First Aid and Community Health Helper Level 3

Who it is for. People who have finished Level 2, hold a current first-aid certificate from a recognised provider, and want to lead teams, organise training and community health work, and run their own enterprise. In Ghana's TVET qualifications framework, National Proficiency II leads on to National Certificate I. This module is an advanced level, comparable in demand to National Certificate I; it is not a CTVET curriculum and gives no accreditation.

Bridge from Level 2: what you already know

Level 2 did not cover leading teams, organising certified training, running a programme with funders and the health service, supervising staff, or registering, financing and accounting for your own business. Level 3 does. The Hub's Money Skills Level 2 and Entrepreneurial Thinking Level 2 teach general bookkeeping and venture basics; this book goes deeper and stays specific to a first-aid and community health service.

How the module works

Each unit has learning outcomes, performance criteria, the range and the evidence your assessor needs. You are judged Competent or Not Yet Competent. Guidance on first aid and first-aid education is international (IFRC, WHO, St John Ambulance UK) unless a Ghana source is named. Business facts come from Ghana's official bodies (ORC, GRA, SSNIT) as read on 7–8 October 2026. Numbers marked example are invented to teach the method; check every fee and price before you rely on it.

Competency standard

Range. Two mock incidents (one road, one crowd event); one real or mock event plan. Evidence. Leadership observation checklist; incident log; event plan; debrief notes.

Taking charge

1. Stop and look. Danger to you, your team and the public first.
2. Say who you are: "I am Kofi, I am a first aider. I will lead until the ambulance arrives."
3. Give roles by name and colour (bibs help): caller (112 and call-backs), scene safety (traffic, crowd, filming), casualty helpers (pairs), recorder (times and actions), runner (kits, water, blankets).
4. Call 112 early to report a possible multiple-casualty incident, then call again with details.
5. Check everyone quickly before treating, then direct care to breathing and circulation problems first.
6. Use bystanders for simple tasks: keeping pressure on a wound, holding an umbrella, watching walking casualties.
7. Keep the log: times, who did what, changes in each casualty.
8. Protect dignity: stop filming, cover casualties. Filming humiliates casualties and blocks responders.

International reviews of multiple-casualty incidents found poor coordination between agencies to be a common failure, and inter-agency coordination the most valuable lesson after an exercise in Sierra Leone. Build relationships with your local ambulance station, police and fire station before an incident.

Handover and debrief

Handover to the ambulance crew (one minute per casualty): age and sex; what happened and when; what you found (primary and secondary survey); what you did and when; changes since; AMPLE answers; belongings and who is with them. Give the written sheet.

Debrief (within 24 hours): what happened; what went well; what to improve; who needs support (psychological first aid for your own team: Level 2); kit to restock; report to write.

Event first-aid plan

St John Ghana provides event first-aid support. As an owner, agree in writing with the organiser and (where you work with one) the recognised provider who leads clinically. A plan covers:

How many first aiders a given crowd needs was not verified for Ghana; ask the recognised provider and the National Ambulance Service, and write their advice into the plan.

Incident reports

Keep a numbered incident report for every incident and event: date, place, people involved (initials in shared copies), what happened, actions, outcome, lessons, follow-up. Review all reports monthly (Unit 4).

Check yourself

1. Why call 112 before checking all casualties at a multiple-casualty incident?
2. Name five roles you can give at an incident.
3. What must a handover include?

Competency standard

Range. One full course plan and one 45-minute refresher delivered (under supervision). Evidence. Partnership comparison; training needs analysis; session plans; records.

Three partnership models

Commercial alternatives also exist: for example, an International SOS-affiliated company runs certified one-day courses in Accra (not verified beyond a search summary). Check any provider's standing with the employer or body that will rely on the certificate.

Why people come: training needs

IFRC's review found that legal or workplace requirements are a strong motivation to learn first aid, stronger than having an at-risk family member. It also notes a model course for commercial drivers in Ghana that trained laypeople already involved in carrying injured people.

