Ghana: Country Profile
The Republic of Ghana is a West African country of about 31 million people. Livestock rearing and husbandry is an important component of the Ghanaian economy, including cattle, pig, birds, goats, and sheep. Recent outbreaks of zoonotic diseases in Ghana such as highly pathogenic avian influenza (HPAI) emphasize the health and economic importance of a One Health approach that works to prevent and stop outbreaks through coordination between human, animal, and environmental services.
Priority Zoonotic Diseases
In 2018, the Ghanaian government conducted a zoonotic disease prioritization workshop supported by the World Food and Agriculture Organization and the U.S. Centers for Disease Control and Prevention. The following diseases were identified as priority areas for intervention in Ghana:
Anthrax is a bacterial infection that typically affects animals and can be transmitted from animals and animal products to humans, with limited human-to-human transmission. In endemic settings, anthrax affects primarily cattle, goats, and sheep, and the bacterial spores can remain in soil for years. The bacteria that causes anthrax can spread to humans through open wounds on the skin, ingestion, or inhalation of the spores. Anthrax outbreaks have occurred occasionally in northern Ghana, typically during the rainy season.
Highly pathogenic Avian influenza (HPAI) is an infection by an influenza virus that can affect almost all species of birds, wild and domestic. HPAI is contagious, especially among poultry such as chickens and turkeys, leading to extremely high mortality when present in factory farms. In 2007, an outbreak of HPAI (H5N1) occurred at a small farm in Ghana and persisted for many years requiring several culling procedures between 2015-2018 to control the spread of the disease.
Rabies remains a widespread disease across the globe, responsible for tens of thousands of deaths worldwide each year. It is a viral infection transmitted by contact with saliva of infected mammals, mainly through bites and scratches and in most places, commonly through dogs. Children are particularly vulnerable to rabies. There were 529 cases of rabies in Ghana between 2018-2022 (Ghana Veterinary Services, 2023). The Disease Surveillance Department of the Ghana Health Services reported that in 2022, there were about 17,000 dog bites, 321 unconfirmed suspected cases and 204 unconfirmed deaths from rabies in the country.
Trypanosomiasis is caused by parasites and is spread through tsetse flies. It may present as a chronic or acute infection that affects the central nervous system. Trypanosomiasis is endemic in Ghana and has a high mortality rate among livestock.
Viral hemorrhagic fevers are diseases caused by a group of viruses and include Ebola virus disease (EVD), Lassa Fever, Marburg, and Rift Valley Fever. EVD is an infection caused by a virus of the filovirus family to which the Marburg virus also belongs. Humans are infected with EVD either by direct contact with its natural host, infected bats, or by handling infected dead or sick animals such as antelope and primates. Human-to-human transmission is possible through direct contact with the blood, secretions, organs or biological fluids of infected individuals. Lassa fever is a disease transmitted through ingestion or inhalation of secretions (urine, feces, blood) of infected mice and specifically the multimammate” or Mastomys type rat. Signs and symptoms of Lassa fever include fever, muscle pain, generalized weakness, diarrhea, and bleeding from orifices. Rift Valley Fever (RVF) is an infection that spreads most commonly to humans from livestock or wild animals via mosquitoes. The disease can also spread through direct contact with the blood or bodily fluids of animals such as sheep, goats and camels. RVF can cause spontaneous abortion in animals, and assisting with abortions is a common source of exposure to the disease. Farmers, abattoir workers, and veterinary or laboratory staff are high risk groups for RVF.
Zoonotic (or Bovine) tuberculosis is caused by the bacterial species Mycobacterium bovis and causes tuberculosis in primarily cattle but is also found in other farm animals such as pigs and goats, and in wild animals like deer. Although individuals who work with cattle are most at risk for this disease, anyone can get zoonotic tuberculosis through consumption, a cut or scratch, or via respiratory transmission. People in Ghana are at risk due to the prevalence of cattle rearing professions and considerable cattle mobility.
