health in ghana health in ghana in precolonial ghana, infectious diseases were the main cause of morbidity and mortality. the modern history of health in ghana was heavily influenced by international actors such as christian missionaries, european colonists, the world bank, and the international monetary fund. in addition, the democratic shift in ghana spurred healthcare reforms in an attempt to address the presence of infectious and noncommunicable diseases eventually resulting in the formation of the national health insurance scheme in place today.the first lady of the united states, mrs. pat nixon visits a child in a hospital in ghana, 1972. physicians at komfo anokye teaching hospital (kath) health indicators life expectancy66 infant mortality39 fertility2.12 sanitation14% (2010) smoker1% obesity female7% obesity male2% malnutrition1% hiv0.7% the human rights measurement initiative finds that ghana is fulfilling 67.1% of what it should be fulfilling for the right to health based on its level of income. when looking at the right to health with respect to children, ghana achieves 89.3% of what is expected based on its current income. in regards to the right to health amongst the adult population, the country achieves only 78.0% of what is expected based on the nation's level of income. ghana falls into the "very bad" category when evaluating the right to reproductive health because the nation is fulfilling only 34.1% of what the nation is expected to achieve based on the resources (income) it has available. the colonial period in 1874 ghana was officially proclaimed a british colony. ghana proved to be an extremely dangerous disease environment for european colonists, driving the british colonial administration to establish a medical department, bringing about an introduction to a formal medical system. this consisted of a laboratory branch for research, a medical branch of hospitals and clinics, and the sanitary branch for public health centered near british posts and towns. in addition to hospitals and clinics staffed with british medical professionals, these select towns were also provided anti-malaria medication to be distributed to colonists and to sell to local ghanaians. in 1878, the towns, police, and public health ordinance was enforced, initiating the construction and demolishing of infrastructure, draining of the streets, and issuing of fines to those that failed to comply with the heads of the colony. in 1893, a public works department was introduced to implement a working sanitation system in urban colonial centers. after world war ii it became increasingly clear that with improved transportation worldwide, international health policy needed to be strengthened. organizations such as the world health organization and the united nations children's fund were active in providing money and support to provide additional western medical care in ghana. these organizations provided, "financial and technical assistance for the elimination of diseases and the improvement of health standards." traditional health practices were not recognized by these initiatives or the british medical department in urban areas and were shunned by christian missionaries in rural areas. however, traditional priests, clerics, and herbalists still remained important health providers especially in rural areas where health centers were scarce. the nationalist period ghana gained her independence in 1957 and held its first multiparty elections as a republic in 1960, electing kwame nkrumah of the convention people's party as ghana's first president. during the period, the government encouraged socioeconomic development by improving citizens' welfare, including increasing their access to healthcare. as part of these reforms, the private medical industry expanded and healthcare was made free for most citizens. during the colonial and early post-independence periods, most healthcare was focused on the control of epidemics and the treatment of infectious diseases. in cities like accra, the rate of chronic diseases increased in middle- and high-income groups due to urbanization, globalization, and nkrumah's focus on infectious disease. ghana's health programs were financed entirely through general taxation, but with free public healthcare and large government spending, ghana found herself struggling economically. the fourth republic in the early 1990s, a democratic movement resurfaced and began to sweep through africa. in response to democratic demands, the rawlings regime transitioned to create a political party, the national democratic congress (ndc), legalized political parties, and organized presidential and parliamentary elections in 1992 during which rawlings won with 58.3 percent of the vote. the new democratic constitution under rawlings included provisions to better social policies such as education and healthcare in the midst of the rising hiv/aids epidemic. in 1996, a medium term health strategy was adopted that signified a shift from time-restricted, rigid projects to a more holistic approach that would better help develop the public health sector. in 2015, life expectancy at birth was 66.18 years with males at 63.76 years and females at 68.66 years. infant mortality is at 37.37 per 1000 live births. the total fertility rate is 4.06 children per woman among the 15 million ghanaian nationals. in 2010, there were about 15 physicians and 93 nurses per 100,000 persons. disease ghanaian biochemist presenting a gene bank in ghana according to the world health organization, the most common diseases in ghana include those endemic to sub-saharan african countries, particularly: cholera, typhoid, pulmonary tuberculosis, anthrax, pertussis, tetanus, chicken pox, yellow fever, measles, infectious hepatitis, trachoma, malaria, hiv and schistosomiasis. though not as common, other regularly treated diseases include dracunculiasis, dysentery, river blindness or onchocerciasis, several kinds of pneumonia, dehydration, venereal diseases, and poliomyelitis. in 1994, the who reported malaria and measles were the most common causes of premature death. in 1994, 70 percent of deaths in children under five were caused by an infection compounded by malnutrition. a 2011 report by the ghana health service said that malaria was the primary cause of morbidity and about 32.5 percent of people admitted to ghanaian medical facilities were admitted because of malaria. the most recent report from the who in 2012 identifies the top causes of death in ghana as lower respiratory infections (11%), stroke (9%), malaria (8%), ischemic heart disease (6%), hiv/aids (5%), preterm birth complications (4%), birth asphyxia and birth trauma (4%), meningitis (3%), and protein-energy malnutrition (3%). the life expectancy for women is 63 years while for men, it is 60 years. the infant mortality rate is 41 out of every 1000 live births. malaria