Urban Growth and Access to Health Facilities in Accra Metropolitan Area

Abstract

Ghana, for the last two decades, has been experiencing tremendous surge in urbanization. It is an over simplification to assert that even though in terms of proportions the country is still predominantly rural, its very large total population make the urban proportion sizeable. This apparent large urban population living in urban centres of various sizes have put a tremendous stress on the physical and social infrastructural facilities o f these centres. The stress is even precarious in the country’s biggest metropolitan and national capital, Accra, which has attracted the bulk of the migrants from the rural areas who have been thrown into the city in search o f non-existent white collar jobs. This over-crowding coupled with inadequate and undeveloped infrastructural facilities have resulted in a precarious health situation, especially for the urban poor. The health care delivery system of the country, to a large extent, has not been specially designed to handle the situation in the urban areas. It has been developed as a national system ignoring the urban-rural differences in the health care demand pattern. Unfortunately, empirical work to provide information of the extent to which the limited health facilities within the city are being used by the total urban population is lacking. For the government to achieve its health policy as enshrined in the Ghana Vision 2020 policy such information is indispensable. For this deficiency, this study attempts to examine the utilization of health facilities within the Accra Metropolitan Area (A.MA.) by preparing an inventory of the various health facilities within each of the submetropolitan areas. In order words, attempts are hereby made to determine some of the factors that inhibit access to proper medicare within the metropolitan area. Among the variables that have been investigated as factors influencing the utilization of health facilities, income, education and distance have been found to be most significant. In the case of traditional health facilities, it was particularly realised that utilization has to be looked at in the light of the health care beliefs of the people and the feet that services are generally considered to be more sociable, quick and inexpensive. This study recommends, among others, the education of the populace to keep to proper environmental sanitation practices as a penacea to the present health problems within the city. More importantly therefore, prevention as against curative health care delivery is being advocated as a way to circumvent the present health hazards feeing the city and the country in general It is hoped that the study will serve as a ‘spring board’ for further detailed research and thus provide the necessary information needed for the proper planning and management of health related problems within AM. A.