Overview of study areas and data collection methods
Data were collected at national and district levels. The national level provided the platform for approaching key informants in policy formulation and implementation while the district level, the conduits through which policies are implemented, provided an avenue to explore the experiences of actors on the ground with respect to how Ghana is responding to the challenge of hypertension and diabetes. In order to include providers and patients from both urban and rural settings, two municipalities were selected for this study: Ga South Municipality in the Greater Accra Region and the Effutu Municipality in the Central Region of Ghana.
The Ga South Municipality is part of Accra – the capital city of Ghana – with 90% population living in urban neighbourhoods (Ghana Statistical Service, 2014a). The municipality had a total population of 485,643 in 2010 (Ghana Statistical Service, 2012). Its capital is Weija. In 2010, about 36% of the population were under the age of 15 and 6.5% were over 60 years (Ghana Statistical service, 2014a). Over 34% of the people working in the Municipality are in the services and sales sector, 23.1% engage in craft and related trade while 9% work in agriculture, fishery and forestry. Close to 90% of the population 11 years and above are literate. Though there are health centres and clinics, the main health facility for general and referral purposes is the Ga South Municipal Hospital.
A second study site was the Efutu Municipality. Efutu is in the Central Region of Ghana and its capital is Winneba (See figure 1). As per 2010 Census, the Municipality had a population of 68,597 (51.2% females) and 33% of the population aged under 15 (Ghana Statistical Service, 2012). Over 80% of the population are literate in a Ghanaian language and English. About 29% are literate in only English; manufacturing contributes 21% of industrial activity in the municipality, 20% retail services, and over 16% fishing (Ghana Statistical Service, 2014b). The largest health facility for general and referral purposes in the Municipality is the Central Regional Hospital.