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Hon Yussif Jajah Writes: Embracing the 24 Hour Economy: A Gateway to Ghana’s Economic Transformation

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BEYOND EARLY DETECTION: WHAT HAPPENS AFTER A BREAST CANCER DIAGNOSIS? 

  Breast cancer awareness must go beyond pink ribbons, screening campaigns and calls for early detection. Ghana must also confront whether its health system is adequately prepared to care for those who receive a diagnosis. Every October, pink ribbons, awareness campaigns and screening activities remind us of the importance of early detection in the fight against breast cancer. Across workplaces, churches, communities and health facilities, women are encouraged to examine their breasts, attend screening programmes and seek medical attention when they notice unusual changes. These messages are important. Early detection can improve treatment outcomes and save lives. But after losing someone I cared deeply about to breast cancer, I have found myself reflecting on a question that deserves equal attention: What happens after early detection? Let me call her Abena. Abena was a woman in her late thirties, a working professional who had spent more than a decade advocating for breast cancer awareness. She organised screening activities within her church and workplace and encouraged other women to take their breast health seriously. She understood the importance of early detection and actively promoted it. In August 2023, she discovered a lump in her armpit. An initial ultrasound examination reportedly indicated that the finding was benign. However, the swelling persisted, and a month later she noticed changes in her left breast. Further investigations, including biopsy, eventually confirmed breast cancer in November 2023. What followed was a difficult journey through the healthcare system. The physician who requested the investigations had travelled outside the country by the time the results became available. Abena was asked to wait until the physician returned before a referral could be made to the next level of care. Eventually, a colleague facilitated the referral. At the oncology unit, she was informed that the workload was high and that an arrangement described to her as "intramural" payment could secure an earlier appointment. Without this payment, her first appointment would have been in February 2024. She paid and was seen that same day. Subsequent review visits also involved additional payments.   The financial demands did not end with securing appointments. Each chemotherapy session cost approximately GH¢2,000, while a supportive injection administered after each session cost about GH¢900 at the time. The medication was provided for administration by health workers at a nearby facility. Abena completed eight cycles of chemotherapy and was preparing for a total mastectomy. Throughout this period, her health deteriorated. She experienced significant complications, including loss of sight and speech, and eventually died in June 2024. Yet, even while battling the illness, she managed to complete her Master of Laws programme. Her determination to keep going remains one of the things I remember most about her. I share Abena's story not to suggest that every aspect of her care was inappropriate or that one experience represents the entire health system. Neither can I establish that the challenges she encountered alone determined the outcome of her illness. However, her experience raises difficult questions about access, affordability, referral coordination and the support available to patients navigating serious illnesses in Ghana. A diagnosis should mark the beginning of a coordinated response, not the beginning of another struggle to find care. BEYOND AWARENESS: EXAMINING THE HEALTH SYSTEM  Early detection is only one part of the cancer care pathway. Following a suspicious finding, patients need timely diagnostic investigations, clear communication of results, appropriate referral, specialist consultation, treatment and continuous follow-up. These services must work together. Delays at any point can create additional anxiety, financial pressure and uncertainty for patients. This is particularly important when viewed against Ghana's commitment to achieving Universal Health Coverage (UHC) by 2030. The Sustainable Development Goals, especially SDG 3, call on countries to ensure healthy lives and promote well-being for all ages. Target 3.8 specifically commits countries to universal health coverage, including access to quality essential healthcare services, affordable medicines and financial risk protection. These commitments must translate into meaningful experiences for people who seek care. Universal health coverage cannot be measured simply by the number of people who enter a health facility or the availability of screening services. It must also be reflected in whether patients receive the right diagnosis at the right time, whether referrals lead to actual access to care, whether treatment is affordable and whether continuity of care is assured. The question is not only whether we can detect diseases early, but whether our health system is prepared to respond effectively when we do. Patient navigation is one area that deserves greater attention in strengthening cancer care. Nurse navigators play an important role in helping patients move through what can be a complex and overwhelming healthcare pathway. They support coordination of appointments and referrals, facilitate communication between patients and healthcare providers, help identify financial and psychosocial barriers and promote continuity throughout treatment. Ghana has made efforts to introduce and strengthen patient navigation services. However, we must look beyond the existence of individual initiatives and ask questions about their reach and sustainability. How many breast cancer nurse navigators are available across the country? How many have undergone structured, competency-based training in patient navigation? Are these services accessible to patients outside the major tertiary hospitals? Do we have adequate systems for their deployment, supervision and continued professional development? A patient navigator should not merely direct a patient from one department to another. The role requires the knowledge and skills to coordinate care, anticipate barriers and help ensure that patients are not lost along the treatment pathway. Strengthening this service should therefore form part of our broader investment in cancer care. The challenges highlighted by Abena's experience are also not exclusive to cancer. Patients living with hypertension, diabetes, stroke, kidney disease and other chronic conditions face similar needs for timely diagnosis, appropriate referral, affordable medicines, regular monitoring and continuity of care. As the burden of non-communicable diseases continues to increase, the demands on our health system will become even greater. This is therefore a broader health-system concern. We need to examine how effectively our services are organised to support patients from the point of first contact through diagnosis, treatment, rehabilitation and follow-up. The ability to provide continuous, coordinated and person-centered care must become a central measure of the quality of our healthcare delivery. TURNING POLICY COMMITMENTS INTO PATIENT EXPERIENCES  Ghana's Free Primary Healthcare initiative presents an opportunity to strengthen access to essential services, improve early identification of health conditions and reduce barriers at the primary healthcare level. Similarly, the Ghana Medical Trust Fund offers an opportunity to address some of the financial challenges associated with serious and chronic illnesses. These are important interventions, but their impact will depend on how effectively they connect with the wider health system. Expanding access to primary healthcare must be accompanied by adequate diagnostic capacity, functional referral systems, specialist services, essential medicines and a health workforce equipped to provide quality care. Financial support must also translate into access to the actual services patients need and when they need them. We must be careful not to create a situation where patients are encouraged to seek early care but encounter delays, prohibitive costs or limited treatment options once a serious diagnosis is confirmed. Access to healthcare should not end at the point of screening or diagnosis. It must extend throughout the patient's journey. This also calls for deliberate investment in the health workforce. Nurses and midwives are central to patient education, early identification, care coordination, treatment support and follow-up. Their capacity must be strengthened through appropriate training, adequate staffing, supportive working environments and the resources required to deliver quality care. Patient navigation, for instance, should not depend solely on isolated projects or the commitment of a few individuals. It should be deliberately integrated into the organisation of cancer services. BEYOND OCTOBER: A CALL FOR NATIONAL REFLECTION  Breast cancer awareness should not end when October ends. Screening campaigns and public education remain essential, but they must be matched by a health system that can respond to the needs of those who receive a diagnosis. Abena's story is a reminder that behind every diagnosis is a mother, a family and a future that may depend on how effectively the health system responds. It is also a reminder that the success of our health policies should ultimately be judged by the experiences and outcomes of the people they are intended to serve. As a country working towards UHC by 2030, we must move beyond counting the number of people screened, educated or reached through awareness campaigns. We must also ask whether those who need further investigations can access them promptly, whether referrals are completed, whether treatment is affordable and whether patients receive the support required to complete their care. This reflection is in honour of Abena and the souls our health system might have failed. Their stories should challenge us to look beyond awareness and confront the gaps that patients encounter when they need care the most. Early detection is important. But what happens afterwards is equally important. And so, beyond the pink ribbons, the screening campaigns and the annual calls for early detection, I leave us with one question: WHAT'S NEXT AFTER EARLY DETECTION?  I hope this question will spark a much-needed national conversation among policymakers, healthcare professionals, health institutions, civil society, communities and every Ghanaian who depends on the health system. We must collectively examine whether our healthcare delivery system is adequately prepared not only to detect illnesses, but also to provide timely, affordable, quality and continuous care to those who need it. Maame Akosua Serwaa Gyening Email: masagg30@gmail.com  

