Question:
You will be required to evaluate a National Health System.
The government of Ghana frames the vision to change the country into the middle-income country by the year 2015. This target is considered as biggest ambition of the country in which almost quarter of the population of the country is facing the issue of poverty, where diseases are the part of the life, and almost 50% populations of the country does not have access to basic facilities such as safe water or better sanitation. Therefore this country requires strong vision and commitment along with the sufficient resources.
National health policy of Ghana states Creating Wealth through Health, and it was designed for the purpose of supporting the ambitious vision of the nation. This policy states that ill health can be considered both reason as well as result of the poverty, and it also considered the effect of environmental factors on the health of the people. It must be noted that health policy farmed by the government was implemented through the Health Service Medium Term Development Plans (HSMTDPs) and Programs of Work (POW) (Internations, n.d.). This paper states various factors related to health issues in Ghana such as first section of the essay states the health problems faced by Ghana, section 2 states the historical factors of key health events and for this purpose we choose Malaria and Stroke, and section 3 analyze the position of the country in the world by using different health indicators. Lastly paper is concluded with brief conclusion.
In 1957, Ghana becomes the first sub-Saharan African country which attains its national independence. This country is considered as the country which has strong political dynamics, and it also has high level of democracy (Commonwealth Health Online, 2017)..
Ghana’s problems in terms of healthcare and health infrastructure are very serious in nature. In this context nation decided to adopt the Millennium Development Goals (MDG) derived from the 2000 UN Millennium Declaration, and for this purpose various steps are taken by the government. Ghana decided to accomplish various goals related to health.
As per the report of World Health Organization, there are some common diseases in Ghana such as malaria, HIV, Chlorea, anthrax, etc. . However, some other diseases are also there such as dracunculiasis, dysentery, river blindness or onchocerciasis, pneumonia, dehydration, venereal diseases, and poliomyelitis (Country studies, n.d.).
As per the report issued by WHO in 1994, malaria and measles were the main reason of premature death in Ghana. In the same year almost 70 % children aged under five were died because of the infection which was emerged because of malnutrition. Report published by WHO in 2011 states that malaria was the main reason of morbidity, and almost 32.5% people were admitted to Ghanaian medical facilities because of the malaria (Ghana News Agency, 2011;UNAIDS, 2017).
As per the report published by WHO in 2017, almost 4,319,919 cases related to malaria are reported and from these cases reported deaths were 2137. These numbers includes those cases which are reported by the health facility. Number related to estimated cases of malaria by WHO are high, as it includes 7,300,000 cases of malaria and estimated deaths are 13000 (WHO, 2017).
As per the report issued by Red Cross in 2012, in recent years child health care and life expectancy of adult have been improved. Currently, mortality rate under Ghana for under five is 69 per 1,000 live births, and life expectancy in case of adult is 64.2 years. Ghana face severe issues in context of basic health care, water and sanitation, and the majority population of this country is suffered from the impact of inequitable distribution of access to basic health services, education, and electricity (IFRC, 2012).
The most affected group in Ghana is group of older population of LMICs, as large proportion of this group is facing the risk of transmitted diseases because of the faecal-oral route, and it specially includes those who are living in rural areas. As per one study of SAGE almost 84.7% respondents had access to the drinking water of improved quality and majority resides in urban area, and only 15% respondents reported that they have improved sanitation and this time again majority resides in urban area.
It must be noted that distribution in context of these health detriments is also related to income of the people, which means those who have lower income have less health facilities and those who have higher income have high access to these facilities. There are number of inadequacies which are related to the access to sources of improved water and sanitation, and sanitation is really the big problem, especially in rural areas because in this majority of the older people live. This study further stated that burden of providing best quality of water for the household relied on female adults and children of the families, and it must be noted that this mainly depends on the factor related t income of the family and whether household was located in urban or rural area (Biritwum, 2013).
Malaria:
Malaria is considered as most dangerous disease, and from this disease almost 1 million people died every year and it affect almost half billion people globally (Keba Africa, 2012). In Ghana, malaria is considered as major cause of poverty and low productivity which accounted almost 32.5% of all OPD attendances and 48.8% admission of children under 5 years in the country.
