PLWNCDs face disruptions in health delivery services in Covid-19 era in Ghana

People Living with Non-Communicable Diseases in the era of Covid-19 are the most affected in regards to access to healthcare. The majority of people living with NCDs (PLWNCDs) have had disruptions in their healthcare services due to focused on Covid-19 cases leaving them to their fate. Meanwhile, NCDs are the leading cause of deaths in the world today, killing 41 million people each year, yet governments and global leaders have paid little attention to it.

The Ghana NCD Alliance by this release seeks to highlight the challenges faced by people living with NCDs in a recent survey it conducted and its implication for healthcare services and the attainment of Ghana’s Universal Health Coverage (UHC) by 2030 and the need for government to pay undivided attention to NCDs and PLWNCDs even beyond Covid-19.

Whilst the world is struggling to address the emerging threats of NCDs, such as hypertension, diabetes, liver disorder, cancers, chronic respiratory diseases, stroke, etc. another pandemic (coronavirus) emerges having massive negative health impact. The health systems in many countries have been overstretched and not able to respond appropriately to the challenges imposed by the deadly pandemic. Ghana and many other countries including the developed economies have not adequately invested and prioritized NCDs as a national and global pandemic, hence the devastating effects on people living with NCDs and other chronic health conditions. The introduction of safety measures such as social distancing, transport lockdowns, mandatory face mask, and closure of outpatient services among others, resulted in the disruption of routine NCD and other chronic service delivery. “COVID19 significantly impacts health services for cancer, cardiovascular disease & diabetes – a survey run by WHO with responses from 155 countries has shown: https://bit.ly/2UeAbPV It’s vital that countries find innovative ways to continue essential services to beat NCDs” Tedros Adhanom Ghebreyesus

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Globally, it is reported that people living with NCDs experienced a multitude of challenges, however in the Ghanaian context, little information exists on NCDs and Covid-19, and the experiences of people living with NCDs amidst the global pandemic. There have however been concerns from the government that the majority of the Covid-19 cases and mortalities recorded in Ghana are a result of NCDs. PLWNCDs

The Ghana NCD Alliance as part of efforts in contributing to national NCDs response and ensuring people living with NCDs needs and priorities are enhanced conducted a rapid qualitative survey aimed to understand the challenges faced by people living with NCDs in this Covid-19 era in Ghana. The evidence-based survey also draws recommendations to inform the national Covid-19 response in the context of the country’s multiple disease burdens, particularly NCDs, other chronic diseases, and the need for health system strengthening.

Data was collected from 127 persons living with stroke, diabetes, hypertension, sickle cell, chronic heart disease, asthma, cancer, and breast cancer from Greater Accra,  Ashanti, Eastern, and Northern regions. The study revealed that a significant number of persons living with NCDs were hugely affected in different ways following the Covid-19 pandemic, especially during the three weeks lockdown. PLWNCDs

The numerous challenges faced by people living with NCDs on daily basis attest to a fall in achieving the Universal Health Coverage, by 2030.

“I run out of medication and had to rely on a co-tenant to share his diabetes drugs because I could not access the prescribed drugs from the community pharmacy as they had none”. Essel Francis Cudjoe, a person living with diabetes

“I have experienced disruptions in accessing my medications due to the high cost charged by the pharmacy which was above my financial strength. I had to stay home due to fear and anxiety and my compromised immune system.  We can  no  longer  hide the fact that NCDs is a national crisis and the needs of persons living with diverse non- communicable diseases can no longer be neglected” Christopher Agbega, a person living with Motor Sensory Neuropathy

The findings revealed that PLWNCDs were given less attention when they visit the hospitals for their regular reviews and the majority reported were told not to return to the hospital since the focus was on Covid-19 cases. PLWNCDs

Some of the key challenges expressed by people living with NCDs included;

1. NCD medication often prescribed by doctors not covered by the NHIS
2. Fear of visiting healthcare centers due to fear of contracting the Covid-19
3. Difficulties in accessing prescribed medications that were out of stock in most healthcare facilities
4. Lack of access to physiotherapy services during Covid-19 in most health centers
5. Inability to undergo scheduled surgeries as Doctors refused to perform surgeries due to Covid-19

The following are recommendations shared by people living with NCDs and caregivers;

• The government should as part of treatment, care and support absorb medical bills of persons living with NCDs under the NHIS
• Psychologists should be stationed at all health centers to provide counseling to PLWNCDs to prevent an escalation of their condition
• Intensify education on Covid-19 and NCDs to reduce stigma, neglect, and discrimination
• Physiotherapy centers should be accessible with ease at all  health  centers to cater to the needs of stroke patients

As government devises strategies and plans towards responding to this pandemic and beyond, the Ghana NCD Alliance calls on government to consider the findings of this evidence-based document in the light of the following;

• The high rates of NCDs undiagnosed cases and poor levels of control for NCDs, especially diabetes, hypertension, cancers, in the country
• The National Policy on the management and control of NCD
• National UHC road map to deliver evidence-based primary health care for people with NCDs;
• National Covid-19 response strategy to address the pandemic
• National Health Insurance Scheme to cover the cost of NCDs
• Government to consider developing standard NCD guidelines for all healthcare centers

For more information Contact Labram M. Musah

National Coordinator: Ghana NCD Alliance

[email protected]