GHS Governance System

Ministry of Health (MOH)

The tenets of Act 525 (1996) that established the Ghana Health Service and Teaching Hospitals make the Ministry of Health (MOH) and the Divisions therein responsible for policy formulation, resource mobilization, allocation, and monitoring. The GHS as an agency of MOH is charged to implement approved health sector polices in such a manner as to ensure access to priority health interventions and to manage prudently resources available for provision of health services.

The MOH oversees the health sector in Ghana. It provides overall leadership and direction to the health sector and coordinates implementation of the Health Sector Medium Term Development Plan and Programme of Work to ensure achievement of the health sector objectives. The Ministry achieves its aims through policy formulation, standards setting, (acquisition for) resource mobilisation and monitoring and evaluating sector performance.

As a sector agency, the GHS executes the MOH’s policies, submit plans and budgets and periodic returns and performance reports to the MOH. Other means by which the Ministry exercises oversight responsibility over GHS include representation on GHS Council, performance agreements, meetings and reviews, monitoring and evaluations and internal controls.

Ghana Health Service Council

GHS is governed by a Council, the membership of which is appointed in line with the provisions of the Act (GHS & THs Act, 1996, Act 525) that sets up the Service. The Council under its chairman is responsible for directing and controlling the affairs of GHS.

Functions of the Council

  • Ensuring the implementation of the functions of the Service
  • Submitting to the Minister recommendation for health care delivery policies and programmes
  • Promoting collaboration between the Ministry of
  • Health, Teaching Hospitals and the Service
  • Advising the Minister on the qualification for posts in the Service and other matters that the Minister may request

GHS Council Committees

  • Human Resource Committee
  • Disciplinary & Welfare Committee
  • Finance & Budget Committee
  • Audit Committee
  • GHS Executives (Management)

1. National (Headquarters) Level

The Chief Executive Officer or the Executive Head of GHS is the Director General who serves as an Ex-officio member of the Council. The Director General leads and manages the Service and is responsible for the direction of the work as well as the day-to-day administration of the Service. Exercise of authority and responsibilities by the Director is derived from and consistent with Sections 3 & 11 of the Ghana Health Service and Teaching Hospitals Act, 1996 (Act 525) as well as authority and responsibilities delegated by the immediate superiors (GHS Council and MOH). In running the affairs of Service, the Director General is assisted by the Deputy Director General (DDG).

The National level has 11 Divisions, which are as follows:

  • Public Health (PHD)
  • Institutional Care (ICD)
  • Policy Planning, Monitoring and Evaluation (PPME)
  • Family Health (FHD)
  • Health Administration and Support Services (HASS)
  • Human Resource Development (HRD)
  • Research and Development (RDD)
  • Finance (FD)
  • Stores, Supplies and Drug Management (SSDM)
  • Internal Audit (IAD)
  • Health Promotion Division (HPD)

Each Division is headed by a Divisional Director who reports directly to the Director General. The Directors supervise all the activities of their Divisions and the Director General oversees all the activities of the Divisions of the Service including the regions.

2. Regional level

The Regional Health Directorates (RHDs) represent the administrative apex of health services delivery at the sub-national level. The RHDs are headed by the Regional Directors of Health Service and they report directly to the Director General just like the Divisional Directors at the headquarters. The RHDs champion the implementation of health policies formulated by the MOH for implementation by GHS at the regional level.

The RHDs are sub-divided into Departments as follows:

  • Regional Public Health Department
  • Regional Clinical Care Department
  • Regional Health Administration and Support Services Department
  • Finance Department

The Departments at the RHDs are headed by Deputy Directors who report directly to the Regional Health Directors. They have technical liaisons with their Headquarters Divisions.

The Act that sets up the Service provides for the setting up of bodies known as Regional Health Committees. The Regional Health Committees do not have executive powers like the GHS Council. They are purely advisory bodies to support the Regional Directors.

3. District Level

District Health Directorates (DHDs) are established in each District of the regions. The DHDs provide leadership, supervision, management and technical support to their sub-districts. The DHDs are headed by the District Directors of Health Service (DDHS), who report directly to the Regional Directors of Health Service (RDHS). The DDHS are the representatives of the DG in the Districts and champion the implementation of health policies and programmes of GHS in the districts.

The Office of the DDHS is supported by the following Units:

  • Public Health Unit
  • Clinical Care Unit
  • Administration Unit
  • Finance Unit

At the District level, the Ghana Health Service and Teaching Hospital Act, 1996 (Act 525) provides for the setting up of District Health Committees which also play advisory role at the District level.

Key Stakeholders of Ghana Health Service

In executing its mandate, the Service engages with a number of internal and external stakeholders that contribute to its outcomes. The stakeholders include: Workers’ Unions, Professional and Managerial Groupings in the health sector, other Agencies of Ministry of Health, other Ministries, Departments and Agencies, Development Partners, Regional Coordinating Councils, District Assemblies and Traditional Authorities.

The Unions, Professional and Managerial Groupings include Health Service Workers Union (HSWU), Ghana Medical Association (GMA), Ghana Registered Nurses Association (GRNA), Ghana Registered Midwives Association (GRMA), Ghana Hospital Pharmacists Association (GHOSPA), Association of Health Services Administrators, Ghana (AHSAG), Health Accounting Staff Association of Ghana (HASAG), Allied Health Professionals Association, Physician Assistant Association, Ghana Association of Certified Registered Anaesthetists (GACRA), District Health Directors and Medical Superintendent Groups etc. These unions and groupings are critical for the implementation of the mandate of the Service. The leadership of the groups play important roles in ensuring harmony on the industrial front and also keeping members in check when there are breaches of the code of conduct of the Service.

Other agencies of MOH includes the Teachings Hospitals, National Blood Transfusion Service, Mental Health Authority, Health Facilities Regulatory Authority (HeFRA), National Health Insurance Authority (NHIA), National Health Training Institutions and other service delivery institutions such as, Christian Health Association of Ghana (CHAG), Quasi Government Hospitals, Police and Military Hospitals and Private Health Institutions. Collaborations with the agencies and the institutions are mainly through clinical and public health activities. The linkages involve sharing information, joint technical working groups, joint priority setting and implementation of common objectives such as planning, policy formulation, programme implementation as well as monitoring and evaluation. The linkages are also manifested in the referral systems.

he Regional Coordinating Councils, which are headed by Regional Ministers are the highest administrative and political bodies charged under the laws of Ghana with ensuring the socio-economic development of the Regions. They formally engage development partners through the government machinery and provide leadership, and direction to contribute to the improvement of the health status of the people, and the socio-economic development of the regions.The district assemblies have in line with the decentralization policies of the country been the main supporters of the health system through the provision of infrastructure, financial and other resources for human resource development, community mobilization, and providing oversight responsibility for health as a social service in each district.The mobilization of communities for participation in health-related activities is carried out by the leadership of the communities with chiefs at the helm of affairs. The eventual release of land to the Service and its partners for construction of health-related infrastructure is the sole prerogative of the chiefs, or the leaders of clans to which land belongs.