In coastal cities of Ghana, malaria is circulated because of the climate-related factors such as flooding and warmer climate. In case of Malaria transmission, environmental conditions play very important role such as mosquitoes adapting to breed in non-traditional locations such as blocked drains of surface. It must be noted that involvement of community and institutional for clearing the environment from potential mosquito breeding sites, associated with health education and improved malaria control programs are critical for reducing the incidences of malaria.
Experts estimated that between the period of 2020-2080, it is anticipated that season of malaria transmission (may-July) will shift by 1-2 months because of shift occurred in peak patters of rainfall. However, it is also predicted by experts that cases of malaria will be decreased with the reduced rainfall and temperatures above 350C, such conditions result in difficult breeding for those mosquitoes which transmitted malaria (Amekudzi, 2014). After considering all these serious issues Ghana enrolled itself to the Roll Back Malaria (RBM) initiative in 1999, and also create a strategic framework which guided its implementation. For the purpose of achieving the goal Ghana ensures four strategies:
Stroke:
Stroke is considered as second largest disease which causes death in adults and it is considered as the major contributor to disability and reduced quality of life. A study shows that stroke is the major cause of death in those countries which have low income graph, and almost 87% of all deaths because of stroke occurred in these countries.
In Ghana, Stroke result in almost 9.1% of total medical adult admissions, and almost 13.2% of all medical adult deaths within the period of 1 year. The estimated age of patient of stroke was 63.7 (95% ci=62.8, 64.57) years. Males live more life as compared to females, because overall male to female ratio was 1:0.96. It must be noted that risk related to age adjusted from stroke was lower in females as compared to males. Fatality rate in stroke cases was 5.7% at 24 hours, 32.7% at 7 days, and 43.2% at 28 days (Agyeman & Nkum, 2012).
Extreme events of heat can also have a direct impact on health which also causes heat stress. Lengthy exposures in context of high temperatures result in heat strokes and these strokes can also cause death of the person. In Ghana, there is a direct relation between the high temperatures and mortality rate because of stroke. Drought conditions in Ghana also affect the stroke because availability and quality of water reduced which also result in increased cases of Stroke (Coumu, 2016).
Position of Ghana at health indicators:
The countries of the African Region face number of health issues which are severe in nature, and for dealing with these issues it is necessary to have efficient management of health information for the purpose of ensuring a complete and accurate response which help in promoting the health of the population. As per the recommendation given by Ouagadougou and Algiers in 2008, the WHO Africa Regional Office (WHO/AFRO) has implemented an African Health Observatory and real-time Strategic Information System (AHO & RSIS), and both the organizations are operational since 2011. The major role played by African Health Observatory besides helping countries of the WHO/AFRO implement health observatories (WHO, 2017).
As stated above, Ghana adopted the goals set by MGD and takes various actions to achieve these goals. MGD stated various targets and one of the target stated by MGD is reduction in the rate of under-five mortality by 2-3rd from 1990-2015. In 1990, average rate in respect of all the developing countries was 99 deaths per 1,000 live births. In 2013, rates had been reduced to 50 or about half the 1990 rate. This progress was considered as big achievement by developing countries, but situations are different at present time because developing countries as whole fail to meet the target stated y MGD. Despite of rapid improvements from 2000, morality rate of children under-five are high in Ghana as compared to other countries of the world (World Development indicators, 2015).
Another issue which can be measured at health indicators is maternal deaths, in this there is lot of risk in pregnancy and delivery. Almost 800 women’s lose their life while delivering the child or after the delivery of the child. In 2013, almost 289,000 women’s were dies in maternal death in the world and 99% cases happened in developing countries.
Almost half deaths occurred in Sub- Saharan Africa (Ghana) and almost quarter in South Asia. Ghana achieved good result in reducing the maternal mortality ratio. In this country maternal deaths are twice as compared to South Asia, and the maternal mortality rate dropped to almost 50% which was considered big success.
After considering the above facts, it can be said that situation of Ghana as compared to other countries are still very poor in context of health indicators, but still country shows great improvement. However, there is long road which Ghana has to walk.
