Connecting the Dots Between Health, Poverty and Place in Accra, Ghana

PubMed Central

Weeks, John R.; Getis, Arthur; Stow, Douglas A.; Hill, Allan G.; Rain, David; Engstrom, Ryan; Stoler, Justin; Lippitt, Christopher; Jankowska, Marta; Lopez-Carr, Anna Carla; Coulter, Lloyd; Ofiesh, Caetlin

2013-01-01

West Africa has a rapidly growing population, an increasing fraction of which lives in urban informal settlements characterized by inadequate infrastructure and relatively high health risks. Little is known, however, about the spatial or health characteristics of cities in this region or about the spatial inequalities in health within them. In this article we show how we have been creating a data-rich field laboratory in Accra, Ghana, to connect the dots between health, poverty, and place in a large city in West Africa. Our overarching goal is to test the hypothesis that satellite imagery, in combination with census and limited survey data, such as that found in demographic and health surveys (DHSs), can provide clues to the spatial distribution of health inequalities in cities where fewer data exist than those we have collected for Accra. To this end, we have created the first digital boundary file of the city, obtained high spatial resolution satellite imagery for two dates, collected data from a longitudinal panel of 3,200 women spatially distributed throughout Accra, and obtained microlevel data from the census. We have also acquired water, sewerage, and elevation layers and then coupled all of these data with extensive field research on the neighborhood structure of Accra. We show that the proportional abundance of vegetation in a neighborhood serves as a key indicator of local levels of health and well-being and that local perceptions of health risk are not always consistent with objective measures. PMID:24532846

Residential characteristics as correlates of occupants' health in the greater Accra region, Ghana.

PubMed

Udofia, Emilia Asuquo; Yawson, Alfred E; Aduful, Kwesi Adu; Bwambale, Francis Mulekya

2014-03-11

Housing has been a relatively neglected site for public health action. However, it remains a place where human beings spend the most part of their day. As a result, the quality of housing has consequences for human health. We investigate residential characteristics associated with self-rated occupant health in five neighbourhoods in the Greater Accra Region, Ghana. A cross sectional study using a semi-structured questionnaire was conducted among 500 informed adults aged 18 years and above to investigate residential characteristics associated with self-rated occupant health in five neighbourhoods in the Greater Accra Region, Ghana. Correlates of occupant rated health were determined using Pearson chi-square test and binary logistic regression. Forty-two per cent of houses were rented, 44% required repair and 46% shared sanitation facilities. One in twenty occupants reported poor health. Gender, employment status, income, ventilation, house wall material, odours, stale air, privacy, shared facilities, hand washing facility, type of house and house repair status were associated with poor health in the bivariate analysis. Only two variables were independently associated with poor self-rated health: occupants who lacked privacy were eight times more likely to report poor self-rated health when compared to peers who did not lack privacy [OR=8.16, 95% CI 2.86-23.26] and women were three times more likely than men to report poor health [OR=2.98, 95% CI 1.06-8.35]. The results provide further evidence of housing as a determinant of occupants' health, and identify housing characteristics and living conditions as issues for public health action in Ghana.

AIDS: An ICT Model for Integrating Teaching, Learning and Research in Technical University Education in Ghana

ERIC Educational Resources Information Center

Asabere, Nana; Togo, Gilbert; Acakpovi, Amevi; Torby, Wisdom; Ampadu, Kwame

2017-01-01

Information and Communication Technologies (ICT) has changed the way we communicate and carry out certain daily activities. Globally, ICT has become an essential means for disseminating information. Using Accra Technical University in Ghana as a case study, this paper proposes an ICT model called Awareness Incentives Demand and Support (AIDS). Our…

Agency, access, and Anopheles: neighborhood health perceptions and the implications for community health interventions in Accra, Ghana

PubMed Central

Jankowska, Marta M.; Stoler, Justin; Ofiesh, Caetlin; Rain, David; Weeks, John R.

2015-01-01

Background Social and environmental factors are increasingly recognized for their ability to influence health outcomes at both individual and neighborhood scales in the developing urban world. Yet issues of spatial heterogeneity in these complex environments may obscure unique elements of neighborhood life that may be protective or harmful to human health. Resident perceptions of neighborhood effects on health may help to fill gaps in our interpretation of household survey results and better inform how to plan and execute neighborhood-level health interventions. Objective We evaluate differences in housing and socioeconomic indicators and health, environment, and neighborhood perceptions derived from the analysis of a household survey and a series of focus groups in Accra, Ghana. We then explore how neighborhood perceptions can inform survey results and ultimately neighborhood-level health interventions. Design Eleven focus groups were conducted across a socioeconomically stratified sample of neighborhoods in Accra, Ghana. General inductive themes from the focus groups were analyzed in tandem with data collected in a 2009 household survey of 2,814 women. In-depth vignettes expand upon the three most salient emergent themes. Results Household and socioeconomic characteristics derived from the focus groups corroborated findings from the survey data. Focus group and survey results diverged for three complex health issues: malaria, health-care access, and sense of personal agency in promoting good health. Conclusion Three vignettes reflecting community views about malaria, health-care access, and sense of personal agency in promoting good health highlight the challenges facing community health interventions in Accra and exemplify how qualitatively derived neighborhood-level health effects can help shape health interventions. PMID:25997424

Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014.

