Strategy Plan for the Prevention and Control of Non-Communicable Diseases in Ghana - 2022 - 2026

Objectives

Ghana’s 2022–2026 Non-Communicable Disease (NCD) strategy seeks to reduce avoidable NCD morbidity and mortality and attain a healthy population that can contribute to national development.[1][2]It aims to reduce the NCD burden to the barest minimum so that it no longer constitutes a major public-health constraint on socio-economic development, while contributing to Sustainable Development Goal target 3.4 on premature NCD mortality, mental health and wellbeing.[2]

• Reduce exposure to behavioural, environmental and metabolic risk factors, including unhealthy diets, physical inactivity, tobacco use, harmful alcohol use, air pollution, high blood pressure, dyslipidaemia, raised blood glucose, overweight, obesity and substance abuse.[2]
• Strengthen early detection and management of NCDs to reduce associated morbidity and mortality through prevention, routine screening, access to care, counselling, therapy, palliative care and rehabilitation.[3]
• Strengthen the health system through governance, research, surveillance, workforce development, essential medicines and devices, rehabilitation, palliative care and emergency services for injuries.[3][4]
• Strengthen multisectoral collaboration through a Health in All Policies approach, legislation, regulation, private-sector participation, patient advocacy and engagement with traditional authorities.[5]
• Ensure sustainable financing and other resources by increasing funding, expanding National Health Insurance Scheme benefits, and embedding NCD interventions in sector planning, budgeting and financial-management systems.[6]

The prevention agenda covers cardiovascular diseases, cancers, chronic respiratory diseases and diabetes mellitus, alongside mental, oral and eye health, injuries, hepatitis B, human papillomavirus, sickle cell disease, nutrition and physical activity.[7][8]It combines population-level risk reduction with service strengthening, including health promotion, school health education, vaccination against human papillomavirus, maternal, infant and young-child nutrition, and safe environments for physical activity.[2]

• Promote public, community and school education, social and behaviour change communication, advocacy and NCD champions to enable healthier choices across the life course.[9][10]
• Improve routine and opportunistic screening, including checks for blood pressure, blood sugar and urine abnormalities, newborn sickle-cell screening and wellness clinics.[11][12]
• Expand quality clinical care through disease-specific management and referral guidance, essential medicines and medical devices, and support services for rehabilitation and palliative care.[4][13]
• Advance tobacco, alcohol and food-policy measures, including taxation, smoke-free requirements, pictorial health warnings, food safety, salt reduction and healthier school food environments.[14][15]

Implementation

Implementation is intended as a whole-of-government and whole-of-society effort led by the Ministry of Health through the health sector’s Common Management Arrangement.[9]The Ministry provides policy development, planning, regulation, coordination, monitoring and evaluation, while the Minister for Health provides political direction and designates directorates to coordinate delivery.[9]The Ghana Health Service is the principal delivery agency for many service, communication, screening and health-promotion activities.[10][16]

• Coordinate delivery through existing sector mechanisms, including inter-ministerial and inter-agency committees, the NCD Steering Committee, Health Sector Working Group, Annual Health Summit, decentralised dialogue and Annual Policy Dialogue.[9]
• Establish a well-resourced NCD Division within the Ghana Health Service to coordinate and implement NCD activities, following approval processes involving the Ghana Health Service Council and Public Services Commission.[3][17]
• Use a multisectoral NCD steering committee and platform, led by the Minister for Health or representative, for dissemination, coordination, monitoring and governance, with four meetings annually planned from 2022 to 2026.[5][18]
• Engage ministries, regulatory agencies, local government, education institutions, professional bodies, civil society, faith-based organisations, traditional leaders, patient groups, development partners and private providers.[19][20]

Operational delivery is structured through time-bound activities, annual targets, named lead institutions and collaborating agencies.[21][11][12]Public communication is to use print, radio, television, social media, health-facility contacts, school programmes and champion-led advocacy.[10][16]School-based interventions are delivered with education-sector partners, while vaccination, screening, nutrition, physical activity and clinical-care activities are delivered through health facilities and decentralised health services.[22][23][24]

• Develop and disseminate guidance for screening, clinical management, referral, medical devices, palliative care, tobacco regulation, school health promotion and food safety.[3][25][26]
• Build capacity through training for frontline staff across hospitals, health centres, Community-based Health Planning and Services facilities, districts, regions and private facilities in NCD, cancer-screening and basic mental-health services.[27][28]
• Strengthen evidence systems through an NCD research network, systematic reviews, capacity-building workshops, a national research conference, the World Health Organization STEPS survey, improved data instruments, cancer registries, sentinel sites and NCD indicators in national surveys.[29][30]
• Improve emergency and supportive services through level-specific emergency units, first-aid and evacuation arrangements, highway accident-and-emergency centres, pre-hospital-care education, physiotherapy, rehabilitation and palliative care.[31][32]

Monitoring is to align with the Health Sector Monitoring and Evaluation Framework and use routine data, stakeholder information sharing, agreed policy indicators and action-plan matrices.[33]Baseline, mid-term and end-line evaluations are planned, alongside annual review through Annual Health Sector Review reports and revision of indicators and targets in response to findings.[32]Reporting deadlines are monthly by the end of the following month, quarterly by the end of the following month after each quarter, mid-year by the end of August and annually by the end of March of the following year.[33]

