"I tell you, getting data for this is hell"-Exploring the use of evidence for noncommunicable disease policies in Ghana.

Abstract

After several years of over concentration on communicable diseases, Ghana has finally made notable strides in the prevention of NCDs by introducing key policies and programmes. Evident shows that there is limited NCD-related data on mortality and risk factors to inform NCD policy, planning, and implementation in Ghana. We explored the evidence base for noncommunicable disease policies in Ghana. A qualitative approach was adopted using key informant interviews and documents as data sources. An adaptation of the framework method for analysing qualitative data by Gale and colleagues' (2013) was used to analyse data. Our findings show that effort has been made in terms of institutions and systems to provide evidence for the policy process with the creation of the Centre for Health Information Management and the District Health Information Management System. Although there is overreliance on routine facility data, policies have also been framed using surveys, burden of disease estimates, monitoring reports, and systematic reviews. There is little emphasis on content analysis, key informant interviews, case studies, and implementation science techniques in the policy process of Ghana. Inadequate and poor data quality are key challenges that confront policymakers. Ghana has improved its information infrastructure but access to quality noncommunicable disease data remains a daunting challenge. A broader framework for the integration of different sources of data such as verbal autopsies and natural experiments is needed while strengthening existing systems. This, however, requires greater investments in personnel and logistics at national and district levels.