The Ghana Association of Certified Registered Anaesthetists (GACRA) has threatened to embark on a nationwide strike from December 1, 2026, if the government fails to address concerns regarding their conditions of service.
The association’s President, James Nwinsagra, said members would have no option but to withdraw their services if their concerns were not addressed appropriately within the shortest possible time.
“If our concerns are not addressed appropriately within the shortest time favourably, we will have no option than to lay down our tools by December 1, 2026,” he said.
Speaking at the association’s 8th Annual General Meeting and Scientific Sessions at the Institute of Local Government Studies in Accra, Mr Nwinsagra said although GACRA had secured its maiden Collective Agreement (CA) after two years of negotiations with the Fair Wages and Salaries Commission (FWSC), the conditions approved by the government had fallen short of members’ expectations.
He said the association was grateful that the agreement had been completed and signed, providing a formal framework for members’ conditions of service, but maintained that the remuneration and benefits approved did not adequately reflect the responsibilities and workload of Certified Registered Anaesthetists.
Mr Nwinsagra argued that anaesthesia providers played a critical role in Ghana’s healthcare delivery system, often working under difficult conditions and serving millions of people despite limited numbers.
The AGM and scientific sessions were held under the theme, “Enhancing Safe, Equitable Access to Anaesthesia and Surgery.”
Addressing participants, the GACRA President said access to safe, timely and affordable surgical and anaesthetic care remained a major global health challenge, particularly in low- and middle-income countries.
He noted that more than five billion people worldwide lacked access to safe, timely and affordable surgical and anaesthetic care, with the majority living in developing countries, including those in sub-Saharan Africa.
He said Certified Registered Anaesthetists remained central to surgical service delivery in Ghana, particularly at district hospitals, where they often served as the primary and sometimes sole providers of anaesthesia services.
According to him, CRAs manage paediatric, obstetric, trauma and general surgical cases, including emergency caesarean sections, making their availability critical to the delivery of essential healthcare.
Mr Nwinsagra also raised concerns about the shortage of anaesthesia professionals, saying the number of CRAs available to serve Ghana’s population was inadequate.
He disclosed that although the country had approximately 1,200 CRAs in 2023, about 30 per cent of trained professionals had left the country in search of better opportunities.
He said a recent report presented to the Ministry of Health during stakeholder engagement on the National Surgical, Obstetrics and Anaesthesia Plan for Ghana put the number of CRAs at 943, while Ghana Health Service records currently indicated 582.
Based on the GHS figure and Ghana’s population of more than 33 million, he said the ratio stood at one CRA to approximately 34,994 people.
The association’s President attributed the situation partly to poor conditions of service and limited opportunities for professional development.
He further called for the expansion of anaesthesia training institutions, arguing that the existing facilities could not produce enough professionals to meet the country’s healthcare needs.
He said Ghana had only two Bachelor of Science-awarding anaesthesia training institutions under the Ministry of Health and one under the Ministry of Defence, with limited admission capacity.
Mr Nwinsagra particularly expressed concern over the situation at the premier anaesthesia training school in Kumasi, which he said had been directed by the Medical and Dental Council (MDC) and the Ghana Tertiary Education Commission (GTEC) to stop admissions because of accreditation challenges.
He said a personal visit to the institution revealed inadequate infrastructure, including the absence of a lecture hall, library, administrative block and offices for teaching staff.
He also lamented the lack of permanent lecturers at the school, which he said had trained approximately 70 per cent of the CRAs currently practising in the country.
He appealed to the Minister of Health to intervene urgently to address the challenges and expand anaesthesia training opportunities.
The GACRA President also called for an upgrade of anaesthesia training programmes to master’s degree-awarding institutions, arguing that the existing career pathway had become unattractive.
He said the association wanted opportunities for further specialisation in areas such as paediatric anaesthesia, obstetric anaesthesia and pain management.
He further expressed concern that anaesthesia had not been incorporated into specialist training programmes at the ultra-modern training centre at Pantang.
Mr Nwinsagra, however, commended the C.K. Tedam University of Technology and Applied Sciences (CKT-UTAS) for introducing an MPhil programme in anaesthesia at its Navrongo campus.
He said the first batch of students had completed the programme this year and appealed for permanent teaching appointments for graduates at the anaesthesia training schools.
He also urged the MDC to recognise the programme, stressing that anaesthesia training required both academic knowledge and practical technical skills.
Mr Nwinsagra revisited the association’s longstanding concerns over the regulator’s Scope of Practice (SoP) document and the recognition of the professional designation Certified Registered Anaesthetist.
He recalled that CRAs withdrew their services in January 2022 in protest against issues surrounding the scope of practice and the regulator’s refusal to recognise the designation as provided under the Health Professions Regulatory Bodies Act, 2013 (Act 857).
He said the intervention of the Christian Health Association of Ghana (CHAG) subsequently led to the establishment of a ministerial task force to examine the concerns.
Although GACRA was not opposed to having a scope of practice document, he said the association disagreed with restrictions preventing its members from administering anaesthesia to children under five, managing cases likely to involve blood loss exceeding 1,000 millilitres, and undertaking major surgical procedures expected to last more than four hours.
According to him, recommendations by the ministerial task force warned that implementing the restrictions could deny many Ghanaians access to essential surgical and anaesthetic services, particularly at peripheral health facilities.
He said the association had consequently resolved to fully comply with the regulator’s directives, including referring children under five and certain high-risk cases to teaching hospitals where physician anaesthesiologists are available.
Such cases, he noted, included antepartum and postpartum haemorrhage, placenta previa, placental abruption, ruptured ectopic pregnancies, mass casualties and major laparotomies.
He acknowledged the potential consequences of the restrictions for access to emergency healthcare, particularly for women and children, but said the association had no option but to comply with the regulator’s requirements.
The association also called for the provision of modern anaesthesia equipment in all operating theatres to improve patient safety.
Mr Nwinsagra said surgical facilities required functional anaesthesia machines, patient monitors, gas supplies, resuscitation equipment, recovery spaces and adequate staffing to ensure safe surgical procedures.
He maintained that the availability of qualified professionals alone was insufficient without the necessary equipment and infrastructure to support their work.
Beyond the professional and institutional challenges, Mr Nwinsagra called on the government to provide scholarships and sponsorship opportunities for CRAs to participate in international conferences and pursue further training.
He also raised concerns about illegal mining, popularly known as galamsey, and its potential consequences for public health.
He urged President John Dramani Mahama to take decisive action against illegal mining, citing the destruction of forest reserves, rivers and other water bodies.
He expressed concern about the emergence of health conditions, including childhood cancers, liver and kidney diseases, and respiratory infections, which he said were partly attributable to environmental pollution.
He acknowledged the efforts of the National Anti-Illegal Mining Operations Secretariat (NAIMOS) but maintained that more decisive measures were needed to address the problem.
The GACRA President further called on the government, the Food and Drugs Authority (FDA) and other stakeholders to introduce stricter measures to regulate the practice, importation and use of drugs to address substance abuse among Ghanaian youth.
He specifically mentioned the abuse of tramadol, non-steroidal anti-inflammatory drugs (NSAIDs), alcohol and cannabis as issues requiring urgent attention.
Concluding his address, Mr Nwinsagra called for collaboration among policymakers, healthcare professionals, educators and administrators to improve access to safe anaesthesia and surgical services.
He said ensuring that no Ghanaian suffered or died because of a lack of access to safe anaesthesia and surgery should remain a national priority.
