Eye health problems are high among the priority health needs of the people living in Ghana.

According to a recent Blindness and Visual Impairment Study the prevalence of blindness in Ghana is 0.74% and 1.07% of the population has severe visual impairment. A large proportion of those with low vision (88.9%) and blindness (67.7%) are due to avoidable causes. The SRC started supporting eye care services in Ghana in collaboration with the Ministry of Health (MOH), Ghana Health Services (GHS) and Ghana Red Cross Society (GRCS) in 1991 expanding these services to the Upper West, the Brong-Ahafo and the Northern Region. It has offered outpatient department and community outreach attendance, school screenings and surgical operations and made significant impact on the eye health of the ordinary citizen of the Northern part of Ghana, considered as one of the poorest.

Project context

Ghana is a democratic state and covers a land area of 238,000km² and is host to an estimated population of 28’3 million people of which about 51% reside in urban centres. The country is divided into 10 Administrative Regions and operates a decentralized administrative system with 216 Districts.

Ghana is endowed with a variety of natural resources which include gold, bauxite, manganese, limestone, timber, and oil and gas. The economy of Ghana depends largely on rain-fed agriculture, employing over 60% of the labour force mainly in subsistence agriculture. However, services and oil and gas sectors have emerged in recent times as economic forces. Ghana’s economy growth has steadily increased by 7% per year on average since 2005 and it is considered as a Lower Middle Income Country since 2010 and due to the discovery of offshore oil reserves, per capita growth in the country has remained relatively high. Despite the growth recorded, inequality has been increasing in the country and poverty remains prevalent in many areas. Households in urban areas continue to have a much lower average rate of poverty than those in rural areas (10.6% versus 37.9%). The gap between urban and rural areas has doubled – rural poverty is now almost 4 times as high as urban poverty compared to twice as high in the 1990s.

The Northern Region, the actual project region, is the largest of the ten regions of the country, accounting for 30% of the total land area of the country and has 2.86 m inhabitants (10 % of the total of Ghana’s 28.3 m population). With a poverty incidence of 50.4% in 2013, it ranks as second region in poverty incidence of the country. Climatically, religiously, linguistically, and culturally, the region differs greatly from the politically and economically dominating regions of central and southern Ghana. The region has four paramount chiefs, (the Yaa Na, Yagbon Wura, Bimbila Naa and the Nayiri), each representing a major ethnic group. The main ethnic groups of the region are the Mole Dagbon (52%), the Gurma, (22%), and the Akan and the Guan (9%). There are no ethnic conflicts between these groups; when conflicts arise, these are usually disputes related to chieftaincy and land rights. The indigenous languages spoken by the people vary from district to district. With only 22 % of the population of 15 years and older classified as literate, the literacy rate in the Northern Region is low, with strong differences between districts.

While public health expenditure as percentage of GDP in Ghana has risen from 1.6% in 1990 to 3.8% in 2010, expenditure has now fallen to 2.1% in 2014. With this level of spending, Ghana belongs to the group of 20 countries in Africa with the lowest percentage of health per GDP expenditure, having reduced human and material resources available for the health sector. Ghana has an average of one physician per 10,000 people, lying beyond the lowest category of “low human development countries” (1.8), developing countries (10.3), sub-Saharan Africa (1.9) and the group of least developed countries.

Location of the Project

The Eye care program will cover all 14 district hospitals and their respective catchment areas in the whole Northern Region of Ghana. The program phase 2017-2020 will continue to support service delivery in 10 facilities (for OPD and surgical services) and districts (for outreach, screening and sensitization) established in earlier program phases (Bole, Damango, West Hospital Tamale, Walewale, Gambanga, Guschiegu, Yendi, Zabzugu, Bambila, Kpandae) and add new facilities (the district hospitals of Salaga, Savelugu and Saboba as well as the Tamale Central Hospital (TCH)) and their respective catchment areas. The following map shows the hospitals supported by the program, whereby new hospitals are marked in green

Beneficiaries

The Northern Region has a total population of 2.86 m, out of which specific sub-sectors will benefit from the different services of the programme:

• 120.000 people as beneficiaries of community outreach activities
• 175.000 school children as beneficiaries of school screening activities
• 44,100 school children treated with drugs during eye health camps
• 1,650 children provided with subsidized spectacles
• 65,800 people reached through OPD services
• 6.300 beneficiaries of subsidized cataract surgeries, (4,250 pro-poor patients)
• 140,000 people reached with eye health messages via radio programs