Health in Ghana
Encyclopedia
Health in Ghana includes the prevention, care and treatment of disease and other maladies. As parts of the Ghanaian economy are not fully industrialized
, issues arise that are common to growing healthcare systems, such as waterborne disease and sanitation
problems. Diseases in Ghana
are fairly similar to those endemic in other Sub-Saharan
countries, with diseases as malaria
and HIV/AIDS having significant impact on the population.
, and decentralization of the rural supply to 138 districts
, where user participation is encouraged. The reforms aim at increasing cost recovery and a modernization of the urban utility Ghana Water Company Ltd. (GWCL), as well as of rural water supply systems.
Another problem which partly arose from the recent reforms is the existence of a multitude of institutions with overlapping responsibilities. The National Water Policy (NWP), launched at the beginning of 2008, seeks to introduce a comprehensive sector policy.
, most health care is provided by the government and largely administered by the Ministry of Health
and Ghana Health Services. The healthcare system has 5 levels of provides: health posts which are first level primary care for rural ares, health centers and clinics, district hospitals, regional hospitals and tertiary hospitals. These programs are funded by the GO
, financial credis, Internally Generated Fund and a donor pool.
Hospitals and clinics run by religious groups also play an important role. There are 172 hospitals in Ghana. Hospitals run by religious groups make up thirty-five percent (35%) of Ghana's health service provision. Collectively they are known as the Christian Health Association of Ghana. Some for-profit clinics exist, but they provide less than 2% of health services.
Health care is very variable through the country. Urban centres are well served, and contain most hospitals, clinics, and pharmacies in the country. However, rural areas often have no modern health care. Patients in these areas either rely on traditional African medicine, or travel great distances for care. In 2005, Ghana spent 6.2% of GDP on health care, or US$30 per capita. Of that, approximately 34% was government expenditure.
and the United Nations Children's Fund
hae been active in providing money and support to provide additional western medical care in Ghana.
Scheme, many people died because they did not have money to pay for their health care needs when they were taken ill. The system of health which operated was known as the "Cash and Carry
" system. Under this system, the health need of an individual was only attended to after initial payment for the service was made. Even in cases when patients had been brought into the hospital on emergencies it was required that money was paid at every point of service delivery. When the country returned to democratic rule in 1992, its health care sector started seeing improvements in terms of:
even with these initiatives in place many still could not access health care services because of the cash and carry system.
The idea for the National Health Insurance Scheme (NHIS) in Ghana was conceived by former president John Kufour who when seeking the mandate of the people in the 2000 elections, promised to abolish the “cash and carry
system” of health delivery. Upon becoming president, former president Kufour pushed through his idea of getting rid of “cash and carry” and replacing it with an equitable insurance scheme that ensured that treatment was provided first before payment. In 2003, the scheme was passed into law. Under the law, there was the establishment of National Health Insurance Authority which licenses, monitors and regulates the operation of health insurance schemes in Ghana. Like many countries in the world, Ghana's health insurance was fashioned out to meet specific needs of its citizens. Since its inception, the country's health facilities have seen constant rise in patient numbers and a considerable reduction in deaths.
the most common diseases in Ghana include those endemic to sub-Saharan African countries, particularly: cholera
, typhoid, pulmonary tuberculosis, anthrax
, pertussis
, tetanus
, chicken pox, yellow fever
, measles
, infectious hepatitis, trachoma
, malaria
, and schistosomiasis
. Though not as common, other regularly treated diseases include dracunculiasis
, dysentery
, river blindness or onchocerciasis, several kinds of pneumonia
, dehydration
, venereal diseases, and poliomyelitis
.
In 1994, the WHO reported malaria and measles as the most common causes of premature death. In children under 5, 70 percent of deaths were caused by an infection
compounded by malnutrition
. A 2011 report by the Ghana Health Service
said that malaria was the primary cause of morbidity and about 32.5 percent of people admitted to Ghanian medical facilities were admitted because of malaria.
