Healthcare System in Ghana and the USA
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Health care system in Ghana and the USA
Introduction
The Healthcare system has portrayed differences and a few similarities in developing countries as well as high economy countries. Apart from costs and effectiveness, accessibility differs due to the availability of skilled professionals and the number of health centers. For instance, in Ghana, the medical care system is centered in large cities such as Accra and Kumasi. In contrast, the USA has invested heavily in the healthcare sector. The US government has ensured adequate medication, health centers, and skilled personnel, thus effective health services. However, other issues such as affordability of health care services affect both economies, especially the vulnerable population groups such as women, children, and the elderly.
Factors that Influences the health care system in Ghana and the USA
Cost
Ghanaians have been experiencing a strain in meeting individual health care needs as most live in rural areas where the health care facilities are a distance from their place of residence. Despite the health care costs ranking below the regional average, most citizens are still unable to afford primary healthcare. The majority of higher-level health facilities are located within the major towns and cities, while low-level health care facilities in Ghana are located in rural areas (Adua Frimpong & Wang, 2017). According to the World Health Organization Demographic Health Surveys, before making National Health Insurance Scheme compulsory in 2005, 70% of the Ghanaians were still not registered under NHIS (Adua Frimpong & Wang, 2017). According to the World Health Organization Demographic Health Survey, the estimated unit cost per patient is only affordable by less than 50% of the total population.
Healthcare in the United States is among the most expensive medical care in the world. The Affordable Care Act (ACA) was enacted by the federal government to share health care responsibilities between the government, employers, and individuals. The US does not have universal health care insurance coverage; preferably, it operates a single or multi-payer health care insurance system known as the hybrid system (Caldwell et al., 2016). The hybrid system involves many private insurance companies, state governments, and the federal government, combining it to cater to the cost of medical care. For instance, more than 89% of the US population is under cover of health a health insurance firm. Private insurance companies cover about 66% of workers while the federal government covers the rest through Medicare, Medicaid, and Veterans medical care (Caldwell et al., 2016). These insurance firms ensure that workers fully covered since the cost of medical services on an individual in the US are high.
Accessibility of Healthcare
In Ghana, the population with physical access to health care is defined as the percentage of people living five kilometers or 1 hour from the healthcare facility. The majority of Ghana’s health centers are generally considered general, as they are only able to focus on general medicine (World Health Organization (2019). This does not offer the citizens access to the full range of diagnostics procedures, testing, and treatment. Only nine hospitals provide surgical services, and only five have specialized in this field (World Health Organization, 2019). However, the government of Ghana is providing healthcare to the people through subsidized medical care costs through insurance covers.
Access to medical care in the United States has been catered for by non-governmental organizations as well as private entities. In the US, 87.6% of the people can physically access the health care as transport and communication services are well developed; others have more than 700 mobile health operating in the country (Caldwell et al., 2016). There are also congregational networks that give a gift of transportation to those who need to get medical services. There is located clinic near people’s residents, and partner clinics held in congregations. The communities and other stakeholders have set up a healthcare access taskforce that with hospitals (Caldwell et al., 2016). The United States government has invested mainly in the healthcare sector, which ensures constant availability of medications and equipment required to perform diagnostic and treatment procedures to the US citizens.
Impact on vulnerable populations
Ghana’s expenditure has increased on improvements in healthcare has increased over the past years. Koblinsky (2016) notes that the introduction of National Health Insurance funds, out of pockets payment has reduced over the past years as the government has put NHIS as mandatory to all citizens. For the past few years, Ghana has experienced political stability, good governance, and openness, which has welcomed an excellent environment for observation of children’s and women’s health rights. Currently, attendance to antenatal clinic ANC and child welfare has been looked into, thus a definite improvement in infant survival rates. Koblinsky (2016) states that since 2008 Ghana demographic health survey (GDHS) shows an increase in 78% women receiving up to 4 antenatal visits, which are an improvement from 69% in 2003 GDHS. Free maternal and child healthcare during pregnancy and postnatal has reduced fetal and maternal mortality significantly. In recent years, infant mortality decreased by 22% in 2008 to 111 deaths per 1000 live births, while by 2010, the survival rates of children under 5 reduced to 64 deaths in 1000 live births (World Health Organization, 2019). In the first month of life, according to GDHS in 2008 fell to up to 30 deaths per 1000 live births. These data show the improvement of health care in Ghana over the years.
