A GNA Feature by Godfred Aaneamenga Polkuu
Bolgatanga, Sept. 13, GNA – At the Upper East Regional Hospital (UERH) in Bolgatanga, the strain on healthcare delivery is evident in rising patient numbers and a shortage of health professionals to care for them.
Serving patients from the Upper East, parts of the North East and Upper West regions, as well as neighbouring Burkina Faso, the 265-bed referral facility is handling increasingly complex cases while expanding specialist and postgraduate training, placing its workforce under intense pressure.
The hospital’s Medical Director, Dr Joseph Kojo Tambil, described the situation as urgent and appealed to the Ministry of Health to address the hospital’s staffing and funding challenges, warning that quality specialist care and postgraduate training were at risk.
The challenge is particularly stark in critical-care areas, where a shortage of personnel could mean that admitting one more patient risks compromising the care of those already receiving treatment.
Dr Tambil recalled an incident at the Intensive Care Unit (ICU) when staffing levels made it difficult to admit another critically ill patient.
“There was only one staff at the ICU at that moment. So to add an additional patient means that we are going to lower the level of care for the patient in the ICU,” he said during a recent visit to the hospital by Mr Kwabena Mintah Akandoh, Minister for Health.
A Regional Hospital Carrying Tertiary-level Responsibilities
Dr Tambil said the experience illustrated a wider problem, as staffing allocations based mainly on patient numbers did not adequately reflect the complexity of cases handled by regional referral hospitals.
Regional hospitals are not simply larger versions of district hospitals. They receive referrals, manage complicated cases and provide specialist services that require more professionals, specialised equipment and longer periods of care.
In surgery, for instance, a complicated procedure could occupy theatre staff for several hours, requiring the attention of surgeons, anaesthetists, nurses and other professionals before, during and after the operation.
“We are pleading that the regional hospitals should not be treated as large district hospitals. The level of complexity is different,” Dr Tambil said.
The Nursing Workforce
The hospital has 236 Registered General Nurses (RGNs), 107 Enrolled Nurses (ENs), nine Community Health Nurses and 116 midwives.
However, the establishment figures do not tell the full story. Thirty-seven RGNs, eight ENs and four midwives are currently away for further training. The nursing complement also includes senior officers and specialist nurses responsible for 28 departments.
As a result, the number of nurses available on the wards at any given time is considerably lower than the headline figures suggest.
A two-day observation by the Ghana News Agency (GNA) brought the challenge into sharper focus.
At the Accident and Emergency Unit on the morning of September 11, 2026, only three nurses were observed on duty for the morning shift at the Red and Triage section of the unit. Although National Service Persons provided some assistance, the workload remained heavy, with several patients waiting for attention.
The wards visited showed a similar pattern. The highest number of nursing staff observed on duty in some units was four, while duty rosters at the Paediatric Medical Ward, Maternity Unit, Theatre, ICU and other critical areas pointed to small teams handling substantial workloads.
For patients, the shortage could mean longer waits and greater pressure on already stretched staff. For healthcare workers, it means doing more with limited resources.
Training Today, Capacity Tomorrow
Some professionals absent from the wards are pursuing additional training, an investment the hospital considers essential to building the specialist workforce it needs.
The facility has secured accreditation for postgraduate training in obstetrics and gynaecology, paediatrics and general surgery. It is pursuing accreditation in orthopaedics and plans to introduce postgraduate training in mental health.
Dr Tambil said the expansion had received support from Dr Samuel Kaba Akoriyea, Director-General of the Ghana Health Service, who wants specialist training established at the hospital.
Internal medicine remains a challenge. Doctors who might otherwise pursue general internal medicine are increasingly opting for subspecialties such as cardiology and endocrinology, areas for which the hospital currently lacks the necessary structures.
Management has also secured a consultant psychiatrist and hopes to establish a mental health training programme, but the specialist is currently posted elsewhere. Dr Tambil therefore appealed to the Health Minister to facilitate the consultant’s release to the hospital.
A Training Hub in the Making
The hospital’s training ambitions extend beyond postgraduate doctors. It supports undergraduate and allied-health education and has an agreement with the University for Development Studies Medical School to provide practical training for medical students.
It also trains students in Nursing, Pharmacy, Medical Laboratory Science and Nurse Anaesthesia.
This creates a difficult balancing act. The hospital needs trained personnel to provide care but must also train more professionals if Ghana is to close its long-term specialist workforce gaps.