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Ghana is 350. This is compared with 409.2 in 2008 and 549 in 1990. The under 5 mortality rate, per 1,000 births is 72 and the neonatal mortality as a percentage of under 5's mortality is 39. The aim of this report is to highlight ways in which the Millennium Development Goals
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Ghana the number of midwives per 1,000 live births is 5 and 1 in 66 shows us the lifetime risk of death for pregnant women.
is the leading malignancy. In 2007, breast cancer accounted for 15.4% of all malignancies, and this number increases annually. Although breast cancer may not be a priority to international aid organizations due to the enormity of other health concerns such as HIV/AIDS and malaria
, roughly 70% of women who are diagnosed with breast cancer in Ghana are in the advanced stages of the disease, resulting in a higher mortality rate compared to high-income countries. In addition, a recent study has shown that Ghanaian women are more likely to be diagnosed with high-grade tumors that are negative for expression of the estrogen receptor
, progesterone receptor
, and the HER2/neu
marker. These triple negative breast tumors are more aggressive and result in higher breast cancer mortality rates for this African patient population.
Explanations for the delayed presentation among Ghanaian women have been traced to the cost of, and access to, routine screening mammography, lack of awareness, and cultural attitudes. In particular, harsh social stigma, fear of mastectomy or death, and the appeal of traditional healers over doctors are cited as cultural reasons for late presentation of breast cancer in Ghana. Furthermore, women with breast cancer in Ghana describe a feeling of hopelessness and helplessness, largely due to their belief in fatalism, which contributes to denial as a means of coping. Mayo et al. (2003) conclude, however, that lack of awareness may be a more critical variable than fatalism in explaining health care decisions among Ghanaian women.
Over the past decade, international delegations and nongovernmental organizations have started responding to the growing problem of breast cancer in Ghana. In particular, the Breast Health Global Initiative and the Susan G. Komen for the Cure
established a Ghana Breast Cancer Alliance to help increase early detection and reduce the high breast cancer mortality rate in the country. Through public education, awareness, training, and particularly promotion of early detection practices, international aid groups can help improve the grave situation in Ghana.
Developing country
A developing country, also known as a less-developed country, is a nation with a low level of material well-being. Since no single definition of the term developing country is recognized internationally, the levels of development may vary widely within so-called developing countries...
, issues arise that are common to growing healthcare systems, such as waterborne disease and sanitation
Sanitation
Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...
problems. Diseases in Ghana
Ghana
Ghana , officially the Republic of Ghana, is a country located in West Africa. It is bordered by Côte d'Ivoire to the west, Burkina Faso to the north, Togo to the east, and the Gulf of Guinea to the south...
are fairly similar to those endemic in other Sub-Saharan
Sub-Saharan Africa
Sub-Saharan Africa as a geographical term refers to the area of the African continent which lies south of the Sahara. A political definition of Sub-Saharan Africa, instead, covers all African countries which are fully or partially located south of the Sahara...
countries, with diseases as malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
and HIV/AIDS having significant impact on the population.
Water Supply and Sanitation
The water supply and sanitation sector in Ghana faces severe problems, partly due to a neglect of the sector until the 1990s. Tariffs were kept at a low level which was far from reflecting the real cost of the service. Economic efficiency still remains below the regional average, resulting in a lack of financial resources to maintain and extend the infrastructure. Since 1994, the sector has been gradually modernized through the creation of an autonomous regulatory agency, introduction of private sector participationWater privatization in Ghana
Water privatization in Ghana has been discussed since the early 1990s as a reaction to poor service quality and low efficiency of the existing urban water utility Ghana Water and Sewerage Corporation , renamed Ghana Water Company Ltd. in 1999...
, and decentralization of the rural supply to 138 districts
Districts of Ghana
||The Districts of Ghana are second-level administrative subdivisions of Ghana, below the level of region.The districts of Ghana were re-organized in 1988/1989 in an attempt to decentralize the government and to combat the rampant corruption amongst officials...
, where user participation is encouraged. The reforms aim at increasing cost recovery and a modernization of the urban utility Ghana Water Company Ltd. (GWCL), as well as of rural water supply systems.
