Social and Policy Context of Tuberculosis Control in Ghana

Abstract

Tuberculosis (TB) continues to exert significant influence on the disease profile of countries, especially in Asia and sub-Saharan Africa. Recent evidence shows that timely chemotherapy and proactive community response can avert deaths associated with TB. This thesis explores TB control in Ghana from 1900 to 2010. Data were collected from four major sources: archival materials from the national archives of Ghana and United Kingdom, the 2008 Ghana Demographic Health Survey, TB surveillance data between 1997 and 2010, and in-depth interviews with some stakeholders in TB and HIV control in the country. The study revealed that the presence of TB on the epidemiological profile of the country predates independence and the anecdotal evidence suggests that the disease originated from contact with Europeans and Arabian traders who came through the coastal south and the northern regions respectively. Following the initial introduction, mining, urbanisation, and the opening up of hinterlands through improved transportation fuelled its internal spread. It was also observed that over the years, there have been significant improvements in completion of dosage and cure and reduction in default and fatality. These positive outcomes could be attributed to better case management, through fixed-dose combination, advances in diagnosis, community treatment care, and incentives for demand generation and public-private partnership. It is envisaged that an inclusive approach involving well coordinated TB and HIV services, as well as public-private partnership, could result in better TB control in the country.