Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis

Abstract Background The World Health Organization (WHO) encourages all member states to adopt and implement a package of essential evidence-based interventions called the Best Buys to reduce the burden of non-communicable diseases (NCDs). To date, little is known about the implementation of national...

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Main Authors: Leonard Baatiema, Olutobi Adekunle Sanuade, Irene Akwo Kretchy, Lydia Okoibhole, Sandra Boatemaa Kushitor, Hassan Haghparast-Bidgoli, Raphael Baffour Awuah, Samuel Amon, Sedzro Kojo Mensah, Carlos S. Grijalva-Eternod, Kafui Adjaye-Gbewonyo, Publa Antwi, Hannah Maria Jennings, Daniel Kojo Arhinful, Moses Aikins, Kwadwo Koram, Ann Blandford, Edward Fottrell
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Health Research Policy and Systems
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Online Access:https://doi.org/10.1186/s12961-024-01242-3
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author Leonard Baatiema
Olutobi Adekunle Sanuade
Irene Akwo Kretchy
Lydia Okoibhole
Sandra Boatemaa Kushitor
Hassan Haghparast-Bidgoli
Raphael Baffour Awuah
Samuel Amon
Sedzro Kojo Mensah
Carlos S. Grijalva-Eternod
Kafui Adjaye-Gbewonyo
Publa Antwi
Hannah Maria Jennings
Daniel Kojo Arhinful
Moses Aikins
Kwadwo Koram
Ann Blandford
Edward Fottrell
author_facet Leonard Baatiema
Olutobi Adekunle Sanuade
Irene Akwo Kretchy
Lydia Okoibhole
Sandra Boatemaa Kushitor
Hassan Haghparast-Bidgoli
Raphael Baffour Awuah
Samuel Amon
Sedzro Kojo Mensah
Carlos S. Grijalva-Eternod
Kafui Adjaye-Gbewonyo
Publa Antwi
Hannah Maria Jennings
Daniel Kojo Arhinful
Moses Aikins
Kwadwo Koram
Ann Blandford
Edward Fottrell
author_sort Leonard Baatiema
collection DOAJ
description Abstract Background The World Health Organization (WHO) encourages all member states to adopt and implement a package of essential evidence-based interventions called the Best Buys to reduce the burden of non-communicable diseases (NCDs). To date, little is known about the implementation of national policies and interventions for NCD control in the WHO member states in sub-Saharan Africa. Our study aimed to evaluate the implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana. Methods This was explanatory mixed methods research which started with a document review of Ghana’s WHO Best Buys scores from the 2015, 2017, 2018, 2020 and 2022 WHO NCD Progress Monitor Reports. Thereafter, we conducted 25 key informant interviews and one focus group discussion (11 participants) with key policymakers and stakeholders in the NCD landscape in Ghana to understand the implementation of the NCD policies and interventions, and the policy implementation gaps and challenges faced. Data from the NCD Progress reports were presented using mean scores whilst the qualitative data was analysed thematically. Results Ghana has shown some advancements in the implementation of the WHO Best Buys measures. Ghana’s implementation scores for 2015, 2017, 2020 and 2022 were 5.0, 9.0, 5.0 and 5.5 respectively, against the mean implementation scores of 7.6/19 for lower-middle-income countries and 9.5/19 for upper-middle-income countries. Efforts to decrease major risk factors such as excessive alcohol consumption and unhealthy diet have been progressing slowly. The most common challenges were related to a) the role of socio-cultural factors, b) stakeholder engagement, c) enforcement and implementation of public health policies, d) implementation guidelines, e) public awareness and education on NCDs, f) financing of NCD prevention and control, g) curative-centered health systems, and h) over-centralization of NCD care. Conclusion Ghana has made progress in adopting the WHO Best Buys targeting risk factors of NCDs. However, the country faces contextual barriers to effective implementation. With the retrogression of some measures over time despite making progress in some earlier years, further investigation is needed to identify facilitators for sustained implementation of the WHO Best Buys interventions.
