How Ghana can become "The Norway of Africa" using her oil resources
(This paper was submitted By Francis Xavier Tuokuu as part of his course work at the Robert Gordon University, UK)
INTRODUCTION
A healthy nation is a productive nation without which there will be huge economic cost to the nation as several amounts will be spent in taking care of sick labour force (Davis et al. 2005).
Natural resource management remains an issue in resource rich countries: it widens the gap between the rich and the poor, and makes citizens of those countries doubt the benefits and distribution effects of these resources.
The energy sector in Ghana has a crucial role to play in helping to improve Ghana’s health sector. This report will explore how that can be done to make Ghana the ‘Norway of Africa’ because Norway is often cited as one of the countries in the world with the best health system and one of the most equal countries in terms of income disparities among her people. The study will give a brief geographical location of Ghana and identify some of the resources available in the country especially energy resources.
It will also explain the concept of health and health inequality and then offer a brief overview of the health situation in Ghana. Afterwards, it will proceed to do a detailed discussion on how the energy sector can help solve some of Ghana’s health challenges drawing experiences from oil rich nations especially Norway and Nigeria. The report will base on examples from other countries and offer systemic, measurable, attainable, realistic and time (SMART) bound recommendations so that the ‘Dutch Disease’ commonly associated with oil rich nations does not occur in Ghana.
GHANA’S LOCATION AND RESOURSE AVAILABILITY
Ghana before independence was known as the Gold Coast because of her abundant gold reserves and mineral resources. Ghana gained independence on 6th March, 1957 from Great Britain and thus became the first Sub-Saharan African country to gain independence. Within the British colonial empire, Ghana was one of the first British colonies worldwide to gain independence after countries such as Egypt and India.
After an erratic political cycle, Ghana finally found her true democratic bearing in 1992 and since moved on to become one of the most stable democracies in a continent replete with so many failed and autocratic states. Summing these, Ghana can best be described as a resource-rich democracy. Geographically, the country to the north shares boundaries with Burkina Faso, to the east is Togo, to the west is La Cote d’ ivoire and to the south is the Gulf of Guinea (Atlantic Ocean). It has ten administrative regions with 212 decentralised districts.
According to the 2010 Population and Housing Census, Ghana’s population is estimated at 24,233,432, with a growth rate of about 2.40% (GSS 2011).
Ghana discovered oil in 2007 and is going to experience the oil kiss of fortune – for better, for worse. This has put Ghana once again on the international spotlight (Okpanachi & Andrews 2012). The excitement is gone past fever pitch as the whole nation is gripped with the prospects of getting rich from oil revenues. Her first oil export from the Jubilee oilfield was in January 2011 (Okpanachi & Andrews 2012).
The International Monetary Fund (IMF) reports that Ghana is likely to obtain an estimated amount of $20 billion as oil revenue from the period of 2012–2030 (IMF 2008) cited in (Okpanachi & Andrews 2012). This is certainly good news for Ghana as the revenue derived from oil proceeds if managed well will help transform all the sectors of the economy particularly the health sector so that Ghana could become the ‘Norway of Africa’.
CONCEPTUALIZING HEALTH
The concept of health is not easy to define, as it is multi-dimensional. It is not just the state of biological well-being of a person (Yuil 200x). The World Health Organisation (WHO) in 1947 at a conference in New York offered a definition of health stating, ‘‘health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’’ (Chris 200x). This definition of health has been contested and has led to various contrasting views among scholars. Some argue that it is not clear what WHO meant by ‘‘complete’’, ‘‘physical’’, ‘‘social’’, ‘‘well-being’’, ‘‘disease’’ and ‘‘infirmity’’ and called on the world body to offer further explanation of these concepts (Ananth 2008) in order to give a clearer explanation of health.
Ananth (2008) notes how this inadequate definition of health has led to the emergence of different schools of thought including the naturalists and normativists concepts of health.
Inequality in health is another issue worth mentioning because it has been a major concern to many governments, the world over (Gwatkin 2000). Health inequality is real in both high income and low income countries. It has been noted that as one moves from the social ladder from the bottom to the top, the health of the person improves (Dahl 2002) and this according to Dahl (2002) is called ‘‘challenge of the gradient’’.
This concern of health inequality has prompted Ghana to adopt the practice of subsidised health care provision for the entire nation or what is referred to as National Health Insurance Scheme (NHIS) (Duodu-Acquah et al 2008) in 2005 which replaced the ‘‘cash and carry’’ system (‘‘pay as you go’’).
To improve the health of women and help bridge the gender gap between men and women, free maternal health care was added to the NHIS (GHS 2009).
