|
Ghana Health Care
![[JPEG]](http://lcweb2.loc.gov/frd/cs/jpeg.gif)
Korle Bu Hospital in Accra
Courtesy Embassy of Ghana, Washington
Ghana has the full range of diseases endemic to a sub-Saharan
country. According to WHO, common diseases include cholera,
typhoid, pulmonary tuberculosis, anthrax, pertussis, tetanus,
chicken pox, yellow fever, measles, infectious hepatitis, trachoma,
malaria, and schistosomiasis. Others are guinea worm or
dracunculiasi, various kinds of dysentery, river blindness
or onchocerciasis, several kinds of pneumonia, dehydration,
venereal diseases, and poliomyelitis. According to a 1974 report,
more than 75 percent of all preventable diseases at that time were
waterborne. In addition, malnutrition and diseases acquired through
insect bites continued to be common.
WHO lists malaria and measles as the leading causes of
premature death in Ghana. Among children under five years of age,
70 percent of deaths are caused by infections compounded by
malnutrition. Guinea worm reached epidemic proportions, especially
in the northern part of the country, in 1988-89. Cerebral spinal
meningitis also spread in the country and claimed a number of
victims in the late 1980s. All these afflictions are either typical
of tropical regions or common in developing countries.
To improve health conditions in Ghana, the Ministry of Health
emphasized health services research in the 1970s. In addition, WHO
and the government worked closely in the early 1980s to control
schistosomiasis in man-made bodies of water. Efforts have been
intensified since 1980 to improve the nation's sanitation
facilities and access to safe water. The percentage of the national
population that had access to safe water rose from 49.2 in 1980 to
57.2 percent in 1987. During that same period, the 25.6 percent of
the population with access to sanitation services (public latrines,
rubbish disposal, etc.) rose to 30.3 percent. According to WHO,
however, many of the reported sanitation advances have been made in
urban areas and not in rural communities where the majority of the
population lives.
On the whole, however, Ghana's health conditions are improving.
The result is reflected in the decline in infant mortality from 120
per 1,000 live births in 1965 to 86 per 1,000 live births in 1989,
and a rate of overall life expectancy that increased from an
average of forty-four years in 1970 to fifty-six years in 1993. To
reduce the country's infant mortality rate further, the government
initiated the Expanded Program on Immunization in February 1989 as
part of a ten-year Health Action Plan to improve the delivery of
health services. The government action was taken a step further by
the Greater Accra Municipal Council, which declared child
immunization a prerequisite for admission to public schools.
Modern medical services in Ghana are provided by the central
government, local institutions, Christian missions (private
nonprofit agencies), and a relatively small number of private forprofit practitioners (see
table 4, Appendix). According to the
United Nations, about 60.2 percent of the country's total
population in 1975 depended on government or quasi-government
health centers for medical care. Of the available health facilities
represented in the 1984 census, about 62.9 percent were still
described as government and quasi-government institutions. Mission
hospitals represented a large percentage of the remainder, while
private hospitals constituted less than 2 percent of modern medical
care facilities (see
table 5, Appendix).
The medical system in Ghana comes under the jurisdiction of the
Ministry of Health, which is also charged with the control of
dangerous drugs, narcotics, scientific research, and the
professional qualifications of medical personnel. Regional and
district medical matters fall under the jurisdiction of trained
medical superintendents. Members of the national Psychic and
Healers' Association have also been recognized by the government
since 1969. Over the years, all administrative branches of the
Ministry of Health have worked closely with city, town, and village
councils in educating the population in sanitation matters.
Many modern medical facilities exist in Ghana, but these are
not evenly distributed across the country. Ministry of Health
figures for 1990 showed that there were 18,477 beds for the
estimated national population of 15 million.
World Bank (see Glossary)
figures showed that in 1965 there was one physician to
every 13,740 patients in Ghana. The ratio increased to one to
20,460 in 1989. In neighboring Togo, the doctor-to-patient ratio of
one to 23,240 in 1965 improved to one to 8,700 in 1989; it was one
to 29,530 in 1965 and one to 6,160 in 1989 for Nigeria, whereas in
Burkina, the ratio of one to 73,960 in 1965 worsened to one to
265,250 in 1989. These figures show that while the doctor-patient
ratio in Ghana gradually became less favorable, the ratio in
neighboring countries, with the exception of Burkina, was rapidly
improving.
The ratio of nurses to patients in Ghana (one to 3,730 in
1965), however, improved to one to per 1,670 by 1989. Compared to
Togo (one nurse to 4,990 patients in 1965 and one to 1,240 in 1989)
and Burkina (one to 4,150 in 1965 and one to 1,680 in 1989), the
rate of improvement in Ghana was slow. Nigeria's nurse-to-patient
ratio of one to 6,160 in 1965 and one to 1,900 in 1989 was
exceptional. A rapidly growing Ghanaian population was not the only
reason for unfavorable ratios of medical staff to patients; similar
population growth was experienced in neighboring West African
countries. Insofar as the Ghana Medical Association and the various
nurses associations were concerned, better salaries and working
conditions in Nigeria, for example, were significant variables in
explaining the attraction of that country for Ghanaian physicians
and other medical personnel. This attraction was especially true
for male and, therefore, more mobile medical workers, as shown by
the arguments of various health workers' associations in 1990
during demonstrations in support of claims for pay raises and
improved working conditions.
Ghana adopted a number of policies to ensure an improved health
sector. These included the introduction of minimum fees paid by
patients to augment state funding for health services and a
national insurance plan introduced in 1989. Also in 1989, the
construction of additional health centers was intensified to expand
primary health care to about 60 percent of the rural community.
Hitherto, less than 40 percent of the rural population had access
to primary health care, and less than half of Ghanaian children
were immunized against various childhood diseases. The training of
village health workers, community health workers, and traditional
birth attendants was also intensified in the mid-1980s in order to
create a pool of personnel to educate the population about
preventive measures necessary for a healthy community.
Since 1986 efforts to improve health conditions in Ghana have
been strengthened through the efforts of
Global 2000 (see Glossary).
Although primarily an agricultural program, Global 2000
has also provided basic health education, especially in the
northern parts of the country where the spread of guinea worm
reached epidemic proportions in 1989. Reports on the impact of
Global 2000 have been positive. For example, participating farmers
have significantly increased their agricultural output--a
development that has contributed to a decline in malnutrition.
Also, the number of cases of guinea worm had dropped significantly
by early 1993.
Data as of November 1994
|
![[JPEG]](http://lcweb2.loc.gov/frd/cs/ghana/gh02_08a.jpg)
