PFA makes significant strides

The Project Five Alive!(PFA), a seven-year initiative to assist ongoing efforts to reduce death in children below ages five in Ghana, using quality improvement methods in health system, has recorded remarkable gains in saving many lives of infants.

At the closing ceremony of the Project in Accra on Monday, Dr. Sodzi Sodzi-Tettey, Senior Technical Director of the Project, sharing some reflections on the impact of the initiative, stated that as of April 2015, the under-five mortality rates in 140 health facilities the project worked with nationally had reduced by 32 percent.

He expressed hope that Quality Improvement (QI) methods used during the project will transcend every facet of national health delivery, noting that a National Quality Forum will be a stepping stone to further ensure QI works in Ghana.

To intensify the QI practice in health facilities, Dr. Sodzi-Tettey called on authorities to redefine the roles of the 400 Improvement Coaches the PFA trained, to help ensure the adherence of quality improvement measures to improve effective health delivery to patients.

He said as the influence of patient communities grows, it must be accounted for in programming, adding that effective community engagement can help solve small problems associated with projects.

“Quality Improvement alone was not enough, but quality planning, quality control and quality improvement integration is key” to ensure success of health interventions in the country, Dr. Sodzi-Tettey observed.         

Project Fives Alive! is a partnership between the Institute for Healthcare Improvement (IHI) and the National Catholic Health Service (NCHS) to reduce morbidity and mortality in children less than five years old (Under-5) and also improve faulty referral processes in maternal and newborn care in Ghana.

Project Fives Alive! officially launched on July 8, 2008, in three districts in northern Ghana, was a seven year project funded by the Bill & Melinda Gates Foundation, and the collaborative work between IHI, NCHS, and the Ghana Health Service to achieve the objectives of the project which was implemented in four consecutive waves (phases) in all regions of Ghana.

Mr. George A. Adjei, Director of NCHS, in a presentation, described the PFA project as special and complex, in terms of its design, duration and strategy, which started in three selected sub-districts, extending to districts and then to all regions of Ghana.

He summarized the experience of the project as challenging, gratifying and inspiring, stating that the results at the end, the project contributed immensely to reducing under-five mortality in Ghana.

The Director said the project was inspirational in that it has taught the personnel skills of improvement science, adding that the NCHS has adopted it as a business strategy, which has been applied in the NHIS billing and claims management and to improve on the pass rate of students in the Midwifery training colleges under NHCS, with remarkable results.

He said the project was also inspiring because it has heightened appreciation of data to tract performance for managers at all level, as well as re-awakened the “do-it-yourself” spirit among managers that has enable them not to wait to be told what needed to be done to fix system bottlenecks.          

Touching on the challenges of the project, Mr. Adjei, noted that the national focus of PFA, and managing staff and resources at different sites from Accra, Tamale and later in Kumasi offices was a challenge; adding it challenging “working with partners from different cultural, ethical and national orientations which sometimes brought little tensions from time to time.” 

He thanked the partners and all past and present staff, who worked and ensured the success of the project, stressing that though the project had closed, it bequeathed to individuals, service providers and country the ideology of Quality Improvement, which gives a new impetus to apply Continuous Quality Improvement methods in all facets of life.

“What we require is the discipline to continue using data to guide our decisions and interventions,” he added.

Most Rev. Joseph Afrifah-Agyekum, Bishop of Koforidua and Bishop responsible for Health, who Co-chaired the function, commended the staff and the partners in their commitment that contributed to the success of the project for the past years.

He noted that though the project was ending with poignant lessons and the impact made in saving lives, its continuity was paramount to ensure quality improvement in healthcare delivery to patients.

Prof. Pierre Barker, Senior Vice President, Institute for Healthcare Improvement, who co-chaired the function, reminiscing exciting experiences during visits to some project sites, thanked all partners and staff for their tireless efforts in making the project a success.

“The project was largely successful with a combination of hard work and faith in God,” he added.     

Dr. Nana Twum-Danso, Former Director of the Project in a brief remark recounted the cordiality that existed among the staff, adding that the project was the most challenging in her professional experience, but added it was the most rewarding.                

She commended the wonderful collaboration that existed between partners on the project; the stimulating mental exercise that brought to bear the wealth of creativity among staff and also the effective team spirit fostered, which helped them to adopt new ideas to adjust designs that ensured the overall success of PFA. 

Some staffs who shared their experiences touched on the challenging lessons PFA taught them and the inspiring opportunity the project gave them to contribute to efforts at saving lives of infants.

Certificates and Souvenirs were presented to staff in appreciation for their hard work, dedication and commitment to the success of Project Fives Alive.     

