The facts and figures on health in Ghana, leading causes of death

Last week, I came across the Ghana Health Service Facts and Figures for 2018. In this document, I found a few things that confounded me. Of little surprise was the fact that malaria continues to be the leading cause of morbidity in our country. However, a critical look at the leading causes of death in our population was more revealing. Heart diseases were the leading cause of death in our society, followed in a clear distance by septicaemia and pneumonia; with malaria not appearing in the top 10 leading causes of death in Ghana.

This finding set me thinking as to how the leading cause of ill health was not the leading cause of death or anywhere near the top. From a statistical standpoint, malaria is responsible for 22.7 per cent of all ill health, while hypertension accounts for only 4.7 per cent. Yet 15.34 per cent of all deaths are attributable to hypertension.

I therefore, decided to look at the data to get an understanding of this supposed anomaly. I found my answers in the very document the Ghana Health Service has published. A close look at the attendance patterns of Ghanaians to outpatient appointments with health professionals where chronic diseases are routinely picked indicates that this has been dropping since 2013. Currently, the average Ghanaian sees a health professional less than once a year; preferring instead to attend pharmacies, herbalists or other non-authorised outlets.

This view is supported by data from the Institute for Health Metrics and Evaluation (IHME). According to the IHME Ghana’s expected life expectancy (that is our predicted life expectancy based on the country’s per capita income, educational attainment and overall total fertility) should be 69 years. However, our observed life expectancy is 65.5 years. This gives an indication that we are dying 3.5 years earlier on the average than we are expected to; with men dying 3.9 years earlier on the average at 62.6 years (expected 66.5 years) and women 3.1 years earlier at 68.4 years (expected 71.5 years). I leave the reader to make a judgement on if this is what we expect of our healthcare system.

Another concern for me was the second and third leading causes of death, septicaemia and pneumonia. I am concerned with these two because of the following: septicaemia (blood poisoning, often caused by bacteria or their toxins) occurs when infections are not managed properly and enter the bloodstream. With our indiscriminate use of antibiotics, I can only speculate that this is a result of excessive self-medication with illegally obtained and ineffective treatments for infections with patients arriving late in hospitals after the infection has poisoned their blood. Alternatively, the frequent prescribing of antibiotics without culture and sensitivity tests and the tendency for patients to discontinue treatment before a course of antibiotics is completed may be contributors too. In all, these developments are giving health professionals little chance of saving these unfortunate individuals.

Let me now make my case for pneumonia. Few people are aware that Ghana has become a dumping site for electronics waste. An article Peter Yeung published in the environmental section of CITYLAB catalogues how heavy, acidic gusts of smoke billow across the Agbogbloshie in Accra due to burning mounds of trash. Those working in this environment are known to often suffer from burns, back problems, and infected wounds, as well as respiratory problems, chronic nausea, and debilitating headaches; brought on by the hazardous working environment and toxic air pollution, the article said.

Sad, to say this is not peculiar to Accra but can be found across the entire nation. Refuse dumps littered with electronics waste are polluting the atmosphere and putting many at risk of respiratory infections.

Though we have chosen to turn a blind eye, my view is that it is beginning to take a toll as can be seen from the increasing deaths due to pneumonia.

This situation must be of concern to us all. As I have said previously our country is not awash with the human resource wealth to allow us to die earlier than we are supposed to. In actual fact, this situation is having a significant toll on our intentions to achieve social mobility and exponential human development. I say this because if our retirement age is 60 years and the majority are failing to achieve this, then there is little likelihood of skills transfer across the human resource supply chain. In essence, ours has become a country in constant training mode with nothing to show for the transfer of expertise along the chain. The few above sixty are either busy altering their age or thinking of how they are going to fund their old age.

Our national health reservoir is bankrupt. This is why I believe a recent research conducted by scientists from the University of York should be of concern to all of us. In that research, it was proving that Ghana’s water bodies are among the most polluted with antibiotics worldwide. Considering that antibiotics are excreted through the urine and faeces of humans, it is clear that apart from open defecation, most of our faecal matter is being dumped by unscrupulous contractors into water bodies rather than recycled. This again is an indication that we are collectively unaware of the harms such actions bring to us all. Yet we wonder why diarrheal diseases are still rampant in our society?

I will conclude by saying, in the area of health, our society has been very apprehensive of the truth, preferring instead to dwell in the realms of conjecture and assumptions. That documents like the Ghana Health Service Facts and Figures are released annually with little fanfare but the inauguration of boreholes and other similar projects attract our attention and receive significant press coverage is indicative of this reality. Unfortunately, the health data and evidence being gathered about us is damning of our claims to being human. It is picturesque of an evolving race of sapiens that has not yet got a grip on the value of data.

We need to urgently reverse this not just because it is the right thing to do but because it has negative implications on our quality of life. We cannot continue to churn out evidence and not use the findings to improve our lot.

By Kwame Sarpong Asiedu