Opinions of Friday, 6 October 2017

Columnist: Awiagah Sherrif Kwame

Preventive medicine: Ghana’s best inadequate

Preventive medicine is much less expensive compared to curative medicine Preventive medicine is much less expensive compared to curative medicine

Preventive medicine is a medical specialty that employs the skills and knowledge gained from medical, social, economic, and behavioral sciences.

This medical specialty can be thought of in the basic sense as public health. The field focuses on promoting health, preventing diseases and managing the health of communities and defined population.

Preventive medicine achieves its goal using four approaches of prevention including primal, primary, secondary and tertiary preventions. The primal approach requires that even before conception is made of a baby, measures must be put in place to ensure that it is not affected health wise during pregnancy, birth and after birth till later years of life.

For example, primal prevention requires that a lady who abuses drugs and alcohol seeks the advice of a medical practitioner before getting pregnant. It also requires that couple who wish to have a baby (especially first pregnancies) must seek the advice of a medical practitioner before conceiving a baby.

Through primal prevention, we are able to reduce the incidence of congenital abnormalities and some genetic/inheritable/ diseases including but not limited to Sickle Cell Disease.

The Tertiary prevention also focuses on maximizing an individual’s residual energy in disability. This is basically rehabilitation, channeling the individual’s energy to other productive ventures other than what they could do but for their condition.

Someone might be asking if our curative medicine is doing enough. The answer is NO and that gives more credence to why our preventive medicines effort must be upped.

Preventive medicine is much less expensive compared to curative medicine (managing illness and disability). It manages the health of population and gives communities the responsibility to be each other’s keeper and watch dog for promoting good health and wellness.

For example preventive medicine will empower members of a community to understand that when house A is left filthy, the entire community becomes at risk for diseases, not forgetting the social impact of illness and/or death on the family and community.

A lot of things including government policies in this country are enough for one to confirm that our attention to preventive medicine is very abysmal.

For instance our ‘Celebrated’ Health insurance scheme does not cover preventive care. What this means is that, you cannot pick your health insurance card walk to the doctor’s office and tell him I am coming for medical checked up, I want to be screened for diseases, I want to know about my risk factors for diseases.

It does means also that with your card, you can’t walk into the hospital to say I want to be vaccinated against a disease. Interestingly you can’t use your insurance card to patronize family planning service but you can use it to seek post abortion care (is a way to say, we are aware you’re young, not ready and not interested in getting pregnant go and pay for the family planning service otherwise get pregnant, attempt or actually abort it and we will get it covered).

The irony of this is that the preventive care which is not covered eventually finds itself into the cycles of curative care and gets covered. In effect one will not be wrong to argue that our health insurance scheme has been developed to take care of damage control.

Another thing in our media suggestive of a laxity in the approach with which our country tackles preventive medicine is the numerous adverts relating to health and lifestyle. Alcohol, alcoholic beverages, herbal medicines and aphrodisiacs have almost taken away the peace of watching uninterrupted programs with their adverts.

The most worrying aspect of it is that these adverts are very seductive to both young and old. Public transports turned to market place for selling and advertising unregistered health products (double agony: selling potential poison and polluting the air).

You see people who can hardly speak English or even Ghanaian languages selling drugs under poor environmental conditions (in a country in which majority of the people do not verify the expiry dates of drugs before consumption).

The incidence of non-communicable diseases including hypertension, kidney diseases, diabetes and various types of cancers is on the rise, pointing to the emergence of poor lifestyles among the population.

The truth is that our weak preventive care has overburdened the curative care and will continue to do so until pragmatic measures are put in place to marry curative with preventive care. If policies are not planned to emphasize on prevention, health expenditure will keep rising forever until few years to come when government will borrow to support curative care.

Preventive medicine does not require anything complex to achieve its goal; all that is needed is policy direction and consented efforts to make it fruitful. Watch out my next article on how to promote preventive medicine in Ghana.