In the early 1980s, Ghana undertook economic reforms its bid to salvage the economy and this decision had a dire consequence on education and health care. This paper seeks to focus on one of the international orders and its implication on Ghana’s healthcare and educational system.
Ghana had independence in an era where there was sovereign international order with fierce competition between the bipolar world with the USSR leading the East and The US leading the West. Sovereign international order was steered towards State-led development, modernisation and industrialisation. This was spearheaded by the US to make alliance and break the bipolar world to a unipolar world with only their hegemony. This era saw the industrialisation and major state-led policies and projects in Ghana. This period saw The US giving development aids through the project of international development (PID) to African countries including Ghana just to make alliance and control their hegemony that was threaten by the Soviet influence.
The liberal international order that emerged in the late 1970s and 2000s, saw the departure of the previous order where the state was in control of projects and markets to an order where the state promoted lassez faire policies with unrestricted transnational corporations that ended the golden age of capitalism. The consequence of the structural adjustment program adopted in Ghana under the liberal international order was so huge that it affected the internal polies in Ghana and changed the fortunes of many Ghanaians even though it appeared to be beneficial initially. The reforms in Ghana resulted in divesture of many government assets through privatization coupled with devaluation of currency that had enormous implication on the subalterns.
The liberal international order uses agencies such like the Bretton Woods institutions to promote its policies in emerging states like Ghana. These agencies, through projects of international development implement policies that changed local policies helping the subalterns. The structural adjustment programs implemented by the Rawlings led PNDC in the 80s had enormous effect on Ghanaians.
The Structural Adjustment Program(SAPs) and its implication on education and health.
The structural adjustment policies under the economic recovery program implemented by the PNDC regime led to commodification of education. The ordinary Ghanaian that could not pay to acquire knowledge had to drop out. The strict conditions attached to the SAPs prevented the northern sector to enjoy free education despite the unequal divide between the north and south. University education also went to cash and carry for only those who could afford to pay to study. This brought burden on the poor Ghanaians because of government’s adoption of liberal policies. This decision took by the PNDC regime goes against then culture of the state taking care of educational cost including the provision of basic material such as books, uniforms etc. This era also saw the reforms of educational curricular and review of certain policies subsidize cost on the educational learning materials.
The sudden change of educational policies in Ghana after the SAPs especial in the early 2000s can be attributed to the lack of interest on the part of the State to continue the implementation of the policy of SAPs impose by the IMF as part it conditionality for economic recovery. The implementation of Capitation Grant and Free SHS is an example of an attempt on the part of Ghanaian government to go back to an era where the State pays for education. The neglect of the health care system and Ghanaians inability to afford brought about epidemic outbreaks and those hit by it were the rural people and urban with less cases in city dwellers. Hospitals and clinics in villages did not have some essential drugs due to lack of funding from government. The high cost of living couples unavailability resulted in deaths in villages and towns
Under Sovereign international order, the political climate that was in place was that of radical nationalist government that prioritize the welfare of its citizens coupled with the socialist ideology policies the government was pursuing. The government took advantage of the sovereign order at that time and implemented health policies that were inclusive of every Ghanaian thus, the burden of health care was on the government not Ghanaians.The cash and carry system was adopted by the government due to its implementation of the structural adjustment policy. The era of government providing free and universal healthcare was no more existential. The resulted in self-prescription and fewer Ghanaians who could afford to pay seek heath care thus, there was not enough data on disease in rural areas for governments.
State of health care after structural adjustment policy(Post-SAPs)
In August of 2003, the State passed the NHIS act which in a way sort to reduce the healthcare cost through annual payment of premium. This policy is in sharp contrast of the health policies that were implemented under the structural adjustment policies. The subsidies on essential drugs, introduction of free maternal healthcare shows that the SAPs policy was not in the interest of the people.
Again, the sudden departure structural adjustment policy in the 80s shows that the policy is not inherently Ghanaian but rather an international order policy under project of international development (PID) that sort to keep Ghana(Africa) depend on aid forever.
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Conclusion
In conclusion, the world order that existed before the 1970s allowed for more intervention projects facilitated by Harry S. Truman's projects of international development(PID). Ghana at this era undertook massive developmental projects that ameliorate the lives of Ghanaians. However, the this order fell and the liberal order came to existence with its agencies like the IMF and World Bank. In this period, Ghana adopted the IMF policy of structural adjustment programme through the Economic Recovery Programme(ERP). These policies brought the burden on the education and health sector due to the withdrawal of government’s subventions. This policies crippled our health system and brought about cash and carry. Again, the commodification of education was also done under the structural adjustment policies(SAPs). Because such policies affected Ghana were not inherently Ghanaian policies, it can be argued that it was adopted due to the change form sovereign international order to liberal International order and this is why such policies never succeeds.