La situation en matière de santé au Ghana
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The Ministry of Health of the Republic of Ghana
In Ghana, the disease pattern has changed very little over the last two decades. Like other countries in early phases of health transition, the pattern of disease in Ghana demonstrates a preponderance of communicable diseases, under-nutrition, and poor reproductive health. Epidemics of cerebrospinal meningitis, yellow fever and cholera remain a significant threat. Emerging and re-emerging diseases of increasing magnitude and threat include HIV/AIDS, tuberculosis, buruli ulcer and filariasis. Non-communicable diseases such as cardiovascular disorders, neoplasms and diabetes are emerging threats, whilst trauma and other injuries are the fifth most common outpatient condition.
The six main causes of morbidity and mortality among children have persisted as the main threat to their health over the years. However these have largely been brought under control through the Expanded Programme on Immunization. Malaria is still the number one killer among children and acute respiratory infections, including pneumonia; diarrhoea, malnutrition including anaemia; and neonatal causes continue to be major health problems. These five health problems account for about 50% of all childhood admissions and 30% of childhood deaths.
The overall morbidity and mortality pattern highlights the linkage between poverty, inequalities and health. Most of this burden results from diseases, such as malaria, diarrhoea and pneumonia whose occurrence could be dramatically reduced by low-cost and effective preventive and curative interventions. In other terms, the marginal social and economic returns from investments in health are highest in avoiding these premature deaths. Since communicable diseases in childhood are, in general, more amenable to broad-based primary prevention efforts than are non-communicable diseases, their heavy burden reflects, among other, the difficult living conditions and the inadequacy of the primary health care system.
The current mortality pattern has wide policy implications. First, it highlights the persistent burden of childhood communicable diseases, for which preventive measures (such as sanitation and health education) and simple curative measures (such as malaria treatment and oral rehydration) can be delivered efficiently through community-based care and outreach services. Therefore, better outcomes and greater savings are possible through the use of community-based care supported by the referral network. This is the basis for the development of the CHPS (Community-based Health Planning and Services) in Ghana. However, the growing burden related to high-cost of chronic and degenerative conditions, such as hypertension, other cardiovascular diseases and diabetes, must be taken into account for planning purposes.
A double burden of disease is already emerging at the early stage of the epidemiologic transition, with a mix of persistent, new and re-emerging infectious diseases and increasing chronic conditions and injuries. This will lead to fundamental changes in the volume and composition of demand for health care, with a more complex case mix and a more costly service utilization patterns.
The health services in Ghana include government health services, private, traditional and nongovernmental providers, civil society, and community groups. It also includes collaboration and partnership with other ministries, departments, and agencies whose policies and services have a major impact on health outcomes.
The health services are organized in several tiers ranging from the subdistrict to national level. The sub-district level comprises health centres, health posts and clinics. As part of the effort to improve access to health services, the Community-Based Health Planning and Services has been designated as another level of health care delivery which combines public health and basic clinical care activities at the community level. The activities of the sub-districts are coordinated at the district level which would normally have a hospital designated as the first referral point. The district health service also includes the activities of private providers of both clinical and public health services. Each of the ten regions has a Regional Health Administration and a regional hospital which provides secondary level and referral services in support of the districts. National level referral facilities include two teaching hospitals, three psychiatric hospitals and a large military and police hospitals.
Government is by no means the only provider of health services in Ghana. Other providers include the mission sector, employers, private medical practitioners and an informal sector, comprising traditional practitioners of various kinds as well as pharmacies and chemical sellers of indeterminate size. Mission Health Services have a long and distinguished history in Ghana. This sector operates nearly 20% of hospitals and clinics in Ghana. Public health and preventive services are commonly offered by mission institutions, often in the form of outreach services or satellite clinics.
The private for profit sector comprises a variety of providers ranging from the formal hospitals, clinics and diagnostic facilities to the informal drug peddlers. Traditional practitioners are also prevalent and span a multitude of provider types and treatment regimens ranging from traditional birth attendants, herbalists and bone setters to homeopaths and spiritual healers.
En bref : Ghana, statistiques, 2013
Fonds des Nations unies pour l’enfance,UNICEF
Country Profile, Urban Health
World Health Organization
Credits Photo: LinkedIn