Takemi Program in International Health
The Takemi Program in International Health seeks to improve health and health systems around the world by welcoming mid-career health professionals and scholars to the Harvard T. H. Chan School of Public Health to conduct path breaking research and develop their leadership skills.
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Beyond Covid-19: sustaining the health promotion strategies for improved health outcomes in Ghana
Francis A. Adzei MRes, PhD,1,3 Jesse B. Bump,1,2 and Stephane Verguet 2
¹ Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA
² Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
³ Department of Health Services Management, University of Ghana Business School
Introduction
The COVID-19 pandemic provided an opportunity to test the readiness of global health systems. Various strategies were deployed for disease management, with health promotion being essential. Previously, the adoption and implementation of health promotion policies in the country were slow.
This study examines Ghana’s experience with health promotion during the pandemic and outlines the lessons learned for future improvements in the health system.
Objectives
- Identify the health promotion strategies used in managing the COVID-19 pandemic.
- Evaluate the effectiveness of these strategies in achieving pandemic control goals.
- Outline how these strategies can be integrated and sustained beyond the pandemic.
- Assess the efficiency of resource allocation before and during the pandemic for future health sector planning.
Methods
The study used a qualitative research design involving 54 key informant interviews and an analysis of health policy documents.
Participants were selected through purposive sampling from the three-tier health system, ensuring national coverage across the three major ecological zones.
Thematic analysis was conducted with the aid of NVivo software.
Ethical clearance was obtained from the Ghana Health Service Ethics Review Committee (No: GHS-ERC: 023/04/24).
Findings
Table 1: Key themes, findings, and implications from health promotion strategies during COVID-19
| Theme | Key Findings | Implications |
|---|---|---|
| Health promotion strategies for managing COVID-19 were basic and context-specific | • Community engagement and outreach at all levels of society • Hand hygiene and improved cough etiquette • Improved health education and communication | Intensive behavior change communication during the pandemic management led to healthy behaviors among populations that were previously slow to change. |
| Preventive practices and infection control | • Emphasis on frequent handwashing, sanitizing, and wearing of masks • Educating staff on the use of PPE and infection control protocols | Health professionals and community members became more aware of healthy behaviors, leading to a reduced incidence of other infectious diseases. |
| Improved criteria for health resource allocation | • Health sector planning budget of the country should be community-based • Crises situations give rise to improvement in resource allocation formula | The centralized formula for health resource allocation could be reconsidered to facilitate rapid improvements in health outcomes. |
| Planning lessons from the management of the pandemic | • Decentralized planning should coexist with centralized priority setting • The unexplored potential of local remedies as appropriate technology in novel situations should be encouraged | Despite shortages in external health support, resorting to local remedies for health interventions was crucial for managing crisis situations. |
| Health promotion practices should be fully integrated into the health system | • Misconceptions between public health and health promotion need to be addressed • The policy thrust of national health promotion policy actualized quickly | There is a need to address the perception that health promotion units compete with public health units, as this hinders the integration of health promotion into the mainstream health system. |
Discussion
- The COVID-19 pandemic revealed the underutilized
- potential nations’ local health management capabilities that were not as well known.
- Ghana acknowledged and emphasized health promotion as a valuable tool for attaining favorable health results in its health sector planning strategies.
- Better public health outcomes would typically result from decentralizing the centralized resource allocation formula.
- The applicability of resource dependency theory is diminished in times of crisis, like COVID-19. The unrealized potential of less developed nations is better understood.
Conclusion and Recommendation
- Health promotion measures, such as hand hygiene, played a crucial role in managing COVID-19 and led to a reduction in cases of other infectious diseases, like cholera.
- Local remedies, such as steam inhalation with herbs and spices, were employed as appropriate technologies to aid in the management of COVID-19.
- Health Promotion Officers should be appointed at all hospitals, health directorates, and sub-district levels.
- Existing national health promotion action plans should be implemented more rapidly.
Acknowledgment
- Japan Medical Association (JMA)
- Japan Pharmaceutical Manufacturers Association (JPMA)