[ Diabetes Solutions ]

Ghana’s Burden of Chronic Non-Communicable Diseases: Future Directions in Research, Practice and Policy

There is evidence that the prevalence of certain non-communicable diseases, such as diabetes and hypertension, is increasing rapidly in parts of sub-Saharan Africa. Eighty-two percent of these “premature” deaths occurred in low- and middle-income countries. What’s needed is public policy: regulation and taxation of unhealthy products; labelling to encourage healthy choices; curbs on industry advertising that shapes the public’s understanding of and desire for consumer products; and media campaigns to inform about the health consequences of unhealthy choices. Without adequate supplies and trained staff to treat patients with NCDs in humanitarian emergencies, this number is expected to grow. They account for 44% of premature deaths worldwide. Data were analyzed using the framework analysis approach. Various diabetes-related problems were identified.

The prevalence of diabetes and hypertension, both self-reported and measured, was unsurprisingly higher in urban communities. – may be listed, when the root cause of those conditions, diabetes, is unrecorded,” said Keeling. Hypertension, stroke, diabetes and cancers have become top 10 causes of death.1 Urbanization, changing lifestyles (including poor diets), ageing populations, globalization and weak health systems are implicated in chronic disease risk, morbidity and mortality.1,2 Despite recognition of a growing chronic disease burden in the early 1990s, a series of low-level interventions over the last fifteen years, and a national health policy that emphasises health promotion and prevention of lifestyle diseases, Ghana does not have a chronic disease policy or an integrated plan.3,4 These structural deficiencies compound the financial and psychosocial challenges faced by individuals, caregivers and families affected by chronic diseases. Now we’re working to make sure those doorways also lead to better care for noncommunicable diseases. On the occasion of World Heart Day, 29 September 2015, WHO is putting the spotlight on the under-recognized and under-treated epidemic of heart disease in women. Brief comments are made on these themes and future directions in research, practice and policy are outlined. Taking lessons from the HIV–AIDS experience and applying them well could shorten the learning curve for noncommunicable-disease prevention and control.

Geneva: WHO; 2008. NCD management is generally poor. NCDs – primarily heart and lung diseases, cancers and diabetes – are the world’s largest killers, with an estimated 38 million deaths annually. Population-based studies, as well as action oriented research – e.g. The WHO African region has already trained health care workers at primary care level in Eritrea and Benin where the tool has been field-tested and these countries are now expending the use of WHO-PEN at a larger scale. More research is required, for example, on asthma in the adult population8, to understand what happens to stroke patients after discharge6, the help-seeking behaviour across medical systems10,15 and to estimate the indirect costs of NCDs on households13. Impact studies on the psychosocial benefit of patient support groups are required to incorporate the work of patient and advocacy groups more adequately in medical care.9,10 Robust qualitative and ethnographic studies are needed to increase understanding of the complex psychological and cultural contexts of risk, illness experience, caregiving and social attitudes.

Interventions must be multi-pronged and encompass primary and secondary prevention. Combatting the rise of noncommunicable disease in Africa will require large-scale investments in prevention and diagnostics and will need to decisively distinguish preventative strategies from those currently being used to address infectious disease. Greater Accra and Ashanti), and high-risk populations (obese individuals; individuals with multiple risks and co-morbid conditions). Chronic diseases like hypertension, diabetes, chronic obstructive pulmonary disease (COPD) develop over time due to underlying risk factors like tobacco, alcohol, physical inactivity, unhealthy diet etc. The result of this study reveals the fact that there exists an inverse relationship between height and the occurrence of diabetes as well as hypertension. Likewise, none of the studies we reviewed reported a system of social security that provides compensation for loss of income incurred by patients and their families because of NCDs. They constitute both a public health and a developmental issue that should be of urgent concern not only for the Ministry of Health, but also for the Government of Ghana.

Pertinent challenges include limited knowledge of NCDs in the general population which contributes to late reporting to clinics for care, high costs of medicines and high rates of preventable complications. Applying this figure to the 57 million deaths worldwide in 200818 shows that >5.3 million deaths (range, 525,000 in the Eastern Mediterranean region to 1.5 million in the Western Pacific region) may be averted annually if all inactive persons become active. Public-private partnerships with the pharmaceutical industry should aim to ensure availability, affordability and accessibility of low-cost generic drugs for the management of chronic diseases. We must also campaign for companion strategies for policies to change food production in the long term.

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