There have been sporadic strikes by health workers across Ghana. Although most reasons rest on pay issues, a deeper level reveals schism between Ghanaian traditional medicine and the formal orthodox medicine. This has been a recurring matter in most part of Ghana’s 50-year existence as economic conditions worsen. While public health workers deserve good pay, like other professionals, their problems are increasingly being worsened by mounting health problems. This calls for sober and holistic reflection of the entire Ghanaian healthcare delivery system.

The burden on public healthcare delivery system in Ghana will be made lighter if traditional medicine, of which 80 per cent of Ghanaians access, is further integrated into the healthcare system as Indians and Chinese have done. This will give value to the increasing call by international health experts for more “focus on primary health care” that will “enable people to increase control over the decisions affecting their health through primary health programs that link with community development or empowerment,” as Dr. Gretchen Roedde of the University of Ottawa’s Medical School, told an international health conference in Ottawa recently.

The world is confronted with severe shortages of health workers, especially in the poor countries (WHO reports that sub-Sahara Africa alone needs about 1 million health workers), yet a large number of traditional health workers wait to be refined and integrated into the formal healthcare system. The long-running notion that traditional medicine is backward should be debunked. Dr. Ibrahim Samba, World Health Organization (WHO)’s Africa Regional Director, explains that even though African traditional medicine has often been stigmatized as a backward practice, it has continued to thrive because it is culturally accepted and accessible to more than 80 per cent of Africans.

Such attempts to correct the historical wrongs against Ghanaian/African traditional medicine come in the face of growing world-wide use of traditional medicine. The World Bank, WHO and other agencies report that in Europe, North America and other industrialized regions, over 50 per cent of the population have used traditional medicine at least once. In San Francisco, London and South Africa, 75 per cent of people living with HIV/AIDS use TM/CAM. Seventy per cent of Canadians have used complementary medicine at least once. In the United States, 158 million of the adult population use complementary medicines and according to the USA Commission for Alternative and Complementary medicines, US$17 billion was spent on traditional remedies in 2000. The global market for herbal medicines currently stands at over US$60 billion annually and is growing steadily.

It is estimated that 70 percent of Ghanaians depend solely on the health care provided by approximately 45,000 traditional healers, most of who are recognized and licensed through various associations that fall under the nationally mandated Ghana Federation of Traditional Medicine Practitioners’ Association. Ghana has passed several decrees to regulate and ensure the safety of traditional medical practices such as homeopathy, naturopathy, and osteopathy among others.

One key attempt to integrate traditional medicine into Ghana’s health care system is decentralization. In line with changing attitudes towards democratic governance, international inclinations favour decentralization in support of primary health care, of which traditional medicine should be its key driver. In Ghana, as in other African states, decentralization of the health care system is in response to poor economic conditions, poor logistics, and reduced public finance for health services. In the U.N Human Development Index, which measures the well-being of nations world-wide, Ghana is ranked 136^th out of 177 countries ranked in 2006. This means Ghana is not doing well as it’s demographic, socioeconomic and health statistics reveal, worsened by frequent strikes by its 51, 910 health workers.

Though PNDC Law 207 (1988) provided the framework for decentralization of Ghana’s healthcare system, it failed to formally integrate traditional medicine into the system, especially at the local levels. The law transferred wide ranging functions, powers and responsibilities to District Assemblies that did not include traditional institutions in the broader sense of Ghana’s development process. Though it aimed at enhancing efficiency and responsiveness to local health needs by shifting some of the burden of financing health care from the public sector to the beneficiaries and also shifting some decision-making from central planning agencies to those in closer touch with local conditions and user needs, traditional medicine was left out as an integrated scheme.

In heavily rural-based population, traditional healers/workers are the only source of health services for majority of Ghanaians/Africans and in most cases; they are the preferred source of health care. In Ghana, every 1 traditional healer attends to 200 patients, while 1 doctor attends to 20,000 patients, according to Erick Gbodossou and associates. The traditional healer has more time to attend to his/her patients than the orthodox doctor. It is estimated that over 85 per cent of sub-Saharan Africans access their health education and health care from traditional healers. Traditional practitioners who far outnumber modern health care practitioners, are culturally accepted and respected, and more universally located.

Indications from demographic, socioeconomic and health statistics demonstrate that Ghana’s health care delivery problems could be alleviated by integrating traditional medicine healers and workers into the health care delivery system. Health Minister, Courage Quashigah and his bureaucrats may be attuned to this but more is needed in this direction.