Chronic Non-Communicable Diseases in Ghana : Multidisciplinary Perspectives
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Editors : Ama de-Graft Aikins, Samuel Agyei-Mensah, Charles Agyemang
Publisher : Sub-Saharan Publishers
Date of Publication : 2013
Place of Publication : Accra
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Item A Comprehensive Review of the Policy and Programmatic Response to Rising Chronic Non-Communicable Disease in Ghana(2013-12-09) Bosu, W.K.Chronic non-communicable diseases (NCDs) in Ghana remain a significant cause of illness and death in Ghana over many years. Yet, until recently, they have been neglected and not considered a health priority. This paper reviews the national policy and programme response to chronic NCDs over the period 1992 to 2009.Unpublished reports, documents, relevant files of the Ghana Health Service (GHS) were examined to assess programmatic response to chronic NCDs. Literature was searched to locate published articles on the epidemiology of chronic NCDs in Ghana. The websites of various local and international health institutions were also searched for relevant articles. Several policy and programme initiatives have been pursued with limited success. A national control programme has been established, NCDs are currently a national policy priority, draft tobacco control legislation prepared, public education campaigns on healthy lifestyles, instituted cervical cancer screening and a national health insurance system to reducing medical costs of chronic NCD care. Major challenges include inefficient programme management, low funding, little political interest, low community awareness, high cost of drugs and absence of structured screening programmes. Emerging opportunities include improving political will, government’s funding of a national cancer screening programme; basic and operational research; and using funds from well-resourced health programmes for overall health system strengthening.Although Ghana has recently determined to emphasise healthy lifestyles and environment as a major health policy for the prevention and control of chronic NCDs, low funding and weak governance have hindered the effective and speedy implementation of proposed interventions.Item The Socio-Cultural and Socio-Economic Context of Africa’s Chronic Disease Burden(2013-12-09) Aikins, A.D.There is increasing recognition that the socio-cultural and socio-economic contexts are important mediating factors for chronic non-communicable disease risks and experiences. In this chapter I situate the burden of NCDs in Ghana and sub-Saharan Africa within the socio-cultural and socio-economic contexts. Drawing on available research evidence I discuss the role of social and cultural norms and socio-economic status of individuals and nations on the major risk factors of NCDs: diets, physical activity, alcohol overconsumption and smoking. I consider the implications for research and intervention.Item Modifiable Risk Factors of Chronic Non-Communicable Diseases in Ghana: Insights from National and Community-Based Surveys(2013-12-09) Awuah, R.B.; Afrifa-Anane., E.Chronic non-communicable diseases (NCDs) are increasingly becoming a major public health problem in Ghana. The increase in the prevalence of some modifiable risk factors has been linked to the rising prevalence of NCDs in Ghana. In this chapter we review empirical studies on the major risk factors of NCDs in Ghana. We conducted a standard literature review of published empirical studies on the modifiable risk factors of hypertension and diabetes (the major chronic NCDs in Ghana). We searched for published research on NCD risk factors in Ghana on PubMed. The findings suggest that obesity, smoking, alcohol consumption and physical inactivity are increasing in prevalence even though there is paucity of data on these risk factors in Ghana. In most studies on chronic NCDs in Ghana, these risk factors have been associated with the prevalence of hypertension and diabetes in particular. Qualitative studies have also indicated that lay healthy individuals and people living with chronic NCDs are aware of most of the risk factors but do not regard obesity as a risk factor of NCDs. Limitations exist in the knowledge and research of modifiable risk factors and their implications on chronic NCDs. We recommend more community-based studies to establish specific risk factors of a population so as to develop specific primary and secondary prevention interventions.Item Mental Health Research in Ghana: A Literature Review(2013-12-09) Read, U.M.; Doku, V.C.Mental health is a neglected area in health care in Ghana. With few clinicians and trained researchers in the field, research has been limited both in quantity and quality. A search of the available literature revealed 98 articles published between 1955 and 2009. Sixty-six are reviewed in this paper. Topics covered included hospital and community-based prevalence studies, psychosis, depression, substance misuse, self-harm, and help-seeking. Much of the research was small in scale and thus largely speculative in its conclusions. Epidemiological data is scarce and unreliable and no large-scale studies have been published. There are very few studies of clinical practice in mental health. The existing literature suggests several important areas for future research to inform the development of targeted and effective interventions in mental health care in Ghana.Item Breast Cancer Research in Ghana: A Review of Social Science Perspectives(2013-12-09) Atobrah, D.Cancers are fast becoming a leading cause of mortality in Ghana. However cancer research is very limited. The situation is worsened by the woefully inadequate research on the subject in the social sciences, which is badly needed to enhance understanding on, and management of the social science dimensions of the disease. The objective of this chapter is to present an overview of research on the different types of cancer in Ghana, and to highlight gaps in social science research on cancer in Ghana, using breast cancer as a case study. An online search of journal publications on all types of cancer in Ghana revealed 105 articles published between 1956 and 2012. The review focused on the type of cancer and the disciplinary themes of the publications. Eighty nine (89.5%) of publications were based on biomedical research on various kinds of cancer. Breast cancer was the most studied type of cancer (n=34) 32.4%, and was dominated by biomedical research n=28 with the remaining 5 being in the social sciences. Social science themes that emerge in the review were mainly on why breast cancer patients report late or abscond during treatment, general knowledge, attitudes and practices on breast cancer screening, fatalism on breast cancer and the cost-effectiveness of breast cancer screening options.Item Stroke Burden in Ghana: A Review of Research(2013-12-09) Agyemang, C.; Sanuade, O.Stroke is becoming an increasing cause of morbidity, mortality and disability in Ghana due to change in lifestyles and an emerging ageing population. Yet, there is paucity of data on the epidemiology of stroke in the country. The aim of this paper is to provide a review of the published literature on the burden of stroke in Ghana and provide implications for future research. We undertook a literature search on stroke burden in Ghana from MEDLINE and Google Scholar for papers published between 1st January 1900 and 31st May 2013. The data indicate that stroke is currently one of the top five causes of deaths in Ghana and is also a frequent cause of admission to hospitals. Stroke is associated with severe disability which poses many challenges to patients and their families, healthcare staffs, and the entire nation. Increasing rate of high blood pressure, diabetes and obesity are major determinants of stroke in Ghana. Also, female admissions and deaths are greater than that of males and most of the stroke cases in the country are haemorrhagic. With the projected rise in stroke burden in Ghana, there is need for more population-based data which would help to trigger effective primary, secondary and tertiary prevention strategies.Item Diabetes in Ghana: A Review of Research on Prevalence, Experiences and Healthcare(2013-12-09) Aikins, A.D.; Owusu-Dabo, E.; Agyemang, C.Diabetes is a major cause of adult morbidity and death in Ghana. In this chapter we review empirical studies on diabetes in Ghana to highlight trends in prevalence as well as medical and social responses to its public health challenges. We conducted by a search of the PUBMED and Psycinfo databases, supplemented by a manual search of bibliographies of the identified articles and through the Ghana Medical Journal as well as local sources of literature available across public libraries. The key findings are as follow. The prevalence of diabetes has risen from 0.2% in the late 1950s (among a community of men in Ho) to 6.0% in 2009 (among a community of men in Kumasi). In Accra, a prevalence of 6.4% was recorded in a mixed community in the late 1990s and 9.1% among civil servants in 2006. Prevalence rates of impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), when measured are double or treble the diabetes prevalence, which suggests that higher numbers of individuals are at risk of developing diabetes in the future. People living with diabetes experience complex psychosocial challenges including psychological and emotional insecurities, and limited social support. Management and self-care is poor, and healer-shopping between medical systems is common. Major limitations exist with diabetes care including poor diabetes education, a lack of guidelines for diabetes care, erratic supply of essential diabetes drugs at health facilities and poorly trained health care professionals to manage diabetes including doctors, nurses and dietitians. We consider challenges for research, healthcare and policy.Item A Review of Population-Based Studies on Hypertension in Ghana(2013-12-09) Addo, J.; Agyemang, C.; Smeeth, L.; Aikins, A.D.; Edusei, A.K.; Ogedegbe, G.Hypertension is becoming a common health problem worldwide with increasing life expectancy and increasing prevalence of risk factors. Epidemiological data on hypertension in Ghana is necessary to guide policy and develop effective interventions. A review of population-based studies on hypertension in Ghana was conducted by a search of the PUBMED database, supplemented by a manual search of bibliographies of the identified articles and through the Ghana Medical Journal. A single reviewer extracted data using standard data collection forms. Eleven studies published on hypertension with surveys conducted between 1973 and 2009 were identified. The prevalence of hypertension was higher in urban than rural areas in studies that covered both types of area and increased with increasing age (prevalence ranging from 19.3% in rural to 54.6% in urban areas). Factors associated with high blood pressure included increasing body mass index, increased saltconsumption, family history of hypertension and excessive alcohol intake. The levels of hypertension detection, treatment and control were generally low (control rates ranged from 1.7% to 12.7%). An increased burden of hypertension should be expected in Ghana as life expectancy increasesand with rapid urbanisation. Without adequate detection and control, this will translate into a higherincidence of stroke and other adverse health outcomes for which hypertension is an established risk factor. Prevention and control of hypertension in Ghana is thus imperative and any delays in instituting preventive measures would most likely pose a greater challenge on the already overburdened health system.