Policy lessons

A practical policy lesson that arises from this study is that implementation of health policies in Ghana should be the responsibility of all stakeholders. The current scenario where all implementation issues have been left to the Ghana Health Service means that other agencies and institutions play the role of bench-warmers in implementing diabetes and hypertension policies. Managing hypertension and diabetes is highly complex and involves all players and interests in a health system. A re-orientation of thinking that recognizes the role played by all interests is key to implementing diabetes and hypertension policies. In this regard, attention should not be given to the policies alone but also to the processes involved in the formulation of policies such that all agencies recognize that once a policy is made, it will be implemented and that their interest must be captured in the formulation stage to engender an all-inclusive and effective implementation.
Another important lesson is that since a major issue in Ghana’s fight against diabetes and hypertension is the implementation of policies, there is the need for policy-makers to keep themselves abreast of modern implementation science techniques. This would enable policy-makers and implementers to scrupulously identify barriers to, and enablers of, effective hypertension and diabetes policy-making and apply this know-how for the development of innovative and evidence-based approaches in delivering hypertension and diabetes programs.
Last, over-concentration on clinical interventions may not be the way forward in terms of managing diabetes and hypertension. A practical lesson might be to utilize resources effectively on a blend of cost-effective preventive and clinical interventions. Managing diabetes and hypertension is complex and demands the utilization of a full range of instruments-legislation, subsidy, taxes, education, investment in research, etc. and not only on treatment.