Healthcare in Ghana
Healthcare in Ghana is mostly provided by the national government, and less than 5% of GDP is spent on healthcare. The healthcare system still has challenges with access, especially in rural areas not near hospitals.
Historically, the healthcare system has gone through several major periods, pre and post-colonial. In the precolonial period traditional priests, clerics, and herbalists were the primary care givers, offering advice.[1] The use of traditional healers persists mostly in rural regions of Ghana.
The post-colonial period marks the beginning of government intervention on behalf of healthcare through a variety of policies on different government regimes. These policies culminate to the implementation of the National Health Insurance Scheme (NHIS). The NHIS is currently serves people in both the formal and informal employment sectors and seeks to increase access to healthcare for all Ghanaians.[2]
History
In urban
In 1874 Ghana was officially proclaimed a British colony. Ghana proved to be an extremely dangerous disease environment for European colonists driving the British Colonial Administration to establish a Medical Department bringing about an introduction to a formal medical system, consisting of a Laboratory Branch for research, a Medical Branch of hospitals and clinics, and the Sanitary Branch for public health centered near British posts and towns.[5] In addition to hospitals and clinics staffed with British medical professionals, these select towns were also provided anti-malaria medication to be distributed to colonists and to sell to local Ghanaians.[5]
The
By 1981, health services had dramatically declined to the extent that hospitals lacked basic supplies, while healthcare workers left the country in hordes.
In 1997, a Health Fund was launched to provide a pool of funding for the sector.[8] Still, however, the biggest barrier to Ghanaians receiving proper healthcare was the high out of pocket fees. Despite exemptions expansions and infrastructure that increased access to healthcare, out of pocket fees remained a huge barrier.[8] In the election of 2000, John Kufuor as part of the New Patriotic Party (NPP) won over the NDC candidate and in 2003 he launched the National Health Insurance Scheme as under the National Health Insurance Act, providing universal healthcare to all Ghanaians.[8]
Healthcare in the 21st century
In Ghana, most health care is provided by the government and is largely administered by the
These programs are funded by the government of Ghana, financial credits, Internally Generated Fund (IGF), and Donors-pooled Health Fund.[10] Hospitals and clinics run by Christian Health Association of Ghana also provide healthcare services. There are 200 hospitals in Ghana. Some for-profit clinics exist, but they provide less than 2% of health care services.
Rural areas
Health care is very variable through Ghana. Urban centres are well served, and contain most hospitals, clinics, and pharmacies in the country. Rural areas often have no modern health care. Patients in these areas either rely on traditional African medicine, or travel great distances for health care. In 2005, Ghana spent 4% of GDP on health care, or US$30 per capita. Of that, approximately 34% was government expenditure.
Expenditure
In 2010, 4.7% of Ghana's GDP was spent on health,
National Health Insurance
National Health Insurance Scheme | |
Agency overview | |
---|---|
Formed | 2003 |
Jurisdiction | Republic of Ghana |
Parent agency | Parliament of Ghana |
Website | Official Website |
Ghana has a
- Service delivery
- Human resource improvement
- Public education about health condition
The current NHIS operates under the one-time premium policy, where people make one payment for a lifetime of healthcare. The one-time premium policy was used as a way to increase access to healthcare services to those “outside formal sector employment”, allowing taxi drivers, street vendors, etc. to benefit from the NHIS.[17] The one-time payment plan has been unable to fully fund health services for all citizens. These services may have to funded by tax revenue.[17] In addition, the actual act of collecting premiums from the informal employment sector can be costly and there has been allegations of fraud on the part of the official collectors.[17] Those in the informal sector, who do not have the means to pay the one-time premium are essentially locked out of the NHIS benefits if they cannot get access to premium exemptions. Due to the unevenly spread benefits, the poor benefit less from the system.[18]
Maternal and Child Health Care
Maternal Health Care
The current population of Ghana is estimated to be 30.42 million (around 50.9% is the male population, while the female population is around 49.1%)[19] In Ghana the number of midwives per 1,000 live births is 5 and the lifetime risk of death for pregnant women 1 in 66.[20]
Maternal deaths accounted for 14% of all deaths, 10% from direct maternal causes and 4% from indirect maternal causes.[21] Nearly all women (98%) aged 15-49 who had live births or stillbirths in the five years before the survey in 2017 received antenatal care (ANC) from a skilled provider (doctor, nurse/midwife, or community health officer/nurse). Among these women, 86% attended their first ANC visit for a checkup, and 14% went due to complications.[21]
In 2015, the maternal mortality rate per 100,000 births for Ghana was 319[22] compared to 409.2 in 2008 and 549 in the year 1990.
With collaborative efforts from the Ghana Health Service, the current Ghanaian Government, and the various policy makers, Ghana has for the first time recorded its lowest maternal mortality rate in 2018 with 128 deaths per 100,000 live births as against 144 per the same number of deliveries in 2017.