One Health Landscape
In Ghana, multi-disciplinary technical working groups (TWG) form part of the One Health landscape. A variety of partners participate in the National One Health TWG and the Risk Communication and Social Mobilization TWG including:
- Ministry of Health
- National Disaster Management Organisation (NADMO)
- Ghana Health Service – Health Promotion Division, Surveillance Division and Public Relations Unit
- Ministry of Food and Agriculture – Veterinary Services Directorate
- Ministry of Local Government and Rural Development
- Ministry of Education – Ghana Education Service (School Health Education Program – SHEP)
- Ministry of Sanitation and Water Resources
- Ministry of Lands and Natural Resources
- Ministry of Information (Information Services Department)
- National Development Planning Commission
- Office of the Head of Civil Service
- Environmental Protection Agency
- Noguchi Memorial Institute for Medical Research
- Ghana Armed Forces, Medical Directorate
- Focal Point, International Health Regulations
- Ministry of Environment, Science, Technology, and Innovation
- Forestry Department – Wildlife Division
- School of Veterinary Medicine, University of Ghana
- United States Agency for International Development (USAID) (Breakthrough ACTION)
- World Health Organization (WHO)
- Food and Agriculture Organisation (FAO)
- Ghana Red Cross Society
See the landscaping analysis conducted in 2019 for more details.
Summary of existing Breakthrough ACTION research
The Breakthrough ACTION Ghana team conducted a literature review in 2019 that summarizes published literature on behavioral determinants and sociocultural factors that influence Ghana’s priority zoonotic diseases. The search involved any articles that: (1) had a focus on key zoonotic diseases in West Africa; (2) involved data collected in West Africa; (3) were published between 2008–2018; and (4) described individual, cultural, or social risk or prevention factors related to one of the zoonotic diseases. The literature search produced 132 articles that met the inclusion criteria. Thirteen articles looked at perceptions, practices, and norms for PZDs in Ghana, and the majority focused on Ebola and HPAI. Overall, the review found substantial knowledge gaps with respect to most PZDs, with moderate risk perception and a variety of rumors and myths that linger in communities.
See the full literature review for more details.
In January 2021, the Breakthrough ACTION Ghana team reviewed communication and information channels to understand community feedback and media monitoring mechanisms that can be leveraged during health emergencies. Through interviews with members of the National Risk Communication and Social Mobilization Technical Working group as well as a review of print and electronic materials, the review identified strengths and gaps in community feedback mechanisms and made recommendations to prepare for future emergencies.
See the assessment report here.
Breakthrough ACTION, in collaboration with the Ghana Health Service (GHS) Health Promotion Division (HPD), Veterinary Services, Ministry of Agriculture and Health, USAID, and other stakeholders conducted formative research in February-March 2023 to inform communication strategies and public health messages promoting rabies prevention behaviors. The study assessed awareness and knowledge of health risks from zoonotic diseases in general but specifically focused on risk behaviors related to rabies, symptoms in animals and humans, prevention strategies, and reporting mechanisms. The analysis explored multi-level factors that influence behaviors at the animal-human interface. The qualitative study conducted 48 focus group discussions in 4 districts with groups comprised of adult men, adult women, and children 10-17 years old. Participants described a variety of perspectives on the role of animals in the household and community, including as a source of protection, food, income, and transportation. Dogs were described as having spiritual significance. Men typically cared for dogs but many were left unconfined, increasingly during the dry season. Participants’ awareness and knowledge of rabies varied, with most participants knowing about an illness that caused aggressive behavior or “madness” in dogs, but participants wanted more information and also shared misinformation about rabies. Risk perception was high, particularly with respect to children and butchers or food vendors. A growing dog and dog meat market supported the sale and consumption of dog meat including the meat of animals believed to be sick with rabies. Many people believed rabies could be treated through traditional remedies and many also patronized this approach for rabies prevention and treatment, even when conventional medical services were provided. Reporting mechanisms for dog bites or other rabies exposure incidents are not well-understood by communities. Few communities had access to animal health workers and rabies vaccinations were scarce or unaffordable.
Read more in the report: Understanding Multi-Level Factors that Influence Risk of Rabies in Ghana
Case study on SBC response
Existing behavioral research in Ghana informed the development of the national Message Guide for Priority Zoonotic Diseases in Ghana which offers talking points and key messages for each PZD.
The Breakthrough ACTION project also worked with the Ghana Health Service to create a flip chart on living safely with animals which is used to facilitate community discussions.