Training needs analysis (for an employer):

1. Number of workers and shifts; where they work; how far from a health facility.
2. Hazards (machines, chemicals, heat, water, vehicles, snakes).
3. Legal duties: a first-aid box per L.I. 655, and first-aid provision with a first aider under section 28 of Act 328.
4. How many trained first aiders per shift: not set by a verified Ghana number; recommend at least one per shift and per work area, and ask the Department of Factories Inspectorate (teaching advice).
5. Special topics (snakebite on farms, drowning at harbours, burns in kitchens).

Session design that works (IFRC education guidance)

• Practice with feedback: devices that give instant feedback on compression depth and rate may improve CPR performance; a simple metronome counts as one. Choose devices to suit learners: a sound-only device suits a learner with low vision but not a deaf learner.
• Blended learning: self-study (reading, video) plus a separate facilitated practical session may build knowledge, confidence and willingness to act; where internet is a barrier, give written material instead.
• Refresh and retrain: skills decline dramatically in the months after a course; refreshers three to six months later, even 45 minutes or less, are valuable.
• Deciding to act is the hardest step: teach learners about hesitation and help them practise acting.
• Include everyone: help learners with sensory or physical disabilities find ways to assess and help that use their strengths.

Classroom hygiene and safety

• Clean manikin faces, mouths and chest plates before each user, following the maker's instructions.
• Disinfect trainer auto-injectors and inhalers with 70% alcohol before and after each user and before storage.
• Give each learner their own bandages and blankets for the session and wash them at the end of the day.
• Manikins only for compressions, thrusts and back blows.

Training records

Check yourself

1. In the organiser model, who assesses and certifies?
2. When does IFRC suggest refreshers, and how long can they be?
3. Why might a sound-only feedback device not suit every learner?

Competency standard

Range. A plan for 10 volunteers covering about 200 households (example). Evidence. Agreement letter draft; training plan; indicator sheet; monthly report.

Agree it with the health service first

CHPS zones are served by a resident community health officer whose core package includes outreach, home visits and referral. Volunteer programmes in Ghana have been coordinated by the District Health Management Team under the national CHPS guidelines. Never run a parallel health programme: write to the District Health Directorate (copy the CHPS officer) describing what your helpers will do and not do, and get the reply in writing.

A volunteer model that has worked (Ghana example)

In a Volta Region programme:

Plan and monitor

Simple monthly indicators

Referral completion is the best sign of value: ask the CHPS officer to confirm which referred people arrived.

Malaria and campaign support

Nets reach families through antenatal care and child welfare clinics, and through mass campaigns. Ghana's 2024–2028 plan aims to test all suspected malaria cases and cut malaria deaths by 90% by 2028. A programme can support net use, early testing ("fever: test today") and campaign registration, only in line with the district health team.

Safeguarding, consent and data protection

• Safeguarding: volunteers never visit a child alone in a closed room; two volunteers for sensitive visits; a named safeguarding lead; report abuse to the health service, Social Welfare or police (teaching advice; follow the funder's policy).
• Consent: ask the household head; explain what you record and why; respect refusals.
• Data protection: under the Data Protection Act, 2012 (Act 843), all data controllers and processors must register with the Data Protection Commission. If your business holds household or learner records, register, keep records locked or password-protected, collect only what you need, and share only with the health service or funder as agreed.

Check yourself

1. Why must the programme be agreed in writing with the health service?
2. What is the best indicator of a helper programme's value, and why?
3. What does Act 843 require of data controllers?

Competency standard

Range. Own service, real or planned, with at least two staff or volunteers. Evidence. Induction checklist; sign-off records; audit; complaints log.

Recruit and induct

Supervise and sign off

Refreshers every three to six months keep skills from fading.

Monthly quality audit

Complaints and incidents

Log every complaint: date, who, what, response, action, closed. Reply within an agreed time (for example 7 days, example policy). Investigate incidents with "what happened, why, what will stop it happening again" and share lessons with the team.

Insurance and liability

Use only insurers licensed by the National Insurance Commission; check at nic.gov.gh. Which covers are compulsory for this business was not verified. Ask about public liability, professional indemnity (for training and event cover), employer's liability or workmen's compensation, and equipment cover. Whether Ghana has a law protecting bystanders who give first aid in good faith ("Good Samaritan" protection) was not verified; IFRC notes that such legal protection matters to first aiders.