The progress, however, still falls short of global targets for reproductive, maternal, newborn, child and adolescent health (RMNCAH) targets to reach a maternal mortality rate (MMR) of 70 per 100,000 live births by 2030.[23]
Fertility
Fertility rate declined from 3.99 (2000) to 3.28 (2010). Looking at the total fertility rate, 3.94 children are born to every woman in the rural region and 2.78 children are born to every woman in the Urban region (2018 est.). Country comparison to the world: 34th[citation needed]
Gross Reproduction Rate | 1.43 babies Per 1,000 births |
---|---|
Ratio at Birth - Male to Female | 102.62 males per 100 females in 2015 |
Maternal Age | Fertility Rate Per 1,000 Women |
---|---|
15 - 19 | 37.80 Per 1,000 Women |
20 - 24 | 112.20 Per 1,000 Women |
25 - 29 | 158.00 Per 1,000 Women |
30 - 34 | 133.40 Per 1,000 Women |
35 - 39 | 82.80 Per 1,000 Women |
40 - 44 | 37.80 Per 1,000 Women |
45 - 49 | 16.80 Per 1,000 Women |
Breast cancer
Breast cancer is the most common cancer among females in Ghana.[25] In 2020, there were 4400 cases of breast cancer and 2797 estimated cervical cancer cases.[26] Over 3,000 women are diagnosed with cervical cancer each year and more than half of the figure die in Ghana.[27] In 2018, it was estimated that over four thousand cases of breast cancer will be diagnosed and about 1800 women could die from cancer.[28]
In Ghana,Child Health Care
About 3.16 million children under the age of 5 years make up the Ghanaian population; with 1.6 million being males and 1.56 million being females.[24]
For under-five mortality, Ghana in 2015 was estimated to have a rate of 61 deaths per 1000 live births and at the current pace, it could only reach 36.6 deaths per 1000 live births in 2030 against the target of 25 deaths per 1000 live births.[23]
Exclusive Breastfeeding Practices
In Ghana, breastfeeding is common with nearly all children being breastfed. However, the Ghana Demographic Health Survey in 2014 has reported an exclusive breastfeeding rate of 52% at 6 months, which is below the optimal Exclusive Breastfeeding rate of 90% in infants less than 6 months set by the WHO/UNICEF for developing countries.[32] About 43% of infants 0–6 months old are exclusively breastfed; Few children receive nutritionally adequate and safe complementary foods;in many countries less than a fourth of infants 6–23 months of age meet the criteria of dietary diversity and feeding frequency that are appropriate for their age.[33] Though the rate of exclusive breastfeeding in Ghana is below the optimal rate for developing countries, Ghana is doing well (52%) compared to the global rate (43%) of exclusive breastfeeding.
The latest Multiple Indicator Cluster Survey shows that about 13% of children below age 5 years are underweight, 23% are stunted, and 6% are wasted. In the country's capital, Greater Accra Region (GAR), underweight is found among 8.3% of children 0–5 years while 13.7% and 5.4% are stunted and wasted respectively.[34] In the Ashanti Region where the capital is Kumasi, The current rate of exclusive breastfeeding till 6 months of age is an estimated 13.9%.[35] In the Northern region where the capital is Tamale, the rate of exclusive breastfeeding is 63.3%.[36]
There are interventions such as The Ghana Health Service's Child Welfare Clinic (CWC) which is a comprehensive child health service that includes immunization, nutrient supplementation, and growth monitoring and promotion to regulate and monitor the under five health care, infant feeding practices, and empower mothers on the appropriate care required for their children in the country.
The Growth Monitoring and Promotion (GMP) component of the CWC is focused on empowering mothers to know about and become competent to practice appropriate child care, feeding, and health seeking. These outcomes are pursued using individualized and group counseling. The GMP provides an opportunity for interaction between public health workers and mothers regarding the health and well-being of their children.[34]
References
- ^ a b "Ghana : a country study". The Library of Congress. Retrieved 2018-05-07.
- ^ "About Us". www.nhis.gov.gh. Retrieved 2021-05-12.
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- ^ a b La Verle Berry, ed. (1994). "HEALTH AND WELFARE". Ghana: A Country Study.
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- ^ Canagarajah, Sudharshan; Ye, Xiao (April 2001). Public Health and Education Spending in Ghana in 1992-98 (PDF). World Bank Publication. p. 21.
- ^ "WHO Statistical Information System". World Health Organization. Retrieved 2008-09-23.
- ^ "Drones to deliver medicines to 12m people in Ghana". Financial Times. 24 April 2019. Retrieved 9 June 2019.
- ^ Field Listing :: Health expenditures Archived 2014-03-26 at the Wayback Machine.cia.gov. Retrieved 24 June 2013.
- ^ a b "These are the countries where I'm the least known" – Bill Gates visits Ghana". TheJournal.ie. 31 March 2013. Retrieved 24 June 2013.
- ^ "National Health Insurance Scheme (NHIS)". nhis.gov.gh. Retrieved 5 June 2013.
- ^ "National Health Insurance Scheme" (PDF).
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- ^ "Ghana Population". world population review. 2019-08-28. Retrieved 2019-09-14.
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- ^ a b https://dhsprogram.com/pubs/pdf/FR340/FR340.pdf.
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(help) - ^ Field Listing :: Maternal mortality rate.cia.gov. Retrieved 7 May 2016.
- ^ a b ANNOH, ABIGAIL (June 27, 2019). "Ghana records first lowest maternal mortality rate". Ghanaian Times. Retrieved 2019-09-16.
- ^ a b "Ghana Population - 2018". Geobase. Retrieved 2019-09-14.
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- ^ GNA (2022-10-19). "Rebecca Foundation launches project to reduce breast, cervical cancers". Ghana News Agency. Retrieved 2022-12-05.
- ^ "3,000 women diagnosed with Cervical Cancer annually – Health officials". Citinewsroom - Comprehensive News in Ghana. 2019-02-23. Retrieved 2022-12-05.
- ^ "1,800 Ghanaian women could die of breast cancer in 2018 – Study". Citinewsroom - Comprehensive News in Ghana. 2018-10-03. Retrieved 2022-12-05.
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- ^ "Improving breastfeeding, complementary foods and feeding practices". UNICEF. Retrieved 2019-09-16.
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