News and Opinions  –  2018

Peter Yeboah - from rural Ghana to representing 41 organizations in 30 countries – engaging in antibiotic resistance

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Peter Yeboah, Chairman and Executive Director, is an optimist. He thinks recent experiences with epidemic outbreaks in Africa demonstrate that global health security lies in strengthening sub-Saharan African health systems. 

From working in rural Ghana to study health policy and public health in London and Amsterdam, he now is Chairman of the African Christian Health Association Platform, representing 41 network organizations in 30 countries. And he is Executive Director of the Christian Health Association of Ghana. He thinks faith based- and civil society organizations play an important role for action on antibiotic resistance.

Peter Yeboah is Chairman of African Christian Health Association Platform (ACHAP). The association represents 41 network organizations in 30 countries. He also is Executive Director of the Christian Health Association of Ghana (CHAG).

What motivated you to study public health and enter this field of work?

– After two decades of managing hospitals in rural Ghana, I realized that the pathway to sustainable and impactful health is investment in population health. I understood that a responsive and robust primary health care package is a universal public good, which could ensure avoidable morbidities and mortalities, and enhance life expectancy at birth in low- and middle income-countries.

– I also felt that the quality of lives and livelihoods are effects/products of feasible health policy and practice. Hence, my professional reorientation and interest in public health and health policy.

Could you give us some background on the work of the African Christian Health Association Platform (ACHAP) on antimicrobial resistance and access to antibiotics?

– Being the prime and largest non-state actor in health, ACHAP network members prescribe large volumes of antibiotics to be consumed by our targeted patients of more than half-a-billion people in sub-Saharan Africa. Naturally, therefore, ACHAP should be, and has been, a major stakeholder in addressing the issue of antimicrobial resistance and access to antibiotics.

“Faith-based health providers and civil society organizations could contribute to addressing antimicrobial resistance”, says Peter Yeboah.

In your opinion, what is the role of civil society organizations and faith based organizations in the effort to address antimicrobial resistance?

– Faith-based health providers and civil society organizations serve significant proportions of many countries in the African region – ranging from 30-70%. By extension, the existing structures and interventions by faith-based health providers and civil society organizations, if properly harnessed, could potentially contribute to addressing 30-70% of the antimicrobial resistance situation. Specifically, faith-based health providers and civil society organizations could contribute to addressing antimicrobial resistance.

– We can do this through:

  • Education –  targeting clients, communities, churches and inter-faith platforms.
  • Service provision – ensuring the provision of quality healthcare in amongst faith-based health providers.
  • Training – health personnel working with faith-based health providers on hand hygiene, hospital acquired infections etc. This would include awareness to improve attitudes, knowledge and practices on antimicrobial resistance.
  • Functional committees – enhancing the work of drug and therapeutic committees, infection prevention committees to enforce adherence to standard operating procedures.
  • Establishing incentives and sanctions for antimicrobial resistance practices.

What motivates you in your work as Chairman for ACHAP and as Executive Director for CHAG?

– The ACHAP network is functional in 30 sub-Saharan African countries with 41 network organizations. Together, we have access to over half-a-billion catchment population who are direct and indirect beneficiaries of ACHAP’s health services.

– Together, ACHAP members provide 30-70% of health services in sub-Saharan Africa. In fact, in fragile settings such as Democratic Republic of the Congo, Sierra Leone, Liberia, South Sudan, faith-based health providers contribute about 70-80% of national health output. Intuitively, therefore, the ACHAP network represents an enormous implementing resource for attaining universal health coverage in terms of ensuring equitable access to quality health service provision to millions of people especially the deprived, vulnerable and marginalized segments of the world’s population.

– Hence, I am always motivated by the prospects and potentials of contributing significantly to global health security by enhancing the capacity, the role and contributions of ACHAP at all levels.

What are you most proud of in regard what you have accomplished in your role at ACHAP so far?

– At the risk of sounding self-promotional, and perhaps uncharacteristic of a faith-based health providers, permit me to cross our self-imposed recluse from public view despite our numerous  widely acknowledged contributions to global health.