Ethics

• Never claim clinical status or certificates you cannot issue.
• Never let staff give medicines, injections or herbs to please a client.
• Never sell medicines; refer.
• Never post casualty or patient images.
• Report safeguarding concerns even if the person involved is a paying client.
• Keep fees honest: what the provider charges, what you charge, and why.

Check yourself

1. Name four things you check before a new staff member works alone.
2. How often should first-aid skills be refreshed?
3. Name three insurance covers to ask about.

Competency standard

Range. Own business plan for a small first-aid and community health service. Evidence. Registration checklist with costs; start-up budget; payroll sheet; one-page plan.

Choose your services

Choose a legal form

Companies file an annual return (GH¢175 a year; late GH¢1,000 for 1 to 4 years, GH¢2,000 for 5 or more), the first 18 months after incorporation. A first-aid service carries liability for training and event cover, so a company limits what owners can lose; a community health programme run as a not-for-profit may suit a company limited by guarantee (teaching advice, not a legal opinion; ask a lawyer).

Registration steps

1. Tax number. Your Ghana Card number is your individual TIN since 1 April 2021; a company gets a GRA TIN after ORC registration.
2. ORC. Register the business name or company (fees above). Business-name renewal can be done on USSD *222#.
3. Partnership agreement with your recognised provider: who teaches, who assesses, who certifies, fees per learner, use of the provider's name and logo, quality checks, complaints.
4. District Health Directorate letter for any community health work (Unit 3).
5. Assembly business operating permit. The Sekondi-Takoradi Metropolitan Assembly runs a permit portal (tcc.stma.gov.gh), with fees in its 2025 fee-fixing resolution. The category and fee for a first-aid training office were not verified. Permits are due by 31 March each year.
6. Fire safety. If you run a training room open to the public, ask the Ghana National Fire Service whether a fire certificate is required (not verified for this use).
7. Data Protection Commission registration before you hold learner, client or household records.
8. SSNIT employer registration before you hire.
9. Insurance from an NIC-licensed insurer.
10. Medicines: your business sells no medicines at all. (Licensed medicine sellers fall under separate rules not covered here.)

Tax choices

• VAT. Under the VAT Act 2025 (Act 1151), VAT is 20% in total (15% VAT plus 2.5% NHIL plus 2.5% GETFund) from 2026. For goods (kits), registration is required above GH¢750,000 turnover; for services there is no threshold: a taxable person making taxable supplies of services registers within 30 days. Whether first-aid training, event first-aid cover and community health promotion are taxable services, or exempt (for example as education or medical services), was not verified: ask the GRA in writing before you set prices. A VAT-registered business cannot use the Modified Taxation Scheme.
• Modified Taxation Scheme. Residents with business income only, not VAT-registered: turnover GH¢20,001 to GH¢750,000 pays 3% of turnover. Professionals, owners of several businesses and partners are excluded.
• Companies. 25% standard company tax; quarterly provisional tax; annual return within four months after year-end.
• Withholding. Company, NGO or government clients that are withholding agents may withhold 7.5% of service fees. Keep the certificates.

Premises and location settings that give good returns

Start-up budget (all figures example)

Manikin prices are Jiji Ghana asking prices seen on 9 October 2026: adult CPR manikin about GH¢4,800; child CPR manikin about GH¢4,800; baby manikins about GH¢550. First-aid kits were advertised at about GH¢360–399 for 25 people. Other lines are invented examples; get real quotes.

(Arithmetic checked by script: 4,800 + 4,800 + 1,100 + 6,000 + 1,300 = 18,000; 18,000 + 4,000 + 15,000 = 37,000; 37,000 + 2,000 = 39,000.)

Funding (example): owner's savings GH¢29,000 and an interest-free family loan GH¢10,000 repaid GH¢1,000 a month from month 4.

