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Opinions of Friday, 22 July 2011

Columnist: Adede, Mercy Bolus

The plight of diabetics in Ghana

- A critical health issue

A study by Eghan et al (2007) reported the evaluation of the prevalence and predictor of micro albuminuria in diabetics in Kumasi and came out with its findings. Another study by Steiner- Aseidu and Rodriges (2009) on “Quality of care for Diabetics among Health plans” also suggested various improvements strategies. In addition a research was conducted in Kumasi by Titty et al (2008) about the prevalence of metabolic syndrome and its individual components among diabetic patients in Ghana and recommended that in the management of diabetics mellitus risk factors of the metabolic syndrome should be assessed from time to time and the appropriate treatment given. It is expected that this will help reduce or better prevent cardiovascular mortality (CVD).

How come these findings have not given the Health Ministry enough intelligence to help with the strategic planning of the nation health regarding the care of all diabetic patients in the country? Who is challenging and questioning the Health Minister to action these recommendations so that in the long round we have a health ppopulation, which equates to a healthier economy? Who is responsible in ensuring that all diabetics in the country are offered better treatment from the health budget?

How are funds allocated for commissioning a service for this group? Is the health Minister fully aware of the financial implications these group of people go through when they are diagnosed as diabetic? I asked these questions simply because of the social challenges most people go through in Ghana?

There are some areas and issues that most diabetics find themselves:

Crucial health issues

Vision check- Year on year foreign eye specialists comes to Ghana to offer free vision care to patients. To every diabetic in the country an annual vision check is critical for improving his or her quality of health. What is the Ministry of Health doing? Are we learning from these strategies as best practice set by these experts?

Cholesterol screening - Given the food choices available in Ghana most people have too much oil on peanut soup or palm nut soup which increases our cholesterol level.

Food choices - Mainly starchy foods with fewer vegetables

Regular urine test - Is this service available in all health centres and clinics to diabetic patients to get free urine test to when needed?

Chiropodist - Are the diabetic patients offered these services?

Medications - Do diabetic patients get any discounts on the medications prescribed or prescribed as free?

Diabetic Retinopathy screening do diabetic patients offer an annual check to the entire diabetics in the country?

Some basic short-term

Solutions:

What could the health centres and polyclinics do to educate the general public about these facts?

Findings from Ghana should be used to improve the health and well being of the diabetic patients in Ghana.

I believe that given the prevalence of people with the diabetic type 1 and 2 in the country surely a serious health promotion campaign strategy should have been implemented long ago. However it is never too late and we need to put in place a plan to promote the awareness about coping strategies via the media and all schools villages, towns and cities. All diabetic patients should carry an identify card to inform the public what needs to be done when they have a crisis. As part of our Health promotion the Government, business and general public must all be educated to highlight help needed.

In the developed world diabetics health and well being have been part of their strategic planning process and therefore are offered free medication and offer crucial health checks identified to ensure that they all achieve their full potential in life. In Ghana it appears diabetic patients are left without any support from the state. On the other hand, in Ghana many diabetic patients die prematurely due to lack of strategic planning on the part of the Health Ministry to ensure a healthier nation for its population.

Having to wait for foreign health missions to offer free sessions to patients’ helps but Ghana must equally take the lead in this direction too. Specialist health professionals in the country should come up with initiatives, which would make a difference in the health and well being of people and not just writings volumes of articles on issues of concerns.

Possible long-term solutions:

The Ministry of Health must deliver service improvement in diabetes care across all health sectors that would lead to measurable improvement in efficiency and quality of care for all patients.

Successful delivery of change through diabetic teams and partners that can apply train and coach others to improve the current diabetic care

There should be an effective implementation of programme plan with appropriate diabetic monitoring arrangements in every market, clinics and hospitals.

We need to implement a transformational change throughout all the regions in Ghana. Diabetic programme managers need to be deployed to make this happen.

Stakeholder management

There must be the involvement of all stakeholders, for examples community leaders, traditional priests, Church ministers, opinion leaders. Health directors need to manage, motivate, persuade and influence the multiple stakeholders mentioned earlier and partners to ensure that all agreed programmes are cascaded in all community to increase take up of the programmes.

Proactive problem solving and health professionals may need to negotiate where issues arise in the development and implementation of the work areas.

Financial management

Allocations of resources should be budgeted for all the regions for the programme become an annual exercise and not just a one off.

Ghana needs an organisational change from the Ministry of Health, which must be cascaded through every regional health authority. It is anticipated that perhaps this would ensure the success of a new service transformation. I believe that these initiatives undertaken by working in partnership with both external and internal stakeholders would help transform the situation.

If the Government needs help they need to go through the media request for Ghanaians in Diaspora who are experts of business administration and organisational change to freely give something back into the community.