 

In the dynamic landscape of global economies, innovation remains a key driver of growth. The proposal of a “24 Hour Economy” by His Excellency John Dramani Mahama, the presidential candidate of the National Democratic Congress (NDC) for the 2024 elections in Ghana, presents a transformative and an exciting opportunity for the country. This brilliant concept, aimed at maximizing the use of resources round-the-clock, can propel Ghana into a new era of economic prosperity.
The Essence of a 24 Hour Economy
At its core, a 24 Hour Economy involves extending business operations, services, and public utilities to function efficiently throughout the day and night. This approach is not just about keeping shops open longer; it’s about creating an ecosystem that supports continuous productivity, thereby enhancing economic output. This ecosystem not only encompasses businesses operating round-the-clock but also includes the development of supporting infrastructure, regulatory frameworks, and cultural shifts. Let’s delve deeper into these elements:
1. Business Operations and Market Expansion:
– Businesses extending their operational hours can cater to a wider range of customers, including those who may work unconventional hours.
– Industries such as manufacturing can increase output by running factories 24/7, thereby meeting higher demand and increasing exports.
– Service sectors like IT and customer support can benefit by aligning with global time zones, offering real-time services to international clients.
2. Infrastructure Development:
– Essential to a 24 Hour Economy is robust infrastructure. This includes reliable public transportation systems functioning at all hours, ensuring safe and accessible commutes for the workforce.
– Energy supply must be consistent and sustainable to support extended operations, calling for investments in power generation and distribution networks.
– Digital infrastructure, crucial for modern economies, must be strengthened to support continuous connectivity and e-commerce activities.
3. Regulatory and Policy Support:
– Government policies need to facilitate night-time operations. This might include labor laws that regulate night shifts and ensure fair compensation for workers.
– Urban planning and zoning laws can be adapted to support businesses operating at night, ensuring residential areas are not adversely affected.
– Safety regulations must be stringent to ensure the well-being of workers and customers during night hours.

