National Policy: Non-Communicable Diseases

Objectives

Ghana’s non-communicable disease policy aims to attain a healthy population for national development by reducing the burden of non-communicable diseases, preventing avoidable morbidity and mortality, and minimising their public-health and socioeconomic impact.[1]It aligns with the Sustainable Development Goals and the World Health Organisation Global Action Plan for Non-Communicable Disease Prevention, including the goal of reducing premature mortality from non-communicable diseases.[2][3]

• Reduce exposure to modifiable risk factors, including tobacco use, harmful alcohol use, unhealthy diets, physical inactivity, air pollution, hypertension, raised blood glucose, overweight and obesity.[3][4]
• Strengthen health promotion, health education, supportive environments, community action and social and behaviour change communication across the life course.[4]
• Improve early detection, screening, clinical management, counselling, rehabilitation and palliative care to reduce morbidity and mortality.[5][6]
• Advance universal health coverage by improving access to quality non-communicable disease care and financial risk protection.[7][1]
• Address cardiovascular diseases, cancers, chronic respiratory diseases and diabetes, while giving specific attention to cancers, injuries, sickle cell disease, mental health, oral health and eye health.[3][8][9]
• Strengthen the health system, multisectoral collaboration, sustainable financing, research, surveillance and human-resource capacity.[4][10][11]

The policy is guided by evidence-informed decision-making, cost-effective interventions, primary health care, attention to social determinants of health, cultural relevance, gender sensitivity, community participation, integrated service delivery, affordable technologies and whole-of-society participation.[1]Its thematic scope covers primary prevention; secondary and tertiary prevention; conditions of special concern; health-system strengthening; financing; and research and development.[12][4]

Implementation

Implementation uses an integrated, life-course and multisectoral model that embeds non-communicable disease services throughout the health system while coordinating action across government, local assemblies, civil society, communities, private-sector organisations, professional bodies, development partners and patient groups.[13][1][14]The Ministry of Health leads policy oversight and supervision, the Ghana Health Service coordinates countrywide delivery, and the Non-Communicable Disease Prevention and Control Programme leads programme implementation.[8][14]

• Strengthen the National Multisectoral Non-Communicable Disease Steering Committee to provide strategic direction, advise the Minister of Health, support policy and legislation, mobilise resources and coordinate monitoring and evaluation.[14][15]
• Establish or strengthen a Non-Communicable Disease Division within the Ghana Health Service, including through formal approval processes, to support coordination, staffing, surveillance, research and implementation.[10][6][16]
• Develop action plans and sector-specific activities under Steering Committee guidance, with lead agencies responsible for initiating actions with relevant partners.[11][15]
• Integrate screening and management into primary health care, Community-based Health Planning and Services, wellness clinics, general hospitals and referral services.[1][5][6]
• Develop and implement screening and treatment guidance, including routine and opportunistic blood pressure, blood sugar and urine checks, newborn sickle cell screening, and disease-specific clinical guidelines.[6][17]
• Improve availability of essential medicines, diagnostic devices and affordable technologies through treatment guidelines, the Essential Medicines List, framework contracts, regulatory enforcement and removal of applicable taxes and levies.[18]
• Expand rehabilitation, palliative care, physiotherapy, tobacco cessation and substance-misuse rehabilitation services, alongside workforce development and more equitable staff distribution.[5][18][17]
• Use legislation, regulation, education and fiscal measures to address alcohol, tobacco and dietary risks, including food and drink labelling, marketing restrictions and exploration of alcohol pricing and taxation measures.[19]
• Strengthen intersectoral action through school health, One Health, Port Health, road-safety and cancer collaborations, including work with education, security, gender and social-protection bodies.[8]

Financing should be integrated into sector planning, budgeting, financial management and annual budgets of ministries, departments, agencies and local assemblies.[13][11]The approach includes resource mobilisation plans, donor mapping, mobilisation conferences, domestic and external funding, local revenue mobilisation, innovative financing, and potential investment of revenues from tobacco, alcohol and sugar-sweetened beverage taxation in prevention and control programmes.[13][18][15][20]Proposed financing indicators include achievement of resource-mobilisation targets, establishment of an NCD Fund, disbursement of budgeted funds and ministry non-communicable disease budget lines.[21]No quantified overall budget, allocation or monetary funding gap is specified.[13][15][20]

