title: Chronic non-communicable diseases and the challenge of universal health coverage: insights from community-based cardiovascular disease research in urban poor communities in Accra, Ghana.
abstract: BACKGROUND
  The rising burden of chronic non-communicable diseases in low and middle income countries has major implications on the ability of these countries to achieve universal health coverage. In this paper we discuss the impact of cardiovascular diseases (CVD) on primary healthcare services in urban poor communities in Accra, Ghana.
  
  
  METHODS
  We review the evidence on the evolution of universal health coverage in Ghana and the central role of the community-based health planning services (CHPS) programme and the National Health Insurance Scheme in primary health care. We present preliminary findings from a study on community CVD knowledge, experiences, responses and access to services.
  
  
  RESULTS
  The rising burden of NCDs in Ghana will affect the achievement of universal health coverage, particularly in urban areas. There is a significant unmet need for CVD care in the study communities. The provision of primary healthcare services for CVD is not accessible, equitable or responsive to the needs of target communities.
  
  
  CONCLUSIONS
  We consider these findings in the context of the primary healthcare system and discuss the challenges and opportunities for strengthening health systems in low and middle-income countries.
authors.forename: Ama
authors.initials: A
authors.lastname: de-Graft Aikins
authors.forename: Mawuli
authors.initials: M
authors.lastname: Kushitor
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Koram
authors.forename: Stella
authors.initials: S
authors.lastname: Gyamfi
authors.forename: Gbenga
authors.initials: G
authors.lastname: Ogedegbe
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics* / Q000628:therapy*; D002908:Chronic Disease; D003153:Community Health Services / Q000191:economics; D005869:Ghana; D006302:Health Services Research; D006801:Humans; D011204:Poverty Areas; D011320:Primary Health Care / Q000191:economics*; D019472:Universal Health Insurance / Q000458:organization & administration*; D019037:Urban Health Services / Q000191:economics
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