The Ministry of Health (MoH) has developed a national policy that sets out the broad path Ghana will pursue in its efforts to prevent and control chronic Non-Communicable Diseases (NCDs).

The policy aims at integrating and coordinating the various programmes being implemented by the MoH and the Ghana Health Service to address the challenges posed by Non-Communicable Diseases (NCDs) to the public and propose strategies to accelerate the country’s response to the problem.

Non-Communicable Diseases, as defined by the World Health Organisation (WHO) include cardiovascular diseases, mainly heart disease and stroke; cancers; chronic respiratory diseases; diabetes; others, such as mental disorders, bone and joint disorders and genetic disorders.

At a day’s forum held in Accra to review the draft National Policy, Dr Billy Bonsu, National NCD’s Programme Manager, said NCDs were diseases or conditions known to affect individuals over an extensive period of time and for which there were no known causative agents that were transmitted form one affected individual to another.

The forum was to offer a platform for stakeholders to assess the health sector’s capacity to respond to NCDs and agree on mechanisms to efficiently coordinate the national response to NCDs.

Giving the rationale for the formulation of a national policy, he said NCDs contributed significantly to illness, disability and deaths in Ghana, but the national response was undermined by low awareness, weak structures, weak capacity, limited funding and insufficient will.

Additionally, there is lack of a multi-sectoral coordinating structure hence the Ministry of Health is currently operating parallel programmes to address a few NCDs.

Globally, the World Health Organsisatio (WHO) estimates that mortality form NCDs will increase overall by 17 per cent in the next 10 years. NCDs are projected to become the commonest cause of death in sub-Saharan Africa by the year 2030.

Much of the increase in the NCSs is due to globalization, rapid unplanned urbanization, population ageing, and lifestyle changes such as tobacco use, decreasing physical activity and increasing consumption of unhealthy foods.

Burden of NCDs in Ghana

NCDs kill an estimated 86,200 persons in Ghana each year with 55.5 per cent of them aged less than 70 years. Based on limited institutional data, cardiovascular diseases accounted for 8.9 per cent of institutional deaths (excluding teaching hospitals) in 2008.

The major NCDs in Ghana, Dr Bosu said, were cardiovascular diseases, cancers, diabetes, chronic respiratory diseases and sickle cell diseases. The first four share common risk factors namely, tobacco, harmful use of alcohol, unhealthy diet and physical inactivity.

In this country, the major NCDs are grouped into four clusters. These are chronic NCDs which share common risk factors- cardiovascular diseases, diabetes mellitus, cancers, chronic obstructive pulmonary disease, NCDs of genetic origin (Sickle cell disease), injuries and other special NCDs such as oral disorders, eye disorders and mental ill-health.

The prevalence of adult hypertension in Ghana appears to be increasing, Dr Bonsu indicated. The reported outpatient cases of hypertension in public and mission facilities other than teaching hospitals increased from about 60,000 cases in 1990 to about 700,000 cases in 2010 and hypertension has ranked in the top five outpatient diseases for more than 15 years.

Dr Bosu said up to 70 per of persons identified to have hypertension were not on treatment with only a negligible number having their blood pressures well controlled. Nearly half of persons identified with hypertension also have target end organ damage suggesting that these persons have had long-standing disease without appropriate treatment.

Studies also show that the proportion of women aged 15-49 years who are overweight or obese and children under five years of age who are overweight have more than doubled.

According to the Ghana Demographic and Health Survey (GDHS) 2008, less than five per cent of adults consume adequate amounts of fruits and vegetables.

He said the draft policy focused on the four major NCDs, namely cardiovascular disease, diabetes, cancers and chronic respiratory disease.

These diseases share common risk factors, which include tobacco use, harmful alcohol use, unhealthy diets, and physical inactivity.
Strategic areas

The NCD policy relates to five strategic areas, which are primary prevention, early detection and clinical care, Health system strengthening, Research and development, Surveillance of NCDs and their risk factors.

Under primary prevention, the policies will relate to tobacco and alcohol control, diet, physical activity, and immunization.

The MOH proposes to give high priority to promoting healthy lifestyles among in—and out-of –school youth. Health promotion policy will promote intake of fruits and vegetables; high fiber diet, moderate physical activity; reducing intake of energy dense foods, salt, trans fatty acids, and sugar; avoiding tobacco; reducing excessive alcohol intake; and undergoing periodic medical check-ups. Commercially marketed diet soda will not be encouraged due to its doubtful value and potential harmful effects.

Dr Bosu said public education would be intensified to raise awareness about cancers and breast and cervical cancer screening will be integrated into reproductive health services. Men aged 45 years and older would also be encouraged to undergo screening for prostate cancer.

To improve clinical care, specialist clinics, outreach care, and medical missions will be established to provide specialist services. MoH will also consider expanding the coverage NHIS, list of benefits package to include medical examination as well as the screening and treatment of common cancers. There will also be improved access to essential medicines and supplies for the care of NCDs.

The policy recommends the establishment of a national multi-sectroal committee to advise the Minister for Health on actions to be taken to prevent and control NCDs and monitor their progress. The committee, it further proposed will ensure that NCDs are given high priority in the national development agenda.

Source: Daily Graphic

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