The west African country of Ghana is famed for supplying Cadbury with fairtrade cocoa. It is also noted for its stable and democratic government and steady economic growth. Although GDP per capita increased to US$1,500 in 2009, nearly 30% of Ghanaians still live below the poverty line. Many are not benefiting from the significant economic growth of the last decade and there is an urgent need to improve public services such as health and sanitation. This Development Update can be read alongside the one in GEOGRAPHY REVIEW Vol. 23, No. 3, which discussed the challenges of providing water and sanitation in developing countries.
As Ghana develops economically it has to manage changes in the healthcare needs of the population. Ghana is typical of developing countries experiencing an ‘epidemiological transition’ (Inset 1). As this happens the communicable diseases associated with poverty and poor infrastructure are replaced by non-communicable diseases such as cancer, which are more typical of developed societies. This places a burden on poor countries. They have to try and deliver healthcare for both groups of diseases and for a changing demographic profile that has both an ageing population and a youthful one.
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