Marking World Hypertension Day… amid 100 % increase in the cost of measuring blood pressure

It was intriguing to me when I walked into a phar­maceutical shop to measure my blood pressure (BP) and I was told to pay GH¢2.00 for the service. Not quite long, I usually go for periodic check up on my BP and paid GH¢1.00.

So biting that Ghana’s economic and financial crisis resulting in high inflation rates has adversely and innocently affected a basic primary health care service by 100 per cent.

Ordinarily, measuring blood pres­sure in public health institutions as part of collection of vital signs for diagnoses and treatment of diseases is “free” of cost.

Indeed, this year’s World Hyper­tension Day was marked on May 17 on the theme “Measure Your Blood Pressure Accurately, Control it, Live longer”.

Certainly, a worthy public cam­paign to get more people to go for check up to help in the prevention, control and management of the health condition that is taking a heavy toll on the population.

Whereas, some private health facilities render the service for free as part of their corporate social responsibility towards the fight against rising Non Communication Diseases (NCDs) others are putting a profit motive on it which has the tendency to defeat the public health campaign for regular check up on BP.

Not everyone can afford to pay the GH¢2.00 to measure one’s blood pressure.

If anything at all, inflation must not affect essential health service and products in view of the fact that NCDs like hypertension, diabe­tes, stroke, Ischemic heart disease, sickle cell, asthma to mention but a few, are on the ascendancy in the country that health stakeholders are calling for urgent steps to stem the tide.

This is in light of public health campaign to sensitise and empow­er people to have regular check up on their BP to determine their status and where there is the need for persons with elevated blood pressure repeatedly above 140/ 90 for them to see the doctor for further diagnoses and management with medication. A normal blood pressure reading is 120/ 80 or less.

What is Hypertension?

An elevated blood pressure repeatedly over 140/90 could be a diagnoses of hypertension. The health condition, also referred to as lifestyle disease is common with people who eat unhealthy diet, consume excessive amount of salt, do not exercise to burn calories accommodated in the body, smoke cigarette or tobacco, and overweight or obese. It could also be hereditary.

Hypertension, when not checked and controlled, leads to severe complications such as stroke, kidney damage, heart attack , among others , with devastating consequences on individuals and households.

One can reduce hypertension by reducing and managing stress, regularly checking blood pressure, and managing other complications, eating plant- based diet.

Ghana Health Services esti­mates that about 600,000 cases of hypertension are recorded annually at health facilities. These figures exclude cases that are not reported at health facilities.

According to the Ghanaian Society of Cardiology, one in four persons in Ghana has hypertension. It estimates the prevalence of hy­pertension at 33.75 per cent in both sexes, involving 36.1 for Women and 31.4 for male aged between 30- 79 years.

The statistics further indicates that 35 percent of Ghanaians have hypertension 49 per cent are aware of their status as being hypertensive, 39 per cent on treatment and 18.6 per cent have their blood pressure under control.

The society adds that in Ghana hypertension is the third most com­mon newly diagnosed outpatient disease among adults, and ranks in the top five outpatient disease for more than 15 years.

Your blood pressure accurately, control it, live longer”

According to the Dr Francis Agyekum, Vice President of Gha­naian Society of Cardiology, in a flier, says “Hypertension is like a thief in the night ,often no signs or symptoms ,until complications de­velop. Hypertension is silent killer.”

Though a “silent killer” hyperten­sion can easily be managed and con­trol with medication and positive lifestyle change in diet and physical activism, for one to live longer and normal life.

At the World Heart Federation summit in Accra last November, Dr Alfred Doku, a consultant physician and cardiologist reportedly told the roundtable discussion that “despite the urgent need, the health system in the country (Ghana) was not well-positioned to tackle the epi­demic of NCDs and cardiovascular diseases.”

In view of the huge challeng­es faced by the health system in respective of NCDs, an Associate Professor of Health Policy and Management at the University of Ghana Business School, Professor Aaron Abuosi, is advocating a shift from curative to prevention and health promotion, to curtail the rapid increase in health expenditure, especially in the management of NCDs.

