A sizeable number of people in communities across the country, especially Ghana's Northern Region, do not have access to health facilities
A report, released by the UN in May this year, shows that Ghana has recorded a 30 per cent reduction in the mortality rate of infants and children below five.
This represents a decline in mortality rate from 111 per 1,000 live births in 2003 to 72 in 2012, according to the World Bank. The risk of a child dying before completing five years of age for Africa as a whole is 95 per 1,000 live births, according to WHO. In countries like Nigeria and Somalia, the under-five mortality rate in 2012 was as high as 125 and 147 respectively, says World Bank data.
How did the African country manage to achieve the significant reduction?
The key to the improved child survival are the country's community-based volunteers, much like the accredited social health activists, ASHAs, who work in rural areas of India.
About 16,500 community-based volunteers (CBVs) trained in Ghana are busy managing common childhood diseases in their communities which lack access to healthcare facilities. They have been trained by the Ghana Health Service, which also supplies them with medication to treat these illnesses. These volunteers are able to correctly treat and provide medication for diseases like malaria, pneumonia and diarrhoea.
The service is a part of rural health initiative called the Integrated Community Case Management (iCCM) and supported by the United Nations Children's Fund (UNICEF) and is funded by the United States Agency for International Development.
According to WHO, the availability of high-quality rapid diagnostic tests (RDTs) for malaria has made testing for malaria at the community level possible. The iCCM approach incorporates WHO’s recommendation that all suspected malaria cases undergo diagnostic testing prior to treatment.
As part of iCCM, front-line workers at the community level are trained, supplied and supervised to diagnose and treat children using oral antibiotics or oral rehydration salts and zinc. The healthy agency also says that in Ghana, 92 per cent of guardians of sick children sought treatment from community-based agents trained to manage pneumonia and malaria; 77 per cent sought care within 24 hours of onset.
According to a report by Inter Press Service, Ghana lacks personnel who can work on health. For instance, in the case of a community in Saboba district in the Northern Region of Ghana, there is only one community health nurse taking care of 20 communities and she is supposed to visit all of them. UNICEF, however, believes that community management of childhood pneumonia could result in a 70 per cent reduction in under-five mortality. The officials there even believe that the initiative that was started in 2007 has led to drastic improvement in health of children and “they no longer record deaths”.
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