Inequality according to Wilkinson and Pickett (2009) is divisive and tends to destroy the good relationship in society. The main cause of inequality they argue is due to ‘‘bigger income differences’’
Wilkinson and Pickett (2009) explain why there is the need for equality in health in both developed and developing nations stating ‘‘in societies where income differences between rich and poor are smaller, the statistics show that community life is stronger and more people feel they can trust others. There is also less violence – including lower homicide rates; health tends to be better and life expectancy is higher. In fact most of the problems related to relative deprivation are reduced; prison populations are smaller, teenage birth rates are lower, maths and literacy scores tend to be higher, and there is less obesity’’.
A major concern of the World Health Organisation (WHO) is to reduce health and nutritional problems amongst the world poorest people. In an address in 1999, the Director General of WHO, Dr Gro Harlem Brundtland stated that, ‘‘…there is a need to reduce greatly the burden of excess mortality and morbidity suffered by the poor’’ (Gwatkin 2000).
THE HEALTH STATUS OF GHANA
The Ghana Health Service Annual Report shows an improvement in the health delivery system of the country. According to the report, ‘‘the nurse to patient population ratio has improved from 1:1079 in 2008 to 1:971 in 2009. Out Patient Department (OPD) per capita increased from 0.77 in 2008 to 0.81 in 2009. Tuberculosis (TB) treatment success rate increased from 84/100,000 population in 2007 to 85.5 /100,000 population in 2008. Skilled delivery rate improved nationally from 42.2% in 2008 to 45.6% in 2009. Institutional maternal mortality ratio fell from 199.7/100,000LB in 2008 to 169.9/100,000LB in 2009. Guinea worm cases fell from 501 in 2008 to 242 in 2009. Immunization coverage for measles increased from 86.5% in 2008 to 89.1% in 2009, with Penta 3 coverage moving from 86.6% in 2008 to 89.3% in the year under review’’ (GHS 2009 pp1-67).
Also, infant mortality fell from 81 to 61 per 1000 live births between 1988 and 1998 which further saw a decline in 2008 (51 per 1000 live births) (Duodu-Acquah et al 2008).This means that there is an overall improvement in Ghana’s health system even though more still need to be done. For example, meningitis cases throughout the country continue to be high (18%) whereas family planning fell from 33.8% in 2008 to 31.1% in 2009 and saw a decline from 97.8% to 92.1% (GHS 2009). HIV/AIDS is another major health issue in Ghana. Even though prevalence rates are far lower when compared to other Sub-Saharan African countries, (Duodu-Acquah et al 2008) notes that 125 people contract the disease on a daily basis.
One problem facing the health sector which is likely to militate against Ghana’s quest to attain the Millennium Development Goals (MDGs) is the loss of trained health professionals to countries of the developed world particularly the United Kingdom (Dovlo 2005). This has put a lot of constraint on the already overburdened health sector (Dovlo 2005). He points out that it will be difficult for Sub-Saharan Africa including Ghana to attain the MDGs particularly goals 4, 5, and 6 (reduce child mortality; improve maternal health; combat HIV/AIDS; Malaria and other diseases) partly because of the exodus of health professionals abroad.
In addition to the above challenge is poor environmental sanitation which is responsible for the high increase in morbidity and mortality in Ghana (Duodu-Acquah et al 2010). Malaria, respiratory and diarrheal diseases are commonly associated with such health problems according to the World Health Organisation (Duodu-Acquah et al 2010) and this is unacceptable in a 21st century Ghana.
The World Bank notes that Ghana’s life expectancy in 2007 was 60 years (World Bank 2007) cited in (Duodu-Acquah et al 2010) which rose to 62 by the end of 2010, an improvement from 45 at the time of Ghana’s independence in 1957 (Duodu-Acquah et al 2010).
THE ROLE OF THE ENERGY SECTOR IN MAKING GHANA ‘THE NORWAY OF AFRICA’
The major partners of Ghana’s Jubilee oil as it has been christened include; the Anglo-Irish company Tullow oil (49.95%) of reserves, Kosmos Energy (18%), Anadarko (18%), Subre oil and gas (4.05%) and Ghana National Petroleum (10%) (www.offshore-technology.com cited in (Okpanachi & Andrews 2012). More discoveries are being made almost on a daily basis and this according to experts will in the near future make Ghana a major oil exporter on the African continent.
Mehlum, Moene, and Torvik (2008) argue that ‘‘the variance of growth performance among resource rich countries is primarily due to how resource rents are distributed via the institutional arrangements’’ (246). Therefore, Ghana must strengthen her institutions and equip them with the necessary tools for them to discharge their duties efficiently and effectively so that the mistakes of others are not visited on the country.
It is said that resource abundance tends to create an elitist society (Lam & Wantchekon 2003) meaning society becomes unequal with the rich controlling much of the resources while the poor live without basic necessities of life. Inequality in society leads to poor health (Chris 200x) and this explains why the energy sector must be structured to help Ghana bridge the gap between men and women, rich and poor as well as the north-south dichotomy.
