PUBLIC HEALTH RISK MAPPING AND CAPACITIES ASSESSMENT IN GHANA Prepared for GHS/MoH with support from WHO JULY 2016 REPUBLIC OF GHANA PUBLIC HEALTH RISK MAPPING AND CAPACITIES ASSESSMENT IN GHANA Prepared for GHS/MoH with support from WHO JULY 2016 Table of Contents LIST OF FIGURES AND TABLES ...................................................................................................... iv List of Figures .................................................................................................................................... iv List of Tables ..................................................................................................................................... iv ACKNOWLEDGEMENTS .................................................................................................................... v ACRONYMS ......................................................................................................................................... vi GLOSSARY OF TERMS .................................................................................................................... viii EXECUTIVE SUMMARY ................................................................................................................... ix CHAPTER ONE - INTRODUCTION .................................................................................................... 1 1.1 Introduction ............................................................................................................................. 1 1.2 Structure of the Report ............................................................................................................ 1 1.3 Rationale ................................................................................................................................. 1 CHAPTER TWO – COUNTRY PROFILE ............................................................................................ 2 2.1 Geography ............................................................................................................................... 2 2.2 Political History and Administration ...................................................................................... 3 2.3 Demography ............................................................................................................................ 4 2.4 Socio-economic status............................................................................................................. 4 2.5 Health status ............................................................................................................................ 4 2.6 Health System ......................................................................................................................... 4 2.7 Ecological Zones ..................................................................................................................... 5 2.7.1 Northern Savannah Zone ................................................................................................ 5 2.7.2 Forest Zone ..................................................................................................................... 6 2.7.3 Coastal Zone ................................................................................................................... 7 2.8 International Health Regulations (2005) ................................................................................. 7 CHAPTER THREE – PUBLIC HEALTH RISK MAPPING ................................................................ 9 3.1 Introduction ............................................................................................................................. 9 3.2 Objectives ............................................................................................................................. 11 3.3 Description of the Methodology ........................................................................................... 12 3.4 Hazard Analysis .................................................................................................................... 12 3.4.1 Hazard Identification ..................................................................................................... 12 3.4.2 Hazard Description ....................................................................................................... 15 3.4.2.1 Cholera ..................................................................................................................... 15 i 3.4.2.2 Meningitis ................................................................................................................. 16 3.4.2.3 Yellow Fever ............................................................................................................. 18 3.4.2.4 Avian and Pandemic Influenza ................................................................................. 20 3.4.2.5 Viral Haemorrhagic Fevers ....................................................................................... 22 3.4.2.6 Flood ......................................................................................................................... 24 3.4.2.7 Drought ..................................................................................................................... 26 3.4.2.8 Earthquake ................................................................................................................ 27 3.4.2.9 Land (Road) Transport Accidents ............................................................................. 29 3.4.2.10 Air Transport (Aviation) Accidents .......................................................................... 31 3.4.2.11 Water Transport Accidents ....................................................................................... 31 3.4.2.12 Structural Collapse .................................................................................................... 32 3.4.2.13 Nuclear and Radiological Emergency ....................................................................... 32 3.4.2.14 Fire ............................................................................................................................ 34 3.4.2.15 Oil and Natural Gas Emergency ............................................................................... 35 3.4.2.16 Chemical ................................................................................................................... 36 3.4.2.17 Civil Disorder ............................................................................................................ 37 3.4.2.18 Terrorism ................................................................................................................... 37 3.5. Risk Analysis ........................................................................................................................ 38 3.5.1 Cholera ................................................................................................................................. 38 3.5.2 Meningitis ............................................................................................................................ 40 3.5.3 Yellow Fever ........................................................................................................................ 42 3.5.4 Avian and Pandemic Influenza ............................................................................................ 44 3.5.5 Ebola Virus Disease and Other Viral Haemorrhagic Fevers ................................................ 45 3.5.6 Flood .................................................................................................................................... 46 3.5.7 Drought ................................................................................................................................ 47 3.5.8 Earthquake ........................................................................................................................... 48 3.5.9 Road Traffic Injuries ............................................................................................................ 48 3.5.10 Aviation or Air Transport Accident ................................................................................... 49 3.5.11 Water Transport Accident .................................................................................................. 49 3.5.12 Structure Collapse .............................................................................................................. 50 3.5.13 Nuclear and Radiological ................................................................................................... 50 3.5.14 Fire ..................................................................................................................................... 50 3.5.15 Oil and Gas Spillage .......................................................................................................... 50 ii 3.5.16 Chemical ............................................................................................................................ 51 3.5.17 Civil Disorder ..................................................................................................................... 51 3.5.18 Terrorism ............................................................................................................................ 51 3.6 Ranking of Risks ................................................................................................................... 53 3.7 Conclusion ...........................................................................................................................