Management of childhood infections in rural Ghana - Filling information gaps

Abstract

Many low-income countries are facing high childhood morbidity and mortality rates. Especially in sub-Saharan Africa and Asia, infectious diseases are the predominant cause of disability-adjusted life years in children. Hence, several national and international health institutions prioritise childhood infectious disease control. However, the success of these control efforts differs between, as well as within nations, highlighting the relevance of local implementation challenges. The aim of this thesis was to provide missing information for childhood infectious disease management in Ghana, with a special focus on the Ashanti Region, and to present these results within the context of available public health data. A conceptual research framework (CRF) was established, which defines data needed to inform childhood infectious disease control. The CRF comprises the components (i) population, (ii) health system, (iii) health services, (iv) disease data, (v) diagnosis and treatment, and (vi) intervention and prevention. The data generated within the frame of the thesis, along with further published documents, were reviewed taking into consideration the objectives posed by the CRF. The thesis demonstrates that Ghana and the Ashanti Region have a well-planned childhood infectious disease management system. Priorities in childhood infectious disease control are identified and formulated into health policies. Various disease-specific interventions are in place to control disease transmission. Furthermore, the organisation of preventive and curative services emphasises childhood infectious disease control. However, implementation challenges constrain successful delivery of health services at all administrative levels. Shortage of medical equipment and health care personnel hamper health service provision, especially in rural areas. Generally, poor people living in remote areas are disadvantaged in several ways they are more likely to be affected by resource constraints, they utilise health services less often, and they are at higher risk of contracting several diseases. Ghana has designed effective disease control programmes, which explicitly prioritise the poor and people living in remote areas. However, resource gaps as well as administrative barriers limit successful delivery of these measures. This thesis shows that no additional health programmes are needed to improve childhood infectious disease management, but the government needs to overcome obstacles identified at all administrative levels in order to successfully deliver established health services to the whole population

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