Finance options

• Own savings and family, with a written agreement.
• Savings groups and susu (terms not verified).
• Microfinance and banks. The Bank of Ghana policy rate was 14.00%; loan rates were not verified. Lenders will want your records (Unit 6).
• Ghana Enterprises Agency. Programmes include SME GO, Business-in-a-Box, SME High Growth and Kaizen; Business Advisory Centres are in Takoradi, Shama, Effia-Kwesimintsim, Mpohor and Ahanta West.
• 2026 Budget lines include GH¢401 million for a Women's Development Bank and GH¢160 million for Adwumawura. Eligibility not verified.
• Assemblies' disability fund: the share rose from 3% to 5% in 2026 and now favours skills, assistive devices and start-up capital.
• Grants and contracts from NGOs and companies for community health and first-aid training (check each funder's rules).

Employing staff: pay and law

• Minimum wage for 2026: GH¢21.77 a day.
• Written contract for work of six months or more (section 12); written statement of terms within two months (section 13); 15 working days' paid leave (section 20); 12 weeks' maternity leave (section 57); casual workers paid at least the minimum for each day (section 74).
• SSNIT: worker 5.5% and employer 13% of basic pay (18.5%), paid by the 14th of the next month; late payment 3% a month.
• PAYE monthly bands from 1 September 2026: first GH¢588 at 0%; next 80 at 5%; next 100 at 10%; next 2,900 at 17.5%; next 16,000 at 25%; next 30,332 at 30%; above that 35%; SSNIT deducted first; due by the 15th.

Worked example (pay figures example, 2026 rates). A training assistant earns GH¢1,500 basic a month. SSNIT 5.5% = GH¢82.50. Taxable = 1,417.50. PAYE: 0 + (80 × 5% = 4.00) + (100 × 10% = 10.00) + (1,417.50 − 768 = 649.50 at 17.5% = 113.66) = GH¢127.66. Net pay = 1,500 − 82.50 − 127.66 = GH¢1,289.84. Employer SSNIT 13% = GH¢195. Total employer cost = GH¢1,695. SSNIT to pay = 82.50 + 195 = GH¢277.50; PAYE GH¢127.66; together GH¢405.16 due next month.

Volunteers and event staff. Allowances to community volunteers and day rates to event first aiders must be recorded and paid as agreed; casual workers are paid at least the daily minimum. Casual workers' PAYE is 5%. Whether volunteer allowances are taxable was not verified: ask the GRA.

Market yourself honestly

• WhatsApp Business: profile, catalogue (kits, courses with provider name, refreshers, event cover), quick replies, away messages. Never post casualty images.
• Google Business Profile: service, area, hours; ask clients for honest reviews.
• Signage and print: "First-aid courses with [provider] · Kits and refills · Event first aid". A leaflet that states your limits.
• Referrals and partners: safety officers, HR managers, transport unions, school heads, churches, NGOs, the GEA Business Advisory Centre.
• Proof: certificates, partnership letter, insurance, client letters, audit results, learner numbers.

Accessibility

Ghana's Disability Act bans discrimination against employees and applicants on grounds of disability, requires employers to provide the tools a disabled worker needs, and requires services open to the public to be accessible.

• Staff with disabilities: course coordination, bookings and records, kit assembly and audits, health talks (including in Ghanaian Sign Language), phone support at events, data and reporting, psychological first aid.
• Learners with disabilities: ground-floor rooms; table-height manikins; visual or sound feedback devices chosen to suit the learner; large print, audio or Braille handouts; sign-language interpreters; assessment adjusted so the learner shows they can direct a helper where a physical task is not possible (agree this with the provider).
• Clients and communities: accessible 112 cards and posters; talks at accessible venues.

Check yourself

1. Why must you ask the GRA about VAT before printing prices?
2. What should a partnership agreement with a recognised provider cover?
3. What is the net pay and total employer cost for an assistant on GH¢1,500 basic?

Competency standard

Range. One month of example or real records. Evidence. Books; statements; reconciliation; break-even; debtors list.

The records

Keep records in Ghana for at least 6 years from the end of the year of assessment or VAT period. Assets = liabilities + owner's equity; a debit increases assets and expenses, a credit increases liabilities, capital and income; a trial balance is only a partial check. Small businesses follow IFRS for SMEs, with a new edition from 1 January 2027. Straight-line depreciation = (cost − salvage value) ÷ useful life.

Cost and price (all figures example)

Margin = profit ÷ price; mark-up = profit ÷ cost. Be clear which one you mean.

