C-19 Global South Observatory

GHANA

Information last updated: May 18, 2020

  • Total population: 30 M
  • Population +65 yo: 3%
  • GDP Per Capita: 5,321 USD
  • Informal employment: 83% (2015)
  • First registered case: 12 March
  • Hospital beds: 2.10 (per 1,000 people)

Sources: TheWorld Bank and WHO  (Population over 65 years old, Informal employment, GDP-PPP, Hospital beds).

Status

Level of confinement and until when:

  • Lockdown initiated on March 30th and lasted 3 weeks, which came to an end Monday the 21st of April, with a lifting of the lockdown in Ghana’s 2 biggest cities: Accra and Kumasi. 

All other measures remain in place:

  • All borders are closed for Non Ghanaian since Sunday 22nd of March and maintained as such for an indefinite period of time.
  • Ghanaian and foreigners with resident permit are put on a mandatory 14 days quarantine.
  • All schools are closed.
  • Suspension of public gatherings, conferences and other public gatherings.

Response set up and capacity

The Inter-Ministerial Coordinating Committee (IMCC) is the major coordinating entity for the covid-19 response in Ghana. It is led by the President, composed by representatives from various ministries and supported by the following organizations:

  • The National Technical Coordinating Committee (NTCC), which provides technical experts tasked with the monitoring and implementation of response measures (it is co-chaired by the WHO and the Ghana Health Service). 
  • The National Public Health Emergency Operations Centre (PHEOC) is mandated to coordinate the covid-19 response activities. 
  • At the regional and district levels, related activities are coordinated by the regional and district Public Health Emergency Management Committees (PHEMCs).

The WHO’s Covid-19 Preparedness and Response Status (16 March 2020) classifies Ghana in the category with a high risk of imported cases and at the Level 3 in terms of preparedness capacity (out of 5, 5 being the highest level of preparedness). 

Covid-19 tests: Ghana has a network of laboratories at the national and regional levels that are well-equipped and have the capacity to test/diagnose pathogens such as Covid-19 on a large scale. This is the basis of the aggressive testing and contact tracing campaign that has been led since the first confirmed cases. Ghana conducts around 2.23 test per 1000 people, which is one of the highest testing rates in Africa and amongst the highest in the global south (this has been refuted by the AFP, finding that Ghana is behind at least 3 other African countries). This approach has contributed to containing the rapid rise of the virus in the country. The authorities were also quick to react early in the pandemic by immediately imposing a range of measures nationwide, from the closure of borders to lockdowns in the most affected (large) cities. Nevertheless, there remains significant weaknesses in the public health system which has been found to be under-resourced, unevenly distributed throughout the country and not optimally prepared to combat infectious diseases. This may cause capacity issues if the number of cases rise exponentially. 

The public health system in Ghana is characterized by 0.18 doctors per 1,000 inhabitants and 2.10 beds per 1,000 inhabitants. 

Stakeholder Mapping

Entities / Organizations

• The Inter-Ministerial Coordinating Committee (IMCC)
• The National Technical Coordinating Committee (NTCC)
• The National Public Health Emergency Operations Centre (PHEOC)
• National Disaster Management Organization (NADMO)
• Regional and district Public Health Emergency Management Committees (PHEMCs)

Additional actors

• UNICEF
• UNRC
• UN Country team
• World Bank

Mitigating factors - What is being done?

