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

Objectives

Ghana’s 2022–2026 Strategy Plan for the Prevention and Control of Non-Communicable Diseases (NCDs) seeks a healthy population that supports national development by reducing the NCD burden.[1]Its mission is to prevent avoidable NCD-related illness and death through health promotion, stronger health systems, adequate resources, partnerships and community empowerment.[1]The goal is to reduce NCDs to the barest minimum so that they no longer present a major public-health or socio-economic obstacle.[1]

• Reduce exposure to behavioural, environmental and metabolic risk factors, including unhealthy diets, physical inactivity, tobacco use, harmful alcohol use, air pollution, high blood pressure, raised blood glucose, overweight and obesity.[2][3]
• Strengthen early detection and management to reduce NCD-related morbidity and mortality through screening, access to care, counselling, palliative care, rehabilitation and therapy.[4][5][6]
• Strengthen the health system for NCD prevention and control, including research, surveillance, workforce capacity, emergency services, rehabilitation and palliative care.[7][8][9][10]
• Strengthen multisectoral collaboration through Health in All Policies, legislation, regulatory action, food and nutrition measures, and engagement beyond the health sector.[11][12][13][14]
• Ensure sustainable funding and other resources through resource mobilisation, National Health Insurance Scheme benefit expansion, cross-government budget lines and integration of NCDs into planning and financial-management systems.[15][16]

Priority prevention measures include public and school health education, human papillomavirus vaccination and education, maternal, infant and young-child nutrition, tobacco and alcohol control, road safety, sickle-cell counselling, and safe environments for physical activity.[3][4][17][5]The strategy also promotes routine blood-pressure, blood-sugar and urine checks, wellness clinics, NCD and sickle-cell screening guidelines, and service standards for medicines and medical devices.[6][18][19]

The plan contributes to the Sustainable Development Goal 3.4 commitment to reduce premature mortality from NCDs by one third through prevention and treatment while promoting mental health and wellbeing.[2][1]It aims to establish baseline data through the National NCD STEPS Survey and to use hypertension and diabetes treatment and control as universal health coverage indicators.[1]

Implementation

Implementation is designed as a whole-of-government and whole-of-society response, led by the Ministry of Health (MoH) through existing health-sector systems and structures.[20]The MoH provides policy development, planning, regulation, coordination, monitoring and evaluation, while the Minister for Health provides political direction and designates directorates to coordinate delivery.[20][21]The Ghana Health Service (GHS) is central to implementation, including establishment of an adequately resourced NCD Division to coordinate NCD activities.[7][22]

• Coordinate action through the Common Management Arrangement, inter-ministerial and inter-agency committees, sector working groups, business meetings, annual health summits, decentralised dialogue and annual policy dialogue.[20]
• Establish a multisectoral NCD steering committee led by the Minister for Health or a representative, with quarterly meetings planned from 2022 to 2026.[11][12]
• Engage ministries, departments and agencies, local government, private providers, corporate bodies, civil society organisations, patient groups, professional bodies, traditional authorities, development partners, teaching hospitals and faith-based organisations.[23][11][24][25]
• Deliver activities across national, regional, district, facility and community-based Health Planning and Services structures, including private facilities and schools.[26][27][28]

Operational delivery combines population prevention with strengthened clinical and referral services. Public communication will use print, radio, television, social media, advocacy campaigns and NCD champions, while school delivery will integrate age-specific NCD content into the School Health Education Programme.[29][28][30][31]Health facilities will implement screening, wellness clinics, treatment and referral guidelines, essential-medicine availability, medical-device standards, palliative care, rehabilitation and tobacco-cessation support.[19][32][33]

Health-system strengthening includes an NCD research network, systematic reviews, research-capacity workshops, a national research conference, a national cancer registry, additional cancer registries and NCD sentinel sites.[34][35]Workforce actions include training frontline personnel in NCD, cervical and breast cancer, mental health, palliative care and diabetic-retinopathy screening, alongside physiotherapy, glaucoma and multidisciplinary mental-health services.[26][27][36][37]Emergency-care actions include facility emergency units, workplace first-aid and evacuation arrangements, highway accident and emergency centres, and pre-hospital care training for commercial drivers and road users.[27][38][39]

Financing implementation will use a Resource Mobilisation Plan, donor mapping, resource-mobilisation conferences, a national NCD Fund, full disbursement of budgeted NCD funds and NCD budget lines across ministries.[15][16]The National Health Insurance Scheme benefit package is to expand to cover NCD screening, childhood cancers and prostate cancer.[15]The plan identifies Government of Ghana support, internally generated funds, development partners, corporate bodies, civil society, public-private partnerships and the National Health Insurance Scheme as possible financing options.[20]

