Global Health

BACKGROUND

On behalf of the American people, the U.S. Agency for International Development (USAID) supports the Government of Ghana (GoG) in its efforts to deliver high-quality, affordable healthcare to improve and save lives. USAID’s health priorities in Ghana are the ongoing response to COVID-19; reproductive, maternal, newborn, and child health; nutrition; Malaria; HIV/AIDS; health system strengthening; water, sanitation, and hygiene; and social protection.

The people of Ghana have become significantly healthier over the past two decades, as measured by several key indicators. Between 2008 and 2022, under-five mortality decreased by 50% from 80 to 40 deaths per 1,000 live births. Available statistics from 2007 to 2017 show that pregnancy-related maternal mortality decreased by 24%, from 451 to 343 per 100,000 live births. The prevalence of malaria in children under five reduced significantly, from 26.7% in 2014 to 8.6% in 2022. 

However, regional disparities persist. Northern Ghana lags in critical health outcomes, exhibiting high levels of under-five malnutrition, severe anemia, and child mortality; lower proportions of fully vaccinated children; and lower coverage of basic health services. Limited access to improved water sources and widespread open defecation remain significant challenges in many rural communities, particularly in the northern regions. Low contraceptive prevalence throughout the country (only 27.8% of married women use modern methods) and high fertility rates in the north negatively affect mothers’ health.

HIV remains high within key populations — 4.6% among female sex workers and 18% among men who have sex with men. Although access to health services is reasonably high, service quality remains weak. Despite these challenges, the GoG remains committed to achieving universal health coverage by 2030, with a focus on primary health care, and USAID is ready to support this goal.

GOALS AND ACHIEVEMENTS

GOAL ONE: COVID-19 RESPONSE

The United States Government (USG) works closely with the Ministry of Health (MoH) and the Ghana Health Service (GHS) to support Ghana’s COVID-19 response.

Key achievements in 2022:

• Donated over 12 million vaccine doses to Ghana and supported the delivery of over 8.5 million vaccine doses across the country.
• Supported demand generation for the COVID-19 vaccine by broadcasting COVID-19 jingles in 13 local languages across the country that reached an estimated 14.3 million people.
• Donated five oxygen-generating plants to the GoG and 28 oxygen concentrators to healthcare facilities across Ghana’s 16 regions.
• Supported Ghana’s COVID-19 national case management team to train clinicians in COVID-19 case management. Through trainings and supportive supervision visits, reached a total of 3,829 individuals over the past two years.
• Committed $1.5 million to rebuild the National Vaccine Storeroom and $2 million to support vaccine manufacturing in Ghana.

GOAL TWO: REPRODUCTIVE, MATERNAL, NEWBORN, AND CHILD HEALTH

USAID partners with the GHS to prioritize building health workers’ competencies to provide high-quality, comprehensive maternal, newborn, and child health services including voluntary family planning services.

Key achievements in 2022 include:

• Improved the quality of services in 88 facilities in northern Ghana through the mentoring and training of 1,300 health workers in emergency care for mothers and small or sick newborns, contributing to a reduction in institutional maternal mortality from 111 to 73 per 100,000 live births (March 2021), and a reduction of institutional newborn mortality from 7.6 to 6.3 deaths per 1,000 live births (April 2022).
• Increased the availability of oxytocin at health facilities from 73% in 2021 to 96% in 2022. Oxytocin is essential to control bleeding after childbirth, a major cause of mortality for mothers.
• Donated $500,000 worth of obstetric and newborn emergency clinical equipment to health facilities in four northern regions of Ghana.
• Expanded access to family planning by procuring $8.2 million of contraceptives for the national family planning program.

GOAL THREE: WATER, SANITATION, AND HYGIENE

USAID partners with the Ministry of Sanitation and Water Resources; Municipal, Metropolitan, and District Assemblies; private water suppliers; and communities to strengthen Ghanaians’ access to water, sanitation, and hygiene (WASH) services.

Key achievements in 2022:

• Completed seven small-town water systems in the Upper West and Oti Regions, providing access to a safe drinking water supply to 15,000 people.
• Provided 11,000 individuals with improved sanitation and nearly 1,500 handwashing facilities for households.

