C ommo nwe a l t h memb e r c o u n t r i e s common, are mental health conditions relating to psychoactive substance misuse. Health systems: In 2012 government expenditure on health was three per cent of GDP, equivalent to US$47 per capita. In the most recent survey, conducted between 1997 and 2010, there were ten doctors, and 93 nurses and midwives per 100,000 people. Additionally, in 2011, 67 per cent of births were attended by qualified health staff and in 2013, 89 per cent of one-year-olds were immunised with one dose of measles. In 2012, 87 per cent of people were using an improved drinking water source and 14 per cent had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that Ghana has seven pharmaceutical personnel per 100,000 people. The Ghana Health Service (GHS) was established in 1996. It is an autonomous executive agency responsible for the implementation of national health policies under the control of the Minister for Health through its governing body, the Ghana Health Service Council. Health service delivery in Ghana is split into three levels: primary, secondary and tertiary, with a corresponding three levels of management. Primary care is provided through health centres and clinics, or health posts in rural areas. There are around 200 hospitals – major ones include the Korle Bu Teaching Hospital, the Komfo Anokye Teaching Hospital, Sunyani Regional Hospital and Bolgatanga Regional Hospital. However, medical facilities are often limited outside of the major centres. Non-government health providers, including not-for-profit institutions like the Christian Health Association of Ghana, quasigovernment health facilities and private institutions, provide more than 40 per cent of medical care in Ghana. UN agencies active in health in Ghana are UNAIDS, Unicef, the World Health Organization, UNFPA and the World Food Programme. The World Bank and African Development Bank also work in Ghana. Other donors include the EU, Germany, Israel, Japan, the Netherlands, Korea, UK and the USA. The GHS is known for meticulous record keeping, with every childhood immunisation documented in the mother’s green booklet, which tracks the health care of each child, and recorded in registry books. The pharmaceutical industry consists of importers, manufacturers, wholesalers and retailers. Locally produced products include antiinfectives, vitamins, painkillers, antacids and antibiotics. Local manufacturing meets around a third of demand local and the rest is imported. The sector is regulated by the Food and Drugs Board. The most recent act relating to mental health in Ghana is the 2012 Mental Health Act. Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. For Ghana to achieve its targets for the reduction of child mortality, which form MDG 4, it would need to have reduced under-five deaths per 1,000 live births to 43 and increased measles immunisation to 100 per cent when analysis of the 2015 data is complete. In 2013 under-five mortality stood at 78 deaths per 1,000 live births and measles immunisation at 89 per cent, suggesting that these goals are unlikely to be met. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. Maternal mortality, therefore, should have fallen to 145 cases per 100,000 live births in Ghana. In 2013 Ghana had an adjusted maternal mortality ratio of 380 deaths per 100,000 live births. As Ghana’s maternal mortality rate is more than twice the given target, it is unlikely to achieve MDG 5 when the 2015 data is analysed. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In 2011 this figure stood at 67 per cent, so this target is also unlikely to be met. The government declared maternal mortality a national emergency in 2008, developing the MDG Acceleration Framework – Ghana Action Plan – with the aim of improving maternal health with the level of urgency required. MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. While Ghana’s HIV prevalence for the 15–49 age group has fallen since 2002, the country is struggling to get back to the HIV prevalence levels of 1990. Similarly, the mortality arising as a result of malaria is still not showing a significant and sustained decline. But the general decline in incidence of and mortality (when mortality data excludes cases comorbid with HIV) from TB is encouraging. Mortality by cause of death (% of all deaths), 2012 200 150 100 50 176 Commonwealth Health Partnerships 2015 Communicable diseases, Injuries maternal, perinatal and nutritional conditions Non-communicable diseases Tuberculosis: Incidence and mortality 1990 2000 2010 Mortality excluding cases comorbid with HIV (per100,000 people) Incidence of tuberculosis (per 100,000 people) – including cases comorbid with HIV 0
Commonwealth Health Partnerships 2015
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