Conclusion:
Ghana’s problems in terms of healthcare and health infrastructure are very serious in nature. In this context nation decided to adopt the Millennium Development Goals (MDG) derived from the 2000 UN Millennium Declaration, and for this purpose various steps are taken by the government. In coastal cities of Ghana, malaria is circulated because of the climate-related factors such as flooding and warmer climate. On the other hand, stroke is considered as second major reason of death in Ghana. In Ghana, there is a direct relation between the high temperatures and mortality rate because of stroke. Drought conditions in Ghana also affect the stroke because availability and quality of water reduced which also result in increased cases of Stroke. It can be said that Ghana as compared to other countries are still very poor in context of health indicators, but still country shows great improvement.
References:
Agyemang, C. & Nkum, B. (2012). Stroke in Ashanti Region of Ghana. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645146/. Accessed on 9th November 2017.
Amekudzi, L. (2014). The impact of climate change on malaria in coastal Ghana. Available at: https://www.researchgate.net/publication/280087746_The_impact_of_climate_change_on_malaria_in_coastal_Ghana. Accessed on 9th November 2017.
Biritwum R, Mensah G, Yawson A, Minicuci N (2013). Study on Global AGEing and adult health (SAGE) Wave 1: the Ghana national report. Geneva: World Health Organization. Available at: apps.who.int/healthinfo/systems/surveydata/ index.php/catalog/6/download/1940. accessed 9th November 2017.
Commonwealth Health Online, (2017). Current health issues and progress in Ghana. Available at: https://www.commonwealthhealth.org/africa/ghana/current_health_issues_and_progress_in_ghana/. Accessed on 9th November 2017.
Coumu, D. (2016). Climate change impacts in Sub-Saharan Africa: from physical changes to their social repercussions. Available at: https://climateanalytics.org/files/ssa_final_published.pdf. Accessed on 9th November 2017.
Country studies. Health and Welfare. Available at: https://countrystudies.us/ghana/54.htm. Accessed on 9th November 2017.
Ghana Health services. National Malaria Control Programme. Available at: https://www.ghanahealthservice.org/ghs-subcategory.php?cid=4&scid=41. Accessed on 9th November 2017.
Ghana News Agency, (2011). Malaria Bites Into Economic Development. Available at: https://www.ghananewsagency.org/details/Health/MALARIA-BITES-INTO-ECONOMIC-DEVELOPMENT/?ci=1&ai=27413. Accessed on 9th November 2017.
IFRC, (2012). Business models for health service delivery in Ghana Red Cross. Available at: https://www.ifrc.org/Global/Documents/Secretariat/201505/1233300-Ghana%20Red%20Cross%20Case%20Study.pdf. Accessed on 9th November 2017.
Internations. Health Issues and Healthcare in Ghana. Available at: https://www.internations.org/ghana-expats/guide/living-in-ghana-15779/health-issues-and-healthcare-in-ghana-2. Accessed on 9th November 2017.
Keba Africa, (2012). Malaria Prevention. Available at: https://www.kebaafrica.org/malaria-prevention-2/. Accessed on 9th November 2017.
UNAIDS, (2017). Ghana. Available at: https://www.unaids.org/en/regionscountries/countries/ghana/. Accessed on 9th November 2017.
WHO, (2017). Ghana Holds Sixth National Annual Newborn Stakeholders Conference. Available at: https://apps.who.int/iris/bitstream/10665/126341/1/9789241507332_eng.pdf. Accessed on 9th November 2017.
WHO, (2017). Ghana. Available at: https://www.who.int/malaria/publications/country-profiles/profile_gha_en.pdf?ua=1. Accessed on 9th November 2017.
World Bank Group, (2015). World Development Indicators. Available at: https://www.google.co.in/url?sa=t&rct=j&q=&edata-src=s&source=web&cd=9&cad=rja&uact=8&ved=0ahUKEwjJ0drJirHXAhWFqo8KHXw3ADEQFghJMAg&url=https%3A%2F%2Fopenknowledge.worldbank.org%2Fbitstream%2Fhandle%2F10986%2F21634%2F9781464804403.pdf&usg=AOvVaw0iCBoGNBJv8swfp_KcFIyT. Accessed on 9th November 2017.
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