Reduce child mortality
Although evidence shows that there has been significant reduction in both infant and under-five mortality rates in Ghana, it is unlikely that the 2015 target of reducing the child mortality rates will be met unless coverage of effective child survival interventions is increased. The Ghana Demographic and Health Survey (GDHS) (2008) showed a 30 per cent reduction in the under-five mortality rate. This represents a decline from 111 per 1,000 live births in 2003 to 80 per 1,000 live births in 2008. Infant mortality rate as at 2008 stood at 50 per 1,000 live births compared to 64 per 1,000 live births in 2003. Data from Interagency Group Child Mortality Estimation (IGME) indicates a decline in under-five mortality from 122 to 74 per 1,000 live births between 1990 and 2010 leaving a deficit of 33. Immunization of under-one year old against measles improved from 68.8 per cent in 1998 to 79.9 per cent in 2008 and further up to 87.7 per cent in 2010.
What contributed to the progress?
Key policy intervention to reduce under-five mortality rate by two-thirds between 1990 and 2015, is the implementation of the Child Health Policy and Child Health Strategy. To significantly improve the child survival indicators, which for the longest period showed stagnation and had not responded to the many interventions, Ghana has launched a new Child Health Policy and Child Health Strategy. The Strategy outlines the key interventions to be scaled up along the continuum of care and focuses on improving access to, quality of, and demand for essential services. It also includes recent new technologies such as low osmolarity ORS and zinc for the management of diarrhoea, and introduction of new vaccines such as 2nd dose measles vaccine, pneumococcal vaccine and rotavirus vaccine through the national EPI. The strategy has contributed to the scaling up and sustenance of the child-health interventions.
Although evidence shows that there has been a significant reduction in both infant and under-five mortality rates in recent times, it is unlikely that the 2015 target of reducing the child mortality rates will be achieved, unless there is an effort to scale-up and sustain the recent child survival interventions which have brought about the current improvement. The following are some key challenges:
• The inability to sustain the funds used to support activities under Expanded Programme on Immunisation, which require enormous resources;
• Inadequate human resources and skills within the health system to improve the poor quality of care;
• Need to improve coverage of some key interventions, e.g. Integrated Management of Neonatal and Childhood Illnesses (IMNCIs), skilled deliveries, and postnatal care;
• In order to give more up-to-date data analysis of child mortality in the country, the ongoing mortality and morbidity data collection needs to be conducted at all levels to provide complete and reliable information on child health;
• Inadequate national data to provide complete and reliable information on child health;
• Inadequate human resources within the health system to improve on the poor quality of care; and
• Low female literacy rate and low level of women’s empowerment. In some parts of the country men make decisions about household healthcare choices and practices, including decisions about the healthcare practices of their wives or female partners.