 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Promote healthy lifestyle awareness among the general population Promote traditional food technologies to improve bioavailability of micronutrients Advocate for the passage of the National Tobacco Control Legislation Implement Regenerative Health and Nutrition Develop national strategy to reduce use of alcohol Projects (Investment) Refurbishment of Health Promotion office Procure equipment for HPD HQ Procure office furniture and ICT equipment Conduct a workplace health impact assessment Management of non- communicable diseases Establish National NCD Epidemiology Reference Group Expand screening programmes for selected noncommunicable diseases: hypertension, diabetes, sickle cell and selected cancers. Increase effective clinical management of NCDs Provide education on family health, health promotion, and disease prevention Develop/reprint IE&C/BCC materials (counselling cards, brochures, posters and booklets) and distribute to regions. To conduct in depth interviews & focus group (FG) discussions to understand issues around male involvement in family planning. Develop materials / strategies (Nutrition Advocacy& strategy, Nutrition Policy, Review of Anaemia Control Strategy, Post NID Strategy, SSFF) To identify one district in a region and make it a Model HP district To strengthen the ICC-HP at all levels Finalization and review of the Health Promotion policy and the development of a strategic plan Provide vehicle to strengthen transport at HPD HQ and for M&E MINISTRY OF HEALTH November 2012 Page 45

46 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 46

47 BUDGET SUB-PROGRAM SUMMARY PROGRAM 2: Strategic National Health Programs SUB-PROGRAM SP 2.5: Occupational Health and Safety 1. Budget Sub-Program Objectives To promote safe and healthy work environment, work practices and procedures in order to minimize work-related injuries and illnesses To ensure safe disposal of medical waste 2. Budget Sub-Program Description The focus of occupational health will be on improving client focus services, patient safety and clinical practices. Key interventions include establishing functional Occupational Health Units in facilities, strengthening quality assurance teams in facilities and improving customer care programs. It also establishes standardized adverse event reporting systems. 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 MINISTRY OF HEALTH November 2012 Page 47

48 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Monitoring and Implementation of Occupational Health Policy Development of IEC material on workplace HIV/AIDS for health sector Development of regional workplace HIV/AIDS implementation programmes by regions Periodic monitoring and annual reviews of implementation of workplace HIV programme Procurement of waste disposal materials, equipment and personal protective equipment (Capital investments) Monitoring and Evaluation of health care waste management No projects Projects (Investment) 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 48

49 BUDGET SUB-PROGRAM SUMMARY PROGRAM 2: Strategic National Health Programs SUB-PROGRAM SP 2.6: Research 1. Budget Sub-Program Objectives To undertake operational research To strengthen evidence-base for policy development and planning 2. Budget Sub-Program Description The health sector has a number of research departments such as the Centre for Scientific Research into Plant Medicine (CSRPM), Kintampo, Dodowa, Adabraka and the Navrongo health research centres which are involved in extensive research activities. The sub-program takes into account research and development of herbal medicines, cultivation of medical plants and analysis of herbalist products. It also seeks to standardise research procedures and conduct operational research using the national research agenda. Additionally, it involves the documentation of research findings and statistics in the sector. MINISTRY OF HEALTH November 2012 Page 49

50 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Access to Herbal medicines improved Output Indicator Number of Herbal medicines produced Number of Herbal medicines formulated Number of Herbalist products analyzed Number of Medicinal plants cultivated and maintained Number of research publications Number of patients attended to by the Clinic Number of research proposals reviewed m (Assorted) 10m (Assorted) 13m (assorted) Budget m (Assorted) Indicative m assorted Indicative m ,000 (assorted plants) 10,000 (assorted plants) 10,000 (assorted plants) 10,000 (assorted plants) 11,000 (assorted plants) 12,000 (assorted plants) ,000 16,267 18,234 21,880 26,256 31, Support for research in the Health sector enhanced Number of research publications Number of health research agenda developed Number of Staff developed in statistical analysis Number of Health information developed On going On going On going MINISTRY OF HEALTH November 2012 Page 50

51 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Research and development of Herbal medicines Production of safe, effective and quality herbal medicine Clinical care with the use of herbal medicine Cultivation of medicinal plants Analysis of Herbalists products Provision of Administrative services(csrpm) Standardized research procedures Conduct Operational Research as per the National Research Agenda Organise an annual National Research Dissemination Forum Organize an annual Stakeholder meeting with other Research Institutions involved in Health Research Strengthen the Documentation Centre at the National Level Projects (Investment) Procurement of production plant and equipment (Decoction bottling line, Tea Bagging machine, Encapsulation machine etc. Acquisitions Laboratory equipment Construction, rehabilitation Administration Block Pharmaceutics and quality control Lab established Refurbishment of Head Department Offices Acquisition of one 4 X 4 Toyota Pick up Rehabilitations of 3 Research Laboratories 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 51

52 BUDGET PROGRAM SUMMARY PROGRAM 3: Health Service Delivery 1. Budget Program Objective To deliver cost-effective, efficient, affordable and quality primary, secondary and tertiary health services 2. Budget Program Description Health Service Delivery is one of the key programs of the Ministry of Health. This program is to deliver cost effective, efficient and affordable and quality health services at the primary, secondary and tertiary levels of care. The services are delivered at all levels of the health system in the form of preventive, promotive, curative and rehabilitative care. Delivery of health services, whether community-based, outreach or institutional are organised through district and regional health services, the teaching hospitals, the psychiatric hospitals, ambulance service, blood transfusion service and faith-based organisations. There are three main sub-programs under this program namely the district health services, secondary and tertiary health services and the specialised hospitals and services. Services include inpatient and outpatient, diagnostic, health education, and promotion and outreach interventions. The services are delivered in all the 230 districts across the country with DHMTS and the district hospitals being the main organized units. Polyclinics exist to provide front line services in the urban centres, but in the rural areas Health Centres and CHPS Compounds are the facilities that provide services as close to the people as possible. There is a regional hospital in each of the ten regions which serve as referral centres and provide training and research. Three Teaching hospitals located in the southern, central and the northern parts of the country provide tertiary care, while specialized hospitals also provide services in the areas of mental, cardio, genetics and orthopaedic MINISTRY OF HEALTH November 2012 Page 52

