Healthcare workers in Ghana have received support to prevent and manage lead poisoning through UNICEF’s programme to end childhood lead poisoning. Like many lower- and middle-income countries, Ghana has environmental risks of lead exposure among the population. A major source of lead exposure is the recycling of used lead acid e-batteries which involves breaking down, carrying, and smelting of the appliance to extract the lead component. Other sources include handling and smelting of electronic waste (e-waste), traditional medicines, some cosmetic eyeliners, some local cooking utensils, and lead based paints among others. Previous studies have revealed that some children in Ghana had blood lead levels, far above the acceptable limits as recommended by the World Health Organization (Ankrah et al,1998). Children and pregnant women are especially vulnerable to the effects of lead.
Equipping healthcare providers for action
As part of efforts to reduce childhood lead poisoning, healthcare workers have been equipped to take active roles in the programme. Since November 2021, UNICEF has supported the Ghana Health Service to train health care workers on the prevention and management of lead exposures. Trainings have been conducted at both the national (using the Trainer of Trainers approach), and the regional levels. To date, over 190 healthcare providers have participated in the programme. These include doctors, physician assistants, nurses and biomedical scientists.
The programme was based on WHO’s 2021 Guidelines for Clinical Management of exposure to Lead (2021) and comprised six modules:
Introduction to lead exposures.
Lead in body systems.
Diagnosis and management of lead poisoning
Laboratory determinations - Blood lead level testing.
The role of the Poison Center in the management of lead poisoning
Prevention of lead exposure. Learners had the opportunity to practically conduct testing of blood lead levels using the Lead testing kit
Learners completed an online evaluation survey, and indicated that the content of the training was comprehensive, with the modules well covered, and a good overall understanding of the topics. Some comments include:
“It’s was an awesome program”
“Protocols can be designed on management of lead poisoning which can be distributed to all health facilities.”
Feedback from participants
E-waste is growing 3 times faster than the world’s population. Globally as many as 18 million children and adolescents, and about 13 million women, are working in the informal sector, of which e-waste is a sub-sector. In Ghana over 1.7 million children are estimated to have blood lead levels exceeding 5 micrograms per deciliter - the level above which there is cause for concern. With millions of children’s lives at stake, we must take urgent action to end child labour and protect children’s health from the effects of e-waste.
Surveillance on chemical exposures
A good monitoring system that can capture chemical exposures, including lead, and induce the needed response is vital to strengthening the health system in the prevention and management of chemical exposures. In October 2022, UNICEF supported health surveillance officers in the Ghana Health Service to develop data elements for reporting chemical exposures into the District Health Information Management Systems (DHIMS 2). The DHIMS 2 is used by the Ghana Health Service (GHS) for collecting, collating, analyzing, and interpreting routine health service data via online reporting. However, since its inception in 2012, the DHIMS 2 lacks the required elements for the systematic reporting of chemical events including lead exposures and poisoning in Ghana. This training serves as a platform on which to build further work to strengthen the monitoring of lead and other chemical exposures in Ghana.
A great start
Through the support of UNICEF, the Ghana Health Service has been able to conduct the first ever national training on the prevention and management of lead poisoning for healthcare providers. Supporting the national surveillance system to track chemical exposures has also been initiated. It is hoped that the knowledge and skills acquired will be scaled up to other healthcare providers in the country, and that through the training and resources to prevent, diagnose and manage lead poisonings, the healthcare system will be strengthened to support children to live in a healthier and safer environment.