Worked month: October (all figures example)

Break-even

Depreciation of manikins

Debtors: late contracts

NGO and company contracts are often paid a month or more late. Rules (example policy): invoice on the last day of the month; payment within 30 days; reminder at day 31; owner call at day 45; written payment plan at day 60. Keep an aged debtors list every week.

Reconciliation: MoMo and bank

Match the MoMo and bank books to the statements weekly. Example: the MoMo book shows GH¢6,000 received; the statement shows GH¢5,940 after GH¢60 charges. Record the charges as an expense; both agree at GH¢5,940. Never let staff collect course fees into a personal MoMo number.

Taxes in the books

• PAYE and SSNIT: PAYE by the 15th, SSNIT by the 14th of the next month. Late SSNIT costs 3% a month.
• VAT (if your services are taxable or you register): charge 20% and pay by the last working day of the next month. Example only: if October's GH¢15,800 of sales were all taxable, output VAT would be 15,800 × 20% = GH¢3,160. Ask the GRA first (Unit 5).
• Withholding tax: keep the certificates when clients withhold 7.5% on services.
• Income tax: under the MTS, 3% of turnover for GH¢20,001–750,000; companies 25% with quarterly provisional tax.

Software and the calendar

Use a spreadsheet, or a free plan such as Zoho Books or Wave.

Month-end routine

Check yourself

1. Why did cash rise much less than profit in the worked month?
2. What is the difference between margin and mark-up?
3. Where do kit purchases go before kits are sold?

Competency standard

Range. Own business plan. Evidence. Business plan; contract outline; cash forecast; pitch.

The market

• Fewer than 1% of Ghanaians are trained in first aid or CPR.
• Legal and workplace requirements are the strongest reason people take first-aid courses; Ghana's First Aid Regulations require first-aid boxes in factories, offices and shops.
• The National Ambulance Service has trained 6,000 community responders and says it has no dedicated funding: a sign of demand for community first aid and of tight public budgets.
• Malaria, diarrhoea and road injuries remain community priorities.

Quality and customer care

• Show clients your audit results and certificate log.
• A named contact for each contract client; a monthly check-in call.
• Remind learners before certificates expire; offer refreshers at three to six months.
• Log and close every complaint.

Pricing strategy

• Cost-plus: each product priced from its cost (Unit 6) plus a margin that covers overheads, growth and a reserve.
• Know the market: compare kit prices and providers' course fees (phone them).
• Packages: "Safe Workplace" (kits + refills + one certified course + refresher); "Safe Event"; "Safe School".
• Clear terms: deposits for courses and events; 30-day terms for contracts; cancellation rules.
• VAT: settle the GRA question before printing prices (Unit 5).

Scale carefully

1. Fix quality, books and cash first.
2. Fill courses (12 learners) before adding dates; fill refill routes before adding areas.
3. Promote a senior first aider to supervise; add a second team only when contracts justify it.
4. Add services that fit: water-safety programmes for coastal schools, snakebite awareness for cocoa and oil-palm farms, kit supply to transport unions.
5. Deepen the provider partnership (assistant trainer, then instructor if the provider offers it).

Partnerships, contracts and tenders

Partners: recognised providers; the District Health Directorate and CHPS; NGOs; employers and safety officers; transport unions; schools and churches; the National Ambulance Service; the GEA Business Advisory Centre.

A client contract should say: parties; services and limits (no medical acts, no medicines); who certifies; dates, numbers and venue; price, deposit and payment terms; cancellation; insurance; complaints; data protection; signatures. Have a lawyer check your standard contract.

Tenders: companies, NGOs and public bodies may ask for: registration papers, TIN, SSNIT compliance, the provider partnership letter, insurance, references, CVs and certificates of your team, a method statement, and your price.

Records for loans: registration papers; 12 months of bank and MoMo statements; profit and loss and balance sheets; debtors list; payroll and SSNIT records; a cash forecast; your plan.

Ethics and succession

• Never sell a certificate you cannot issue or a course the provider did not run.
• Never let staff give medicines or herbs, or teach snakebite myths.
• Never underpay staff or skip SSNIT to win a price war.
• Succession: name who runs the business if you are ill or away; train them; keep contracts, policies, passwords and records where they can be found.