53 3. Budget Program Summary : Expenditure by Sub-Program, Economic Classification Program 3: Health Service Delivery Expenditure By Budget Sub-Program Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH BSP1 District Health Service 292,815, ,187, ,241,904 BSP2 Secondary and Tertiary Hospitals 45,235,647 39,533,010 39,909,757 BSP3 Specialized Hospital Service 20,899,287 20,914,261 21,108,280 Total Expenditure 358,950, ,634, ,259, Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees 233,673, ,009, ,009, Use of Goods and Services 92,012,761 85,697,174 82,527, Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 92,789 82,289 83, ,698,165 1,698,165 1,715,146 1,314,933 1,208,267 1,220, Non-Financial Assets 30,158,373 23,938,723 20,703,540 Total Expenditure 358,950, ,634, ,259,942 Expenditure by Projects Actual Budget Est. Budget Indicative Indicative Outturn GH GH GH Office equipment 36,555 36,555 36,920 Construction of multi-purpose hospital block 110, , ,585 Purchase of computers 50, Rehabilitation of office block 41,600 41,600 42,016 Furniture 290, ,000 45,450 Reconstruction of Bangalow 438, , ,885 Construction of Multi-Purpose Hospital Block 650,00 650, ,500 Purchase of Computers 147, , ,177 Purchase of Ultrasound Machine 286, , ,239 MINISTRY OF HEALTH November 2012 Page 53

54 Purchase of computers,fridges 3,070, , ,100 Administration Block & emergency ward 800, , ,000 Staff quarters 411, , ,918 Computers 411, , ,918 Eye equipment 764, ,969 0 Staff accommodation 625, , ,250 Computers and Accessories 427, Construction of Matenity and Children Block 769, , ,942 Installation of Intercom 939, , ,390 Staff quarters 695, , ,900 Reproductive and child health unit 555, , ,550 Bungalows 1,754, Fixtures and fittings 298, , ,225 Furniture 648,800 10,000 10,100 Medical equipment 966, , ,165 Contstuction of eye centre and opd blocks 140, , ,400 Build a statue 339, , ,119 Construction of maternity ward 25,000 25,000 25,250 Purchase of autoclave 590, ,000 0 Purchasing of biochemestry analyser 246,000 80,000 80,800 Purchasing of bus 3,347 3,347 3,380 Computer software 557, , ,252 Construction of Adm & O&G block 475, , ,750 Purchase of computers 335, , ,350 Staff Village roads 195, , ,950 Computer software 144, , ,097 Construction of Adm & O&G block 491, , ,032 Purchase of computers 323, ,100 0 Staff Village roads 217, Building of doctors' bungalows 30,000 30,000 30,300 Construction of overhead tank 235, , ,754 Renovation of existing structures 63,500 63,500 64,135 Cost (hover) 20,000 20,000 20,200 Rennovation of OPD Block 2,000 2,000 2,020 Senior staff Quarters 157, , ,873 Aneasthetic machine 70,000 70,000 70,700 Computers 86,940 86,940 87,809 Hospital fence wall 570, , ,538 Laboratory builbing 89,500 89,500 90,395 Opd block 570, , ,538 MINISTRY OF HEALTH November 2012 Page 54

55 Air conditioners 24,500 24,500 24,745 Clients chairs 77,400 77,400 78,174 Computers for networking 275, , ,550 Construct new opd block 282, ,500 0 Construction of Office Fence Wall 46,600 46,600 47,066 Construction of staff quarters 25, Installation of x-ray and accessories 200, , ,000 Office chairs 250, Rehabilitation of Maternity Ward 21,500 21,500 21,715 Rehabilitation of Mothers' Lodge 26,500 26,500 26,765 Trollers and stretchers 25,994 25,994 26,254 Internet service installation/networking 1,800 1,800 1,818 Nurses/staff quarters 94, Purchase 6 air conditioners - opd, administration, store, phc &others 17,700 17,700 17,877 Purchase of Autoclaves, Suction Machine, Stretcher and Urine Analyzer etc 55,000 55,000 15,150 Purchase of Computers and Accessories 55,000 55,000 15,150 Purchase of Furniture/Fittings 55,000 55,000 15,150 Purchase two Vehicles 55,000 55,000 15,150 Autoclave & steel cabinet 55,000 55,000 15,150 New administrator 81,500 81,500 82,315 New Digital x'ray Block 71,800 71,800 72,518 New orthopaedic block 40,000 40,000 40,400 Purchase of Drag Van 26,000 26,000 26,260 Beautification 60,000 60,000 60,600 Computers and accessories 20,500 18,000 18,180 Hospital equipments 113, ,500 0 Mortuary 160, , ,000 Other medical equipments 87,600 87,600 0 Renovation of opd, lab &male ward 1,500 1,500 1,515 Staff bungalows 210, , ,100 Anaesthetic machine 92,806 92,806 93,734 Automation of the hospital 40,000 40,000 40,400 Computer 261, , ,610 Doctors bungalow (4 flat) 30,000 30,000 30,300 Emergency unit 33,000 33,000 33,330 Extension of female ward 34,000 34,000 34,340 Other medical and office equipments 60,000 60,000 60,600 Toilet facility at phc 46,300 46,300 46,763 Ultrasound machine 33,000 10,000 10,100 Air-conditioners 101, ,000 0 MINISTRY OF HEALTH November 2012 Page 55

56 Blood chemistry analyiser 68,500 68,500 69,185 Computers 17,500 17,500 17,675 Laundry machine 104, ,500 0 Opthalmosope machine 207, , ,171 Staff quarters 238, , ,440 Baby incubator 2,000 2,000 2,020 Oxygen cylinders & accessories 33,850 33,850 34,189 Radiant heater unit 1, ,212 Refurbish pharmacy block 60,000 60,000 60, unit staff qtrs 1, ,212 Charges 1,200 1,200 1,212 Expansion of laboratory unit 40, Mortuary 68,500 68,500 69,185 Opd block waiting area 450, ,000 0 Pabx intercom1 1,200 1,200 1,212 Nursing school 64,100 64,100 0 Opd block 64,100 64,100 0 Investment activities 4,320,372 4,320,372 4,363,576 Total Expenditure 30,158,373 23,938,723 20,703,540 MINISTRY OF HEALTH November 2012 Page 56

57 BUDGET SUB-PROGRAM SUMMARY PROGRAM 3: Health Service Delivery SUB-PROGRAM SP 3.1: District Health Services 1. Budget Sub-Program Objectives To deliver accessible and affordable quality health services at district and lower level health facilities 2. Budget Sub-Program Description The sub-program delivers cost effective, efficient, affordable and quality primary health services as close to the client as possible. It ensures efficient and effective systems for prevention, detection and case management of communicable and non-communicable diseases as well as management of health services. These are carried out by the district health administration, sub-district and CHPS compounds. MINISTRY OF HEALTH November 2012 Page 57

