The Medical Assistant is a middle level cadre in health service workforce with a level of training apt and appropriate for the basic and essential health care needs of the people of Ghana. Though with less emphasis on high levels of technical sophistication, the Medical Assistants Training Programme turns out grandaunts with high level of expertise and skills less expensive in scope of operation, economic in cost and yet efficient in quality. Blending the components of curative (clinical) preventive, promotional (public health) and administrative services, the Medical Assistant is nonetheless a very versatile health human resource and epitomizes efficiency in human resource crises. The Medical Assistant provides services in Rural Health settings, Urban Health Centres and sometimes augments staffing levels when shortage in higher professional cadres is marked as in District Hospitals and Polyclinics. Nevertheless, the cadre has responsibility for the health of 70%of the Ghanaian population.
The Medical Assistant has a lead role in operations of the Sub District Health systems, the functional unit of Health Care Delivery and Health policy dissemination. The Medical Assistant is ultimately the pillar from which the Ghana Health Service derives its strength. Given the gap between the essential health needs of the Ghanaian and the availability of higher level professionals, the Medical Assistants Programme plays a mitigating role in the provision of Health Care and may continue to do so for a long time with the unending crisis in higher level manpower.
It is quite evident and goes without gain saying, that the vast majority of the population needs just the basic essential Health Care needs the Medical Assistant provides with those needing higher levels of sophisticated professional care in the minority. The need to fine tune and broaden the scope of operation of this workforce by way of capacity building is paramount and could be a very cost effective attempt at addressing the crisis in technical manpower.
HISTORIC BACKGROUND OF THE MEDICAL ASSISTANTTS PROGRAMME
Long before the establishment of the Rural Health Training School for the training of Medical Assistants in 1969, the need for this level of health cadre had been dire in all respects. Attempts at giving birth to this level of human resource had been many and coming under different nomenclature at every given time. Before 1960 there had been a silent attempt at the programme until it moved from Saltpond in the Central Region to Kintampo in 1960 under Mr. J.E. Kwofie as the training officer. This programme moved in with the name Health Centre Superintendents as a formal start. In 1962, the Health Centre Superintendent Training School was moved to Kpando in the Volta Region only to return to Kintampo the same year, with six referred students. As the need for this level of human resource increased, a six month training programme was introduced to increase the turn out in 1965 under the name Health Post Assistant.
In order not to compromise quality in the quest for quantity, the health centre superintendents training was reintroduced in 1968. As the importance of this programme gained prominence all over the country, the need to solidify the gains made, led to the establishment of the Rural Health Training School in Kintampo in 1969. Mr. S.K Hagan was appointed training officer under the supervision of Dr. N.F Hammond Quaye, a senior medical officer. Mr. C.K Fosu, a Health Centre Superintendent replaced Mr. Hagan in 1973. In 1977 Dr. Otoo assumed duties as the senior medical officer in charge.
As the name Health Centre Superintendent was conflicting with the title “Medical Superintendent” as the leader of the Medical hierarchy in the hospital setting, the name was changed to “MEDICAL ASSISTANT” IN 1978. Mr. G.G Agbenyekey assumed duty as the administrator of the school assisted by Mr. G.K Boso, a medical assistant who replaced Mr. C.K Fosu as course coordinator for the programme. Dr. Okwabi and Asare took charge in 1981 and 1985 respectively.
In 1989 Dr.Sam Akor was appointed the first director of Rural Health Training School. Dr. Emmanuel Teye Adzase replaced Dr. Akor in 2000 as the new director. Under his directorate the school and for that matter the Medical Assistants Programme has risen to an Advanced Diploma in Community Medicine.
The current programme expansion ongoing, seeks to add impetus to the training agenda. The training of Community Oral Health Officers offers diversity in the agenda. A degree programme in Psychiatry is in the offing, (Medical Assistant Psychiatry) for practicing Medical Assistants.
Training at eh degree level for other specialty areas is to begin soon, for Trauma, Dermatology and Pediatrics, also for practicing Medical Assistants. Presently, there are two streams in the training programme for Medical Assistants:
· The post basic programme which is still ongoing along side;
· The second generation programme of straight entry which is intended to be a degree programme.
Recognizing the potential in the Medical Assistant and acknowledging their immense contribution to the Nations Health System, the Medical and Dental Council for Ghana has brought this cadre under regulation under the name Physician Assistant. This is a major break through stride which has again repeated the history of nomenclature change that has been consistently synonymous with this workforce.
· Must be a registered Professional Nurse of not less 3 years post qualification working experience.
· Must not be over 35 years at the time of entry into the grade.
· Must have attended and successfully completed the Rural Health Training School- Kintampo or its equivalent institution with Advance Diploma in Community Medicine.
· Must have passed the SSS OR WASCE science-biased with aggregate 20 or better in six subjects(3 core and 3 electives) for the straight entry programme.
DUTIES AND RESPONSIBILITIES
The range of duties and responsibilities for the Physician Assistant cadre includes, among other:
Administration of the Sub District Health System
Facility level management including logistics, Human Resource and Financial Resource Management.
Clinical case management at Health Centres, Hospital OPDs etc and referrals to appropriate levels of care.
Provision of Primary Eye, Oral and ENT care
Diagnosis and management of minor surgical problems such as simple fractures, first degree burns incision and drainage, etc.
ACCREDITED INSTITUTIONS RUNNING THE PHYSICIAN ASSISTANTS PROGRAMME
RURAL HEALTH TRAINING SCHOOL – KINTAMPO - ADVANCED DIPLOMA /BSC
NARTH-BITA COLLEGE –TEMA - DIPLOMA
CENTRAL UNIVERSITY COLLEGE – ACCRA - BSC
PRESBYTERIAN UNIVERSITY COLLEGE –AGOGO –ASHANTI - BSC
ALLIED HEALTH UNIVERSITY - HO - BSC