Opinions of Thursday, 16 November 2023

Columnist: Sekyi-Brown Reginald

Enhancing access to diabetes care in Ghana: A call for collaborative action

The author is a Pharmacist & Chairperson for Early Career Pharmacists Group of Ghana The author is a Pharmacist & Chairperson for Early Career Pharmacists Group of Ghana

Introduction

In the intricate web of Ghana's healthcare system, the delivery of services spans four crucial levels—CHPS centers, health centers/polyclinics, district hospitals, and regional hospitals, some of which have attained the prestigious status of teaching hospitals. The recent addition of the University of Ghana medical center further enriches this landscape, constituting what is technically referred to as a Quaternary Hospital.

Within the expansive healthcare structure, the pharmacy healthcare value chain is a linchpin, encompassing pharmacists and support staff such as pharmacy technicians, medicine counter assistants, and over-the-counter medicine sellers. The Pharmacy Council of Ghana's latest report reveals a network of 5,584 pharmacists and 4,372 pharmacies across the nation. In the realm of chronic disease management, particularly diabetes, pharmacists assume critical roles.

The Burden of Diseases in Ghana
Ghana grapples with a dual burden of diseases, encompassing both infectious and non-communicable ailments, including diabetes, hypertension, and cancers. Noteworthy measures, such as the Public Health Act of 2012 (Act 851) and the Integrated Disease Surveillance and Response (IDSR), have been enacted. Diabetes, hypertension, and road traffic injuries are now integral components of Ghana's IDSR.

On a global scale, diabetes stands as the leading cause of chronic kidney disease, while in Ghana, it ranks second. Shockingly, for every 100 Ghanaians, seven are affected by diabetes, underscoring the urgent need for comprehensive strategies to enhance access to diabetes care.

Recommendations for Collaborative Action
Pharmacy Fraternity Advocacy:

The pharmacy fraternity must champion the establishment of a national centralized data system for chronic diseases. This innovative approach will capture comprehensive patient medical histories, including lab reports, providing holistic solutions irrespective of geographical location. This directly addresses the identified weaknesses in data systems for non-communicable diseases (NCDs) outlined in the National NCD Policy.

Community Pharmacies:
Advocate for the integration of routine diabetes screening as a standard service in all community pharmacies. This proactive approach ensures early detection and intervention, aligning with the overarching goal of improving access to diabetes care at the grassroots level.

Key Messages for Diabetes Management
* Medication Adherence: Emphasize the critical importance of adhering to prescribed medications with unwavering commitment.
* Family Medical History: Encourage heightened awareness of family medical history, recognizing its pivotal role in effective diabetes management.
* Regular Consultation: Stress the significance of regular consultations at community pharmacies as a cornerstone for ongoing diabetes care.

Ghana statistical service (GSS)

GSS should consider the inclusion of pharmaceutical products in its monthly Consumer Price Index (CPI). This will help policy makers understand reasons for the inertia or willingness of people living with diabetes in accessing care.

Political Intervention:
Highlighting the mean annual financial cost of managing one diabetic case at the outpatient clinic (estimated at GHS 540.35 or 2021 US $194.09), this underscores the economic impact of diabetes. Politicians play a pivotal role in managing the economy, which, in turn, influences citizens' nutritional choices and impacts diabetes statistics. A stable economy supports informed nutritional decisions through a nuanced understanding of facts on nutritional labels. Ultimately, there is a dire need of deliberate political will to initiate non-taxation incentives for local manufacturers to initiate the local production of critical medicines and consumables used in the management of diabetes.

Prevention
All employers should consider the incorporation of routine medical testing to cushion their employees. This will help in the early detection of diabetes and allow individuals take proactive steps to avert any dire consequences.

Conclusion
In conclusion, the challenge of diabetes in Ghana necessitates a collaborative, multifaceted approach. By fostering a robust national data system, ensuring economic stability, and incorporating routine diabetes screening at community pharmacies, we can make substantial strides in improving access to diabetes care and mitigating the impact of this prevalent chronic condition. The call to action is clear - let us unite for the health and well-being of our nation.