  • 11 March – The President’s speech outlines informational campaigns to be rolled out to combat Covid-19 and details a host of measures that will come into effect the 16th of March. 
  • 12 March – Contact tracing of first infected persons is initiated. First case is confirmed after two infected people returned from Norway & Turkey. 
  • 16 March – The government imposes a ban on all public gatherings for 4 weeks.  All schools and universities are to be close for the same period. Business and workplaces are allowed to remain open on the condition of practicing social distancing and good hygiene. 
  • 16-17 March – Restrictions imposed on entry into Ghana by non-nationals coming from countries which have recorded more than 200 Covid-19 cases (with an exception for resident permit holders). A 14-day self-quarantine is mandated for those allowed to return. 
  • 20 March – Contact tracing expands to cover all infected persons. 
  • 22 March – Additional travel restrictions are imposed through the closure of Ghana’s borders to human traffic (by air, land and sea). Goods, supplies and cargo will not be affected. 
  • 28 March – The Ministry of Information and the President declare that Ghana will begin testing all contacts of those who test positive. 
      • Interest rates are to be reduced by 2%; granting by the banks of a 6 month moratorium of principal repayments to entities in the airline and hospitality industries; credit measures are offered for other sectors to be reviewed on a case-by-case basis. 
      • Announcement of planned Coronavirus Alleviation Programme financial aid to stimulate the economy and alleviate social issues related to the pandemic. 
      • Extra funds are earmarked to increase the stock of test kits, pharmaceuticals, equipment, and bed capacity.
      • A Covid-19 fund for raising money from the public to assist the most vulnerable in society is established. 
  • 30 March – Lockdowns imposed in Accra and Kumasi for a period of 2 weeks, subject to review. 
  • 5 April – Presidential office and the Ministry of Information outline following measures: 
      • Border closure is extended for 2 weeks. 
      • The government is absorbing all water bills of Ghanaian citizens for the next 3 months. 
      • Food aid is to be delivered to vulnerable communities in Accra, Tema, Kumasi and Kusoa. 
      • Health workers are receiving tax cuts and salary raises. 
      • A soft loan scheme will be rolled out for SMEs. 
  • 8 April – The Ministry of Information clarifies the $100 million financial aid packages will be implemented shortly. 
  • 10 April – The government announced that it will also be absorbing all electricity bills of the poorest households.
  • 13 April – Lockdowns are extended for 1 week (closure of public transport and workplaces). Restrictions on public gatherings are extended for 2 weeks.
  • 13-15 April – GH Covid-19 Tracker app for contact tracing is launched to track all those that have come into contact with infected persons. 
  • 20 April – 3 weeks lockdown is ended. However, schools remain closed and ban on large gatherings remains in place.  The use of drones is implemented to increase testing.
  • 25 April – A Ministerial Directive on wearing masks in public places is put in place, being mandatory for some groups of persons (market food vendors, drivers, public transport, etc..
  • 30 April – The government waives all demurrage and rent charges incurred by importers and all other ports users during the Covid-19 partial lockdown between March 30 and April 19, as part of a relief package for shippers.
  • May 15 – UNICEF launches its third report on “GHANA: Covid-19 situation“, noting that this country “currently has the highest number of confirmed cases of coronavirus (COVID-19) in the West and Central Africa region”.
  • 19 May – Ghana launches three policies  to further deepen financial inclusion for rapid growth in the economy: 1) the national financial inclusion and development strategy, developed in collaboration with the World Bank, aimed at creating economic opportunities to reduce poverty; 2) the digital financial services policy, built on existing technological gains to create a resilient and inclusive digital ecosystem, and 3) the Cash-Lite Roadmap (with the assistance of the United Nations-based Better-Than-Cash Alliance) to create better access to financial services.

Risks, vulnerabilities, obstacles

  • A 2018 holistic sector assessment using WHO criteria highlighted that the Ghanaian healthcare system remains weak as it is inadequately resourced and unequally distributed throughout the country. 
      • A recent study has found that Ghana scores quite poorly in 2 indicators of health care readiness to infectious diseases ((a) State Parties Self-Assessment Annual Reporting Tool and; (b) Infectious Disease Vulnerability Index). 
      • According to a UNICEF report from the 15th of April, the suboptimal public health infrastructure and healthcare system of Ghana is vulnerable and at high risk if the pandemic worsens as people may lack access to much needed, adequate health care. 
  • Sanitation systems in Ghana are –generally– of poor quality, and proper hygiene practices are not widespread, meaning that proper preventative measures of hygiene to combat the spread of the virus may be hampered. 
  • The combination of restrictive measures taken are expected to have negative socioeconomic impacts in the context of a slowdown in economic activity due to travel and business restrictions. The finance minister has cut the projected growth rate from 5.8% to 1.5%, the lowest rate in 37 years. This may exacerbate vulnerabilities to poverty and deprivation and thus put livelihoods at risk. 
  • The latter may furthermore push families to expose themselves to health risks in order to sustain their livelihoods (e.g. by breaking lockdown regulations). This is pertinent in light of the large share the informal economy and self-employment rates within the labour market (75% for men and 88% for women). These population is particularly vulnerable due to a heavy reliance on day-to-day activities that are affected by lockdown measures. 
  • The economy also risks suffering from the pressure the pandemic is having on exacerbating the decline in prices of crude oil, a significant source of revenue for Ghana (accounting for 20% of export revenues in 2018). 

There also exist fears that containment measures may fuel domestic violence which has been shown to be prevalent in recent data (more than 25% of the population according to the Ghana Statistical Services and the Institute of Development studies, 2016).

Potential actions and demands

a) There has been a mixed reaction to the ending of the 3-week lockdown (especially as cases have spiked during the first two weeks of May, post lockdown): 

  • Some health experts had urged to extend the lockdown in light of the increasing number of confirmed cases. 
  • The National Democratic Congress (the main opposition party) opposed the easing of restrictions and accused the President of not caring for Ghanaian lives in light of the increasing cases. 
  • On the other hand, low-income workers welcomed the easing of restrictions as their livelihoods depend on being able to conduct their day-to-day activities. 
  • Other actors, such as the trade union congress, and the institute of statistical, social and economic research, also welcomed the lifting of measures. 

b) Ghana was the first nation in the world to use drone technology to test for COVID-19 from suspected rural victim to urban laboratory. Once collected, either in local clinics or by health workers out in the field, the test swabs are packaged with ice in specially designed bio-safe containers, fitted with a parachute, and placed into the bellies of the drones. The zips, as they are called, won’t actually land at the laboratories. Instead they swoop down to release their payloads at designated drop zones, where attendants –alerted to the pending arrival via SMS– are waiting to collect them. The whole round-trip journey, which could take up to whole a day by car, takes under 30 minutes.

Key resources

Contributor(s): Kevin Henkens.

The C-19 Global South Observatory is a collaboration between