Over the past two decades, the mix of diseases and disabilities affecting the health of Ghanaians has transformed. Despite global decreases, infectious diseases like malaria and HIV/AIDS continue to kill thousands, while heart disease and stroke are beginning to take a greater toll on the health of citizens.
These are some of the findings from the Global Burden of Diseases (GBD), Injuries, and Risk Factors 2010 Study (GBD 2010), a collaborative project led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
Country-specific findings, including for many countries in East Africa, were announced in March, at the Bill & Melinda Gates Foundation in Seattle, by IHME Director Dr. Christopher Murray and Foundation Co-chair and Trustee Bill Gates.
These findings detail the causes of death and disability – across age groups and genders – for 187 countries around the world. GBD 2010 encompasses researchers from 303 institutions and 50 countries.
The work, which generated one billion estimates for health challenges, large and small, was funded by the Bill & Melinda Gates Foundation.
“Our goal is to help governments and citizens make well-informed decisions about health policies and investments by arming them with information that is up-to-date, comprehensive, and accurate,” said IHME Director Dr. Christopher Murray.
“With these new ways of making the data understandable, people everywhere for the first time can see the incredible progress being made in health and the daunting challenges that remain.”
The GBD reveals surprising health trends around the world. For instance, Ghanaian life expectancy is increasing, but these longer lives are filled with more sickness and disability. The average life expectancy in Ghana increased from 60.5 in 1990 to 64.9 in 2010; yet only 55.3 of those years are lived in perfect health.
This is in keeping with a global shift to an older population that struggles with a complex combination of health problems. This gap between life expectancy is greater in many countries in Africa and beyond. People in 139 other countries worldwide live healthier lives than Ghanaians.
“This is what we are seeing in the hospitals and clinics throughout Africa,” said Dr. Felix Masiye, Head of the Department of Economics at the University of Zambia and a leading health metrics researcher in East Africa.
“We are extending our life spans, but we need to be thinking about how we make sure that we are living more of those years in full health.”
Decrease in overall mortality rates is a trend that nearly all West African countries have encountered over the last two decades. For example, the overall mortality rate has decreased by 21 percent for men and 23 percent for women between 1990 and 2010 in Ghana. The greatest reductions in mortality rates were experienced by females between the ages of 1 and 4, decreasing by 58 percent.
Much of this increased life expectancy is due to the dramatic progress that has been made in preventing child deaths. In 1990, there were more than 28,000 deaths of children ages 1 to 4 in Ghana.
By 2010, that number was down to under 17,000. Much of sub-Saharan Africa has made significant gains against child killers such as malaria, tuberculosis, and diarrheal disease, but communicable diseases remain a severe health challenge to many countries on the African continent, including Ghana.
In many countries, children who survive past the age of 5 are plagued by deadly ailments as young adults. For those aged 20 to 24 in Ghana, the number of deaths from malaria rose by 241 percent between 1990 and 2010, and HIV/AIDS saw a 58 percent increase. The number of young people who die in traffic accidents is increasing as well, with 11 percent of deaths of young people aged 20 to 24 dying on the road.
Causes of death for young Ghanaians differ for men and women. HIV/AIDS and maternal disorders kill the most young women, while the most young men are dying from malaria and lower respiratory infections.
Iron deficiency anaemia continues to be the top cause of years lived with disability in almost all West African nations. Depression, low back and neck pain, migraine, and anxiety disorders are taking a greater toll on Ghanaian health than ever before.
High body-mass index as a risk of disability jumped from number 11 to number three between 1990 and 2010, and high blood sugar increased in ranking from seven to five. Increased obesity-related risks reveal the need for government to address issues with diet and exercise.
At the same time, environmental risk factors like household air pollution persist as risks in Ghana. Household air pollution and ambient particulate matter pollution are both on the top 10 risk factors for health burden, ranked at one and 10, respectively. Environmental policies should be built and strengthened to reduce these risks.
Professor Irene Akua Agyepong, lead author of the Ghana-specific study told this reporter, “There’s a lot of anxiety that people are going to forget the Millennium Development Goals and stop caring about things like HIV, malaria or childhood deaths or maternal deaths.”
“We can’t forget. The GBD findings show that we have made enormous progress, and we need to keep that momentum going.”
She said “the GBD allows you to make comparisons across populations, across conditions and over time.
Because the GBD approach, in effect, levels the playing field with different health conditions, you can really see how much health loss is caused by road traffic accidents and how much is caused by diabetes. When you do this, it becomes clear that we are spending our money wisely in some areas and that we may be totally unprepared for dealing with emerging health crises.”
The release of the country-specific data and visualizations follow the December 15 publication of GBD global and regional findings in The Lancet, the first time the journal has dedicated an entire triple issue to one study. The seven scientific papers and accompanying commentaries provide a new platform for assessing the world’s biggest health challenges, and then finding the best ways to address them.
GBD 2010 provides the evidence for a range of new research projects and targeted policymaking in Ghana and beyond. It also opens the opportunity for countries to conduct detailed burden studies of their own populations.
The Institute for Health Metrics and Evaluation (IHME) is an independent global health research centre at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems and evaluates the strategies used to address them. IHME makes this information freely available so that policymakers have the evidence they need to make informed decisions about how to allocate resources to best improve population health.
By Maxwell Awumah
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