Healthcare sector sophistication and favorable government policies are among the significant factors that have favored maternal and child survival in the USA. Congress has increased funding of maternal and child health care and has adopted a more extended term budget intending to end preventable child and maternal death. Both federal and state governments contribute to maternal child-related programs such as the Emergency medical programs for the children and special supplemental food programs for women, infants, and children. However, despite the government investing in the health care sector, maternal and child mortality trends have risen. This is because women are not in a position to cover half their health costs as employer-sponsored insurances demand higher purchasing power. A report produced by the commonwealth shows that among high-income countries, America has the most significant risk of women dying from pregnancy complications. The financial burden adds to the risk regardless of the education, political stability, and income of the citizens.
Management of communicable and non-communicable diseases
The prevalence of infectious and non-communicable diseases determines the distribution of health outcomes, such as life expectance and mortality. Rapid urbanization has led to an increase in the population’s sedentary lifestyle and consumption of refined food, especially in urban cities of Ghana (Adu Tomdi & Darkwa, 2020). This lifestyle has contributed much to an increment of cases of non-communicable diseases such as diabetes and cardiovascular diseases. Ghana mainly relies on low-level interventions as there is still no comprehensive policy for managing chronic non-communicable diseases. Therefore, it is not surprising that the life expectancy of Ghana is 64.1 years, which is low compared to 78.94 years in the United States (Adu Tomdi & Darkwa, 2020). The present health outcomes in Ghana is as a result of increasing health expenditure and healthcare policies. NHIS does not cover the treatment of most non-communicable. Therefore, the patients are compelled to pay for treatment and care for these conditions. The CDC has been working with Ghana in efforts to mitigate both communicable and non-communicable diseases. According to Adu Tomdi & Darkwa (2020), the most significant causes of death in Ghana are tropical infectious diseases such as malaria and lower respiratory infections. Other conditions such as stroke, ischemia, HIV/ AIDs, tuberculosis, and neonatal disorders. The public and private sectors are coming together to lay strategies on coming up with proper infection prevention measures.
The United States, similar to Ghana, non-communicable, are the most significant causes of death. These diseases contribute to 79% of total deaths. Edemekong & Huang (2019) acknowledge that cardiovascular diseases, cancer, respiratory diseases, and diabetes are the leading causes of non-communicable disease deaths. Like Ghana, most of these diseases are caused by a sedentary lifestyle characterized by reduced physical activity and consumption of an unhealthy diet. In the case of infectious diseases, various bodies such as the Occupational Safety and Health Administration (OSHA), are responsible for ensuring that workers are safe. It makes sure all workers get vaccinated against conditions such as influenza, measles, mumps, rubella, and many others (Edemekong & Huang, 2019). In efforts to prevent foodborne microorganisms, which are likely to add up a load of communicable diseases, the United States healthcare sector licenses and inspects food handlers (Edemekong & Huang, 2019). Health education is provided by a skilled medical professional on infection prevention measures and waste management, which has contributed to a reduction in infectious diseases.
The Theory of Practice and Health Promotion
In the past years, Ghana has experienced inadequacy in skilled health professionals such as doctors and nurses, thus registering the low levels of health standard, especially in rural areas. Salifu (2016) notes that community-based health practices which entail training of health professional, as well as the people on essential community-based interventions, are conducted. For instance, health education campaigns are done throughout healthcare facilities concerning the prevention of common childhood illnesses. Back in 2004, the World Health Organization, in conjunction with UNICEF, supported the recommendation of community-based care of all childhood illnesses (Salifu, 2016). Through the healthcare sector, the government has developed actionable strategies for health promotion measures, such as building a strong public health policy. Other actions include creating a physical and social environment that supports the individual effort of change, strengthening community action, and developing skills to increase self-efficacy among the patients. According to Salifu (2016), the research confirms the theory of practice in the Ghanaian context of nursing education and training. However, there exists also system inadequacy, such as resource constraints and challenges in the clinical learning environment.
Americans’ Office for Disease prevention and health promotion (ODPHP) plays a vital role in keeping the nation healthy. Jou et al. (2018) note that this body was created in congress to keep the country healthy by leading the disease prevention campaigns and health promotion efforts in the United States. The organization wants to accomplish the role of maintaining the health objectives by setting health objectives and supporting programs that improve the health of all Americans (Jou et al., 2018). The United States national health observances educate and encourage healthy dietary guidelines, physical activities, health care quality, health literacy, and the president’s council on sports, fitness, and nutrition (Jou et al., 2018). The Health Care Quality discover the initiative to improve health care quality and patients throughout the United States.