58 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator OPD attendance per capita Doctor population ratio Equity Index: Geography (services) Supervised deliveries) Number of Psychiatric patients treated and rehabilitated rate Budget 2013 Indicative 2014 Indicative :10,500 1:9,700 1:9, :1.8 1:1.7 1: , Increase access to primary health care services Psychiatric patient treatment and rehabilitation rate ( %) Percentage of community psychiatry nurses trained and deployed Equity Index: Ratio of mental health nurses to patient population Nurse: population ratio HIV positive clients receiving ARV Incidence of guinea worm Percentage of population with valid NHIS membership card - 10 baseline % 10% 25% :1,000 1:9,00 1:8, <100 < MINISTRY OF HEALTH November 2012 Page 58

59 Percentage of children fully immunized by age one-penta 3 Institutional Maternal Mortality rate per 10,000 live births Hospital Admission rate Average Length of Stay (days) Percentage of Bed Occupancy Turnover per bed MINISTRY OF HEALTH November 2012 Page 59

60 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Refer serious cases of malnutrition to district hospital Identify and treat cases of micronutrient deficiencies Promote the use of iodized salt Identify and treat cases of micronutrient deficiencies Projects (Investment) VOLTA REGION Construction of Offices for RHMT Completion of DHMT Offices at Kete - krachi Completion of 3 No. Bungalows at Ho Medical Village Prevention, control and management of specific endemic diseases Diagnose and manage cases of malaria Review and develop standard protocols and guidelines for institutional care including referrals Create access to services by expanding specialist outreach programmes Disseminate and train respective institutions on use of standards and protocols in Provide inpatient services Provide Dental Services Conduct major operations (surgery) Conduct minor operations (Surgery) Provide diagnostic services: Laboratory, Radiological services Provide pharmaceutical Services Construction of DHMT Offices at Kpeve Purchase of 2-Storey Building at Avatidome for Staff of Volta Regional Hospital, Ho Construction of DHMT Office Facility at Dzodze for Ketu North District. Construction of Accident & Emergency Unit at Sogakope Hospital Rehabilitation of Health Centre at Alavanyo Completion of DHMT Office Building at Odumasi - Lower Manya Completion of Maternity Ward at Kade Hospital Construction of 2 Bedroom Semi-detached Quarters at Kibi Completion of 1 No. Bungalow at Achiase Health Centre, Birim South District Extention of Regional Health Administration at Koforidua Construction of 2 No. 4 Units x 2 Bedroom Semi-detached Quarters at Ofoase, Akyemansa District Provide antenatal and neonatal Services Construction of DHMT Office Building at Donkorkrom - Provide ophthalmological services Provide physiotherapy care Provide ENT Services Kwahu North District Redevelopment of Akuse Hospital BRONG AHAFO REGION Completion of 1 No. Ward at Atebubu Construction of Surgical Ward at Bechem Hospital - Phase I Provide Mental Health Services Undertake Outreach Services Ensure availability of safe blood Provide referral services Provide Morgue services Completion of 1 No. Doctor's Bungalow at Sunyani Construction of 4 Unit 2 Bedroom Semi-Detached Senior Staff Quarters at Sunyani Construction of 1 No. 18 Unit 3-Storey Block of Flats Construction of 3 no. Junior Staff Quarters at Tanoso Health Centre Construction of 10 No. 2-Bedroom Flats for Middle Level MINISTRY OF HEALTH November 2012 Page 60

61 Staff at Goaso Hospital Orientate of staff on Health Information Systems Construction of 250 Capacity Conference Hall, Sunyani (DHIMS 2) Organize/Provide systematic immunization at the health ASHANTI REGION centre Maintain cold chain Rehabilitation and Expansion of Kumasi South Hospital - (New Storey Maternity Block) Promote the use of iodized salt Construction of Health Centre at Pankrono CHAG Provide OPD Services Provide inpatient services Conduct major operations (surgery) Provide pharmaceutical Services Provide antenatal and neonatal Services Provide dental care services Provide ophthalmological service Provide physiotherapy care Provide referral services Provide laundry services Provide morgue services Continue HIV Aids programs Provide immunisation outreaches Provide orthopaedic Services Rehabilitation & Expansion of Old Tafo Health Centre (Theatre, Surgical Ward and Maternity) Construction of 4-Storey 3-Bedroom Semi-detached Flats at Abrepo Upgrading of Manhyia Polyclinic in Kumasi - Construction of Male and Female Wards Completion of DHMT Office at Obuasi Construction of Hospital at Dabaa in the Atwima Nwabiagya District - Phase II Completion of Health Centre at Bompata in Asante Akyem South District Rehabilitation of Bungalow No. 2 Cedar Avenue in Kumasi NORTHERN REGION Construction of Fence Wall at West Hospital at Tamale Rehabilitation of Damongo Hospital (Phase II) - Completion of Theatre Drilling and Installation 6 No. Mechanised Boreholes at Kpembe, Chando, Yipala, Karaga in Northern Region Extension of Water & Power to 4 no. Staff Accommodation at Salaga Hospital Construction of 1 no. 2-bedroom bungalow at Buipe Health Centre Construction of 1 no. 1-bedroom Semi-detached Quarters at Karaga Health Centre Construction of CHPS Compound at Wakawaka Construction of Fence Wall at Walewale Hospital Redevelopment of Old Hospital in Tamale (Phase I) Reconstruction of Facilities Destroyed by Floods in UER (Phase I - 18 Facilities) at Atiyorom, Katanga/ Dubila, Pelungu, Tongo, Soe Yipala and Salpiiga Completion of Health Centre at Bolgatanga Completion of Mechanical Workshop at Bolgatanga Expansion of Regional Medical Stores at Bolgatanga - Phase II Expansion of Regional Disease Contol and Prevention Unit Cold Room including Provision of Equipment & Furniture at Bolgatanga Rehabilitation of Kultamse Clinic in the Bawku Municipal MINISTRY OF HEALTH November 2012 Page 61

