16
2008, showing an improvement in coverage in one
of the key child survival interventions (MoH, 2008;
GHS, 2003).
The key child health interventions are antenatal care
(ANC), delivery care, postnatal care, immunization,
nutrition, management of childhood illnesses and
malaria prevention. In the last decade some progress
has been made to improve child survival. Household
ownership of insecticide-treated nets has improved
to 61.6 percent (urban) and 66 percent (rural) areas,
immunization coverage is high (Penta3 87 percent,
see GHS 2008
1
), National Health Insurance Scheme
(NHIS) coverage is high, antimalaria combination
therapy is universally available and infant and child
mortality have declined (see GSS 2008
2
; MICS
3
).
Maternal health care has improved over the past
20 years albeit at a slow pace. Between 1990 and
2005, maternal mortality ratio reduced from 740
per 100,000 live births to 503 per 100,000 live
births, and then to 451 per 100,000 live births
in 2008. If the current trends continue, maternal
mortality will be reduced to only 340 per 100,000 by
2015, instead of the MDG target of 185 per 100,000
by 2015. The improvement, however, is not the same
for all regions. There are disparities in the institutional
maternal mortality rate (MMR) across the 10 regions
in Ghana from 1992 to 2008 in the Northern and
Western Regions; 120.1 per 100,000 in Volta and the
Eastern Regions; and 59.7 per 100,000 in the Upper
West, Brong Ahafo and Ashanti regions. The only
region where the ratio has worsened is in Greater
Accra (by 87.6 per 100,000). Maternal death was
declared notifiable within seven days in Ghana in
January 2006 and the notification rate in 2007 was
71.8 percent. A quarter (75.4 percent) of 751 maternal
deaths in Ghana (2007) were audited.
After a decline from a high of 3.2 percent in 2006
to a low of 2.2 percent in 2008, evidence from
the 2009 Sentinel surveillance report suggests
an increase in the HIV/AIDS prevalence rate in
Ghana to 2.9 percent in 2009. According to the
Ghana AIDS Commission, the current up-and-
down movement in the prevalence rate between
2003 and 2008 signals a leveling eect or stabi-
lization of the epidemic.
On MDG 7 – ensuring environmental sustainabil-
ity – Ghana is on track to achieve the target of
halving the proportion of people without access
to safe water. Critical challenges exist in achieving
the targets for reversing the loss of environmental
resources, reducing the proportion of people with-
out access to improved sanitation, and achieving
significant improvement in the lives of people living
in slum areas. Although up-to-date data on the rate
of forest depletion is unavailable, evidence suggests
that the country is depleting its forest cover at an
alarming rate. Between 1990 and 2005, the forest
cover declined from 32.7 percent to 24.2 percent.
While access to safe water services in rural areas
has improved considerably, there has been slow
progress on access to safe water within urban areas.
Even though Ghana has made progress in reducing
the proportion of the population without access to
improved sanitation, the target may not be achieved
by 2015 if the current trends continue. If the current
trend is maintained, the proportion of the population
with access to improved sanitation will reach 21.2
percent by 2015 instead of 52 percent. The propor-
tion of the urban population with access to improved
sanitation will be 23.4 percent instead of 55 percent
by 2015, while in the rural areas, it would be only
20.6 percent instead of 50.5 percent. Also, though
the proportion of urban population living in slums
shows a decline, if the current pattern continues, a
significant proportion (about 14 percent) will still be
living in slum areas by 2020.
In terms of global partnerships for development,
many developed countries have not met the 0.7
percent GNP target for aid. However, aid inflows to
Ghana appear to have increased in nominal terms
from $578.96 million in 2001 to $1,433.23 million
in 2008. The current concern, however, is the level
1) GHS, Disease Control and Prevention Department 2008 Annual report.
2) GSS, Demographic and Health Survey 2008.
3) MoH, Multiple Indicator Cluster Survey (MICS) 2006.