GOAL FOUR: NUTRITION

As part of the USG’s Global Health and Feed the Future Initiatives, USAID partners with the GoG to improve the nutritional status of women and children under five. The flagship activity, Resilience in Northern Ghana II (RING II), is designed to sustain improvements in the delivery of services that promote the nutrition and resilience of vulnerable populations in Northern Ghana. RING II builds government capacity to plan, finance, and deliver local services and empowers citizens to participate in improving social sector service delivery.

Key achievements in 2022 include:

• Increased the proportion of children consuming a minimum acceptable diet from 10% to 65% in USAID-supported districts in the Northern, Savannah, and North East regions.
• Supported the GHS to train 751 health workers in 487 healthcare facilities selected from 17 districts in Northern Ghana to deliver high-quality nutrition services to children under five and pregnant women. More than 338,858 children under five and 76,840 pregnant women benefited from this support.

GOAL FIVE: MALARIA

USAID, in partnership with the U.S. Centers for Disease Control and Prevention (CDC), leads the U.S. President’s Malaria Initiative (PMI) to scale up proven measures to prevent and treat malaria. PMI supports the GoG’s National Malaria Elimination Program to strengthen its capacity to design, implement, and monitor interventions tailored to specific regional and district needs.

Key achievements in 2022 include:

• Procured and delivered 2,391,865 insecticide-treated bed nets; 970,000 doses of medicine to prevent malaria in pregnancy; 2,795,300 doses of preventive malaria medication for seasonal malaria chemoprevention in northern Ghana; and 2,500,000 kits of malaria rapid diagnostic tests.
• Sprayed 355,940 houses with insecticides, protecting 961,413 residents.
• Collaborated with the Global Fund to conduct four rounds of seasonal malaria chemoprevention to prevent children under five from malaria in 72 target districts, covering more than 90% of the target population of 1,446,282 people.
• PMI supported the last mile distribution of bed nets, through the installation of storage containers at three Regional Medical Stores. Bed nets have been integrated into last mile distribution in five regions – Eastern, Western, Western North, Oti, and Volta, resulting in 97% availability of bed nets at service delivery points in November 2022.

GOAL SIX: HIV/AIDS

The USG’s President’s Emergency Plan for AIDS Relief (PEPFAR) works closely with the Ghana AIDS Commission, the GHS National AIDS/ST Control Programme, and civil society organizations to achieve objectives outlined in Ghana’s HIV and AIDS Strategic Plan 2021-2025.

Key achievements in 2022 include:

• PEPFAR improved multi-month dispensing of antiretrovirals, currently at 73% of total prescriptions, ensuring 95% of persons transitioned to the improved WHO Tenofovir, Lamivudine, and Dolutegravir (TLD) line of treatment and piloting the use of pre-exposure prophylaxis and HIV self-testing.
• USAID linked 5,782 (95%) of 6,066 persons identified as HIV positive to treatment, and sustained the provision of treatment to approximately 34,836 in the Western, Western North, and Ahafo regions by the end of 2022.
• PEPFAR supported GHS in putting 5,782 new individuals on HIV treatment and maintained treatment for 34,836 clients in the Western, Western North, and Ahafo Regions.

GOAL SEVEN: HEALTH SYSTEMS STRENGTHENING

USAID supports the GoG in strengthening Ghana’s national healthcare system and policy environment and invests in sustainable supervision structures to ensure high-quality care delivery at all levels of the system.

Key achievements in 2022 include:

• Supported the GoG to operationalize the Ghana Integrated Logistics Management Information System (GhILMIS), by training almost 700 health facilities on the GhILMIS, increasing the number of onboarded facilities to 2,346 since inception.
• Provided more than $16 million in funding to procure commodities to improve access to essential health services related to maternal, newborn and child health, family planning, malaria, and HIV.

GOAL EIGHT: SOCIAL PROTECTION

USAID partners with UNICEF to support the Ministry of Gender, Children, and Social Protection(MoGCSP) to strengthen social protection and welfare systems for improved health outcomes of marginalized women and children.

Key achievements in 2022 include:

• Supported the GoG to reach 18,000 children needing care and protection, including 327 children reunified with their families and 244 placed in foster care.
• Engaged 2,278 community members on child protection toolkits and family-based care messaging in communities.
• Trained 1,011 social service providers on the guidelines for case management for child protection and family welfare.
• Supported the MoGCSP in developing and passing the National Policy Framework for Child Protection Strategies.