62 Construction of 2 Bedroom Staff Accommodation at Busongo Clinic in the Kassena Nankana West District Construction of DHMT Office Block at Garu for Garu Tempane District Reconstruction of Facilities Destroyed by Floods in UER (Phase I - 18 Facilities) at Atiyorom, Katanga/ Dubila, Pelungu, Tongo, Soe Yipala and Salpiiga Completion of Health Centre at Bolgatanga Completion of Mechanical Workshop at Bolgatanga Expansion of Regional Medical Stores at Bolgatanga - Phase II Expansion of Regional Disease Contol and Prevention Unit Cold Room including Provision of Equipment & Furniture at Bolgatanga GREATER ACCRA REGION Construction of RHMT Office in Accra Construction of Staff Bungalow at Ada Hospital Hospital - Phase 3 Completion of Theatre at Ussher Polyclinic Completion of 3-Storey Ward Block at Mamobi Polyclinic Rehabilitation of Health Centre at Prampram Phase II - Laboratory Block and Paving of Compound Construction of Staff Accommodation for Teshie Hospital - 1 No. Block of 12 Flats (2-Bedroom Type) Rehabilitation of Bungalow No. E 1 Labone CENTRAL REGION Extension of Office Block for Regional Health Directorate at Cape Coast Rehabilitation of Block B at 3rd Ridge for Regional Health Directorate Rehabilitation of Mortuary at Saltpond District Hospital including Mortuary Equipment Rehabilitation of Agona Abodom Health Centre Rehabilitation of Nyakrom Health Centre Rehabilitation of Nsaba Health Centre Upgrading of Nyankomasi Ahenkro Health Centre to Polyclinic Construction of 1 no. 30 units Bedsitter Housemen Flats Construction of 1 no. 2-bedroom Bungalow for Senya Breku Health Centre WESTERN REGION Construction of 3-Bedroom Bungalow at Half Assini Construction of 1 No. 6-Unit Semi detached Quarters at Takoradi (Phase II) Completion of Health Centre at Adabokrom Completion of Health Centre at Nsawora MINISTRY OF HEALTH November 2012 Page 62

63 Completion of Health Centre at Asawinso Construction of CHPS Compound at Sowudadzem Construction of CHPS Compound at Boikrom Construction of CHPS Compound at Nyamebekyere UPPER WEST REGION Construction of 1 No. 4 Unit 2-Bedroom Staff Quarters at Lawra Construction of 1 No. 4 Unit 2-Bedroom Staff Quarters at Funsi Construction of 1 No. 4 Unit 2-Bedroom Staff Quarters at Tumu Completion of Health Centre at Ullo Construction of DHMT Office Block at Wa Completion of Administration and OPD Block at Nandom Hospital including Furniture and Equipment Completion of 3-Bedroom Bungalow for Wa Hospital Construction of 1 No. 3 Bedroom Bungalow at Hamile Health Centre Construction Of; OPD Blocks Laboratory Blocks Pharmacy Blocks Administration Blocks X-Ray Block Staff Accommodation Toilet Facility Theatre Block Eye Centres Mortuaries Procurement Of Computers Procurement Of Administrative Vehicles Procurement Of Equipment Procurement Of Plants And Generators MINISTRY OF HEALTH November 2012 Page 63

64 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees 218,453, ,638, ,638, Use of Goods and Services 46,784,329 46,297,051 42,613, Subsidies 82,289 82,289 83, Grants Social Benefits 598, , , Other Expenses 1,058, , ,790 Capital Expenditure 31 Non-Financial Assets 25,838,001 19,618,351 16,339,964 Total Expenditure 292,815, ,187, ,241,904 MINISTRY OF HEALTH November 2012 Page 64

65 BUDGET SUB-PROGRAM SUMMARY PROGRAM 3: Health Service Delivery SUB-PROGRAM SP 3.2: Secondary and Tertiary Hospital Services 1. Budget Sub-Program Objectives To deliver quality secondary and tertiary level institutional care To improve capacity for referral and emergency response, medical training and education and health research. To ensure timely availability of safe blood and blood products for transfusion 2. Budget Sub-Program Description This sub-program covers services provided by all secondary and tertiary level health providers. This group of providers serve as referral centres for primary health care givers; provide prehospital emergency care and advanced clinical services such as surgery, accident & emergency, child health, obstetrics and gynaecology, DEENT care and make safe blood and blood products affordable and accessible to all. In addition, these institutions provide diagnostic and imaging services to clients. Under the sub-program, research is conducted into prevailing health and other health related issues within their catchment areas and provides undergraduate and post graduate professional clinical training. MINISTRY OF HEALTH November 2012 Page 65

66 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Maternal Care Pathological services Out-patient care OPD Attendants Patients Admissions Essential medicines availability Planned preventive maintenance of plants, vehicles and machinery Provide Emergency Care Post operative/procedural deaths Death audits and post mortem examination Output Indicator Institutional maternal mortality rates per 100,000 live births Percentage of Improvement in Pathological services Percentage of reduction in waiting period Percentage of increase in OPD attendance Percentage increase in Admissions Percentage of essential medicines available Percentage of Operational Plant, vehicles & Machinery Case Response Time Percentage of post procedural deaths Percentage of deaths audited/ PM examination conducted Budget 2013 Indicative 2014 Indicative mins, 30sec % of cases 15minutes 1% of cases % of cases 1% of cases MINISTRY OF HEALTH November 2012 Page 66

67 Patients satisfaction Patients satisfaction levels - - Satisfaction level of 65% Satisfaction level of 75% Satisfaction level of 80% Satisfaction level of 85% Equipment utilization Equipment utilization rates % 90% 95% 100% Outreach activities Blood donor education and recruitment campaign Safe Blood & Blood Products Number of Outreach activities No. of Donor Education Talks/Lectures in Educational Institutions, Work Places, Churches Mosques, etc. No. of times Documentaries on Voluntary Blood Donations are aired in mass media No. & % of Voluntary Non- Remunerated Blood Donations Number & Percentage of Collected Blood Screened for TTIs (HIV I&II, HBV, HCV, & SYPHILIS) (AABC) 780 (AABC) At least 2 outreaches a year At least 2 outreaches a year At least 3 outreaches a year At least 4 outreaches a year N/A (100%) - AABC - 138,000 (60.0%) 230,000 (100%) 175,000 (70.0%) 250,000 (100%) 224,000 (80.0%) 280,000 (100%) MINISTRY OF HEALTH November 2012 Page 67

68 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Tertiary Institutions, Emergency Services, Blood Transfusion Services Train and develop staff Provide out-patient services Provide in-patient services Conduct major and minor surgeries Provide pharmaceutical services Provide management and administrative services Provide physiotherapy services Provide diagnostics and imaging services Ensure 100% functionality of all sub-bmcs Improve financial management and budgetary controls Monitor all processes along the supply chain Institutionalize continuous Planned Preventive Maintenance activities Recruit specialized health professionals Institutionalize QA practices Provide research activities Provide support to GHS institutions and organize outreach & educational programmes Provide safe blood and blood products Conduct blood donor education and recruitment campaigns Provide pre-hospital emergency care Improve policy, planning and M&E activities Provide Surveillance on diseases and provide Immunization services Repair and maintenance of plant and equipment Projects (Investment) Procurement of plants & machinery Procurement of landed properties Rehabilitation of buildings Paving of Ground & Water Supply System at Regional Health Directorate in Kumasi Procure Training equipment (LCD, Screen, etc) Construction of Conference hall /In-Service Training centre for the Region Procure Blood bank vehicles for blood transfusion services Regional Hospitals and Service(10 Regional Health Admin & Hospitals) Carry out quarterly facilitative visits to all Districts and Hospitals MINISTRY OF HEALTH November 2012 Page 68

