Improved Capacity in Social Services
UNDAF Thematic Area 3 – Human Development and Productive Capacity for Improved Social Services – targets significantly expanding the capacity in the social sectors to increase access to, and utilisation of, high impact health and nutrition, educational, social protection, and HIV and AIDS programmes and services, including reaching disadvantaged groups. This goal is anchored in the section on human development, productivity and employment of the Ghana Shared Growth and Development Agenda (GSGDA I and II) for 2010-2013 and 2014-2017 respectively.
In 2014-15, Ghana sustained improvement in social sector programmes that contributed considerably to the progress made towards the MDG targets related to universal primary education (MDG 2); gender parity (MDG 3) in primary school attendance; significant reduction in HIV prevalence (MDG 6), to 1.3% by 2014; and halving of the proportion of people suffering from hunger. However, slower progress was made towards MDG targets related to reducing infant and child mortality (MDG 4), and cutting maternal mortality (MDG 5).
The mixed record on achievements appears to be largely related to accumulating funding deficits, persistent inequalities in access to and quality of services (by wealth quintile, rural-urban residence, region and gender), and inefficiencies in the deployment and management of available resources for major pro-poor interventions like the National Health Insurance Scheme (NHIS). Per capita total expenditure on health which peaked at $85 in 2013 has since declined to $58 in 2014 (World Bank data).
Proper diagnosis and community-based simplified case management of pneumonia, diarrhoea and malaria has significantly reduced deaths in children. Preventive measures like provision of safe drinking water, improvement of sanitation, distribution of insecticide treated nets, introduction of rota viral and pneumococcal vaccinations, Vitamin A supplementation, and community-based management of acute malnutrition and improvement in infant and young child feeding have contributed to the survival and healthy growth of young children.
Despite a decline in HIV prevalence, challenges remain regarding sustainability of treatment programmes and complacency among young people about protection.
The proportion of the health sector's budget for goods and services funded by the central government has also been falling from 12% in 2014 to 6% in 2015. This budgetary contraction is negatively affecting service delivery: Arrears in the National Health Insurance Scheme to its providers is consistently in excess of a six-months.
Scaling-up of Maternal, Newborn and Child Health (MNCH) services has stalled, particularly at district level. Investments are constrained in community-based health planning services and related primary health-care infrastructure and systems. Persistent industrial actions by public sector health workers, especially doctors, nurses and pharmacists, over payment arrears and working conditions have had a negative impact on health service delivery.
In the area of improving capacity in social services, UN Ghana aims to achieve the following results:
Maternal and Child Health (UNDAF Outcome 6)
- Strengthened capacity of health care providers in deprived Northern regions in areas of maternal and child health services
- Improved coverage of nutrition interventions at community level
- Improved availability of family planning services
- Harmonised systems for data collection and management
- Improved MNCH policy implementation capabilities
Social Services (UNDAF Outcome 7)
- Expanded access to social services by disadvantaged and vulnerable groups
- Operationalisation of a strengthened National Social Protection Policy
- More effective provision of key social services by providers, reaching the poorest and most vulnerable groups
HIV/AIDS (UNDAF Outcome 8)
- Implementation of National Strategic Plans for HIV and AIDS
- Effective strategies target most at risk populations
- Full respect for the rights of persons with or affected by HIV/AIDS
- Greater capacity of health care providers to expand outreach of effective HIV support services
Education (UNDAF Outcome 9)
- Achievements towards MDG on equal access to primary education equally for boys and girls
- Extension of appropriate education and support services to most vulnerable groups of children
- Improved quality of education