Prioritizing Workplace Health Promotion Policy to Address High Blood Pressure and Obesity in a Public University in the Northern Region of Ghana

Abstract

The International Labour Organization (ILO) recommends the engagement of the world of work in providing comprehensive and effective prevention strategy for noncommunicable diseases (NCDs). Workers are at risk of developing 1 or more cases of NCDs due to their exposure to risk factors at work. The ILO suggests that the work-related risk factors can be prevented by improving working conditions and integration of workplace health promotion programs. Workplace health promotion policies promote workers general health, improve working environment, work practices, and reduces the risks of common NCDs including hypertension (high blood pressure) and obesity among employees. A number of studies have described the increasing trends of hypertension and obesity among civil servants but are limited in assessing the availability and effectiveness of workplace health promotion policies to address them. We assessed the availability and effectiveness of workplace health promotion policy to address the prevalence of high blood pressure in a public university in the Northern Region of Ghana. Using a mixed method study design, 191 administrative staff were recruited and in-depth qualitative interviews conducted among 5 key informants. The study found significant number of participants with elevated and high blood pressure and overweight and obesity with no functional workplace health promotion at the time of the study. We therefore recommend the prioritization and development of a workplace health policy to reduce the prevalence of high blood pressure and obesity among staff of the university using the integrative workplace health promotion model.

What do we know already about the topic?

High blood pressure and obesity are common health risks among workers globally but with increasing burden in developing countries.

How does your research contribute to the field?

Our knowledge on the availability and effectiveness of health promotion policies to address high blood pressure and obesity among workers is less known in Ghana. It is therefore important for researchers and policy makers to shift attention to workplace health promotion policies and appropriate models to address NCDs.

What are your research’s implications toward theory, practice, or policy?

The study highlights the need to develop and incorporate workplace health promotion policies in organizations to address high blood pressure and obesity. There is a knowledge gap in the existence of workplace health promotion policies in organizations and their effectiveness to address high blood pressure and obesity. Studies should be shifted on workplace health promotion policies and the implications for high blood pressure and obesity reductions among workers, especially in the Ghanaian context.

Introduction

The International Labour Organization (ILO) ¹ recommends the engagement of the world of work in providing comprehensive and effective prevention strategy for noncommunicable diseases (NCDs). Workers are at risk of developing 1 or more cases of NCDs due to their exposure to risk factors at work.^{1 -3} The World Health Organization (WHO) suggests that the work-related risk factors can be prevented by improving working conditions and integration of workplace health promotion programs.^1,4 The integrative approach to workplace health promotion is known to be effective in providing 1-size-fits all programs and policy approach to workplace health needs and risk reduction. ⁴ NCDs have many effects on the worker and the national economy including general work output, diversion of resources from productive purposes to treating the disease and an increase in poverty gap of households and threat to attaining the SDGs (particularly, goals, 1, 2, 3, 4, 5, 8, and 10). ⁵

Workplace health promotion programs and policies has the potential to improve blood pressure levels and associated risk factors among workers. ⁶ Workplace health promotion policies promote workers’ general health, improve working environment, work practices, and reduces the risks for common NCDs including hypertension and obesity among employees.^6,7 Prevalence of high blood pressure and obesity among civil servants in Ghana is unacceptably high.^3,8,9 The reason for the increasing prevalence of high blood pressure and obesity among civil servants in Ghana can partly be attributed to the failure to promote healthy living practices and the lack of health promotion policies in organizations. Workers spend productive hours at the workplace and are at increased risk for high blood pressure and obesity due to some risks as the sedentary nature of their work and unhealthy lifestyle characteristics. A number of studies have described the increasing trends of high blood pressure and obesity among civil servants^3,8,9 but are limited in assessing policies adopted or developed to address high blood pressure and obesity. The study therefore assessed the availability of health promotion policy and the prevalence of high blood pressure in a public university in the Northern Region of Ghana.

Methods

Using a mixed method study design, 191 administrative staff of the University for Development Studies, Tamale Campus were randomly recruited and in-depth qualitative interviews conducted among 5 key informants. The quantitative data was collected using a modified WHO STEPwise approach to noncommunicable diseases risk factor surveillance data collection tool combined with blood pressure and body mass index measurements ¹⁰ and were subsequently analyzed using SPSS version 25. The qualitative data was collected using expert reviewed interview guide and were subsequently analyzed using thematic content analysis.

Evidence/Results

Our recent study, “Prevalence and Associated Risk Factors of Hypertension and Obesity among Administrative Staff of a Public University in Northern Ghana” ¹¹ found the prevalence of high blood pressure and obesity among participants to be significant. Among the 191 participants, the prevalence of elevated and high blood pressure was 48.7% and 17.3%, respectively. The prevalence of overweight and obesity was 35.6% and 11.5%, respectively. However, workplace health promotion policy that may target and direct interventions to reduce elevated and high blood pressure and obesity was absent at the time of the study.

Related Studies

There exist varying high blood pressure (hypertension) and obesity prevalence among workers in Ghana. As an illustration, Addo et al ¹² reported in a cross-sectional study, the prevalence of obesity and overweight to be 17.8% and 37.8%, respectively, among bankers. Another study among civil servants reported 29.9% overweight and 4.8% obesity prevalence. ¹³ Addo et al ³ reported age-adjusted prevalence of hypertension to be 21.9% and 31.8% among civil servants in lower and upper socioeconomic position. In a systematic review Addo et al ¹⁴ reported the prevalence of hypertension among civil servants to range from 37.1% to 30.3% in urban areas. Agyemang-Pambour et al, ¹⁵ Aidoo et al, ¹⁶ and Aryeetey and Ansong ¹⁷ equally reported the prevalence of hypertension to be 29.3%, 31.7%, and 34.0%, respectively, among some civil servants including staff a public university.

Recommendations

All the related studies did not report on institutional interventions such as workplace health promotion programs and policies to deal with hypertension and obesity among workers. Our study addressed the policy gap in dealing with high blood pressure and obesity in the workplace, which was none existent during the study period. In order to address the increasing prevalence of elevated and high blood pressure and obesity among staff of the university and civil servants in Ghana, organizations (including tertiary institutions) should adopt the integrative workplace health promotion approach to develop policies and programs that will address high blood pressure and obesity. The integrative workplace health promotion model is recommended by the WHO to provide a comprehensive and appropriate interventions to manage contemporary workplace health and safety challenges.

Conclusion

High blood pressure and obesity prevalence were significant among study participants and constitute major health concerns among workers in Ghana. Addressing high blood pressure and obesity among workers have not received the needed attention. Prioritizing a workplace health promotion policy is required to reduce the prevalence of elevated and high blood pressure and obesity.