By applying QI methods, Project Fives Alive! sought to assist and accelerate Ghana’s faith-based and public health services to reach the country’s fourth Millennium Development Goal (MDG) of reducing mortality in children under-5 from an estimated 110 per 1000 live births to less than 40 per 1000 live births (66% decrease) by 2015

Secondly, the core QI framework upon which the project was designed was the Model for Improvement, which enabled the project staff and the local QI teams with whom they work to set aims, identify process failures and develop, test and assess whether changes were leading to improvements.

The Improvement Collaborative Network, which accelerates peer-to-peer learning and improvement on a large scale, was an integral part of the project’s design. Thus in every four to six months, the local QI teams convene at a Learning Session to acquire QI knowledge and skills, and to share their QI experiences and learn from their peers’ successes and challenges. They therefore apply what they have learned during the intervening Activity Periods, with support from their district managers and the project staff who visit them monthly to assist with development and testing of change ideas, and implementation and sustainability of successful changes.

Who can access a deceased person’s bank accounts?

We do not want to discuss death as Africans. Our culture has found a way to consign issues about death to the background. We hardly discuss what could happen to our loved ones after we have died. We do not want to discuss what could happen; not that we do not care, but rather because our culture makes it appear as if it is a taboo or bad omen. It is a tough subject for Christians who even believe in Heaven after death to fully grasp.

But, the single most important truth we must all acknowledge is that death, being part of humanity is inevitable. We may not know when, but it will painfully happen one day. The recent June 3^rd disaster that claimed about 200 lives in Accra, caused by flooding and fire in a fuel station demonstrates the harsh reality of death. Did those beautiful and innocent people know they will never return to their loved ones when they left home on that fateful Wednesday?

Is there one person in your life you trust that knows your estates including your bank accounts? Or, have you documented all your estates (property, bank accounts, investments in shares or mutual funds, insurance, etc) in a way that will make accessibility of these estates easier for loved ones when you are no more? I have decided to focus only on bank accounts for this article.

Let us discuss what happens to someone’s bank accounts when the person is deceased. As someone who works in the banking industry, it is painful to see how relatives of deceased persons who do not know the procedural matters associated with deceased person’s bank accounts and estates are left to wallow in abject ignorance because they did not know what to do. In some cases, the monies left in the bank accounts of these deceased persons when left unclaimed for some years, are returned to the Government’s chest whilst the deceased’s loved ones struggle with their lives.

Each bank has its own procedure on how it deals with a deceased customer’s bank accounts. It is important for the deceased’s relatives, friends or lawyer to notify the bank through letters of administration provided by a competent Court when someone passes away, as the bank will not necessarily be aware of a customer’s death. A bank normally freezes a deceased customer’s private accounts when notified of the death. If a deceased customer had a joint account, the account will usually be transferred into the living account holder’s name.

Who can obtain information about and access to a deceased customer’s bank accounts?

Banks still have a duty of confidentiality to their customer, even after their death. This means banks cannot disclose information about their customers to anyone other than parties who are legally entitled to it. In most cases a bank can only take instruction from the executors or administrators of the estate and is unable to release information to other parties, such as next of kin, family member or estate beneficiaries.

Banks are not mandated to give the status of a deceased person’s financial records to wife, children, parents, Abusuapayin, beneficiaries of a will, etc until the necessary legal clearance documents (letters of administration) are produced. Banks owe their fiduciary responsibility of confidentiality to the courts and the dead. You must do the right thing legally to obtain access to the funds in the deceased person’s bank account.

A bank is only able to take instructions regarding a deceased person’s account from someone who is authorised to act on behalf of the deceased’s estate. The legal process is usually to obtain probate or letters of administration from the High Court. This allows executors or administrators to deal with the deceased’s property. Once probate or letters of administration have been obtained, the executors or administrators should be able to set up a special account called “the Estate of [deceased’s name]”.

The bank will then transfer funds from the deceased customer’s accounts to the estate account and close the deceased’s personal accounts. The estate account is used to distribute/share funds as documented in a will, intestate law or any other certified sharing formula. Once distribution is completed, the estate account is closed.

Dealing with the estate of the deceased

Probate is the legal process of distributing the estate of a deceased person. First you will need to find out whether the person made a valid will. A will explains what should happen to the deceased

person’s estate – their money, property and possessions. It may be held by a bank, solicitor, a safe custody facility, a trusted friend or relative.

If there is no will, the person is said to have died intestate and so different rules apply. For example, in Ghana, the Intestate Succession Law (PNDC Law 111) will be used by the courts to share the estate if the potential beneficiaries apply to the courts through their lawyers.

If there is a will, the deceased will usually have appointed executors to deal with the estate including monies and financial investments held in commercial and investment banks or insurance companies. If no executors were appointed, or there is no will, the court will appoint an administrator.  Executors and administrators are responsible for ensuring that beneficiaries obtain what is due them from a deceased’s estate.