Giving a health talk to his school mates of Old NAVASCAN Union Accra branch meeting recently, Prof. Aaron Abuosi said health expenditure in Ghana per individ­ual was rising exponentially, from estimated $76 in 2019 and projected to increase to $176 in 2050.

He posits that the rising health expenditure is largely driven by the rise in Non -Communicable Diseases(NCDs) including hyper­tension, diabetes, cancer, sickle cell asthma, which are expensive and difficult to manage, as the country is moving from developing country to a developed country, that comes with changes in lifestyle.

He, therefore, expressed the need for government to put in place con­crete policies and programmes to promote physical activity, nutrition education to public to eat locally-produced foods and health facilities to add screening for workers, to reduce the exponential rising of health expenditure per capita, as a result of increase in NCDs.

He added that National Health Insurance Scheme must include health promotion to empower peo­ple to take their health seriously and to reduce cost of curative care.

Explaining further, Prof. Abuosi said Ghana faced a “double burden of disease” of both Communicable Disease (CDs) otherwise known as infections disease like malaria, cholera, pueumonia and typhoid fever and NCDs, adding that CDs were fast giving way to NCDs, driving health expenditure because the NCDs were difficult and costly to manage.

He added that Ghana was going through “ demographic transition” from high birth and death rate to low birth and low birth rate occa­sioned by advancement in medicine, which also came with “epidemiolo­gy transition” from CDs to NCDs adding that “the more a country develops, the more it moves away from CDs to NCDs.”

Situating his talk within a decade backed by statistics, the health policy and management expert said between 2009 and 2019 NCDs had been on the rise in the country, while CDs were on the ascendancy.

He said though malaria was still a major public health problem, the incidence of malaria in Ghana had reduced by 33.9 per cent within the period, while stroke had increased by 35.2 per cent.

He said in 2009, diabetes was the number 10 cause of death, but moved to number 9 position in 2019, adding that infectious diseases as lower respiratory infection had reduced by 0.5 per cent, neonatal disorder by 18.6 per cent , HIV/ AIDS by 32.6 per cent, Tuberculosis by 12.0 per cent and diarrhea diseas­es by 13.1 per cent.

Conversely Prof. Abuosi said NCDs as Ischemic heart disease had increased in Ghana by 37.6 per cent between 2009-2019 while diabe­tes increased by 24.6 percent and cirrhosis by 12.3 per cent.

Prof. Abuosi, said work place safety must include screening for NCDs risk factors, walking rather using lift, incorporate gym and other keep fit facilities, flexible work schedule that also allows worker to work from home.

He noted that NCDs as lifestyle diseases, there was the need to avoid alcohol, reduction in quantity of starch and protein, oils, sugar, salt and coffee, and emphasised increase in vegetables and fruits, daily exercise between 30 and an hour walk and periodic medical check-up blood pressure , Body Mass Index to check for overweight ing sugar level, kidney functioning.

Touching on population, he said Ghana’s population which was more 30 million was still style in pyramid form with youthful base, adding that the population was projected to be over 50 million by 2100.

He said fertility had declined to 3.2 percent, adding that by 2100, Ghana’s fertility rate was projected to be at 1.3 percent, while life ex­pectancy at birth would up 81 years for female and 71 years for male , from the current 68.4 for female and 62.6 for male.

Way forward

In order, to make the public campaign and sensitisation on Hypertension meaningful, espe­cially on the theme “Measure Your Blood Pressure Accurately, Control it, Live Longer” there is the need to synchronise it with provision of services.

Blood pressure monitor must be made available at subsidised prices for ordinary household to own it as part of health care delivery.

Measuring of blood pressure must be made free in health institu­tions nationwide. So that people can easily walk into any health facility and pharmaceutical shops to check up their BP.

Workplaces must have a desk to encourage regular BP check-up in the work force.

A stitch in time saves nine, so “Measure Your Blood Pressure Ac­curately, Control it, Live Longer”.

Hypertension, when not checked and controlled, leads to severe complications such as stroke, kidney damage, heart attack, among others, with devastating consequences on individuals and households

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