69 Compile Quarterly, Half year and Annual Reports Organise Refresher training for District HMIS Staff Train RHD managers in Database management Undertake support supervision and monitoring visits Undertake routine financial monitoring Hold quarterly Audit Report Implementation Committees Meetings (ARIC) Develop and implement Health promotion strategies towards health promotion and nutrition Organize quarterly maternal mortality conferences Collate data on incidence and prevalence of NCD in the region Identify and demarcate zones for CHPS compounds Identify and support staff for training to main PH labs Equip all Laboratories in the region to carry out essential lab investigations Carry out monthly supervision of all hospital to access the state of the facilities Collate and advocate for the construction of specialised units in all hospitals Evaluate state of institutional ambulances and social support from Government and donors Hold stakeholders meetings for CET initiative Provide routine maintenance for all Cold chain equipment in the region Provide effective storage for all tracer drugs and supplies Develop and implement PPM vehicle maintenance schedule Develop and implement CHPs information system and integrate into DHIMS Undertake support visit to Districts/Hospitals during operational researches and quality assurance surveys Organise annual capacity training for Hospital Information Officers data management Organize in service training for theatre staff on wrong site surgery Provide adverse incidents register at the OPD and on the wards Run hypertension and diabetic clinics Provide OPD and Inpatient services Train staff on the effective management of Diabetic and stroke cases Conduct regular screening of clients for eye related conditions Perform eye surgeries Conduct eye outreach Provide IMCI MINISTRY OF HEALTH November 2012 Page 69

70 Establish an adolescent corner Screen all pregnant women for HIV Conduct focus ANC Conduct delivery and PNC Provide Pharmaceutical services Use ITNs on the wards provide physiotherapy services Establish a local area network at the hospital Provide psychiatric services Conduct community psychiatric outreaches 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees 1,839,838 1,858,237 1,858, Use of Goods and Services 37,708,876 31,999,391 32,319, Subsidies 10, Grants Social Benefits 1,100,000 1,100,000 1,111, Other Expenses 256, , ,560 Capital Expenditure 31 Non-Financial Assets 4,320,372 4,320,372 4,363,576 Total Expenditure 45,235,646 39,533,010 39,909,758 MINISTRY OF HEALTH November 2012 Page 70

71 BUDGET SUB-PROGRAM SUMMARY PROGRAM 3: Health Service Delivery SUB-PROGRAM SP 3.3: Specialized Hospitals and Services 1. Budget Sub-Program Objective To provide quality specialized health care 2. Budget Sub-Program Description The sub-program aims to provide specialized care in the area of Psychiatry, Orthopaedics, Cardio, Plastic and Burns reconstruction surgery, Genetics and related health care specialities. They also conduct research and provide undergraduate and postgraduate training. Psychiatry deals with the assessment and treatment of both neurotic and psychotic mental disorders. The Ghana Institute for Clinical Genetics (GICC) continues to carry out its mandate through quality clinical care (outpatient and day detention, laboratory and pharmaceutical services), counseling and education as well as research to give patients and practitioners evidence on the most effective medical options. MINISTRY OF HEALTH November 2012 Page 71

72 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Psychiatric Health care Total specialist OPD attendance Percentage reduction in relapse rate Total in-patient admission Percentage Psychiatric patient /day care treatment and rehabilitation rate Equity Index: nurses to patient population 95,691 97, , , , , ,729 7,129 7,579 7,000 7,000 7, /106 1/108 1/120 1/80 1/60 1/50 Rate of Stigmatisation (%) Patient waiting time (hrs) Doctor: Patient Ratio 1:845 1:895 1:840 1:800 1:700 1:600 MINISTRY OF HEALTH November 2012 Page 72

73 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations PSYCHIATRIC CARE Undertake Psychiatric Assessment at OPD/Assessment Unit/wards Out Patient & In-Patient Psychiatric Care Provide psychological care (Psychologist) Provide Community Psychiatry services/ programs Provide occupational therapy/ rehabilitation of patients on admission Rehabilitation: Of Patients on admission Occupational Therapy Horticultural activities Of Patients with psychoactive substance use disorder Provide treatment and rehabilitation of patients with psychoactive substance use disorders Assessment of Mental State Provide social Welfare services GHANA INST. OF CLINICAL GENETICS Conduct public Education & Sensitization on the sickle cell disease Provide Outpatient care for people living with the Sickle Cell Condition Improve & accelerate the process of scientific discovery (Research ) to enhance patient care Counsel of Patients & Family Ensure Staff Welfare including Occupational Health & Safety Recruit, Train & Continuously develop staff. Streamline General Admin Processes including financial Activities by Improving Financial Management Strategies. Ensure the availability of Chemicals and Other Consumable (Efficient Supply Chain Management). Reduce patient waiting time through the chit & appointment system Establish, Support & monitor the performance of trained teams at the Satellite (polyclinics) Clinics Screen Well Babies at 6 months as well as the Screening of Outreach Participants Projects (Investment) PSYCHIATRIC CARE Tarring of road network Expansion of rehabilitation unit Equipment for the OPD Construction of new mortuary Rehabilitation of wards and offices Replacement of concrete protected W/C toilets GHANA INST. OF CLINICAL GENETICS Improve Administrative Infrastructure (Expansion of Administrative Offices & Equipment) Laboratory Equipment(Chemistry & Hematology analyzers etc) Expand Health Care facilities (Expand day detention(resuscitation) ward as well as build an In Patient Ward) Landscaping (Paving the Compound) MINISTRY OF HEALTH November 2012 Page 73

74 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH 21 Compensation of Employees 13,379,732 13,513,529 13,513, Use of Goods and Services 7,519,556 7,400,732 7,594, Subsidies Grants Social Benefits Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure 20,899,288 20,914,261 21,108,280 MINISTRY OF HEALTH November 2012 Page 74

