Transformative Education
for Health Professionals

The Physician Assistant Profession in Ghana

E.T. Adjase, MD, MPH, Dip. Health Systems Management, D.Sc. Honoris causa, Nadia Cobb MS, PA-C

The Physician Assistant profession started in 1969 in Ghana. They are primarily stationed in the rural outreaches of the country,  and serve the primary care needs of 70% of the population. They truly exemplify the phrase from the Kintmapo Rural Health Training School (where the profession started) "Educating for Service". 

Full project description: 

The term Physician Assistant (PA) in Ghana today refers to three (3) distinct groups of health professionals trained on the medical model to practice medicine and dentistry. They are the PA – Medical (otherwise known as Medical Assistants), PA- Dental and also known as Community Oral Health Officers and PA – Anesthesia (also known as Nurse Anesthetists). These groups of mid- level health providers were trained exclusively in the past by Health Training Institutions (HTIs) under the Ministry of Health with the aim of extending care to the populace where physician numbers were scanty or not present.

The first of such training programs started in the mid – 1960s on ad –hoc basis and for short periods. By the late 1960s a formal and a more structured training program for middle level medical providers began at Kintampo. This was in response to not only the acute shortage of Physicians in the country but also due to the mal-distribution of the health workforce in general.  And therefore, in 1969 the Ministry of Health - Ghana established the Rural Health Training School at Kintampo to train professional nurses on the medical generalist model for 18 months to care for the rural and underserved populations. At the time, they were called Health Centre Superintendants – as they were trained specifically to ‘man’ health centres dotted across the country.

The training of the other two PA health professional groups started decades later with the same philosophy. With an approximate number of about 4,000 Physicians – both Medical and Dental in Ghana today, the policy strategy to invest in the training of PAs to extend care is still most relevant and cost effective. Issues of uneven distribution of Physicians across the geographical locations of the country, across medical disciplines and sub-specialties to serve a population of about 25 million people remain a big challenge.

Physician Assistant numbers – all categories - have been on the increase since the inception of PA training and practice in Ghana. Today, there are about 2,500 PAs in the country. About 90 percent of them have been licensed to practice with many more waiting to be licensed by the Medical and Dental Council (MDC) of Ghana which is the regulatory body at the moment mandated to regulate the practice of these health professionals.  Of the total number of practicing PAs, close to 72 percent are Physician Assistants – Medical. *(MDC Data Base)

The Medical and Dental Council in the last 4-5 years has been directed and given the mandate by the Ministry of Health – Ghana to set standards for training and regulation of practice as well as keeping and maintaining an up to date register of all PA practitioners in the country. This Ministerial Directive is timely as PA numbers and training institutions have shot up and continue to grow.   

PAs are well accepted in Ghana and form the bedrock for Primary Health Care throughout the country. The PAs – Medical work mostly in primary health care settings taking care of about 70 percent of the health needs of the rural and marginalized population groups. They practice as generalists, triaging and managing all kinds of medical and health conditions at the health facilities and within the community.

The PAs – Anesthesia and Dental on the other hand practice mainly in the District and Regional Hospitals across the length and breadth of Ghana. Due to the inadequate numbers of Anesthesiologists and Dental Surgeons, these groups of health professionals take up Physician responsibilities and work alongside physicians to provide the needed care.

CoHK from 2010 has established PA specialty programs taking into consideration the disease burden and the need to address some of the issues of scarce numbers as well as the uneven distribution of Physicians in some critical specialty areas. Programs in Clinical Psychiatry and Clinical Dermatology were  introduced.

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