4. Safety and Security:
– Enhanced security measures are vital. This includes increased policing during night hours and well-lit public spaces to ensure the safety of citizens.
– Businesses will also need to invest in security infrastructure, such as surveillance systems and private security services.
5. Cultural Adaptation:
– Shifting to a 24 Hour Economy requires a cultural change, where nocturnal business activities become normalized.
– Public perception needs to evolve to see night-time work not just as a necessity but as an opportunity for flexible and lucrative employment.
6. Economic Diversification:
– This model opens doors for new sectors to flourish, like night-time entertainment, 24-hour childcare services, and food services catering to different schedules.
– It encourages innovation in business models, for instance, shared workspaces that operate 24/7, adapting to different work patterns.
7. Workforce Management:
– Companies will need to manage their human resources effectively, ensuring worker health and well-being with flexible, rotational shifts.
– Training and upskilling of employees to adapt to a more dynamic work environment will be essential.
In essence, a 24 Hour Economy in Ghana would not just be about keeping businesses open longer; it’s about creating a holistic environment where continuous productivity is sustainable, secure, and beneficial for all stakeholders involved. This involves a coordinated effort between the government, private sector, and the community to build an economy that operates efficiently and effectively, leveraging the full potential of the country’s resources and workforce.
Benefits for Ghana
1. Boosting Employment Opportunities:
Expanding operational hours naturally necessitates a larger workforce. This will significantly reduce unemployment, offering varied work schedules and creating jobs in sectors like retail, security, transportation, and hospitality.
2. Enhanced Productivity and Economic Growth:
By operating round-the-clock, businesses can optimize their output. This increased productivity directly contributes to economic growth, providing a competitive edge in the global market.
3. Revitalization of Urban Centers:
A vibrant night economy can lead to the revitalization of urban areas. Safe and lively city centers at night can boost local tourism and create a cosmopolitan image for cities like Accra and Kumasi.

4. Improved Work-Life Balance:
Flexible work hours can lead to a better work-life balance for employees, catering to different lifestyles and personal commitments.
5. Optimization of Infrastructure:
Utilizing infrastructure such as public transport and utilities 24/7 ensures that investments are maximized, reducing idle time and increasing efficiency.
The Global Perspective
Globally, cities like New York and Tokyo have thrived under a 24 Hour Economy, showcasing improved economic resilience and diversity. Ghana, by adopting this model, can position itself as a forward-thinking, economically robust nation in Africa.
Let’s explore some examples from various developing nations where elements of a 24/7 economy have been implemented:
1. India – IT and Outsourcing Hub
India’s rise as a global IT and outsourcing hub is a prime example of the 24/7 economy. The country’s IT sector services clients worldwide, necessitating round-the-clock operations to align with different time zones. This sector’s growth has not only boosted India’s economic output but also created millions of jobs, contributing to the development of urban infrastructure and service industries.
2. Vietnam – Manufacturing and Export
Vietnam has become a significant player in global manufacturing, particularly in textiles and electronics. By operating factories 24/7, Vietnam meets high international demand, contributing significantly to its GDP growth. This continuous manufacturing cycle has attracted foreign investment, technology transfer, and skills development, aiding Vietnam’s economic transformation.
3. Nigeria – Entertainment and Nightlife
Nigeria, particularly Lagos, has developed a thriving entertainment and nightlife sector. This includes music, cinema, and hospitality, operating round-the-clock. This has not only boosted local economies but also positioned cities like Lagos as cultural hotspots, attracting tourism and global attention to the Nigerian entertainment industry.
4. Mexico – Tourism and Retail
In tourist hotspots like Cancun and Playa del Carmen, Mexico operates a 24/7 economy catering to international tourists. This includes hotels, restaurants, and retail outlets. The continuous operation in these areas contributes to employment and local economic growth, demonstrating how tourism can benefit from a 24/7 economic model.
5. Philippines – Call Centers and BPO
The Philippines has a robust Business Process Outsourcing (BPO) industry, providing services such as customer support, telemarketing, and back-office tasks to global clients. The 24/7 nature of these services has led to economic growth, urban development, and significant employment opportunities, even in less urbanized areas.

6. Egypt – Suez Canal Operations
The Suez Canal, an essential global shipping route in Egypt, operates 24/7. This continuous operation is crucial for global trade and significantly contributes to Egypt’s economy. The canal’s operational efficiency impacts global shipping and trade, highlighting the strategic importance of round-the-clock operations in certain sectors.
These examples demonstrate that the 24/7 economy in developing countries can be sector-specific, driven by global demand, and tailored to the unique strengths and needs of each country. In each case, the 24/7 economy model has led to job creation, economic growth, and in some instances, global integration. For Ghana, adopting a similar model would mean identifying sectors that can effectively operate round-the-clock, considering the local context and global trends, and harnessing these for economic expansion and development.
The 24 Hour Economy presents an exciting opportunity for Ghana to expand its economic horizons. By embracing this model, Ghana can create a more inclusive, productive, and vibrant economy, setting a standard for African nations. It’s a call to innovation and resilience, one that every Ghanaian should support for a brighter, more prosperous future.

By Hon Yussif Jajah
Member of Parliament, Ayawaso North Constituency

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