Another problem which partly arose from the recent reforms is the existence of a multitude of institutions with overlapping responsibilities. The National Water Policy (NWP), launched at the beginning of 2008, seeks to introduce a comprehensive sector policy.
Healthcare
In GhanaGhana
Ghana , officially the Republic of Ghana, is a country located in West Africa. It is bordered by Côte d'Ivoire to the west, Burkina Faso to the north, Togo to the east, and the Gulf of Guinea to the south...
, most health care is provided by the government and largely administered by the Ministry of Health
Ministry of Health, Ghana
The Ministry of Health is the government ministry of Ghana that is responsible for the health of Ghana. It is involved in providing public health services, managing Ghana's healthcare industry, and building Ghana's hospitals and medical education system.Ministry main offices are located in...
and Ghana Health Services. The healthcare system has 5 levels of provides: health posts which are first level primary care for rural ares, health centers and clinics, district hospitals, regional hospitals and tertiary hospitals. These programs are funded by the GO
Go
Go may refer to:* Go , to move from one place to another-Games:* Go , an abstract strategy board game for two players* Travel Go , a game based around world travel...
, financial credis, Internally Generated Fund and a donor pool.
Hospitals and clinics run by religious groups also play an important role. There are 172 hospitals in Ghana. Hospitals run by religious groups make up thirty-five percent (35%) of Ghana's health service provision. Collectively they are known as the Christian Health Association of Ghana. Some for-profit clinics exist, but they provide less than 2% of health services.
Health care is very variable through the country. Urban centres are well served, and contain most hospitals, clinics, and pharmacies in the country. However, rural areas often have no modern health care. Patients in these areas either rely on traditional African medicine, or travel great distances for care. In 2005, Ghana spent 6.2% of GDP on health care, or US$30 per capita. Of that, approximately 34% was government expenditure.
History
Traditionally, village priests and Muslim clerics were the primary care givers, offering herbal remedies as well as spiritual healing. Though herbalist have traditionally offered the most ready treatment of illness, premodern traditional beliefs stressed the combination of spiritual and physical healing. Western medicine was introduced by Christian missionaries to the Gold Coast in the nineteenth century, and these were the sole medical providers until after World War I. After the war, the central government made a concentrated effort to expand western style medical facilities and after World War II both the World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
and the United Nations Children's Fund
United Nations Children's Fund
United Nations Children's Fund was created by the United Nations General Assembly on December 11, 1946, to provide emergency food and healthcare to children in countries that had been devastated by World War II...
hae been active in providing money and support to provide additional western medical care in Ghana.
National Health Insurance
Until the establishment of the National Health InsuranceNational health insurance
National health insurance is health insurance that insures a national population for the costs of health care and usually is instituted as a program of healthcare reform. It is enforced by law. It may be administered by the public sector, the private sector, or a combination of both...
Scheme, many people died because they did not have money to pay for their health care needs when they were taken ill. The system of health which operated was known as the "Cash and Carry
Cash and carry
Cash and carry may refer to:*Cash and Carry , the first network-televised game show*Cash and carry , a revision of the Neutrality Acts, designed to aid the British...
" system. Under this system, the health need of an individual was only attended to after initial payment for the service was made. Even in cases when patients had been brought into the hospital on emergencies it was required that money was paid at every point of service delivery. When the country returned to democratic rule in 1992, its health care sector started seeing improvements in terms of:
- Service delivery
- Human resource improvement
- Public education about health condition
even with these initiatives in place many still could not access health care services because of the cash and carry system.
The idea for the National Health Insurance Scheme (NHIS) in Ghana was conceived by former president John Kufour who when seeking the mandate of the people in the 2000 elections, promised to abolish the “cash and carry
Cash and carry
Cash and carry may refer to:*Cash and Carry , the first network-televised game show*Cash and carry , a revision of the Neutrality Acts, designed to aid the British...
system” of health delivery. Upon becoming president, former president Kufour pushed through his idea of getting rid of “cash and carry” and replacing it with an equitable insurance scheme that ensured that treatment was provided first before payment. In 2003, the scheme was passed into law. Under the law, there was the establishment of National Health Insurance Authority which licenses, monitors and regulates the operation of health insurance schemes in Ghana. Like many countries in the world, Ghana's health insurance was fashioned out to meet specific needs of its citizens. Since its inception, the country's health facilities have seen constant rise in patient numbers and a considerable reduction in deaths.