PubMed

Ohene-Adjei, Kennedy; Kenu, Ernest; Bandoh, Delia Akosua; Addo, Prince Nii Ossah; Noora, Charles Lwanga; Nortey, Priscillia; Afari, Edwin Andrew

2017-10-11

Cholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked. We carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission. Up to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis. The 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.

Environment, wealth, inequality and the burden of disease in the Accra metropolitan area, Ghana.

PubMed

Boadi, Kwasi Owusu; Kuitunen, Markku

2005-06-01

The study examines environmental problems and adverse impacts on the health of urban households in the Accra metropolitan area, Ghana. Accra is faced with severe inadequacy of urban infrastructure in the face of rapid population growth in the metropolis. More than half of the city's population do not have access to solid waste collection services. Only 39.8% of households have indoor pipe and over 35.0% of households depend on unsanitary public latrines whilst 2.5% do not have access to toilet facilities. Human excrement, garbage and wastewater are usually deposited in surface drains, open spaces and streams in poor neighbourhoods. The resultant poor sanitation has serious health impacts as more than half of reported diseases are related to poor environmental sanitation. The majority of households depend on solid fuels for cooking and this leads to indoor air pollution and high incidence of respiratory infections. Poor households bear a disproportionately large share of the burden of environmental health hazards than their wealthy counterparts, due to their particular vulnerability resulting from inadequate access to environmental health facilities and services.

Corporal Punishment in the Schools of Ghana: Does Inclusive Education Suffer?

ERIC Educational Resources Information Center

Agbenyega, Joseph S.

2006-01-01

This paper reports on a study that compared the practice of corporal punishment in ten basic schools in the Greater Accra District in Ghana. Five of the ten schools were designated as inclusive project schools (IPS) and the other five as non-inclusive project schools (NIS). The primary purpose was to find out if the inclusive project schools were…

Housing and Health in Ghana: The Psychosocial Impacts of Renting a Home

PubMed Central

Luginaah, Isaac; Arku, Godwin; Baiden, Philip

2010-01-01

This paper reports the findings of a qualitative study investigating the impacts of renting a home on the psychosocial health of tenants in the Accra Metropolitan Area (AMA) in Ghana. In-depth interviews (n = 33) were conducted with private renters in Adabraka, Accra. The findings show that private renters in the AMA face serious problems in finding appropriate and affordable rental units, as well as a persistent threat of eviction by homeowners. These challenges tend to predispose renters to psychosocial distress and diminishing ontological security. Findings are relevant to a range of pluralistic policy options that emphasize both formal and informal housing provision, together with the reorganization and decentralization of the Rent Control Board to the district level to facilitate easy access by the citizenry. PMID:20616989

Residential characteristics as correlates of occupants’ health in the greater Accra region, Ghana

PubMed Central

2014-01-01

Background Housing has been a relatively neglected site for public health action. However, it remains a place where human beings spend the most part of their day. As a result, the quality of housing has consequences for human health. We investigate residential characteristics associated with self-rated occupant health in five neighbourhoods in the Greater Accra Region, Ghana. Methods A cross sectional study using a semi-structured questionnaire was conducted among 500 informed adults aged 18 years and above to investigate residential characteristics associated with self-rated occupant health in five neighbourhoods in the Greater Accra Region, Ghana. Correlates of occupant rated health were determined using Pearson chi-square test and binary logistic regression. Results Forty-two per cent of houses were rented, 44% required repair and 46% shared sanitation facilities. One in twenty occupants reported poor health. Gender, employment status, income, ventilation, house wall material, odours, stale air, privacy, shared facilities, hand washing facility, type of house and house repair status were associated with poor health in the bivariate analysis. Only two variables were independently associated with poor self-rated health: occupants who lacked privacy were eight times more likely to report poor self-rated health when compared to peers who did not lack privacy [OR = 8.16, 95% CI 2.86-23.26] and women were three times more likely than men to report poor health [OR = 2.98, 95% CI 1.06-8.35]. Conclusion The results provide further evidence of housing as a determinant of occupants’ health, and identify housing characteristics and living conditions as issues for public health action in Ghana. PMID:24612884

Gestational diabetes mellitus among women attending prenatal care at Korle-Bu Teaching Hospital, Accra, Ghana.