75 BUDGET PROGRAM SUMMARY PROGRAM 4: Human Resources for Health Development and Management 1. Budget Program Objective To facilitate the development and management of skilled, Health professionals of all categories. 2. Budget Program Description To ensure the availability of adequate and highly productive staff in the sector, there is the need for effective Human Resource (HR) development and management. HR development involves the production of adequate, appropriately balanced, skilled health professionals and the provision of adequate resources to support their training. Human Resource Development is carried out at both the Pre-Service (Basic) and the In-Service levels. Pre-service training is undertaken for those entering the health sector for the first time. Trainees are usually graduates from secondary school and receive basic training in their field of interest. Basic Training Institutions are accredited and regulated by their respective regulatory bodies, namely, Nurses and Midwives Council of Ghana, Pharmacy Council, Medical and Dental Council, Allied Health Task and Traditional Medicine Practice Council in collaboration with the National Accreditation Board and the National Council on Tertiary education. Personnel who are already health professionals and desire to specialize in a specific area of discipline undertake training at the In-Service level. Training at the In-Service level is in two categories namely, Post Basic Training and the Postgraduate Specialization Training. Post basic training is carried out after completing a basic diploma programme and leads to the award of an advanced diploma. The areas of specialization for this programme are mainly in the nursing profession and include Peri Operative and Critical Care Nursing, Ophthalmic Nursing, Ear, Nose and Throat Nursing and Anaesthesiology. Medical/Physician Assistantship is also undertaken at the post basic level. Post-graduate specialization is mainly for Professionals who are at the graduate level. The graduates of this programme become specialists in different areas of expertise such as Medicine, Nursing, Pharmacy and Non Physician. Institutions involved in this training are the Ghana College of Physicians and Surgeons, West African College of Physicians and Surgeons and the West African College of Nurses and Midwives. HR Management comprises the development and implementation of clear guidelines and supportive mechanisms for equitable distribution and rational utilization of available Human Resources for Health Service Delivery. Management of Human resources encompasses operations such as monitoring performance, improving productivity and putting in measures to ensure appropriate deployment, retention and motivation of staff. MINISTRY OF HEALTH November 2012 Page 75

76 Challenges encountered in HR development and management includes: Differences in the structures of the various Agencies which hampers implementation of HR policies Weak collaboration with sister Agencies Inadequate infrastructural and logistical support for Health Training Institutions Inadequate number of Tutors for Training Institutions Low staff productivity Inequitable distribution of staff MINISTRY OF HEALTH November 2012 Page 76

77 3. Budget Program Summary : Expenditure by Sub-Program, Economic Classification Program 4: Human Resources for Health Development and Management Expenditure By Budget Sub-Program BSP1 Human Resource Development BSP2 Human Resource Management Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Capital Expenditure 31 Non-Financial Assets Total Expenditure Expenditure by Projects Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Total Expenditure MINISTRY OF HEALTH November 2012 Page 77

78 BUDGET SUB-PROGRAM SUMMARY PROGRAM 4: Human Resources for Health Development and Management SUB-PROGRAM SP 4.1: Human Resource Development 1. Budget Sub-Program Objectives To produce adequate numbers of appropriately skilled health professionals To produce adequate numbers of mid-level cadre To produce adequate numbers of specialised health professionals 2. Budget Sub-Program Description The sub-program involves the production of adequate and balanced skilled health professionals. Training is undertaken at the Basic, Post Basic and Post-graduate specialization levels. Basic training mainly refers to new trainees who pursue certificate, diploma and firstdegree programs. Post basic training is carried out for health professionals who have completed a certificate or diploma basic program. There are two main categories of basic and post basic health training institutions, namely, private and public. These training institutions offer programs in all aspects of health care including Medical, Nursing, Pharmaceutical and Allied Health programs. Public training institutions comprise schools, which are managed by the Ministry of Health and schools which are managed outside the Ministry of Health (mainly by the Ministry of Education). Other public institutions are run by quasi government institutions such as the Military. Graduates are usually middle level cadres who have specialized in an area of discipline and come out with the award of an Advanced Diploma on successful completion. Health professionals who have completed a basic first-degree program undertake postgraduate specialization. Specialists in this field are classified into medical and dental specialties, nursing and midwifery specialties, pharmacy specialties and allied health specialties. Institutions producing these specialists are the Ghana and West Africa Colleges of Physicians and Surgeons for medicine and dentistry, the West Africa College of Nursing for Nursing and Midwifery, and the West African Postgraduate College of Pharmacists for Pharmacists. Pharmacy and Allied Health specialties are currently trained in various universities. Under the sub-program, postgraduate institutions oversee the conduct of examinations and award diplomas, certificates and other professional distinctions to health professionals as well as accreditation of health institutions. MINISTRY OF HEALTH November 2012 Page 78

79 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Training for desired number, mix and skills of staff to offer health services to the populace provided Number of doctors trained Number of nurses trained Number of Specialists & Consultants trained Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Admit qualified candidates in basic, post basic and post graduate programs Train adequate number of auxiliary, professionals and specialists in all skill sets Assess graduates to ensure improved standards and ensure quality Supervise trainees undergoing fieldwork in districts and communities Upgrade training institutions to meet accreditation criteria Conduct continuous professional development programmes for postgraduate health professionals Projects (Investment) Procure Vehicles Renovate training institutions Construct training institutions MINISTRY OF HEALTH November 2012 Page 79

80 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 80

81 BUDGET SUB-PROGRAM SUMMARY PROGRAM 4: Human Resources for Health Development and Management SUB-PROGRAM SP 4.2: Human Resource Management 1. Budget Sub-Program Objectives To recruit, distribute, retain, and motivate health staff at all levels To improve Human Resource productivity To institute performance management systems 2. Budget Sub-Program Description The sub-program includes the gamut of activities involved in the efficient management of all activities of the health workforce. In ensuring this, a set of clear guidelines are developed to cover all areas of HR such as deployment and distribution, retention, motivation and remuneration of staff. Deployment involves the equitable distribution of health professionals across the country to ensure access to health care for all people living in Ghana. Current trends show a highly skewed geographical distribution among some categories whilst other categories are moderately skewed. This sub-program therefore looks at implementing appropriate distribution strategies and guidelines. Retention is the maintenance of staff within areas of need. This looks at ways to reduce staff attrition both internal and external. Internal attrition refers to the movement of staff from one geographical area to another within the country. The trend is mainly from rural to urban areas. External attrition refers to the movement of staff to other countries. Though external attrition is relatively low, internal attrition is still very high and retention strategies are needed to arrest the situation. The sub-program also looks at ways of motivating staff using incentive packages, performance management contracts, reward systems as well as the remuneration levels of all staff. Measures to improve productivity, client satisfaction and ensure quality assurance all fall within this sub-program. This program is achieved in collaboration with the Agencies of the Ministry as well as the Public Services Commission and the Office of the Head of Civil Service. Development partners also play a key role in providing technical support for this program. MINISTRY OF HEALTH November 2012 Page 81

