Editorial: Addressing contemporary public health challenges in Ghana for improved outcomes: getting to SDG 3

Résumé

As the world moves forward in its efforts towards the SDG targets in 2030, decision making and implementation for public health programs to promote, restore, maintain, and improve health outcomes needs to be informed by research evidence generated at local as well as international levels. The need is imperative as the low-and middle-income countries (LIMC) disease burdens evolve from the traditional recognized patterns of mainly communicable diseases and maternal and child health problems to an increasingly sophisticated triple burden incorporating noncommunicable diseases 1 , 2 , 3 , 4 . This supplement's topic therefore aimed to attract a collection of articles mainly but not exclusively related to learning from Ghana, an LMIC in Sub-Saharan Africa's, research experience; to draw lessons for Ghana as well as the wider global community and especially for similarly placed countries in terms of contemporary health challenges and dilemmas as to how to best address them. The focus on an LMIC also had the dual aim of encouraging and promoting LMIC led research and innovation as part of strengthening LMIC capacity and leadership for research to respond to contemporary health challenges. Though the call and focus of this special supplement was on Ghana, two papers are included in the supplement from research in China and Taiwan in East Asia, given the relevance of the themes to contemporary public health in Ghana.The conceptual / theoretical framework within which the papers in this supplement are categorized draws on the concepts of health systems and the core functions of public health.Public health deals with the concern of societies to ensure the conditions in which people can be healthy. The UN's Sustainable Development Goal 3, 'ensure healthy lives and promote wellbeing for all at all ages' depends on the effective execution of the core functions of public health for its success. Drawing on the 1988 IOM report 5 , we used the concept of assessment (gathering the evidence about the state of health of the population, how and why and the conditions in which populations can stay healthy), assurance (putting in place the service, programs, and interventions to promote, restore and maintain health), and policy development (making of decisions that become authoritative for communities and societies to ensure the promotion, restoration, and maintenance of health) as the three core functions of public health; to categorize the papers in this supplement.We additionally drew on the WHO definition of the health system as referring to all institutions, actors, processes, and actions whose primary intent is to promote, restore and maintain health and contemporary constructs of the health system that go beyond the traditional WHO building blocks and take a social constructivist perspective that recognizes that health systems are social and complex adaptive systems. How the building blocks are structured and function and how the core functions of public health are executed; and the resulting outcomes are influenced by people, their values, interests, ideologies, power, and use of power to influence processes.(figure 1) Within each category of the categories related to the core functions of public health, we explore whether there is an underlying focus related to the increasingly triple burden faced by LMIC of maternal and child health, communicable and non-communicable disease.Of the five papers in the assessment category, all the three papers from West Africa are related to maternal and child health. Salifu et al evaluate the change in two survey periods of anemia and predictors and contributors to observed trends in Ghana, Sierra Leone, Mali, and Benin. Taken together, the collection of articles in this special supplement, bring out the importance of focusing on the increasingly multi-dimensional nature of evolving disease burdens and therefore policy and program priorites in LMIC like Ghana. Without neglecting the traditional priorities of maternal and child health and communicable disease such as malaria in research, policy and program agendas; disease of epidemic potential as well as non communicable diseases increasingly need more attention.

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