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Cost analysis of health workforce investments for COVID-19 response in Ghana

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James Avoka Asamani, Hamza Ismaila, Sunny C. Okoroafor, Kingsley Addai Frimpong, Ebenezer Oduro-Mensah, Margaret Chebere, Adam Ahmat, Juliet Nabyonga-Orem, Christmal Dela Christmals, Jennifer Nyoni, Patrick Kuma-Aboagye


The COVID-19 pandemic had multiple adverse impacts on the health workforce that constrained their capacity to contain and combat the disease. To mitigate the impact of the pandemic on the Ghanaian health workforce, the government implemented a strategy to recruit qualified but unemployed health workers to fill staffing gaps and incentivise all public sector health workers. This paper estimated the cost of the new recruitments and incentives given to health workers and presented lessons for health workforce planning in future health emergencies towards health systems resilience. Between March and November 2020, 45 107 health workers were recruited, representing a 35% boost in the public sector health workforce capacity, and an increase in the recurrent public health sector wage bill by about GHS103 229 420 (US$17 798 176) per month, and about GHS1.24 billion (US$213.58 million) per annum. To incentivise the health workforce, the government announced a waiver of personal income taxes for all health workers in the public sector from April to December 2020 and offered a 50% additional allowance to some health workers. We estimate that the Government of Ghana spent about GH¢16.93 million (equivalent to US$2.92 million) monthly as COVID-19 response incentives, which translates into US$35 million by the end of 2020. Ghana invested considerably in health workforce recruitment and incentives to respond to the COVID-19 pandemic, resulting in an almost 37% increase in the public sector wage bill. Strengthening investments in decent employment, protection and safety for the health workforce using the various resources are helpful in addressing future pandemics.


  • The COVID-19 pandemic had multiple adverse impacts on the health workforce, including infections and mortalities, violence and harassment, discrimination, burn-out and mental disorders, which have contributed to reducing the availability of the health workforce and the weakening of the health systems’ capacity to respond to the pandemic.

  • Lessons from Ghana show that responding to the COVID-19 pandemic requires a tailored investment in the health workforce to ensure the availability of skilled and motivated health workers.

  • Ghana’s example highlights that providing incentives to health workers can play an essential role in mobilising the health workforce needed for public health emergency response.

  • There is a need for health workforce planners and policy-makers to heighten advocacy for strengthening investments in decent employment, protection and safety for the health workforce as a means to achieving health systems resilience.

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