82 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Output Indicator Budget 2013 Indicative 2014 Indicative 2015 Human Resource management in the sector improved No of Staff awarded No. of performance contracts signed and monitored Doc Pop ratio (GAR/NR) :4099 / 1: :3616 / 1: :3113 / 1: :2811 / 1: :2553 / 1: Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Implementation of appropriate reward schemes Effective HR deployment Institute Performance management systems HR Performance monitoring Projects (Investment) Purchase Sever for IPPD Procure items for awards Procure vehicles for monitoring Improve staff Productivity MINISTRY OF HEALTH November 2012 Page 82

83 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 83

84 BUDGET PROGRAM SUMMARY PROGRAM 5: Health Sector Regulation 1. Budget Program Objective To ensure that acceptable standards of health services and products are maintained. 2. Budget Program Description The Health Sector Regulatory Agencies have the responsibly of ensuring that competent health care providers practice within agreed standards and their services are accessible to the whole population. This is achieved by regulation of health facilities, health professionals, pharmaceuticals and medical products, and food and non-medical products. The Agencies involved in the implementation of the program are Private Hospitals & Maternity Homes Board, Pharmacy Council, Medical & Dental Council, Nurses and Midwives Council, Food and Drugs Board, Allied Health Professional Council, Traditional Medicine Practice Council and Centre for Scientific Research into Plant Medicine. The many challenges faced by the Regulatory Agencies include: Inadequate comprehensive enabling legislation with regulations and supportive guidelines that applies to current environmental changes and political support. Inadequate resources human, logistical and financial to enable the agencies execute their mandate. Limited border post-activities. High cost of radio programs and television advertisements, as well as adverts in the print media for consumer education. Increasing enforcement costs on joint police swoops, description of fake unwholesome and substandard products and post market surveillance functions. High cost of reagents and equipment for FDB and Centre for Scientific Research into Plant Medicine laboratories. The program is funded by the Government of Ghana, Internally Generated Fund and Multi Donor Support. MINISTRY OF HEALTH November 2012 Page 84

85 3. Budget Program Summary : Expenditure by Sub-Program, Economic Classification Program 6: Health Sector Regulation Expenditure By Budget Sub- Program BSP1 Regulation of Health Facilities BSP2 Regulation of Health Professionals BSP3 Regulation of Pharmaceutical and Medical Products BSP4 Regulation of Food and Non- Medical Health Products Total Expenditure Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH Expenditure by Projects Actual Budget Est. Budget Indicative Indicative Outturn GH GH GH BSP1 Regulation of Health Facilities BSP2 Regulation of Health Professionals BSP3 Regulation of Pharmaceutical and Medical Products BSP4 Regulation of Food and Non- Medical Health Products BSP1 Regulation of Health Facilities Total Expenditure MINISTRY OF HEALTH November 2012 Page 85

86 BUDGET SUB-PROGRAM SUMMARY PROGRAM 5: Health Sector Regulation SUB-PROGRAM SP 5.1: Regulation of Health Facilities 1. Budget Sub-Program Objective To ensure compliance and maintenance of agreed standards for public and private health facilities 2. Budget Sub-Program Description The Health Sector Regulation sub-program has the objective of ensuring that acceptable standard of health provision and health products are maintained. This objective is achieved by the enforcement of health legislation, regulations and prescribed standards for health facilities. Licensing and registration are important mechanisms that the Agencies involved in the implementation of the sub-program employ to confer authority on individuals or corporate bodies to provide health care services. The Agencies ensures that health facilities are licensed and are well distributed in the country to improve access to health care as well as to aid National Health Insurance Scheme. One of the tools used for inspection of premises is monitoring. The fundamental responsibility lies with the inspecting officers who have the duty to enforce the law. Also for effective regulation there is the need for a well-developed enforcement system to be in place, as well as policies relating to sanctions, penalties, prosecutions, investigation and the appropriate Legislative Instruments (LI). The organizations involved in the implementation of the sub-program are Private Hospitals & Maternity Homes Board, Pharmacy Council and Traditional Medicine Practice Council, Medical and Dental Council and Nurses and Midwives Council. MINISTRY OF HEALTH November 2012 Page 86

87 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs All health facilities meet minimum standards for operating Health Facilities Licence renewal Process new applications for licensing of health facilities Output Indicator Percentage of health facilities meeting minimum standards Percentage of facilities license renewed Percentage of facilities licensed Budget 2013 Indicative 2014 Indicative Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Accreditation, Registration and licensing of private health facilities Renewal of health facilities licenses Projects (Investment) Construction, Rehabilitation and expansion of infrastructure Purchase of fifteen (15) computers and accessories Enforcement of monitoring MINISTRY OF HEALTH November 2012 Page 87

88 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 88

89 BUDGET SUB-PROGRAM SUMMARY PROGRAM 5: Health Sector Regulation SUB-PROGRAM SP 5.2: Regulation of Health Professionals 1. Budget Sub-Program Objective To assure quality through adherence to agreed standards for practising health professionals. 2. Budget Sub-Program Description The Regulation of Health Professionals sub-program seeks to prescribe, uphold, and enforce professional conduct and standards. The main operations involved are continuous professional development, licensure and re-licensure of practicing health professionals registered to practice in Ghana and collaborate with other health training institutions. The organizations involved in the Regulation of Health Professionals are Pharmacy Council, Medical & Dental Council, Nurses and Midwives Council, Allied Health Professional Council and Traditional Medicine Practice Council. MINISTRY OF HEALTH November 2012 Page 89

90 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs Critical health professionals (Nurses/ doctors/pharmacist must satisfy minimum practice standards Health interns to undergo internship training in accredited health institutions Output Indicator Percentage of health professionals in current registration Percentage of health graduates who are posted to do their internship Budget 2013 Indicative 2014 Indicative posting 100 posting 100 posting 100 posting 100 posting Re-license health professionals registered to practice in Ghana Percentage of health professionals relicensed - 80 licensure 90 licensure 100 licensure 100 licensure 100 licensure Arraign persons and companies in breach before disciplinary and general purpose committee Percentage of discipline cases reported and dealt with of offenders 100 of offenders 100 of offenders 100 of offenders 100 of offenders Register health interns who pass health professional qualifying examination Percentage registered Educate health practitioners and service providers on the laws and agreed standards for practicing health professionals Number of educational activities done - 2 per year 2 per year 2 per year 2 per year 2 per year MINISTRY OF HEALTH November 2012 Page 90

