The double burden of disease and the challenge of health access: Evidence from Access, Bottlenecks, Cost and Equity facility survey in Ghana

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Despite the double burden of infectious and chronic non-communicable diseases in Africa, health care expenditure disproportionately favours infectious diseases. In this paper, we examine quantitatively the extent of this disproportionate access to diagnoses and treatment of diabetes, hypertension and malaria in Ghana. A total of 220 health facilities was surveyed across the country in 2011. Findings indicate that diagnoses and treatment of infectious diseases were more accessible than NCDs. In terms of treatment, 78% and 87% of health facilities had two of the recommended malaria drugs while less than 35% had essential diabetes and hypertension drugs. There is a significant unmet need for diagnoses and treatment of NCDs in Ghana. These inequities have implications for high morbidity and mortality from NCDs. We recommend the use of task shifting as a model to increase the delivery of NCD services.

Related collections

Most cited references 23

Record: found
Abstract: found
Article: not found

Hypertension in sub-Saharan African populations.

Lionel Opie, Yackoob K Seedat (2005)

Hypertension in sub-Saharan Africa is a widespread problem of immense economic importance because of its high prevalence in urban areas, its frequent underdiagnosis, and the severity of its complications. We searched PubMed and relevant journals for words in the title of this article. Among the major problems in making headway toward better detection and treatment are the limited resources of many African countries. Relatively recent environmental changes seem to be adverse. Mass migration from rural to periurban and urban areas probably accounts, at least in part, for the high incidence of hypertension in urban black Africans. In the remaining semirural areas, inroads in lifestyle changes associated with "civilization" may explain the apparently rising prevalence of hypertension. Overall, significant segments of the African population are still afflicted by severe poverty, famine, and civil strife, making the overall prevalence of hypertension difficult to determine. Black South Africans have a stroke rate twice as high as that of whites. Two lifestyle changes that are feasible and should help to stem the epidemic of hypertension in Africa are a decreased salt intake and decreased obesity, especially in women. Overall, differences from whites in etiology and therapeutic responses in sub-Saharan African populations are graded and overlapping rather than absolute. Further studies are needed on black Africans, who may (or may not) be genetically and environmentally different from black Americans and from each other in different parts of this vast continent.

0 comments Cited 158 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Epidemiological transition and the double burden of disease in Accra, Ghana.

Samuel E Tekyi-Mensah, Ama de-Graft Aikins (2010)

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana's capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana's socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A "protracted" double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities.

0 comments Cited 122 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Deaths preventable in the U.S. by improvements in use of clinical preventive services.

Thomas A Farley, Mehul A. Dalal, Farzad Mostashari … (2010)

Healthcare reform plans refer to improved quality, but there is little quantification of potential health benefits of quality care. This paper aims to estimate the health benefits by greater use of clinical preventive services. Two mathematical models were developed to estimate the number of deaths potentially prevented per year by increasing use of nine clinical preventive services. One model estimated preventable deaths from all causes, and the other estimated preventable deaths from specific categories of causes. Models were based on estimates of the prevalence of risk factors for which interventions are recommended, the effect of those risk factors on mortality, the effect of the interventions on mortality in those at risk, and current and achievable rates of utilization of the interventions. Both models predicted substantial numbers of deaths prevented by greater use of the preventive services, with the greatest increases from services that prevent cardiovascular disease. For example, the all-cause model predicted that every 10% increase in hypertension treatment would lead to an additional 14,000 deaths prevented and every 10% increase in treatment of elevated low-density lipoprotein cholesterol or aspirin prophylaxis would lead to 8000 deaths prevented in those aged <80 years, per year. Overall, the models suggest that optimal use of all of these interventions could prevent 50,000-100,000 deaths per year in those aged <80 years and 25,000-40,000 deaths per year in those aged <65 years. Substantial improvements in population health are achievable through greater use of a small number of preventive services. Healthcare systems should maximize use of these services. 2010 American Journal of Preventive Medicine. All rights reserved.

0 comments Cited 69 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Mawuli Komla Kushitor: Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Sandra Boatemaa:

ORCID: http://orcid.org/0000-0002-0638-6261

Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Mark G. Shrime: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 23 March 2018

Publication date Collection: 2018

Volume: 13

Issue: 3

Electronic Location Identifier: e0194677

Affiliations

[001]Regional Institute for Population Studies, University of Ghana, Legon, Accra, Ghana

Harvard Medical School, UNITED STATES

Author notes

Competing Interests: SB has completed the online competing interest form and declared no competing interest. MKK has no competing interest to declare.

* E-mail: boatemaasandra@ 123456gmail.com

Author information

Sandra Boatemaa http://orcid.org/0000-0002-0638-6261

Article

Publisher ID: PONE-D-17-28953

DOI: 10.1371/journal.pone.0194677

PMC ID: 5865721

PubMed ID: 29570720

SO-VID: 9e4b50ea-139c-4a79-a1e1-72f30870d13a

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 4 August 2017

Date accepted : 7 March 2018

Page count

Figures: 0, Tables: 5, Pages: 11

Funding

SB was funded by the Hewlett Foundation, through the Regional Institute for Population Studies (RIPS) and MKK was funded by the RIPS Endowment Fund.

Custom metadata

Data Availability Data are available from the Institute for Health Metrics and Evaluation (IHME)'s Access, Bottlenecks, Costs, and Equity (ABCE) project in Ghana: ABCE Facility Survey 2012 and Seattle, WA: IHME, 2015. The data can be accessed at: http://ghdx.healthdata.org/record/ghana-access-bottlenecks-costs-and-equity-project-2012/.

The double burden of disease and the challenge of health access: Evidence from Access, Bottlenecks, Cost and Equity facility survey in Ghana

Read this article at

Abstract

Related collections

PLOS Global Public Health

Most cited references 23

Hypertension in sub-Saharan African populations.

Epidemiological transition and the double burden of disease in Accra, Ghana.

Deaths preventable in the U.S. by improvements in use of clinical preventive services.

Author and article information

Contributors

Journal

Affiliations

Author notes

Author information

Article

History

Page count

Funding

Categories

Custom metadata

Comments

Comment on this article

Similar content 432

Cited by 32

Most referenced authors 2,025