Non-communicable diseases in Ghana: risk factors, prevalence and social support systems

Banchani, Emmanuel (2021) Non-communicable diseases in Ghana: risk factors, prevalence and social support systems. Doctoral (PhD) thesis, Memorial University of Newfoundland.

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Abstract

The aim of this thesis is to examine the effects of individual and neighborhood socioeconomic status (SES) on hypertension, establish an association between non-communicable diseases (NCDs) and disability and examine the role of social support systems in management of NCDs in Ghana. Specific focus is given to the burden of hypertension, diabetes, and stroke. The study is motivated by the scarcity of research on NCD-related risks among women in Ghana. Similarly, there is paucity of academic literature on relationships between NCDs, disability, and social support systems available to people living with these chronic conditions. In examining these issues, a mixed methods sequential explanatory research design is adopted using the World Health Organization’s Commission on Social Determinants of Health (CSDH) as a conceptual framework. Specifically, data from the Women’s Health Study of Accra (WHSA-I) and the Ghana Global Ageing on Adult Health Survey (SAGE) are analyzed using multilevel logistic regression and ordinary least squares (OLS) regression respectively. In addition, qualitative interviews were undertaken in two teaching hospitals in Ghana with 33 patients living with NCDs, who were recruited for the study using purposive sampling technique. Results from the quantitative analyses reveal that wealthy women are more likely to be hypertensive compared to poorer women. However, the effects of neighborhood SES/wealth was attenuated after adjusting for individual-level SES/wealth. In addition, respondents with higher education reported higher levels of disability compared to those with no education, while stroke emerge as the major contributor to disability among Ghanaians. Thematic analysis of the interview data further indicate that the nuclear family is the main source of social support for the self-management of NCDs. The results suggests that efforts aimed at the prevention, control and management of hypertension should focus on changing individual behavioral lifestyles. Health promotion programs should also focus individual factors (engaging in physical activity and adoption of healthy diet with an emphasis on fruit and vegetable consumption etc) in the prevention, control and management of hypertension in Ghana. This research also offers innovative contributions to the extant literature by confirming that the International Classification of Functioning, Disability and Health (ICF) can be effectively used to classify individuals with disabilities living in Ghana not only based on their medical conditions, but also by their functioning level. This research further demonstrates that the ICF framework can be used within the healthcare setting to promote inclusiveness within the broader community. Finally, the study findings demonstrates that social support can be used as a strategy in the promotion of the physical and mental well-being of these NCD patients.

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