A 12-month cash forecast (all figures example)

Assumptions: month 1 is the October worked month. Kit sales (kits) 15, 15, 18, 18, 20, 20, 22, 22, 25, 25, 25, 28 at GH¢300; kit contents bought each month to replace those sold, at GH¢200 (plus the GH¢2,000 owed from month 1, paid in month 2). Refill clients 25, 26, 27, 28, 30, 30, 32, 32, 34, 35, 35, 36 at GH¢80, 80% collected in the month and 20% the next; materials GH¢35 per client. Courses per month 1, 1, 1, 2, 1, 2, 2, 1, 2, 2, 2, 1, each 12 learners at GH¢400, provider GH¢200 per learner, venue GH¢600. NGO contract GH¢3,000 a month for months 1–6 only, paid the next month; volunteer allowances GH¢1,200 in months 1–6. Events per month 1, 1, 2, 1, 1, 2, 1, 1, 2, 1, 2, 3 at GH¢1,500. One assistant (net pay in the month; SSNIT and PAYE GH¢405.16 the next month). Overheads GH¢1,700 a month; drawings GH¢2,000 a month; loan repaid GH¢1,000 a month from month 4; renewals GH¢1,500 in month 6. Opening cash GH¢15,000. Tax and VAT are left out. (Arithmetic checked by script.)

Reading the forecast.

• Year totals: sales GH¢236,900; 253 kits, 18 courses (216 learners), 18 events.
• Costs for the year (cost of kits, refill materials, course costs, allowances, staff, overheads, depreciation, renewals) GH¢172,990. Profit before tax and drawings = GH¢63,910. Drawings of GH¢24,000 come out of this.
• Months 1–2 are the tightest: the NGO pays a month late and the supplier must be paid. A course deposit and faster refill collection would help.
• Month 7 shows the NGO contract ending: sales fall by GH¢3,000 a month. Plan the next contract before month 6.
• Month 8 shows a weak month (one course, one event): fixed costs do not fall.
• Cash at the end of month 12 includes GH¢405.16 of SSNIT and PAYE still to pay, and GH¢1,000 of the family loan is still owed (10,000 − 9 × 1,000).
• Tax questions. Turnover of GH¢236,900 is below the GH¢750,000 MTS ceiling; a sole trader not registered for VAT would pay 3% = GH¢7,107. Kit sales (GH¢75,900) are well below the goods VAT threshold, but if training or event cover are taxable services, VAT registration is required with no threshold and the MTS would not apply. Settle this with the GRA before launch.
• Test it: what if the NGO pays 60 days late? What if two courses are cancelled? What if the provider raises its fee by 25%?

Business ideas

Capstone

Present to a panel: a one-page business plan and a 12-month cash forecast. Include your scope (and the hard gate), provider partnership, quality plan, registration checklist (with open questions), staffing and payroll, and a risk list.

Check yourself

1. Why does month 7 of the forecast matter?
2. What must every client contract state about limits?
3. Name four documents a lender will ask for.

1. What is the first thing you do as leader at a multiple-casualty incident, after scene safety?
2. Name five headings of an event first-aid plan.
3. In the organiser model, what do you do and what does the provider do?
4. What does IFRC say about refreshers?
5. Name three features of the Volta volunteer model.
6. What is referral completion and why does it matter?
7. What must a data controller do under Act 843?
8. What are the 2026 ORC fees for a business name and a company limited by shares?
9. What is the VAT position for services under Act 1151, and why does it matter here?
10. Work out net pay for an assistant on GH¢1,500 basic.
11. In the worked month, what were the net profit and closing cash?
12. What does the 12-month forecast warn about month 7?

Best next reads: the IFRC International First Aid, Resuscitation and Education Guidelines 2020 (education chapters); your recognised provider's instructor requirements; the Hub's Money Skills Level 2 and Entrepreneurial Thinking Level 2; the GRA and ORC fee pages before you register.

What this module does not cover: clinical care of any kind, medicine sales, ambulance services, and formal instructor qualification (which only a recognised provider can give).

Every source used in this manual is listed, with links, in the Teacher Copy.