As an emerging oil producing country, Ghana requires new ways of doing things in managing its oil extraction so that the ills and mistakes of oil management policies often associated with countries like Nigeria and other oil rich nations which often lead to riots and destruction of properties and sometimes deaths, does not happen in Ghana (Vertigans 2011) explains how the transnational corporations operating in the Niger Delta Region of Nigeria often employ ‘‘colonial tactics such as divide and conquer’’ in their operations. Many people live few metres away from the oil wells in the Niger Delta yet hardly enjoy descent standard of living especially in accessing health care.
One thing Ghana must not do is to make sure that she does not transact her oil deals “with confidentiality clauses” with these transnational oil companies or share her profits among government officials as is often the case in Nigeria (International Crisis Group 2006, 23) but invest that money in infrastructure and the health of the people.
Furthermore, the Scandinavian countries particularly Norway are often mentioned as having high levels of equality and the best health systems in the world (Chris 200x) as a result of their efficient management and prudent investment of their oil revenue in their economies. Ghana must therefore follow the ‘Scandinavian Model’ by investing its oil revenue in the people instead of sending these monies into personal overseas accounts through the connivance of oil companies. The oil companies will do the people of Ghana well if they are transparent and accountable in their dealings with government officials.
Income inequality has been identified by Wilkinson as one of the factors causing health inequality among countries adding that, ‘‘the greater the gap, or greater the inequality between the rich and the poor then the worse those problems are’’ (Chris 200x). Finding solutions to solve income disparities among workers especially between management and employees is what Wilkinson calls economic democracy (Chris 200x). Energy companies should work to improve the income levels of their workers as this will lead to a trickle-down effect on the families which will eventually lead to an improvement in the standard of living of the people, hence quality health.
One point worth considering is that the government of Ghana should institute a law or a directive which will make it mandatory for oil and gas companies to devote a percentage of their oil proceeds to invest in the health of the people as part of their contributions to corporate social responsibility (CSR) or what is referred to as Socially Responsible Investments (SRI). This will go a long way to help improve the health care system of the country.
Norwegian companies are noted for their contributions to the welfare of local communities particularly in their operational areas. It is said that the first institution of higher learning in that country was started by a private company (Carson & Kosberg 2003) cited in (Bull 2003). These are lessons Ghanaian oil companies can learn from and contribute to make the society a better place for not only the benefit of the Ghanaian society but the oil companies as well.
However, (Frynas 2005, 583) argues that “CSR agenda may be inappropriate for addressing social problems in developing countries and may divert attention from broader political, economic and social solutions for such problems”. What he fails to recognise is the fact that business and society are interwoven (Wood 1991). They complement each; it will therefore be irresponsible on the part of energy companies to concentrate in making profits for their shareholders and neglect their stakeholders.
Women’s health is crucial to national development because what affects them affects their families and their societies (Kwapong 2008). Women manage virtually everything in the household, from cooking, taking care of children, and provision of water to making sure that everyone is healthy in the family (Kwapong 2008). Therefore, any attempt to promote the health of a nation must put the woman at the centre of all programmes. A significant amount of oil revenue should be spent on maternal health, women reproductive health and women empowerment as this will go a long way to reduce the factors that militate against women’s health. These programmes can be incorporated into the corporate social responsibility (CSR) of oil companies operating in Ghana.
CONCLUSION
Conclusion could be drawn from the above discussion by stating that Ghana could become the ‘Norway of Africa’ if she manages her oil resources well with the support of the energy companies. The health of the people should be paramount to every government and that is why a lot of investments from a country’s rich natural resources like oil must be committed to solving some of the factors militating against its development. Good health care delivery system should definitely be a topmost priority and the energy sector in Ghana certainly has a role to play in that direction.
From the discussion it is fair to say that Ghana’s health system has seen tremendous improvement since independence judging from the increase in life expectancy which according to the World Bank stood at 62 as at the end of 2010. Despite this, a lot still need to be done especially in retaining most of the trained health professionals to help achieve the MDGs. The report revealed that Ghana has a lot to learn from countries like Nigeria whose energy resources have not translated into wealth and good health for her people. ‘The Norwegian Model’ certainly should serve as the bench mark for Ghana if Ghana is to make any progress in the health sector. Energy companies must employ Wilkinson’s economic democracy to help solve the problem of income differentials in order to bridge the gap between the ‘‘haves’’ and the ‘‘have nots’’ in society. If the energy companies are able to do this in partnership with the Ghana government in transparency and accountability without signing any contract in secrecy, Ghana will surely become the ‘Norway of Africa’ and will be a model for others to learn from.
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