For more information, I advise readers to consult the following regulations in Ghana; Administration of Estates Act, 1961 (Act 63), The Wills Act, 1971 (Act 360), Intestate Succession Act, 1985 (PNDC Law 111), Intestate Succession Amendment law, 1991 (PNDC Law 264), Marriages Ordinance Act, 1951 (Cap 127). Copies of these acts can be obtained from the Assembly Press in Accra, Ghana near the Accra Polytechnic.

Example of Mr. Tawiah and his deceased Sister’s bank accounts

Mr Tawiah wanted information from his deceased sister’s bank about her accounts.  He and his family also wanted an explanation from the bank about why it had allowed insurance premium payments made by standing order to continue from his sister’s account following her death. The bank was not willing to provide this information to Mr Tawiah because he had not been appointed to act on behalf of his sister’s estate.

Mr Tawiah wrote to a daily newspaper and also reported to a radio station on behalf of his family to see whether they could help him get this information from the bank. The media house which knew probate processes referred the matter to a lawyer. The lawyer advised Mr Tawiah that a media house is a wrong place to contact for assistance because the administration of his sister’s estate can only be authorised by a court.  To be able to help him, he needed a waiver of confidentiality from the administrator of the estate or someone appointed to act on behalf of the estate, such as a lawyer.  The relationship between a bank and its customer is confidential. 

Mr. Tawiah followed the lawyer’s advice by engaging the services of a lawyer. The lawyer followed the necessary procedures from the courts and the bank eventually released the necessary information that enabled the family to get access to their late sister’s funds. The Bible says for lack of knowledge, my people perish (Hosea 4:6). To avoid unnecessary delays when you need access to a deceased person’s bank accounts, always engage the services of a family lawyer to handle all probate and letter of administration matters.

Important Definitions

Administrator: A person appointed by the court to handle the estate of a person who died intestate, whose will is invalid, or whose named executors are unwilling or unable to act.

Beneficiary of the Estate: Someone who receives a specific gift or an amount of money from the deceased, as detailed in their will.                    

Estate: All assets, including (but not limited to) money, shares, real estate, vehicles and personal possessions.

Executor: A person or trust company named in the will to administer the estate of the deceased.

Letters of Administration: A document granted by the High Court which appoints administrators of an estate when the person has died intestate or when the will is invalid. 

Intestate: When a person dies without a will.

Probate: A document granted by the High Court which acknowledges the executors of the will as administrators of the deceased’s estate.

Will:  A legally enforceable document which specifies the desired distribution of a person’s property upon their death.

‘Use technology to improve healthcare delivery’

Most Rev. Emmanuel Kofi Fianu, Bishop of Ho, says the use of technology in health delivery should aim at improving quality healthcare to the patient, adding that it was important to look at the relationships between human beings and the use of technology in order to guarantee the patients safety.  

He thanked health workers for their dedicated efforts in serving humanity and reechoed the call on them to always work with compassion and love.

Bishop Fianu, made the remarks, when he recently chaired the opening of the 13^th Annual Conference of National Catholic Health Service at Ho, which was themed: “Patient Safety & Modern Health Technologies”.

While entreating the health facilities to institute routine maintenance regimes to ensure medical equipment work efficiently, the new Bishop of Ho charged health mangers to ensure effective data collection and timely delivery of reports to complement the work of NCHS Directorate.

Most Rev. Joseph Afrifah-Agyekum, Bishop of Koforidua and Bishop Responsible for Health, in a keynote address, urged healthcare providers even in their use of modern health technologies, to always approach their daily work with God.

For any health system to succeed he noted that it was important to discuss the use of modern technologies; open up for transformation, and to be guided by Catholic values in the usage of these modern health technologies in their facilities.

He stressed the importance of maintenance of medical equipment, emphasing that the maintenance of technologies must be the responsibility the whole facilities and not one department alone.  

While entreating the Ghana Health Service to show good fate to avoid duplicity in the allocation of medical equipment, Bishop Afrifah-Agyekum bemoaned the fact that the delayed payment of the National Insurance Scheme rendered by mission facilities, adding that it threatens the survival of these facilities.

The prelate lamented about the some deductions and charges made on the claims due the facilities, without considering inflation, and said this treatment was unacceptable.   

He said the Church was considering alternative actions including legal one to ensure that the National Insurance Authority made prompt payment of claims.

“We will not stop agitating for what is due our facilities,” he said, adding that “what we are demanding is a right and not a privilege.”    

In his address, Mr. George Adjei, Director of the Health Directorate, highlighted the need for the responsible use of Modern Health Technologies to engender patient safety.

To ensure patient safety, Mr. Adjei also reiterated the fact it was duty of health professional to continuously educate patients to appropriately use health technologies to better improve upon their health.

The Director, commending the warm collaboration between the NCHS and the Ghana Health Service at the national and regional level, entreated facilities to keep monitoring Ebola cases and report suspected cases at the designated places.      