– First, ACHAP’s visibility, role, contributions and prospects as a major stakeholder, champion and advocate of primary health care and universal health coverage has been recognized by many development partners and actors in health.

– Secondly, ACHAP is being repositioned as an indispensable development partner in sub-Saharan Africa regarding matters of health and healing as well as partnerships for socio-economic development for improving lives and livelihoods.

– I believe that ACHAP’s scale and scope, capacity and capabilities for high population impact health services provision is awaiting to be explored or optimized for the sake of global health security.

Why is it so important that civil society organizations and faith-based organizations engage in this effort? What assets do they bring to the table that other stakeholders lack?

− Faith-based health providers and civil society organizations have several leverages, competencies and capacities, which could be explored:

  • They have access to four safe public spaces and constituents: church, schools, health facilities and inter-faith platforms.
  • Their leadership have unquestioned authority and captive audience.
  • Accountable and transparency systems in terms of declaration of intent, results of projects, prudent financial management and optimal utilization of resources.
  • Stewardship and longevity of organizational structures that ensure sustainable programmes and projects.
  • They control a significant portion of patient population.
  • Possess technical competencies in advocacy and skill training.
  • They have social resources and social capital-trust, community reach and mobilization and perceived quality of service delivery amongst others.

How do you reason around access and antibiotic resistance – how can we get antibiotics out to those who need them while at the same time making sure they are not used in the wrong way?

– Antibiotics are prescription-only drugs. In many communities, people are getting antibiotics without prescriptions. Chemical shops that should not stock antibiotics are doing so. Meanwhile, personnel in these shops do not have the requisite capacity to educate clients on antibiotic use, side effects and possible. Funding of facilities from insurance is mostly delayed. As a mitigation measure, some facilities do not stock essential medicines including antibiotics. This situation leaves clients to purchase antibiotics from the open market most of which do not have appropriate storage conditions. Again, some antibiotics in the open market are expensive. So clients are unable to access due to high cost. Some may resort to herbal medicines.

– In addressing antimicrobial resistance comprehensively, the following interventions are suggestive:

  • Restricting antibiotics prescription and dispensing only to hospital and community pharmacies.
  • Enforcing regulation on access to antibiotics.
  • Improving funding to health facilities to ensure that essential antibiotics are stored at the facilities.
  • Insituting local drug formularly in ACHAP facilities.
  • Regular stock taking and time procurement to prevent stockout of medicines.
  • Formation and support for drug and therapeutic committies (DTCs) & infection prevention & control committees.
  • Provision of appropriate storage conditions for antibiotics to preserve efficacy.
  • Sustained education of clients on antibiotics use particularly at the point of dispensing.

–  Ultimately, addressing antimicrobial resistance require attention to policy and practices which affect the supply and demand issues associated with antibiotics availability, accessibility, affordability and acceptability in all instances.

What would you like to accomplish in the future?

– I have been, and still remain, an optimist. Recent experience with epidemic outbreaks in Africa demonstrate that global health security lies in strengthening sub-Saharan African health systems. I think we need to enhance ACHAP’s capacity, responsiveness and resilience for the sake of global public health. Coming at the heels of the 40th Anniversary celebratory conference in Astana-Kazakhstan,  FBHPs, who were co-creators of PHC in 1978,  at the country levels must be recognized and actively supported to deliver comprehensive holistic health services (preventive, promotive, curative, rehabilitative, palliative) in the communities they serve.

– So in the years ahead, ACHAP looks forward to promoting effective partnerships with all stakeholders interested and committed to re-igniting public health care and efforts towards achieving universal health coverage by 2030. I believe antimicrobial resistance should be an integral part of public health care given its effects and significance as a global public health issue. So ACHAP intends to be a champion and advocate for antimicrobial resistance in the ensuing years in all its fora and platforms. May I use this opportunity to invite ReAct to the upcoming ACHAP Biennial Conference to be held in Yaounde-Cameroon in February 25 to March 1,2019?

What do you like to do in your spare time?

– I explore geo-politics, read about current trends in global diplomatic relations, play country music, watch investigative movies, amongst others.