Monitoring and evaluation will use the MoH Monitoring and Evaluation Framework and Health Sector Monitoring and Evaluation Framework, routine service-level reporting, agreed policy indicators, stakeholder feedback and supportive supervision.[16]Reports are due monthly, quarterly, mid-year and annually according to specified deadlines.[16]Evaluation milestones comprise a baseline assessment in 2022, a midterm assessment in 2024 and an end-line assessment in 2026, with annual reviews incorporated into Annual Health Sector Review reports.[12]

Monitoring & Evaluation

The monitoring and evaluation framework combines Ministry of Health-led cross-sector oversight, routine surveillance, activity-level indicators, periodic evaluations and structured reporting. The Ministry of Health leads monitoring and evaluation across sectors, while the Ghana Health Service implements much of the operational surveillance and service monitoring.[40][7][16]

• Conduct routine surveys and surveillance, including the World Health Organization STEPS Survey; update non-communicable disease data-collection instruments; train districts in their use; establish cancer registries and sentinel sites; and include indicators in the Ghana Demographic and Health Survey and Multiple Indicator Cluster Survey.[26][35][8][9]
• Track implementation through indicators covering communication outputs, school-health integration, vaccination, nutrition, physical-activity infrastructure, screening, facility readiness, medicine availability, workforce training, rehabilitation, palliative care, emergency capacity, research outputs and multi-sectoral engagement.[30][31][33][8][10][41][42]
• Use hypertension and diabetes treatment coverage and control rates as universal health coverage indicators, with the National STEPS Survey intended to establish the baseline for global targets and service coverage. Preliminary evidence indicates treatment coverage of 20% among diagnosed people, alongside a projected 200% increase in service coverage subject to baseline confirmation.[1]
• Conduct baseline, mid-term and end-line evaluations in 2022, 2024 and 2026 respectively, incorporate annual reviews into Annual Health Sector Review reports, and revise indicators and targets in 2022, 2024 and 2026 in response to monitoring and evaluation findings.[12]
• Establish a multi-sectoral steering committee, hold quarterly meetings between 2022 and 2026, and use the platform to coordinate, disseminate, monitor and govern non-communicable disease activities.[11][12]
• Apply five monitoring and evaluation pillars: stakeholder collaboration and accountability; timely, reliable and accurate data; comprehensive data repositories; timely analysis and use of information; and feedback supported by monitoring and evaluation.[16]
• Submit monthly reports by the end of the following month, quarterly reports by the end of the month after each quarter, mid-year reports by the end of August, and annual reports by the end of March of the following year.[16][30]

Targets include 100% implementation of the nutrition strategy by 2026, 100% coverage for several workforce and service indicators, four regional cervical cancer screening centres, 100% of regions with glaucoma screening centres, and accident and emergency centres along 40% of major highways by 2026.[17][36][37][39]School nutrition implementation is targeted to rise from 10% of schools in 2023 to 70% in 2026, with national, regional and district league tables published annually from 2023 to 2026.[14]Detailed values for the appendix performance indicators, comprehensive data sources, and a consolidated accountability framework are not specified in the supplied extracts.[16][30][31][33]

Costing & Financing

Sustainable funding and resource mobilisation are a strategic objective, supported by Government of Ghana budgetary support, internally generated funds, development partners, corporate bodies, civil society organisations, public-private partnerships and the National Health Insurance Scheme.[43][20][15]The Government of Ghana commits to treating implementation funding as urgent.[40]

• Develop a resource mobilisation plan, map donors, organise annual resource mobilisation conferences, establish a national non-communicable disease fund, disburse allocated funds, and introduce non-communicable disease budget lines across ministries.[44][15]
• Expand National Health Insurance Scheme benefits to cover non-communicable disease screening, wellness services, childhood cancers and prostate cancer, while using the Scheme to improve financial risk protection and access to quality care.[1][15][42]
• Integrate non-communicable disease interventions into sector planning, budgeting, financial management, internal audit and control systems, aligned with the Health Sector Monitoring and Evaluation Framework to reduce fragmentation and duplication.[45][16]
• Increase resource mobilisation targets from 30% in 2022 to 100% in 2026, achieve full disbursement of budgeted non-communicable disease funds annually from 2022 to 2026, and raise the proportion of ministries with relevant budget lines from 40% in 2023 to 100% in 2026.[15]

Explicit costed totals include 1,148,800 Ghana cedis for strengthening surveillance, 2,300,300 Ghana cedis for workforce capacity, and 480,000 Ghana cedis for emergency services.[26][27]The Objective 5 table records a total allocation of 733,500.00 under the label “GHG”, including 301,500.00 for increased funding and 432,000.00 for integration into planning, budgeting and financial management.[44][45]It also records a grand total of 36,956,950.00 under that label.[45]The supplied extracts do not specify a reconciled overall budget, funding gap, disbursement schedule, expenditure estimates or economic assumptions.[26][27][38][44][45]