Mr. Peter Yeboah, Executive Secretary of the Christian Health Association of Ghana (CHAG), noted that the recent spate in legal suits and claims against CHAG Hospitals for cases of malpractice, medication and surgical errors, treatment delays and a host of adverse events highlights to need to situate patient safety at the centre of healthcare provision.

He stated that the adoption of Modern Health Technologies could potentially improve access to healthcare, improve patient safety and ultimately enhance clinical outcomes and cost effectiveness, and pledged CHAG’s support to the NCHS in improve quality healthcare delivery.

Touching on National Health Insurance Authority’s scaling up on capitation payment, which Mr. Yeboah said offers potential challenges and opportunities for CHAG facilities to further consolidate, deepen its Christian values of love, charity, compassion and quality healthcare.

At a Mass to kick-start the three-day Annual Conference, prayers were said for 26 departed workers from various NHCS Facilities across the country, meanwhile four distinguished health workers including Rev. Msgr. Cletus Frank Egbi, Executive Secretary of Health for the Ho Diocese, were awarded for their long outstanding and dedicated service in their respective facilities.

Mgsr. Egbi, on behalf of the awardees thanked the Health Directorate for the honour and present given them.

“I thought I was only working without being seen; I thought I was just helping in a small way to improve upon the health of the people,” he said after the awards was handed over to him and thanked all his collaborators and workers in the health facilities for their support.

He however noted that anybody could achieve big results, if we could do our little bit and see our work as a call to serve, instead of just seeing it as a profession.

“Do the little you can do, keep doing what you are called to do and do it sincerely and God will bless you,” he stated.  

Earlier in a welcome, he stressed that the use of technology should seek to improve life and not endanger it, adding that man cannot be to a slave to technology.

At the Conference health experts took participants, topics including The Human Factor in Health Technologies; Current and Future Outlook for Health Technologies; Practical Issues in Health Aided Technologies-A Pathologist’s Perspective and Self-Administered Health Technologies-Role of Health Worker.    

Centre of Hope climaxes Silver Jubilee

The Centre of Hope, a Catholic Non-Governmental Organisation under the auspices of the Catholic Archdiocese of Accra, climaxed its Silver Jubilee at the Holy Family Parish, Mataheko, with an appeal to the faithful to continue supporting the work of the Centre.

Most Rev. Charles G. Palmer-Buckle, Metropolitan Archbishop of Accra, who presided over the Mass, entreated Christians to continue to give their little support to the Centre to enable it cater for the destitute, aged and the sick.

He said like the little boy in the Gospel passage of St. John 6: 9, who gave five barley loaves and two fish that Jesus Christ blessed to feed 5,000 men, Christians were also being urged to offer their little to the needy and leave the miracle to God.

The Archbishop also advised the aged and the needy not to be despondent but trust in God’s providence to provide their needs, urging them to cry in faith to the Lord who listens to the cries of the poor.

He observed that the tendency for the needy to always think of stomachs, have resulted in a lot of the aged and the needy to complain, but urged them to be thankful to God and pray for their children who might have forgotten and neglected them. 

The year-long Anniversary which was launched at the same Parish in February was on the theme: ‘Twenty-Five Years of Inspiring Hope Through Charity’.

The Archbishop who commended the foresight of Most Rev. Dominic K. Andoh of blessed memory for establishing the Centre as well as the numerous benefactors of the Centre of the years.

He acknowledged the tremendous efforts of the Franciscan Missionaries of Mary, managers of the Centre for their efforts over the past two and half decades, and urged the parishioners to encourage their daughters to join the religious vocation like the sisters to work in apostolates such as caring for the poor.   

Among some of the activities organized to mark the anniversary included Visitation to the Catholic Media Organisations, Visitation to some Parishes and Rectorates in the Archdiocese, Anniversary Lecture as well as a day with beneficiaries and benefactors, and  Awards Nights slated for December 12, 2015.

Present at the Mass was Sr. Benedicta Amiziah, FMM, Provincial Superior, Ghana-Liberia Province of the Franciscan Missionaries of Mary, the FMM Sisters, the Board of the Centre, and collaborators of the Centre.

The benefactors and beneficiaries of the Centre were also represented.

Archbishop Palmer-Buckle later at a reception held at the Centre for benefactors, beneficiaries and Board of Members of the Centre, FMM Sisters as well as invited guest, explained the efforts and the various projects the Archdiocese was running to serve the urban poor and offer them support.  

The Centre was established in 1990 by then Bishop of the Accra Diocese, Most Rev. Dominic Andoh to cater for the destitute, marginalized people with disability, the sick and invalid and poor and needy children in the City.

With a mission to render selfless services through charity and make God’s love a reality in the lives of the poor and needy, the Centre has over the years been a haven for many and impacted positively in their lives.