Behavior and Lifestyle Factors Affecting Health
Ghana has not invested much in healthcare facilities compared to developed countries such as the US. This makes it rely more on lifestyle modification measures to lower the risk of lifestyle-related conditions. Rural areas and fewer urban areas characterize Ghana. Tagoe, & Dake, (2015) notes that in towns and urban centers such as Accra and Kumasi, many Ghanaians have adopted a sedentary lifestyle. Unhealthy lifestyle behaviors include poor dietary practices, reduced physical activity, smoking, and alcohol abuse. The urban environment has discouraged physical exercises, especially among women, according to the Ghana Demographic Health Survey 2008 (Tagoe, & Dake, 2015). The trend in obesity in Ghana is worrying as epidemiological studies have shown an increased risk in the entire population, regardless of their residence location. Health reports indicate an increased prevalence of lifestyle diseases such as diabetes type 2 and hypertension. Urbanization, globalization, and nutritional transition are significant drivers of unhealthy lifestyle behaviors, especially in developing countries such as Ghana. The ministry of health in Ghana is in the process of mitigating lifestyle-related conditions has come up with Regenerative Health and Nutrition (RHN) (Tagoe, & Dake, 2015). The main objective of RHN is to promote healthy practices that would eliminate the diseases that impact the health and well-being of the Ghanaians.
One of the major lifestyle factors that influence the health and prevalence of various illnesses among Americans is the social factor. According to Koh et al. (2011), unhealthy social behavior such as smoking tends to be more prevalent among low income generating groups. Education levels vary with various ethnic groups in the entire American population. Therefore, psychosocial behavior such as excessive alcohol intake has been attributed to communities of lower education levels. The aspect of healthy behavior can also be addressed through dietary intake, sexual activities, and physical activities (Koh et al., 2011). The health care sector of the US is providing health education to the citizens to minimize the effects of unhealthy behavior on people’s health.
Conclusion
Health is the state of well-being among the people should be among the key factors which enable the development of other sectors. Factors such as place of residence and the community’s socioeconomic characteristics are among the significant determinants of health. The governments in both developing and high-income countries should subsidize healthcare to ensure the citizens are healthy and productive.
References
Adua, E., Frimpong, K., Li, X., & Wang, W. (2017). Emerging issues in public health: a perspective on Ghana’s healthcare expenditure, policies, and outcomes. EPMA Journal, 8(3), 197-206.
Adu-Gyamfi, S., Tomdi, L., & Darkwa-Dompreh, B. (2020). Evolutionary Study of Chronic Non-Communicable Diseases Policy as Healthcare Intervention in Ghana (2000-2019). International Journal of Body, Mind, and Culture, 6(4), 185-200. https://ijbmc.org/index.php/ijbmc/article/viewFile/190/161
Caldwell, J. T., Ford, C. L., Wallace, S. P., Wang, M. C., & Takahashi, L. M. (2016). The intersection of living in a rural versus urban area and race/ethnicity in explaining access to health care in the United States. American journal of public health, 106(8), 1463-1469. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4940644/
Edemekong, P. F., & Huang, B. (2019). Epidemiology of Prevention of Communicable Diseases. https://ropepmc.org/books/n/statpearls/article-21205/
Jou, J., Kozhimannil, K. B., Abraham, J. M., Blewett, L. A., & McGovern, P. M. (2018). Paid maternity leave in the United States: Associations with maternal and infant health. Maternal and child health journal, 22(2), 216-225.
Koblinsky, M., Moyer, C. A., Calvert, C., Campbell, J., Campbell, O. M., Feigl, A. B & McDougall, L. (2016). Quality maternity care for every woman, everywhere: a call to action. The Lancet, 388(10057), 2307-2320. https://eprints.soton.ac.uk/404681/1/THELANCET-S-16-05490.pdf
Koh, H. K., Piotrowski, J. J., Kumanyika, S., & Fielding, J. E. (2011). Healthy people: a 2020 vision for the social determinants approach. Health Education & Behavior, 38(6), 551-557.
Salifu, D. A. (2016). Theory-practice gap: Perceptions of Nurse Faculty and Nursing students at the University for Development Studies and Clinicians in Tamale Teaching Hospital (Doctoral dissertation, University of Cape Coast). https://ir.ucc.edu.gh/jspui/bitstream/123456789/3067/1/DAVID%20ABDULAI%20SALIFU.pdf
Tagoe, H. A., & Dake, F. A. (2015). Healthy lifestyle behavior among Ghanaian adults in the phase of a health policy change. Globalization and health, 7(1), 7. https://link.springer.com/article/10.1186/1744-8603-7-7
World Health Organization. (2019). Non-communicable disease prevention and control: a guidance note for investment cases (No. WHO/NMH/NMA/19.95). World Health Organization.