Monitoring combines routine data collection, sentinel surveillance, periodic risk-factor surveillance, population surveys, cancer registries, sentinel sites and strengthened inclusion of non-communicable disease indicators in national data systems.[18][16]The policy provides for baseline, mid-term and end-line evaluations, incorporation of findings into Annual Health Sector Review reports, and revision of relevant indicators and targets.[22]Indicator areas include public education, screening, service readiness, workforce training, surveillance, legislation, partnerships, physical-activity environments and nutrition interventions.[15][23][24][22]

Monitoring & Evaluation

The policy establishes a monitoring and evaluation approach centred on strengthened routine data systems, surveillance, screening data, periodic review and multisectoral oversight, while recognising weak non-communicable disease data collection as a constraint on planning and implementation.[8][18]

• Strengthen routine data collection and establish sentinel surveillance for continuous collection, analysis and interpretation of non-communicable disease and risk-factor data.[18]
• Use population surveys, research, routine surveillance and local evidence to track prevalence, risk factors, morbidity and mortality and to inform decisions, guidelines and implementation plans.[3][1]
• Maintain surveillance through Integrated Disease Surveillance and Response, including diabetes, hypertension and road-traffic injuries, and strengthen cancer and eye-health surveillance.[7][9]
• Monitor early-detection delivery through screening guidelines, newborn screening, facility-based blood pressure, blood sugar and urine checks, wellness clinics, staff training, medicine availability, devices, rehabilitation and palliative-care access.[6]
• Track health-system capacity through establishment of the Non-Communicable Disease Division, research outputs, STEPS Survey activities, revised data-collection tools, cancer registries, sentinel sites and inclusion of indicators in the Ghana Demographic and Health Survey and Multiple Indicator Cluster Survey.[16]
• Use indicators for communication, health education, social and behaviour change communication, advocacy, school health, nutrition, physical activity, road safety and other prevention actions.[15][23][24]
• Measure implementation through indicators such as districts conducting road-safety campaigns, facilities implementing the Maternal, Infant and Young Child Nutrition Strategy, districts with physical-activity areas and roads with pedestrian walkways.[23][24]
• Conduct baseline, mid-term and end-line evaluations, incorporate findings into Annual Health Sector Review reports and revise relevant indicators and targets.[22]
• Coordinate monitoring and evaluation through the National Multisectoral Non-Communicable Disease Steering Committee, while the Ministry of Health supervises and monitors implementation across ministries, departments and agencies with support from the Inter-Ministerial Coordinating Committee.[15][25]
• Monitor whether ministries, departments, agencies and local assemblies include non-communicable disease activities in plans and annual budgets, including the proportion of ministries with budget lines and disbursement of budgeted funds.[13][21]

Indicator tables and appendices include indicators, targets and sources where specified, but the supplied extracts do not consistently provide indicator definitions, levels, numeric targets, reporting schedules, evaluation methodology, data sources or detailed accountability procedures.[15][6][22][21]

Costing & Financing

Financing is a core policy objective and implementation theme, intended to address historically poor funding for non-communicable disease prevention, health promotion, risk reduction, treatment adherence, programme coordination and staffing.[2][7][8]

• Increase funding for prevention and management services and integrate non-communicable disease interventions into sector planning, budgeting, financial management, internal audit and control systems.[11][21]
• Require relevant ministries, departments, agencies and Metropolitan, Municipal and District Assemblies to include non-communicable disease activities in annual budgets.[13]
• Mobilise resources through Ministry of Finance collaboration, domestic revenue, multilateral and bilateral partners, donor mapping, resource mobilisation plans and resource mobilisation conferences.[13][20]
• Establish an NCD Fund and monitor achievement of funding targets, budget disbursement and ministry budget-line coverage.[21]
• Explore innovative financing aligned with domestic, bilateral and multilateral mechanisms, including earmarking returns from taxation of tobacco products, alcoholic beverages and sugar-sweetened beverages for non-communicable disease programmes.[18][15]
• Expand National Health Insurance Scheme benefits to support financial risk protection, wellness and cancer services, and screening and treatment for common cancers beyond cervical and breast cancer.[7][11][15]
• Prioritise cost-effective interventions, affordable technologies, medicines and delivery systems, and integration of services and programme funding to reduce costs and improve efficiency.[1][15]

The policy recognises direct and indirect costs to individuals, including diagnostics, medicines, long-term treatment and geographical access barriers.[18]Rehabilitation across the continuum of care may reduce costs, disability and loss of quality of life.[5]A 2009 study associated psychological distress with a 7% loss of gross domestic product.[10]The supplied extracts do not specify a total budget, unit costs, allocations, financing shares, quantified funding gaps, tax rates or broader economic assumptions.[11][15][20]