Disease
According to the World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
the most common diseases in Ghana include those endemic to sub-Saharan African countries, particularly: cholera
Cholera
Cholera is an infection of the small intestine that is caused by the bacterium Vibrio cholerae. The main symptoms are profuse watery diarrhea and vomiting. Transmission occurs primarily by drinking or eating water or food that has been contaminated by the diarrhea of an infected person or the feces...
, typhoid, pulmonary tuberculosis, anthrax
Anthrax
Anthrax is an acute disease caused by the bacterium Bacillus anthracis. Most forms of the disease are lethal, and it affects both humans and other animals...
, pertussis
Pertussis
Pertussis, also known as whooping cough , is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched "whoop" sound in infected babies and children when they inhale air...
, tetanus
Tetanus
Tetanus is a medical condition characterized by a prolonged contraction of skeletal muscle fibers. The primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, rod-shaped, obligate anaerobic bacterium Clostridium tetani...
, chicken pox, yellow fever
Yellow fever
Yellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....
, measles
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...
, infectious hepatitis, trachoma
Trachoma
Trachoma is an infectious disease causing a characteristic roughening of the inner surface of the eyelids. Also called granular conjunctivitis and Egyptian ophthalmia, it is the leading cause of infectious blindness in the world...
, malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
, and schistosomiasis
Schistosomiasis
Schistosomiasis is a parasitic disease caused by several species of trematodes , a parasitic worm of the genus Schistosoma. Snails often act as an intermediary agent for the infectious diseases until a new human host is found...
. Though not as common, other regularly treated diseases include dracunculiasis
Dracunculiasis
Dracunculiasis , also called guinea worm disease , is a parasitic infection caused by Dracunculus medinensis, a long and very thin nematode . The infection begins when a person drinks stagnant water contaminated with copepods infested by the larvae of the guinea worm...
, dysentery
Dysentery
Dysentery is an inflammatory disorder of the intestine, especially of the colon, that results in severe diarrhea containing mucus and/or blood in the faeces with fever and abdominal pain. If left untreated, dysentery can be fatal.There are differences between dysentery and normal bloody diarrhoea...
, river blindness or onchocerciasis, several kinds of pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
, dehydration
Dehydration
In physiology and medicine, dehydration is defined as the excessive loss of body fluid. It is literally the removal of water from an object; however, in physiological terms, it entails a deficiency of fluid within an organism...
, venereal diseases, and poliomyelitis
Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...
.
In 1994, the WHO reported malaria and measles as the most common causes of premature death. In children under 5, 70 percent of deaths were caused by an infection
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
compounded by malnutrition
Malnutrition
Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....
. A 2011 report by the Ghana Health Service
Ghana Health Service
The Ghana Health Service is a Ghanian government body established in 1996 as part of the Health Sector Reform of Ghana. The Health Service is under the Ministry of Health. The Health service primarily administrates the health services provided by the government and in implementing government...
said that malaria was the primary cause of morbidity and about 32.5 percent of people admitted to Ghanian medical facilities were admitted because of malaria.
