The recent launch of the Free Primary Health Care (FPHC) initiative by President John Dramani Mahama represents a significant move toward preventive medicine in Ghana. By establishing annual screenings, the policy aims to tackle the root of our national health crisis: non-communicable diseases (NCDs).

However, while we celebrate this advancement, a crucial gap exists in the "User Guide" for individuals over 18. Items 3 and 4, Blood Glucose Testing and Body Mass Index (BMI) Assessment, currently exclude the youngest and most vulnerable members of our population.

To truly strengthen our health system, we must address the "neglected 5%" and the rising levels of childhood obesity that threaten the next generation of Ghanaians.

The Data: A Growing Crisis

Even though diabetes is often seen as an adult issue, our clinics reveal a different reality.

- Childhood Diabetes: Statistics show that childhood diabetes makes up about 5% of all diabetes cases in Ghana. Unlike Type 2 diabetes in adults, Type 1 diabetes in children can quickly become fatal without early detection.

- The Obesity Surge: The rate of obesity among Ghanaian children and adolescents (ages 5–19) has dramatically increased. Recent data indicate that obesity rates in boys grew from 2.34% to nearly 9%. For girls, the rise was even steeper, from 2.15% to over 15% between 1990 and 2022.

- The "Pre-Pubertal" Risk: The highest risk for developing obesity is now seen in early childhood (ages 5–9), making this the most important period for intervention.

The Consequences of Neglect

Failing to assess BMI and glucose levels for those aged 5 to 18 is not just a missed opportunity; it is a public health crisis with serious consequences:

1. Late Diagnosis of Type 1 Diabetes: Without regular glucose checks, many children only receive a diagnosis after reaching Diabetic Ketoacidosis (DKA), a life-threatening emergency that can lead to coma or death.

2. Early-Onset NCDs: Childhood obesity is a leading cause of early-onset hypertension and Type 2 diabetes. By the time these individuals turn 18 and become eligible for FPHC screening, they may already have irreversible organ damage.

3. The Economic Burden: Managing complications like kidney failure, vision loss, and cardiovascular problems in young adults is far more costly for the state than early screening and lifestyle changes in childhood.

4. Stunted Potential: Childhood obesity and undiagnosed diabetes result in higher school absenteeism and lower cognitive performance, which directly affects Ghana’s future workforce.

A Call for Inclusive Policy

The FPHC is a strong framework, but it needs to be more inclusive. We cannot wait until a person is 18 to start monitoring their metabolic health.

Recommendation: I urge the Ministry of Health and the Ghana Health Service to expand Items 3 and 4 of the FPHC User Guide. This should include mandatory annual BMI and glucose screenings for children aged 5 to 18 years.

Our children deserve to be part of the shift toward prevention. By identifying these risks early, we don't just treat a disease; we safeguard the future.

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The Hidden Problem: Why Ghana's Free Primary Health Care Cannot Leave Our Children Behind

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