Taking staff away from already stretched units for training could worsen immediate shortages, even though the investment is crucial for the future.
The Funding Problem
Dr Tambil also raised concerns about funding for postgraduate training and specialist outreach.
He said the hospital relied on visiting specialists from Kumasi in the Ashanti Region and Tamale in the Northern Region to perform procedures and train residents, but bringing them to Bolgatanga required additional resources.
He also complained about what he described as low National Health Insurance Scheme tariffs for regional hospitals, saying some facilities received primary-level tariffs when patients arrived without referral letters.
“The secondary tariffs have been slashed. We are being paid primary tariffs,” he said.
For a hospital handling secondary and increasingly tertiary-level cases, Dr Tambil argued that funding must reflect the complexity of services provided.
The Missing Fourth Phase
The hospital is also awaiting the fourth phase of its redevelopment project, intended to elevate it into a proper tertiary-level facility.
The Medical Director said the project was captured in the 2025 and 2026 budgets, but construction was yet to begin.
“We are supposed to have a phase four of the redevelopment project. And the aim of that is to get us to the level of a proper tertiary facility. But the pickaxe has not hit the ground yet,” he said.
For management, the project is more than construction. Expanded and better-equipped facilities would provide the space needed for specialist services, diagnostics, postgraduate training and complex referrals.
However, infrastructure alone cannot deliver the transformation.
Building Specialist Capacity from Bolgatanga
Despite the constraints, the hospital is pushing ahead with efforts to strengthen specialist care.
Management has begun establishing a histopathology laboratory to speed up the diagnosis of diseases, including cancers and immunological conditions.
The hospital has also requested an MRI machine from the Ghana Medical Trust Fund and expects its installation by the end of 2026 following an assurance that one would be provided.
Plans are also underway to bring specialist teams from Tamale and Kumasi for regular outreach in oncology, neurology, and ear, nose and throat care.
Such services could reduce the need for patients in the Upper East Region to travel long distances for specialist treatment, while strengthening the hospital as a training centre.
But every new service ultimately depends on people. A diagnostic machine needs trained professionals to operate and interpret it. A postgraduate programme needs consultants and support staff. A tertiary hospital needs enough nurses and other health professionals to care safely for patients around the clock.
The Minister’s Response
Mr Akandoh acknowledged the enormous workload confronting the hospital and commended staff for their dedication and sacrifices.
“I know Upper East Regional Hospital, you have a lot of load. I am so much aware that the load here is quite enormous,” he said.
The Minister said the Government was working towards a more equitable distribution of doctors and specialists, particularly in underserved areas, and had decided to decentralise postgraduate training to help address specialist shortages.
He also assured the hospital that the Government would provide the equipment and logistics required for health professionals to perform their duties.
Improvements in staffing data, he said, were helping the Ministry of Health and the Ghana Health Service identify gaps and undertake more targeted recruitment.
A Hospital at a Crossroads
At the heart of the Upper East Regional Hospital’s staffing crisis is a broader national question: how can Ghana distribute healthcare workers according to need?
Underserved regions often struggle to attract and retain professionals, even as referral hospitals in those areas carry workloads extending far beyond their immediate populations.
The Upper East Regional Hospital is now at a critical point. Its responsibilities are expanding, patient needs are becoming more complex, and it is developing postgraduate programmes, specialist services, diagnostics and outreach. Yet critical units can still operate with only a handful of staff.
The ICU experience captures the dilemma. When one nurse is responsible for critically ill patients, admitting another patient is not simply a question of finding a bed. It is a question of whether the standard of care can be maintained.
The staffing challenge, therefore, is not merely about the number of names on a payroll. It is about having enough trained professionals, on the floor and at the right time, to safely care for patients.
The hospital needs more staff, sustainable financing, specialist support, diagnostic equipment and completion of its redevelopment programme. More importantly, it needs a staffing model that recognises the difference between treating routine cases and running a regional referral hospital increasingly expected to function as a specialist and postgraduate training centre.
The Government’s commitment to equitable staffing, decentralised postgraduate training and improved logistics offers a pathway forward.
But the urgency is already visible on the wards.
The question is no longer simply how much more responsibility the Upper East Regional Hospital can take on.
It is whether its workforce will grow quickly enough to carry it.
GNA
Edited by Caesar Abagali/Audrey Dekalu
Writer: Godfred Aaneamenga Polkuu
Writer’s email: [email protected].