Overview

Ghana is situated in the western quarter of Africa; it is the eastern neighbour to Côte de Ivoire, with Burkina Faso to its north, Togo to its east and the Gulf of Guinea to its south. It is one of the most heavily populated countries in West Africa, with scenery that includes wooded hills, large valleys, great coastal plains and deep rainforest.

Formed from the merger of the British colony of the Gold Coast and the Togoland trust territory, in 1957 Ghana became the first country in colonial Africa to gain its independence. A long series of coups resulted in the suspension of the constitution in 1981 and the banning of political parties. A new constitution, restoring multiparty politics, was approved in 1992. Ghana is currently on a positive trajectory developmentwise. It has a steadily growing economy and is politically stable; a well-administered country by regional standards, Ghana is often seen as a model for political and economic reform in Africa.

There are exciting, colourful markets, beautiful crafts, beaches and towns that are full of history and ancient culture. The country has some beautiful beaches and lagoons to show its visitors. The people are vibrant, extremely friendly and welcoming. It is generally a very safe country to travel and work in and is relatively unexplored by tourists. Public transport on the other hand is pretty dreadful and the roads are very poor.

Health system

The Ghana Health Service (GHS) was created to assume responsibility for service delivery and implementation of the health policies and programmes designed by the Ministry of Health. To make the health sector more responsive, all public-owned health institutions, divisions, facilities and agencies were given responsibility for their own planning, budgeting, implementation, monitoring and evaluation. National, regional, district, sub-district and community levels are organized to implement the Five-year Plan of Work (5YPOW) which is developed by the ministry and all key partners/stakeholders. The private sector and NGOs, including the Christian Health Association of Ghana, provide over 40 per cent of health care in Ghana, especially in the rural areas.

In 2005, Ghana introduced the National Health Insurance Scheme (NHIS) to improve financial accessibility to healthcare. The NHIS is administered peripherally through District-Wide Health Mutual Insurance Schemes (DWHIS). The scheme is tax-based and covers most services offered at the district hospital level. Despite a number of constraints, it has registered over 58% of Ghana’s population. In 2008, free maternal care was included in the range of services covered by the NHIS.

The health sector is under-funded, and there is low human resource capacity because of the emigration of health professionals. Health workers are disproportionately distributed to the advantage of the southern part of the country and urban areas. Accra and Ashanti regions, which account for about 33.1% of the total population of the country, are overly catered for by over 60% of all doctors and nurses in Ghana. The establishment of the Ghana College of Physicians and Surgeons in 2003 and other health training institutions, the expansion in health training infrastructure, the increase in the number of health trainees and improved remunerations are expected to have a positive impact on the sector. Programmes like “Brain Gain” are encouraging Ghanaian health workers in the diaspora to return.

Ghana is experiencing an epidemiologic transition with an increasing prevalence of noncommunicable diseases. The major causes of child mortality include malaria, diarrhoea and upper respiratory infection. HIV infection, hypertension, diabetes mellitus and road traffic accidents are major causes of mortality in adults. Low level of literacy, poor sanitation, under-nutrition, alcohol abuse, sedentary life styles and unhealthy diets constitute the broad determinants of ill-health contributing to high mortality rates. Cholera has become endemic in the country and there have been outbreaks every year over the last six years. The prevalence of malnutrition remains high but is decreasing.