HIV/AIDS
Like other countries worldwide, HIV/AIDS is present in Ghana. In 2004 there were an estimated 404,000 people infected with the virus. HIV prevalence is highest in the Eastern Region of Ghana and lowest in the northern regions of the country. In response to the epidemic, the government established the Ghana AIDS Commission which coordinates efforts amongst NGO's, international organizations and other parties to support education about and treatment of HIV/AIDS throughout Ghana. The United States, European nations and the United Nations have supplied aid to help alleviate HIV/AIDS issues in Ghana.Women's Health
The health of women in Ghana is critical for national development. Women’s health issues in the country are largely centered on nutrition, reproductive health and family planning. According to the Ghana Demographic and Health Survey report, 65% of pregnant women and 45% of non-pregnant women are malnourished in Ghana. Reproduction is the source of many health problems for women in Ghana. The Ghana Living Standards Survey Report of the Fifth Round revealed that only about 17% of women reported that they, or their partners, were using modern forms of contraception. This statistic has significant implications for the spread of HIV/AIDS, which currently affects 140,000 women in Ghana (of the 260,000 people living with the disease in the country). Interventions for improving the health of women in Ghana, such as the Ghana Reproductive Health Strategic Plan 2007-2011, focus on maternal morbidity and mortality, contraceptive use and family planning services, and total empowerment of women.Maternal and Child Health Care
In June 2011, the United Nations Population FundUnited Nations Population Fund
The United Nations Population Fund is a UN organization. The work of the UNFPA involves promotion of the right of every woman, man and child to enjoy a life of health and equal opportunity. This is done through major national and demographic surveys and with population censuses...
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Ghana is 350. This is compared with 409.2 in 2008 and 549 in 1990. The under 5 mortality rate, per 1,000 births is 72 and the neonatal mortality as a percentage of under 5's mortality is 39. The aim of this report is to highlight ways in which the Millennium Development Goals
Millennium Development Goals
The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Ghana the number of midwives per 1,000 live births is 5 and 1 in 66 shows us the lifetime risk of death for pregnant women.
Breast cancer
In Ghana, breast cancerBreast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
is the leading malignancy. In 2007, breast cancer accounted for 15.4% of all malignancies, and this number increases annually. Although breast cancer may not be a priority to international aid organizations due to the enormity of other health concerns such as HIV/AIDS and malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
, roughly 70% of women who are diagnosed with breast cancer in Ghana are in the advanced stages of the disease, resulting in a higher mortality rate compared to high-income countries. In addition, a recent study has shown that Ghanaian women are more likely to be diagnosed with high-grade tumors that are negative for expression of the estrogen receptor
Estrogen receptor
Estrogen receptor refers to a group of receptors that are activated by the hormone 17β-estradiol . Two types of estrogen receptor exist: ER, which is a member of the nuclear hormone family of intracellular receptors, and the estrogen G protein-coupled receptor GPR30 , which is a G protein-coupled...
, progesterone receptor
Progesterone receptor
The progesterone receptor also known as NR3C3 , is an intracellular steroid receptor that specifically binds progesterone...
, and the HER2/neu
HER2/neu
HER-2 also known as proto-oncogene Neu, receptor tyrosine-protein kinase erbB-2, CD340 or p185 is an enzyme that in humans is encoded by the ERBB2 gene. Over expression of this gene is correlated with higher aggressiveness in breast cancers...
marker. These triple negative breast tumors are more aggressive and result in higher breast cancer mortality rates for this African patient population.
Explanations for the delayed presentation among Ghanaian women have been traced to the cost of, and access to, routine screening mammography, lack of awareness, and cultural attitudes. In particular, harsh social stigma, fear of mastectomy or death, and the appeal of traditional healers over doctors are cited as cultural reasons for late presentation of breast cancer in Ghana. Furthermore, women with breast cancer in Ghana describe a feeling of hopelessness and helplessness, largely due to their belief in fatalism, which contributes to denial as a means of coping. Mayo et al. (2003) conclude, however, that lack of awareness may be a more critical variable than fatalism in explaining health care decisions among Ghanaian women.
Over the past decade, international delegations and nongovernmental organizations have started responding to the growing problem of breast cancer in Ghana. In particular, the Breast Health Global Initiative and the Susan G. Komen for the Cure
Susan G. Komen for the Cure
Susan G. Komen for the Cure, formerly known as The Susan G. Komen Breast Cancer Foundation, often referred to as simply Komen, is the most widely known, largest and best-funded breast cancer organization in the US....
established a Ghana Breast Cancer Alliance to help increase early detection and reduce the high breast cancer mortality rate in the country. Through public education, awareness, training, and particularly promotion of early detection practices, international aid groups can help improve the grave situation in Ghana.