A comprehensive review of the policy and programmatic response to chronic non-communicable disease in Ghana.

INTRODUCTION: Chronic non-communicable diseases (NCDs) in Ghana have caused significant illness and death in Ghana for many years. Yet, until recently, they have been neglected and not considered a health priority. This paper reviews the national policy and programme response to chronic NCDs over the period 1992 to 2009.
METHODS: Unpublished reports, documents, relevant files of the Ghana Health Service (GHS) were examined to assess programmatic response to chronic NCDs. Literature was searched to locate published articles on the epidemiology of chronic NCDs in Ghana. The websites of various local and international health institutions were also searched for relevant articles.
RESULTS: Several policy and programme initiatives have been pursued with limited success. A national control programme has been established, NCDs are currently a national policy priority, draft tobacco control legislation prepared, public education campaigns on healthy lifestyles, instituted cervical cancer screening and a national health insurance system to reducing medical costs of chronic NCD care. Major challenges include inefficient programme management, low funding, little political interest, low community awareness, high cost of drugs and absence of structured screening programmes. Emerging opportunities include improving political will, government's funding of a national cancer screening programme; basic and operational research; and using funds from well-resourced health programmes for overall health system strengthening.
CONCLUSIONS: Although Ghana has recently determined to emphasise healthy lifestyles and environment as a major health policy for the prevention and control of chronic NCDs, low funding and weak governance have hindered the effective and speedy implementation of proposed interventions.