With its robust economic growth and strong democratic institutions, Ghana transitioned to lower middle-income status in 2010. Despite facing significant challenges from malaria, HIV and tuberculosis, the country is steadily moving towards achieving the health system goals of improving health outcomes and increasing system responsiveness to meet citizens’ needs. The UHC vision is comprehensive, and includes robust commitments to increase domestic investments in health.
In Ghana, the ADP has promoted policy coherence and alignment between the various national sectors relevant to health, medicines regulation, industry and innovation. Efforts are focused on ongoing policy review processes, including review of the National Medicines Policy (NMP) by the Ministry of Health (MOH). Encompassing a range of issues, including medicines selection, access and pricing, sustainable supply issues and development of pharmacovigilance capacity, the NMP seeks to promote an integrated approach to governance of the pharmaceutical sector in Ghana. The NMP ensures that efficacious and quality medicines are available, affordable and safe, which is critical in ensuring equitable access to health care under UHC. The ADP provides technical assistance to the technical working group established to revise the NMP, particularly in the development of key implementation tools comprising costed plans for NMP implementation, related monitoring and evaluation, and advocacy. The ADP also facilitated engagement of a cross-section of national stakeholders to ensure broad inputs, and promote country ownership of the NMP. The results of the ADP’s support include the development of a comprehensive implementation plan with cost estimates, a monitoring and evaluation plan to measure implementation progress, and an advocacy and communications plan to create greater awareness of related policy goals and objectives.
In addition, the ADP has an ongoing engagement with the Ministry of Justice and the Attorney-General’s Department to enhance coherence of policies relating to innovation, public health and access to health technologies, which is expected to culminate in a technical briefing for parliamentarians on integrating public health considerations in the legal framework in 2017.
In Ghana, the ADP has adopted a health system strengthening approach to equip stakeholders with the necessary skills to develop and sustain the health system and ensure efficient and effective access to new health technologies. One aim is to build a cohort of researchers who are able to effectively plan and conduct priority implementation research. The Research and Development Division of the Ghana Health Service (GHS) and the network of Health Research Centres across the country serves as the lead country partner for this area of the ADP’s work. To this end, the ADP supported sensitization and training of policymakers and staff members from GHS, regional training centres and national disease control programmes on the importance of implementation research in the effective introduction of new health technologies. These trainings focused on the process of prioritizing implementation challenges and setting the national health research agenda. Seven managers and senior researchers from one regional health research facility were successfully trained in developing implementation research proposals, resulting in the development of four research study protocols. Through ADP support, national researchers have so far been able to raise almost US$80,000 in research funding. One of these studies has been funded by the Global Fund and is being implemented by the National TB Control Programme. Another study, addressing the persistent transmission of lymphatic filariasis, has also secured funding from the UK Department for International Development and will commence in June 2016.
A review of the National Health Research Agenda was undertaken with one of the key outputs being a list of priority research areas to improve effectiveness of disease control. The process of national agenda-setting for implementation research has been documented and will be published, along with a compendium of priority research areas. Overall, the robust stakeholder analyses and engagement has strengthened dialogue and relationships between control programmes and researchers, and equipped disease control programme teams to explore why certain challenges persist despite massive programme efforts. Programmes have also been empowered to develop action plans and activities to systematically address common challenges, and there is increased awareness among top research managers and policymakers on the critical importance of implementation research.
The ADP is working with the country’s pharmacovigilance programme in providing technical and capacity- building support to the Ghana Food and Drugs Authority in the development and implementation of a management system for individual case safety reports. The ADP will support the incorporation of a consumer reporting section, validation of the various sections of the system, and large-scale training of health care providers and regional pharmacovigilance officers, as well as media campaigns for patients for customer reporting. A common database for this purpose will help in the effective management of pre- and post-approval safety information.
|Human Development Index ranking||140|
|Population total (millions)||26.4|
|Gross national income per capita (USD)||3,852|
|Population living below $1.25 a day (%)||28.6|
|Public health expenditure (% of GDP)||5.4|
|Life expectancy at birth (years)||61.4|
|Under-5 mortality rate (per 1000 live births)||78.4|
|TB prevalence (per 100,000)c||282|
|TB incidence (per 100,000)||165|
|Deaths due to TB (per 100,000)||52|
|TB case detection (%)||33|
|Estimated cases of malaria (per 100,000)||31,439|
|Total deaths due to malaria (per 100,000)||56.8|
|Children aged <5 years with fever who received
treatment with any antimalarial (%)
|SAC population requiring PC for STH / coverage||6,681,171 / 29.8%|
|Population requiring PC for LF / coverage||12,599,186 / 64.5%|
|Population requiring PC for SCH / coverage||9,366,463 / 19.7%|
|SAC population requiring PC for SCH / coverage||3,843,473 / 48.0%|
|Population requiring PC for onchocerciasis||3,372,058|
All data from 2014 unless stated. SAC: school-aged children, PC: preventive chemotherapy; STH: soil-transmitted helminths; LF: lymphatic filariasis; SCH: schistosomiasis.