Abstract:
Background:
The epidemiological transition, touted as occurring in Ghana, requires research that tracks
the changing patterns of diseases in order to capture the trend and improve healthcare delivery.
This study examines national trends in mortality rate and cause of death at health facilities
in Ghana between 2014 and 2018.
Methods:
Institutional mortality data and cause of death from 2014–2018 were sourced from the
Ghana Health Service’s District Health Information Management System. The latter collates
healthcare service data routinely from government and non-governmental health institutions
in Ghana yearly. The institutional mortality rate was estimated using guidelines from the
Ghana Health Service. Percent change in mortality was examined for 2014 and 2018. In
addition, cause of death data were available for 2017 and 2018. The World Health Organisation’s
11th International Classification for Diseases (ICD-11) was used to group the cause of
death.
Results:
Institutional mortality decreased by 7% nationally over the study period. However, four out
of ten regions (Greater Accra, Volta, Upper East, and Upper West) recorded increases in
institutional mortality. The Upper East (17%) and Volta regions (13%) recorded the highest
increase. Chronic non-communicable diseases (NCDs) were the leading cause of death in
2017 (25%) and 2018 (20%). This was followed by certain infectious and parasitic diseases
(15% for both years) and respiratory infections (10% in 2017 and 13% in 2018). Among the
NCDs, hypertension was the leading cause of death with 2,243 and 2,472 cases in 2017
and 2018. Other (non-ischemic) heart diseases and diabetes were the second and third
leading NCDs. Septicaemia, tuberculosis and pneumonia were the predominant infectious diseases. Regional variations existed in the cause of death. NCDs showed more urbanregion
bias while infectious diseases presented more rural-region bias.
Conclusions:
This study examined national trends in mortality rate and cause of death at health facilities
in Ghana. Ghana recorded a decrease in institutional mortality throughout the study. NCDs
and infections were the leading causes of death, giving a double-burden of diseases. There
is a need to enhance efforts towards healthcare and health promotion programmes for
NCDs and infectious diseases at facility and community levels as outlined in the 2020
National Health Policy of Ghana.
