Therapy exodus, looming crisis

In recent times, Ghana, as part of bilateral relations and diplomacy, has been exporting health professionals to other countries.

Even though the World Health Organisation (WHO) recommends using these bilateral agreements to ensure fair and ethical international recruitment, it proposes safeguards which are necessary to ensure there is minimal to no negative impact on source countries.

This is why it is strange to see Ghana’s preparedness to export already scarce specialists, such as audiologists, speech and language therapists, and occupational therapists, abroad.

This is a looming crisis for most of its vulnerable citizens, who are children with special needs.

Access to these allied rehabilitation specialists for children who live outside the Greater Accra and Ashanti Regions is actually a luxury at the moment.

In the Western Region of Ghana, for instance, children have to risk their lives by travelling all the way to Cape Coast to access these services.

Ghana has only a handful of speech and language therapists, and a very small cohort of audiologists and occupational therapists, considering the size of the population.

This issue calls for attention because these services are essential.

Experience Honest comfort
Early identification and intervention for hearing loss, speech delay, autism, cerebral palsy and other developmental disorders can make the difference between a child who learns to communicate, join school and work later in life, and a child who is left permanently excluded.

Compared to high-income countries with tens of thousands of allied health professionals, Ghana’s workforce is starkly inadequate.

Training capacity is also slowly expanding while the need is gradually growing.

Exporting therapists now, even under bilateral agreements that offer short-term economic or diplomatic gains, will deepen inequity and raise hidden long-term costs.

Practical harms include the unavailability of professionals to help manage early-identified developmental red flags, interrupted early-intervention programmes, lack of access to the much-needed therapies and increased burden on families forced to travel far or pay out-of-pocket for private services.

There is also a systems cost. If therapists leave the country, health and education teams will lose mentors and trainers who should be helping to build local capacity.

These losses, though hard to measure, are evident every day in delayed diagnoses and children falling permanently behind.

The situation is already dire and needs serious investment.

The last thing Ghana’s Ministry of Health should ever consider is the export of such professionals, as this will further worsen the plight of children with special needs and their families.

Policy
Beyond ethics, the policy is strategically weak. Ghana’s investment in training will only yield returns if those trained are available to practice here.

Sending such skilled professionals abroad without parallel measures to expand domestic training and create career pathways only serves to subsidise other countries’ health systems while undermining Ghana’s own human capital.

With immediate effect, there should be a halt to outbound recruitment of scarce allied-rehabilitation professionals until a workforce impact assessment is completed.

The salaries and career progression for therapists working in public services should reflect their invaluable contributions, with attractive incentives for those who are willing to serve in remote areas.

There should be expansion of university programmes and scholarships focused on audiology, speech and language pathology, and occupational therapy.

These should be tied to service contracts in underserved regions.

The country should invest in task-sharing as a stopgap while the workforce grows.

Children with disabilities cannot wait while policy experiments play out.

The government must choose whether it will be remembered for empowering every child to reach their potential or for exporting the professionals who make that possible.

It is important that Ghana’s own children are guaranteed access to the services they desperately need as a way of upholding fairness, inclusion and equity in practice, not just in principle.

The writer is a child development expert/Fellow, Zero-To-Three Academy, USA.E-mail: nanaesi.gaisie@wellchildhaven.com