PubMed

Oppong, Samuel A; Ntumy, Michael Y; Amoakoh-Coleman, Mary; Ogum-Alangea, Deda; Modey-Amoah, Emefa

2015-12-01

To determine the burden of gestational diabetes mellitus (GDM) among pregnant women in Accra, Ghana. The present cross-sectional study enrolled women at 20-24 weeks of pregnancy attending their first prenatal clinic at Korle-Bu Teaching Hospital, Accra, between March and November 2013. Participants underwent a 2-hour, 75-g oral glucose tolerance test between 24 and 28 weeks. The odds of GDM among different body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) groupings were calculated in a multiple logistic regression model. Among 399 women screened, 37 (9.3%) had GDM. Compared with women with a BMI in the normal range (18.50-24.99), obese women (BMI >30.0) had an increased risk of GDM (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.08-8.20; P=0.034]; overweight women (BMI 25.00-29.99) had a slightly elevated risk (OR 1.20, 95% CI 0.41-3.55; P=0.742). Maternal age, parity, education, employment status, place of residence, and previous pregnancy complications did not affect the risk of GDM. GDM was found in 10% of pregnant women in Accra. Women who were obese by 20-24 weeks of pregnancy had a significantly increased risk of GDM. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Counselling Needs of Pupils with Special Educational Needs and Disabilities in the Greater Accra Region of Ghana: Implications for Inclusive Education in Ghana

ERIC Educational Resources Information Center

Ocansey, S. K.; Gyimah, E. K.

2016-01-01

In this fast changing world, pupils all over the world have developed severe social and psychological needs that affect their interactions with others and subsequently, the achievement of their life goals. Essentially, the social and psychological needs of school pupils have manifested in diverse mal-adjusted behaviours that hinder their academic…

Investigating the Small and Medium Enterprise Landscape of Accra, Ghana: Prospects and Barriers to Economic Development

DTIC Science & Technology

2012-02-01

similar comments on a previous visit to Ghana-there is a familial aversion and almost a cultural “ shame ” to give up control of an entity that is seen to...firm that manufactures cosmetics made of shea butter (shea butter is a common fat extracted from the African Shea tree and is becoming very popular in

Sachet drinking water in Ghana's Accra-Tema metropolitan area: past, present, and future.

PubMed

Stoler, Justin; Weeks, John R; Fink, Günther

2012-01-01

Population growth in West Africa has outpaced local efforts to expand potable water services, and private sector sale of packaged drinking water has filled an important gap in household water security. Consumption of drinking water packaged in plastic sachets has soared in West Africa over the last decade, but the long-term implications of these changing consumption patterns remain unclear and unstudied. This paper reviews recent shifts in drinking water, drawing upon data from the 2003 and 2008 Demographic and Health Surveys, and provides an overview of the history, economics, quality, and regulation of sachet water in Ghana's Accra-Tema Metropolitan Area. Given the pros and cons of sachet water, we suggest that a more holistic understanding of the drinking water landscape is necessary for municipal planning and sustainable drinking water provision.

When urban taps run dry: Sachet water consumption and health effects in low income neighborhoods of Accra, Ghana

PubMed Central

Stoler, Justin; Fink, Günther; Weeks, John R.; Otoo, Richard Appiah; Ampofo, Joseph A.; Hill, Allan G.

2011-01-01

Intraurban differentials in safe drinking water in developing cities have been exacerbated by rapid population growth that exceeds expansion of local water infrastructure. In Accra, Ghana, municipal water is rationed to meet demand, and the gap in water services is increasingly being filled by private water vendors selling packaged “sachet” water. Sachets extend drinking water coverage deeper into low-income areas and alleviate the need for safe water storage, potentially introducing a health benefit over stored tap water. We explore correlates of using sachets as the primary drinking water source for 2,093 women in 37 census areas classified as slums by UN-Habitat, and links between sachet water and reported diarrhea episodes in a subset of 810 children under five. We find that neighborhood rationing exerts a strong effect on a household's likelihood of buying sachet water, and that sachet customers tend to be the poorest of the poor. Sachet use is also associated with higher levels of self-reported overall health in women, and lower likelihood of diarrhea in children. We conclude with implications for sachet regulation in Accra and other sub-Saharan cities facing drinking water shortages. PMID:22018970

Health insurance and care-seeking behaviours of female migrants in Accra, Ghana.

PubMed

Lattof, Samantha R

2018-05-01

People working in Ghana's informal sector have low rates of enrolment in the publicly funded National Health Insurance Scheme. Informal sector workers, including migrant girls and women from northern Ghana working as head porters (kayayei), report challenges obtaining insurance and seeking formal health care. This article analyses how health insurance status affects kayayei migrants' care-seeking behaviours. This mixed-methods study involved surveying 625 migrants using respondent-driven sampling and conducting in-depth interviews with a sub-sample of 48 migrants. Analyses explore health status and health seeking behaviours for recent illness/injury. Binary logistic regression modelled the effects of selected independent variables on whether or not a recently ill/injured participant (n = 239) sought health care. Although recently ill/injured participants (38.4%) desired health care, less than half (43.5%) sought care. Financial barriers overwhelmingly limit kayayei migrants from seeking health care, preventing them from registering with the National Health Insurance Scheme, renewing their expired health insurance policies, or taking time away from work. