In Ghana’s busy cities and quiet villages, old health threats are getting new attention.
Heart disease, diabetes, and cancer—once thought to be “rich people’s problems”—are now affecting everyone. “This is because these diseases predominantly seemed to affect the affluent people in our society," says Patience Dapaah, PATH’s Senior Advocacy and Communication Advisor in Ghana. "They were associated with those who could afford the finest things in life, in terms of expensive food, leisure, and an opulent lifestyle.”
“Well, not anymore,” adds Ms. Dapaah. “[NCDs] are now regarded as common diseases in Ghana. Everyone, irrespective of their socioeconomic status, can potentially be affected, and the numbers are increasing alarmingly. It’s a worrying trend.”
Although significant progress has been made over the last decade in the detection and management of NCDs, they are still some of the leading causes of death globally. NCDs affect about 41 million people each year worldwide and are estimated to be responsible for about 70 percent of mortalities globally.
According to the World Health Organization (WHO), NCDs account for 43 percent of all deaths in Ghana, with cardiovascular diseases accounting for 19 percent of NCD deaths. As a result, Ghana, like many middle- and low-income countries, is dealing with the rapid rise of NCD cases.
In the next 15 years, WHO predicts that NCDs will become the most common cause of death in Africa, unless interventions are implemented to change the trend.
Building a healthier future
Ghana is fighting back. With smart ideas and determined health workers, the country is working to keep all its people healthy, no matter their background.
To support their efforts, PATH partnered with the Ministry of Health and Ghana Health Service under the Access Accelerated NCD project and Healthy Heart Africa program to improve access to early NCD screening, diagnosis, and care in the country.
Since its launch in 2019, this collaboration has been working to address some of the key challenges to NCD prevention and management. PATH and partners have been leading an integrated approach to implementing NCD-related programs focused on enabling data-driven decision-making and strengthening information systems, strengthening access to NCD services at clinics and in communities, strengthening NCD prevention supply chain efficiency, and raising public awareness.
“Due to the chronic nature of NCDs, the cost of care tends to be lifelong, further driving families and communities into poverty as a result of an endless cycle of catastrophic spending on health care," says Dr. Wallace Odiko-Ollenu, a representative of the Ghana Health Service NCD Program. "Therefore, there is need to minimize the cost of NCD care, improve NCD management at all levels of care, increase awareness about NCDs, and address health systems challenges at all levels to improve preventive care in communities.”
A targeted and coordinated response
People at risk for or living with NCDs often do not know they are at risk, so they do not seek services. Screening and diagnostic technologies have been designed in and for high-resource settings and are often not readily available in low-resource settings. Services for NCD prevention and care are underresourced, fragmented, and difficult to access. Proven solutions, including low-cost medications, are not consistently available.
That’s why the Access Accelerated NCD project and the Healthy Heart Africa program have implemented strategies to improve screening, linkage to health facilities, and treatment adherence, including:
• Training of health care workers.
• Donating screening equipment, data capture tools, and referral tools.
• Instituting patient follow-up practices.
• Establishing patient support groups.
• Organizing services for patients through NCD clinics.
This comprehensive approach has proven crucial—not only in prioritizing NCD treatment for those already impacted but also in preventing NCDs through community-based interventions and health systems strengthening.
In the past five years, the project has conducted more than 2.5 million screenings across 17 districts in Ghana and diagnosed and linked more than 125,000 persons living with NCDs to care.
“NCDs so often hurt people in their prime—they push families into poverty and reduce their productivity. That’s why at PATH, our priority is to reduce preventable death by increasing access to NCD prevention and care.”— Dr. Patience Cofie, PATH Ghana Country Representative
Integrating NCD prevention and care at all levels
Given the critical role of primary health care in the fight against NCDs, PATH is working with partners to build the capacity of primary health care staff for the prevention of NCDs, early detection, appropriate management, and prompt referral.
Dr. Robert Yeboah, Program Director of the Healthy Heart Africa program, says, “As we speak, over 400 primary health care workers in three regions of Ghana have been trained in effective prevention, detection, and control of NCDs.”
These health care workers have been equipped with the required knowledge and tools in screening and management of NCDs, while local facilities have been supported to leverage community health workers to enhance screening opportunities. These include screening during home visits and targeted outreach for high-risk groups in vantage locations within communities.
PATH and the Ghana Health Service's NCD Program collaboration will also ensure the national NCD policy and strategy are operationalized. PATH’s support to the NCD program and the implementation of the policy and strategy would help reduce exposure to risk factors that contribute to NCDs by prioritizing an integrated approach to implementation of NCD-related programs focusing on health promotion, early detection, and health systems strengthening.
A health provider records hypertension measurements during a community health activity organized by PATH. Photo: PATH/Charles Wanga
Improving access to NCD medicines and health products
Additionally, Access Accelerated and PATH collaborated with the Ministry of Health and Ghana Health Service to analyze supply chain channels for NCD-related commodities. Against this backdrop, PATH conducted an end-to-end NCD supply chain assessment in 2020. The recommendations, including enhancing access to medicines across all disease areas, were adopted by the Ministry of Health and an NCD subgroup was set up to the national supply chain technical working group to develop a roadmap to implement these recommendations.
With the acknowledgment that improving supply security for key NCD medicines is critical to improve overall outcomes for people living with NCDs like heart disease and diabetes, PATH worked with Ghana’s Ministry of Health to conduct NCD landscaping assessment to expose barriers to and vulnerabilities in accessing NCD medicines. These assessments have been crucial to strengthen the health systems by identifying the gaps and challenges creating the largest barriers to accessing high-quality NCD-related prevention and care services.
The NCD Navigator, an innovative digital mapping tool, aims to establish a platform for partners engaged in NCD endeavors to exchange information pertaining to their activities, programs, and project locations across regions and districts.
For a long time, governments and stakeholders have struggled with the lack of high-quality local NCD information to inform priority setting, coordination, and resource allocation. Recognizing the need for data to drive decision-making and resource allocation, PATH developed the NCD Navigator in 2018 in collaboration with Ghana Health Service and Access Accelerated.
The NCD Navigator is a living data management and NCD reporting solution to support the execution of a coordinated strategy. It is a novel and dynamic mapping program that shows the scale and coverage of NCD programming across Ghana with real-time data and visualizations. These data can help to align NCD work with the national strategy, allow for a coordinated response, and support effective resource allocation.
The NCD Navigator, which has been scaled up in all 16 regions of Ghana, is making it possible for the government to make data-driven decisions to ensure efficient and effective use of public resources, to pick up gaps between NCD prevalence and interventions by geographical area and specific NCD conditions, and to determine effective, resilient, and sustainable ways to achieve reducing the NCD burden in Ghana.
