Management of chronic non-communicable diseases in Ghana: a qualitative study using the chronic care model

Abstract

Background While the burden and mortality from chronic non-communicable diseases (CNCDs) have reached epidemic proportions in sub-Saharan Africa (SSA), decision-makers and individuals still consider CNCDs to be infrequent and, therefore, do not pay the needed attention to their management. We, therefore, explored the practices and challenges associated with the management of CNCDs by patients and health professionals. Methods This was a qualitative study among 82 CNCD patients and 30 health professionals. Face-to-face in-depth interviews were used in collecting data from the participants. Data collected were analysed using thematic analysis. Results Experiences of health professionals regarding CNCD management practices involved general assessments such as education of patients, and specific practices based on type and stage of CNCDs presented. Patients’ experiences mainly centred on self-management practices which comprised self-restrictions, exercise, and the use of anthropometric equipment to monitor health status at home. Inadequate logistics, work-related stress due to heavy workload, poor utility supply, and financial incapability of patients to afford the cost of managing their conditions were challenges that militated against the effective management of CNCDs. Conclusions A myriad of challenges inhibits the effective management of CNCDs. To accelerate progress towards meeting the Sustainable Development Goal 3 on reducing premature mortality from CNCDs, the Ghana Health Service and management of the respective hospitals should ensure improved utility supply, adequate staff motivation, and regular in-service training. A chronic care management policy should also be implemented in addition to the review of the country’s National Health Insurance Scheme (NHIS) by the Ministry of Health and the National Health Insurance Authority to cover the management of all CNCDs.

Management of chronic non-communicable diseases in Ghana: a qualitative study of patients’ coping strategies and the role of caregivers

“…This observation in the present study, where patients engaged in social activities such as visiting families and friends as well as attending social gathering as a coping mechanism point to the role of families and friends in enabling patients with the chronic non-communicable disease to cope with their conditions. This is consistent with the findings of previous studies where patients suffering from chronic diseases sought social support by talking to families and friends as a way of coping with their conditions [ 25 , 36 – 39 ].…”

“…Ethical clearance (Reference number: UHAS-REC A.9 [ 36 ] 20–21) was obtained from the University of Health and Allied Sciences Review Committee and authorization from the hospital before data was collected. Informed consent had been obtained from participants before including them in the study.…”

How Can “Community Voices” from Qualitative Research Illuminate Our Understanding of the Implementation of the SDGs? A Scoping Review

“…In the majority of studies, data was collected from extremely poor rural locations or city slums. Not surprisingly, many research participants reported difficulties in accessing health care, including financial barriers, drug shortages and lack of transport [8][9][10][11][12][13]. Six studies also cited shortages of health-care workers and unfriendly interactions with health-care providers as barriers to accessing health care [11,[14][15][16][17][18].…”

Scoping review of community health participatory research projects in Ghana

“…Ghana and other sub-Saharan African countries are facing a steady increase in the prevalence of diabetes and other NCDs, driven by the increasing incidence of NCD risk factors such as physical inactivity and unhealthy diets. This epidemiological transition is evident in Ghana, where around 43% of deaths are caused by NCDs and the health system is not currently built to tackle this rising burden [ 19 , 20 ]; thus the need to explore approaches that can help in the prevention and management of NCDs is crucial [ 19 , 20 ].…”