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spelling doaj-art-97ba42a8c58c47bbb62039735f4a73072024-11-17T12:54:14ZengBMCHealth Research Policy and Systems1478-45052024-11-0122111410.1186/s12961-024-01242-3Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysisLeonard Baatiema0Olutobi Adekunle Sanuade1Irene Akwo Kretchy2Lydia Okoibhole3Sandra Boatemaa Kushitor4Hassan Haghparast-Bidgoli5Raphael Baffour Awuah6Samuel Amon7Sedzro Kojo Mensah8Carlos S. Grijalva-Eternod9Kafui Adjaye-Gbewonyo10Publa Antwi11Hannah Maria Jennings12Daniel Kojo Arhinful13Moses Aikins14Kwadwo Koram15Ann Blandford16Edward Fottrell17Department of Health Policy, Planning and Management, School of Public Health, University of GhanaDepartment of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine at the University of UtahDepartment of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of GhanaInstitute for Global Health, University College LondonDepartment of Community Health, Ensign Global CollegeInstitute for Global Health, University College LondonNoguchi Memorial Institute for Medical Research, University of GhanaDepartment of Health Policy, Planning and Management, School of Public Health, University of GhanaNoguchi Memorial Institute for Medical Research, University of GhanaInstitute for Global Health, University College LondonInstitute for Lifecourse Development, University of GreenwichMental Health and Addictions Research Group, Department of Health Sciences, University of YorkMental Health and Addictions Research Group, Department of Health Sciences, University of YorkNoguchi Memorial Institute for Medical Research, University of GhanaDepartment of Health Policy, Planning and Management, School of Public Health, University of GhanaNoguchi Memorial Institute for Medical Research, University of GhanaDepartment of Computer Science, University College LondonInstitute for Global Health, University College LondonAbstract Background The World Health Organization (WHO) encourages all member states to adopt and implement a package of essential evidence-based interventions called the Best Buys to reduce the burden of non-communicable diseases (NCDs). To date, little is known about the implementation of national policies and interventions for NCD control in the WHO member states in sub-Saharan Africa. Our study aimed to evaluate the implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana. Methods This was explanatory mixed methods research which started with a document review of Ghana’s WHO Best Buys scores from the 2015, 2017, 2018, 2020 and 2022 WHO NCD Progress Monitor Reports. Thereafter, we conducted 25 key informant interviews and one focus group discussion (11 participants) with key policymakers and stakeholders in the NCD landscape in Ghana to understand the implementation of the NCD policies and interventions, and the policy implementation gaps and challenges faced. Data from the NCD Progress reports were presented using mean scores whilst the qualitative data was analysed thematically. Results Ghana has shown some advancements in the implementation of the WHO Best Buys measures. Ghana’s implementation scores for 2015, 2017, 2020 and 2022 were 5.0, 9.0, 5.0 and 5.5 respectively, against the mean implementation scores of 7.6/19 for lower-middle-income countries and 9.5/19 for upper-middle-income countries. Efforts to decrease major risk factors such as excessive alcohol consumption and unhealthy diet have been progressing slowly. The most common challenges were related to a) the role of socio-cultural factors, b) stakeholder engagement, c) enforcement and implementation of public health policies, d) implementation guidelines, e) public awareness and education on NCDs, f) financing of NCD prevention and control, g) curative-centered health systems, and h) over-centralization of NCD care. Conclusion Ghana has made progress in adopting the WHO Best Buys targeting risk factors of NCDs. However, the country faces contextual barriers to effective implementation. With the retrogression of some measures over time despite making progress in some earlier years, further investigation is needed to identify facilitators for sustained implementation of the WHO Best Buys interventions.https://doi.org/10.1186/s12961-024-01242-3Non-communicable diseasesImplementationWHO Best BuysPolicyBarriersGhana
spellingShingle Leonard Baatiema
Olutobi Adekunle Sanuade
Irene Akwo Kretchy
Lydia Okoibhole
Sandra Boatemaa Kushitor
Hassan Haghparast-Bidgoli
Raphael Baffour Awuah
Samuel Amon
Sedzro Kojo Mensah
Carlos S. Grijalva-Eternod
Kafui Adjaye-Gbewonyo
Publa Antwi
Hannah Maria Jennings
Daniel Kojo Arhinful
Moses Aikins
Kwadwo Koram
Ann Blandford
Edward Fottrell
Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis
Health Research Policy and Systems
Non-communicable diseases
Implementation
WHO Best Buys
Policy
Barriers
Ghana
title Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis
title_full Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis
title_fullStr Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis
title_full_unstemmed Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis
title_short Implementation of national policies and interventions (WHO Best Buys) for non-communicable disease prevention and control in Ghana: a mixed methods analysis
title_sort implementation of national policies and interventions who best buys for non communicable disease prevention and control in ghana a mixed methods analysis
topic Non-communicable diseases
Implementation
WHO Best Buys
Policy
Barriers
Ghana
url https://doi.org/10.1186/s12961-024-01242-3
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