Financing actions include developing a resource-mobilisation plan, mapping donors, convening annual resource-mobilisation conferences, creating a national NCD Fund, disbursing budgeted NCD funds, establishing ministry budget lines and expanding National Health Insurance Scheme coverage for screening, childhood cancers and prostate cancer.[34][33]Potential funding sources include Government of Ghana budget support, internally generated funds, development partners, corporate bodies, civil-society and non-governmental organisations, public-private partnerships and the National Health Insurance Scheme.[9]

Monitoring & Evaluation

The strategy establishes a broad monitoring, evaluation and accountability system for Ghana’s non-communicable disease (NCD) prevention and control agenda for 2022–2026. The Ministry of Health leads sector-wide monitoring and evaluation, while the Ghana Health Service and other named agencies hold activity-level delivery responsibilities.[35][9]Monitoring is intended to align with the Health Sector Monitoring and Evaluation Framework, using routine information systems, stakeholder collaboration, data quality, analysis, feedback and supportive supervision to reduce fragmentation.[33]

• Track implementation through an integrated NCD monitoring and evaluation plan, routine surveys, surveillance, periodic evaluation and continuous collection, analysis and interpretation of NCD and risk-factor data.[5][3]
• Conduct baseline, midterm and end-line evaluations of NCD prevention and control activities, incorporate annual reviews in Annual Health Sector Review reports, and revise indicators and targets in response to findings.[32][36]
• Report monthly by the end of the following month, quarterly by the end of the month following each quarter, at mid-year by the end of August, and annually by the end of March of the following year.[33][37]
• Use the multisectoral NCD platform and steering committee for dissemination, coordination, monitoring and governance, under leadership of the Minister for Health or a representative.[5]The steering committee is expected to meet four times annually from 2022 to 2026.[18]
• Monitor communication and prevention through outputs such as SBCC materials, print, radio, television and social-media activities, advocacy campaigns, school-health implementation, vaccination, nutrition programming, physical-activity measures and road-safety activity.[10][22][37]
• Measure screening and care through facility implementation of screening guidance, newborn sickle-cell screening, routine blood-pressure and blood-sugar checks, wellness-clinic availability, trained personnel, service access and essential-medicine stock-outs.[11][12][38]
• Track health-system readiness through medical-device availability, palliative and rehabilitation services, physiotherapy, morphine consumption, tobacco-cessation capacity, mental-health teams, cancer and eye-screening provision, emergency units and pre-hospital-care capacity.[4][13][31][32]
• Strengthen surveillance through the World Health Organization STEPS Survey, revised District Health Information Management System instruments, cancer registries and sentinel sites, and inclusion of NCD indicators in demographic, health and Multiple Indicator Cluster Surveys.[30][39][40]
• Assess research and workforce development through indicators on the NCD research network, systematic reviews, workshops, a national conference, policy dissemination and training coverage across hospitals, health centres, Community-based Health Planning and Services facilities, districts, regions and private providers.[29][27][28]
• Monitor multisectoral policy measures through indicators on legislation, taxation reviews, tobacco compliance surveys, smoke-free signage, food-safety enforcement, salt reduction, school nutrition, private-sector partnerships, patient groups and traditional-authority engagement.[14][15][41][42]

Targets include reducing salt in processed foods by 5% in 2023, 10% in 2025 and 15% in 2026, alongside progressive implementation of nutrition-friendly school guidelines.[14][15]Service coverage under the Universal Health Coverage roadmap is to use hypertension and diabetes treatment and control rates, with baseline confirmation through the National STEPS Survey.[2]Several extracts list indicator titles, annual activity targets, responsible agencies and collaborating partners, but do not consistently provide indicator definitions, levels, data sources, reporting methods or formal sanctions for non-performance.[37][39][43]

Costing & Financing

The financing approach seeks sustainable, cross-sector funding for NCD prevention and control, but the supplied material provides no overall monetary budget, costed activity total, funding-gap estimate, unit cost, currency-denominated allocation or economic assumption.[44][6][34]The Government of Ghana commits to fund implementation as an urgent priority, and inadequate funding during the 2014 strategic-plan period is identified as a major obstacle that prevented many intended activities.[35][6]

• Mobilise financial, capital and human resources through Ministry of Health collaboration with government agencies, development partners and other stakeholders.[9]
• Draw on potential sources including Government of Ghana budgetary support, internally generated funds, development partners, corporate bodies, civil-society and non-governmental organisations, public-private partnerships and the National Health Insurance Scheme.[9]
• Develop a resource-mobilisation plan, undertake donor mapping, hold annual resource-mobilisation conferences, establish a national NCD Fund and ensure disbursement of allocated NCD funds.[34]
• Increase funding for prevention and management services and establish NCD budget lines across ministries, while integrating interventions into sector planning, budgeting, financial-management, audit and internal-control systems.[6][34][33]
• Expand the National Health Insurance Scheme benefit package to include NCD screening, wellness services, childhood cancers and prostate cancer.[34][45]
• Use financing-related policy levers including tobacco-tax review, legislation on reduced taxation for NCD medicines and devices, and fundraising support for patient advocacy groups.[14][41]

The resource-mobilisation framework sets progressive funding-achievement targets from 30 in 2022 to 100 in 2026, requires 100 disbursement of budgeted NCD-related funds throughout 2022–2026, and targets NCD budget lines in all ministries by 2026.[34]These are percentage performance targets rather than monetary amounts.[34]An OCR-affected budget table for tobacco-control activities cannot be reliably interpreted for currency or machine-readable values.[25][26]