Ghana: Will health project ‘Agenda 111’ come to fruition despite delays, weak economy?

By Nii Larte Lartey
Posted on Wednesday, 20 April 2022 12:02

Image with caption: Agenda 111 Hospital Projects. Commencement of works 17 August 2021 (Facebook)
Image with caption: Agenda 111 Hospital Projects. Commencement of works 17 August 2021 (Facebook)

What started out as a political promise at the height of the pandemic could soon be launched as Ghana's largest health infrastructure project. The government has committed $1.76bn to the construction and refurbishment of 111 health facilities.

The project, known as ‘Agenda 111’, was initiated to cover 88 districts that had no dedicated hospitals. The timeline has however been pushed back three times and analysts are worried about the impact that this could have on Ghana’s already fragile economy.

Meanwhile, the country has received global praise for its handling of the Covid-19 pandemic despite its ailing health system. The government is hoping that these new health projects will help the country live up to its reputation for competence in the sector.

Each new facility will cost $16.88m: nearly 13m will go into construction, while the remaining $4m has been allocated to medical equipment. Ghana expects to create some 33,900 jobs for construction workers and to employ 34,300 for health workers upon completion of the project.

The government is also seeking to attract medical tourists, with Nigerian patients – who currently fly to London for treatment – targeted as potential clients.

Overly ambitious?

The designs for the project, which was launched in August 2021, have already been validated. However, the 18-month timeline looks unachievable with each passing day, raising concerns about the government’s commitment.

“If I’m unable to tell you the commencement date, I will not be able to tell you the exact date of completion as well,” Health Minister Kwaku Agyemang Manu told Parliament in his response to questions from the opposition.

If you say you want to build new hospitals, who [is] going to man them? Are they done matching the new hospitals to the old ones?

“Our health infrastructure deficit is real. The delays are unfortunate. We don’t [know] fully the factors, but we hope it’s done. Our concern is the political transition where projects never get completed,” Titus Beyuo of the Ghana Medical Association tells The Africa Report. He also cites the lack of emphasis on training medical specialists.

“Let’s look at pragmatic realities. These projects are not going to come in the next year or two. We are missing the point. Let’s make sure we are spending money on an immediate priority. We have to be practical and prioritise,” says Nana Kofi Quakyi, a public health researcher.

Policy interventions struggle to gain purchase

Ghana lost $5.8m to abandoned and delayed projects, according to the 2020 ‘Auditor-General Report’.

The government is also struggling with major policy interventions for education, agriculture and job creation. Experts have proposed a review of the initiatives to reduce expenditure, but the government says it is not rolling back on key policies despite the weakening economy.

Ghana’s financial managers are currently grappling with a depreciating currency, large debt stock, high inflation, and rising food and fuel prices.

Analysts suggest limiting the scope of the project to avoid being spread too thin, but the government refuses, stating that work has already begun at 87 out of 111 sites.

“Our biggest issue should be financing for service delivery. If we have any money that is where we need to spend it. If you say you want to build new hospitals, who are going to man them? Are they done matching the new hospitals to the old ones? That is not what we need,” says health economist Gordon Abeka Nkrumah.

Political impact

Given the current economic challenges, President Nana Akufo-Addo has pushed completion of the project to 2025, when his tenure will be coming to an end.

“Like all major construction projects, it is evident that the initial schedule we gave for the completion of the ‘Agenda 111’ was overly ambitious, but we have every intention of seeing this project through to a successful end before I leave office on 7 January 7,” said Akufo-Addo.

Does this mean the government is using the completion of this project as a way to fulfil a major promise before the next general elections?

“This project was promised, but it hasn’t materialised. It is a flagship project. There [are] high expectation[s]. If [the] government fails to deliver, it will be catastrophic,” Kobby Mensah, a political analyst, tells The Africa Report.

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