It’s FASD Month: Is Alcohol Use A Public Health Concern In Ghana?

According to the New Zealand Health Promotion Agency, alcohol could basically be described as the ingredient found in beer, wine and spirits that causes drunkenness. Alcohol is also classed as sedative drug, which means it acts to depress the central nervous system (Center for Disease Control, 2015).

A study (prospective and retrospective) by Alcohol Collaborators, (2018) funded by Bill and Melinda Gate Foundation revealed that globally, alcohol use was the seventh leading risk factor for both deaths and disability-adjusted life-years (DALYs). The level of alcohol consumption that minimizes health loss is zero. This basically means there are no more safe limits for alcohol consumption. And the fact that alcohol use is a leading risk factor for global disease burden and causes substantial health loss calls for a global concern. More importantly, the outcome of this recent study suggests that alcohol control policies might need to be revised worldwide, with a focus on lowering overall population-level consumption.

According to the Center for Disease Control (2015), drinking alcohol during pregnancy has been linked to miscarriage, stillbirth, premature birth and lifelong physical and mental disabilities – including low intelligence quotient (IQ) for the child. This range of effects is known as Fatal Alcohol Spectrum Disorder (FASD). It has also been established that there is no safe time to drink alcohol during pregnancy (New Zealand Health Promotion Agency, 2015). A baby’s brain and central nervous system grow and develop throughout the nine months of pregnancy so can be affected by alcohol at all stages, including in the early weeks before a woman even knows she is pregnant, ibid. The baby is not protected from alcohol by the placenta as misconstrued by some; alcohol can pass freely through the placenta and can reach levels in the baby’s blood that are as high as those in the mother (Center for Disease Control, 2015).

Despite the harm associated with alcohol use is widely known, just as in the case of tobacco and tobacco products, there seem to be deliberate regulation and policy direction towards tobacco control. For instance, packages of tobacco products have potential health loss/risk warning written on them and the new development is the image of a cancerous liver on the packs of cigarettes to heighten user perceived susceptibility to tobacco-related health losses and severity of tobacco-related conditions. Unfortunately, same deliberate alcohol use control mechanism is currently not in place for alcohol in the case of Ghana. As part of efforts to control the use of tobacco and tobacco products, at least, these products (tobacco) are not promoted in the Ghanaian media.

Today, all kinds of alcohol are promoted in the media, flooding every local television channel and radio station. One major worrying public health concern surrounding the promotion of alcohol use in the media is the phenomenon of alcohol companies luring unsuspecting consumers and potential consumers into believing that these alcohol products (liquor) have health benefits. Most dangerous among such deceits are those projecting some alcoholic products as having the potential of addressing menstrual cramps and or boosting sexual strengths and fertility.

Given the level of proliferation of alcohol, its high level of promotion and consumption by both men and women, could it be possible we have cases of children in Ghanaian schools and communities living with FASDs? Could there be some level of correlation between poor academic achievements of some students in Ghanaian schools and FASDs? These may be quite hypothetical, but it is worth subjecting them to a national study to inform public health policy and national decision making processes.

A recent study conducted in South Africa clearly established that easy access to alcohol and exposure to alcohol advertisements are positively associated with adverse health and social outcomes (Amanuel et al., 2018).

Lugina, (2003), cited by WHO, (2004) took a look at the consumption and impact of a locally made alcohol (akpeteshie) in the Upper West region of Ghana and found that “akpeteshie” drinking among both men and women is on the rise. Elsewhere in the Greater Accra, significant number of women in a study were reported to have consumed alcoholic beverages before pregnancy and during pregnancy (Da Pilma et al., 2017). In a related development, a study conducted in the Bosomtwe District by Adusi-Poku et al., (2013) reported that a little over 20% (n = 397) pregnant women drank alcoholic beverage, of which the most preferred drink was “akpeteshie” (36.4%).

The proliferation of alcohol production in Ghana and its high level of promotion in the media is a potential threat to public health. But the fact that most users have no knowledge on its associated health losses, especially women, including those in fertility age who have no knowledge on it potential consequences on their health and the health of the unborn child calls for immediate national public health action and upstream policy interventions. Interventions to limit alcohol promotional activities and advertisements should be highly considered by decision makers to protect population health.

It is in the light of this and other public health challenges confronting the nation, that government must consider a national health policy for Ghana which should operate in “Health in all Policies” concept to promote population health.

Author: Samson Gbolu
President, PHAN Ghana
[email protected]
References
Adusi-Poku, Y., Bonney, A. A. and Antwi, G. D. (2013) ‘Where, when and what type of alcohol do pregnant women drink?’, Ghana medical journal, 47(1), pp. 35–9. doi: 10.2134/jas1988.66102646x.

Alcohol Collaborators (2018) ‘Articles Alcohol use and burden for 195 countries and territories , 1990 – 2016 : a systematic analysis for the Global Burden of Disease Study 2016’, Lancet, pp. 1015–1035. doi: 10.1016/S0140-6736(18)31310-2.

Amanuel, H., Morojele, N. and London, L. (2018) ‘The health and social impacts of easy access to alcohol and exposure to alcohol advertisements among women of childbearing age in urban and rural South Africa’, Journal of Studies on Alcohol and Drugs, 79(2), pp. 302–308. doi: 10.15288/jsad.2018.79.302.

Center for Disease Control (2015) Alcohol Use in Pregnancy.

Haseba, T. and Ohno, Y. (2010) ‘A new view of alcohol metabolism and alcoholism-Role of the high-Km class III alcohol dehydrogenase (ADH3)’, International Journal of Environmental Research and Public Health, 7(3), pp. 1076–1092. doi: 10.3390/ijerph7031076.

New Zealand Health Promotion Agency (2016) ‘Alcohol – the Body and Health Effects’, pp. 5–19.

Matejcic, M., Gunter, M. J. and Ferrari, P. (2017) ‘Alcohol metabolism and oesophageal cancer: A systematic review of the evidence’, Carcinogenesis, 38(9), pp. 859–872. doi: 10.1093/carcin/bgx067.

New Zealand Health Promotion Agency (2015) Alcohol and your baby.

Da Pilma Lekettey, J. et al. (2017) ‘Alcohol consumption among pregnant women in James Town Community, Accra, Ghana’, Reproductive Health. Reproductive Health, 14(1), pp. 1–8. doi: 10.1186/s12978-017-0384-4.

WHO (2004) ‘Country Profiles: trinidad_tobago_ recorded adult per captita consumption (age 15+)’, pp. 5–8. Available at: http://www.itdg.org/html/technical_enquiries/docs/toddy_palm_wine.pdf,%0Ahttp://www.who.int/substance_abuse/publications/en/trinidad_tobago.pdf.