By 
The Christian Health Association of Ghana (CHAG) is advocating for the integration and nationwide implementation of the SafeCare quality improvement program within Ghana’s healthcare delivery system.
Executive Director of the Christian Health Association of Ghana (CHAG), Dr Peter Yeboah, who made the call for the adoption of the SafeCare quality improvement methods, said the SafeCare methodology has been tested in all the CHAG facilities in Ghana and is an effective standard for measuring quality care.
Dr Yeboah emphasised the need for the scale-up of the QI program. “Before piloting SafeCare, quality health delivery was aspirational in CHAG, but now, there is a paradigm shift because SafeCare is an intentional, focused, and scientific way of measuring, rating, and benchmarking the state of quality of service and using effective interventions to improve the gaps identified,” he said.
He emphasized that the provision of quality care is a fundamental objective of every health policy and should serve as the cornerstone of health services. “Without quality, the unintended consequences of providing health services could be fatal.”
He underscored that quality, as facilitated by SafeCare, represents a value proposition for the entire health sector. Quality healthcare, he stressed, should stand as a focal point in all the endeavors of healthcare providers, working towards the achievement of Universal Health Coverage goals.
As Ghana endeavors to reach the United Nations’ goal of attaining Universal Health Coverage by 2030, outlined in the Sustainable Development Goals, stakeholders highlight the importance of healthcare quality.
Dr. Yeboah argues that linking NHIS claims to the quality of healthcare provided by service providers will, in the long run, stimulate enhancements in quality standards within hospitals nationwide.
“We have to move SafeCare from organization to nationalization so that the entire country will benefit from this scientific way of measuring, rating, ranking, and benchmarking the quality of healthcare provisions in institutions.”
“The value proposition that SafeCare provides is self-marketing, embracing all the efforts and commitment of key actors, policymakers, professionals, providers, patients, the public, and, most importantly, we are looking at how the payer, the National Health Insurance (NHIS), would also embrace SafeCare as an essential tool for assessing the quality of healthcare provided by the public to its insured members. SafeCare should ultimately become that value-based instrument for assessing the value aspect of reimbursed services; that is what CHAG is all about.”
In Low and Middle-Income Countries (LMICs), it is estimated that poor-quality care results in approximately 5 million deaths annually—surpassing the number of deaths attributed to inadequate access to care, which stands at 3.6 million, as reported by the Lancet Global Health Commission.
Despite this, the paramount importance of quality is not adequately acknowledged and valued in the worldwide conversation on universal health coverage (UHC). A crucial step is enhancing the measurement of health system quality.
SafeCare presents a distinctive standards-based method for evaluating and enhancing the quality of healthcare services in resource-limited settings. Since 2019, PharmAccess Ghana, in partnership with CHAG, has been applying the SafeCare standards and quality improvement methodology to fortify healthcare systems within the CHAG network.
Under this collaboration, PharmAccess uses its SafeCare standards to assess, rate and benchmark the quality of all the network’s healthcare facilities.
Moreover, the program aids in capacity building, skill enhancement, and promotes the advancement of healthcare delivery quality across CHAG facilities nationwide.
Bonifacia Benefo Agyei, the Director for SafeCare Ghana, emphasized the program’s dedication to enhancing the benchmarks of healthcare delivery.
The SafeCare Director noted that SafeCare saves lives by improving health outcomes and reducing risks, and it also improves efficiency in the operations of healthcare facilities.
She added that some healthcare facilities’ managers have adopted the SafeCare standards as a guide to run the operational systems of their hospitals and clinics. “It is time to make quality a culture in all health systems in Ghana.”
Referring to the Lancet Commission’s article on mortality due to low-quality health systems, Bonifacia Benefo Agyei commented that “it means that you are even better off if you do not have access to healthcare than to have access but to poor quality of care. That is not acceptable; we think we should be able to change that narrative through the implementation of the SafeCare quality improvement programme.”
In the upcoming phase of the program, PharmAccess Ghana collaborates with CHAG to integrate and institutionalize the SafeCare quality program within the CHAG system. The aim is for CHAG to independently manage the program without external donor support, fostering a culture of quality. Additionally, discussions are underway with the Ghana Health Service to extend the integration of SafeCare methods to the entire healthcare delivery system in Ghana.
“The Ghana Health Service is also coming on board to make the SafeCare-supported quality improvement program a national initiative. We are looking forward to a future where quality becomes a culture and the norm in our healthcare system; we don’t have to beg for quality.” She added.
Dr. Maxwell Antwi, the Country Director for PharmAccess, said healthcare facilities should become safe nets for everyone who needs healthcare irrespective of who they are in society.
He explained that SafeCare does not only let health facilities know and acknowledge the gaps in their healthcare delivery systems, but it also provides guidance and standards to fix and improve the operations of the hospitals, clinics, and other facilities according to internationally certified standards.
“What we are doing with CHAG is driving equity and access to health, not only for the rich and famous but for the ordinary Ghanaian. “One of the lessons we have gathered is that quality improvements save more lives than access to care because more people live if they have quality care than if they don’t have the care at all,” Dr Antwi explained.
He said the Ghana Health Service has launched the Ghana Network of Practice through the leadership of the Director General, Dr Patrick Kuma–Aboagye.
Dr Antwi noted that SafeCare is to be the quality improvement programme for the network of practice.
With the Ghana Health Service gradually adopting SafeCare, there is a collective anticipation of a future where the pursuit of quality healthcare is not a plea but an inherent aspect of the nation’s healthcare ethos.
The journey towards quality healthcare for all is an ongoing endeavour, and these collaborative efforts are instrumental in forging a path towards a healthier and more resilient nation.
