Preparing Health Systems for a Critical Transition

In Ghana, the growing wealth of citizens is hailed as a sign of progress. But the country’s economic success is also bringing on new threats to public health.

It’s a challenge faced by many historically low-income countries. As average incomes rise, they lose eligibility for various forms of health-related aid. If the country’s own health system isn’t prepared to fill the gaps, hard-earned health gains can be lost, and vaccine-preventable diseases such as malaria and AIDS can come roaring back.

Osondu Ogbuoji, deputy director of DGHI’s Center for Policy Impact in Global Health, is part of a team trying to keep that from happening. He is leading a project funded by the Bill & Melinda Gates Foundation that focuses on six countries – Ghana, Sri Lanka, Kenya, Nigeria, India and Myanmar – that are facing such transitions. The center is working alongside in-country policymakers to design and implement new approaches to health policy, financing and service that can help them navigate the path away from donor funding.

Ogbuoji began his career as a physician in his native Nigeria, but he was dogged by the feeling that simple policy changes could do so much more to expand access to healthcare. While working on policy may not provide the immediate gratification of providing hands-on care, he hasn’t regretted shifting gears. “You know it’s going to have long-lasting effects,” he says.

Now his focus is on big-picture dynamics that will change the nature of problems healthcare workers may have to confront. All six countries in the study are experiencing changes in disease patterns, with higher rates of non-communicable diseases like diabetes and high blood pressure. Most have large adolescent populations, but are also seeing increases in elderly and immigrant communities.

For policymakers in Ghana, these factors all point toward complex questions: How does the health service need to adapt, and importantly, “what’s the bill the government should be ready to pick up?” asks Ogbuoji. Helping countries answer these questions, he says, is a critical step toward navigating the transition to self-sufficiency.