91 4. Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Education and training of health professionals (Doctors, Pharmacists and Professional and Auxiliary Nurses and health Technicians) to equip them with the requisite knowledge, skills and competence Re-licensure of practicing health professionals registered to practice in Ghana. Health interns undergo internship training in accredited health institutions. The internship is a pre-requisite for writing health professional qualifying examination Career and development programs for health practitioners and service providers on regulation and standard for practice Develop and review of curricula for programmes for training institutions to meet current trends and developments Licensing and renewal of license of health professionals Conduct research and evaluate standards of education, training and practice of health professionals Projects (Investment) Complete head office and laboratory complex building for Food and Drugs Board Complete office building for Nurses and Midwives council Acquisition of residential accommodation for CEO of FDB Procure office accommodation for Traditional Medicine Practice Council Procure twenty(20) vehicles for agencies regulating health professionals Procure fifteen(15) computer and accessories for agencies regulating health professionals Networking infrastructure Purchase of furniture and fittings MINISTRY OF HEALTH November 2012 Page 91

92 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 92

93 BUDGET SUB-PROGRAM SUMMARY PROGRAM 5: Health Sector Regulation SUB-PROGRAM SP 5.3: Regulation of Pharmaceutical and Medical Products 1. Budget Sub-Program Objective To ensure consumer safety through quality control of pharmaceutical and medical products 2. Budget Sub-Program Description This sub-program aims at ensuring consumer safety through testing, inspection and licensing of pharmaceuticals, medical products and herbal medicine. The main operations are: Licensing of pharmaceutical manufacturers. Ensure consumer safety through quality control of pharmaceutical products. Approval for import/sale of pharmaceutical products. Conducting medical and basic science research Production of safe, effective and quality herbal medicine. Analysis of herbal medicine for registration with FDB. Review of Essential Herbal Medicines List by Centre for Scientific Research into Plant Medicine. Provision of technical expertise in the cultivation and sustainable harvesting of medicinal plant. Advocate for provision of intellectual property rights for traditional medicines. Educational programs on tobacco use and drug abuse for the public. Strengthening post market surveillance. Inspection and monitoring of pharmacies and licensed chemical shops. Monitoring of pharmaceutical products in pharmacies and licensed chemical shops. Review of medicine classification by FDB. The organizations involved in the implementation of the sub-program are Food and Drugs Board, Pharmacy Council and Centre for Scientific Research into Plant Medicine. MINISTRY OF HEALTH November 2012 Page 93

94 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Main Outputs Medicinal products, medical devices and cosmetics and household chemicals meeting minimum requirements Pharmaceutical manufacturers licensed Import/sale of pharmaceutical products approved Output Indicator Percentage of products in current registration Percentage of reported product adverse reaction investigated Number of manufacturers licensed Number of products approved Past s Budget 2013 Projections Indicative 2014 Indicative Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Licensing of pharmaceutical manufacturers. Quality control of medical products Approval for import/sale of pharmaceutical products. Conducting medical and basic science research Projects (Investment) Procure vehicles (verify) Rehabilitation, construction and expansion of infrastructure Procure computers and accessories Monitor the production of safe, effective and quality herbal medicine. Review of Essential Herbal Medicines List by Centre for Scientific Research into Plant Medicine. Review of medicine classification by FDB Monitoring of pharmaceutical products in pharmacies and licensed chemical shops. MINISTRY OF HEALTH November 2012 Page 94

95 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 95

96 BUDGET SUB-PROGRAM SUMMARY PROGRAM 5: Health Sector Regulation SUB-PROGRAM SP 5.4: Regulation of Food and Non-Medical Health Products 1. Budget Sub-Program Objective To ensure consumer safety through quality control and licensing of food and non-medical products 2. Budget Sub-Program Description This sub-program is responsible for food safety management systems in food manufacturing industries and enforcement of relevant regulations and guidelines to ensure the quality, efficacy and safety of food and non-medical products for local market and for export. The operations involve are: Training and inspection of street vendors in the country. Inspection of institutional catering facilities (second cycle schools catering facilities and under the Ghana School Feeding Program). Sensitizing of stakeholders in food and non-medical product safety issues. Implementation of Good Manufacturing Practice principles in industries producing regulated products in line with international best practice. Ensure iodine fortification of salt. Strengthening post-market surveillance operations. Strengthening laboratory support systems for regulatory decisions. Approval for import/sale of food products. Licensing of manufacturing and production, sales and supplies facilities. Inspection and monitoring of food manufacturing industries. Publishing list of catering facilities issued with Food Hygiene Permit in the print media. The challenges faced by the Regulatory Agencies include: Inadequate comprehensive enabling legislation with regulations and supportive guidelines that applies to current environmental changes and political support. Inadequate resources human, logistical and financial, to enable the agencies execute its mandate. Lack of operational vehicles and equipment to monitor and enforce regulations. MINISTRY OF HEALTH November 2012 Page 96

97 3. Budget Sub-Program Results Statement The table indicates the main outputs, its indicators and projections by which the Ministry measures the performance of this sub-program. The past data indicates actual performance whilst the projections are the Ministry s estimate of future performance. Past s Projections Main Outputs To maintain quality and safety of food and non-medical products Licensing of manufacturing and production, sales and supplies facilities Inspection and monitoring of food manufacturing industries Output Indicator Number of health and food products certified Budget 2013 Indicative 2014 Indicative Number licensed Percentage covered Budget Sub-Program Operations and Projects The table lists the main Operations and Projects to be undertaken by the sub- program. Operations Licensing of manufacturing and production, sales and supplies facilities. Implementation of food safety management systems in food manufacturing industries Inspection and monitoring of food manufacturing industries Training and inspection of street vendors in the country. Projects (Investment) Procure Laboratory equipment Approval for import/sale of food products Publishing list of catering facilities issued with Food Hygiene Permit in the print media Ensure iodine fortification of salt Strengthening post-market surveillance activities MINISTRY OF HEALTH November 2012 Page 97

98 5. Budget Sub-Program Summary: Expenditure by Economic Classification Expenditure by Economic Classification Current Expenditure 21 Compensation of Employees 22 Use of Goods and Services 25 Subsidies 26 Grants 27 Social Benefits 28 Other Expenses Capital Expenditure 31 Non-Financial Assets Total Expenditure Actual Budget Est. Outturn Budget Indicative Indicative GH GH GH MINISTRY OF HEALTH November 2012 Page 98

99 PART C: FINANCIAL INFORMATION Annexure 1: Summary of Expenditure by Program, Economic Classification and Funding Source

100 Annexure 2: Expenditure by Program and Sub Program

101 Annexure 3: Expenditure by Project and Program MINISTRY OF HEALTH November 2012 Page 101

102 Annexure 4: Expenditure by Funding and Program MINISTRY OF HEALTH November 2012 Page 102

103 MINISTRY OF HEALTH November 2012 Page 103

104 Annexure 5: Expenditure by Program/Sub-Program and Economic Classification MINISTRY OF HEALTH November 2012 Page 104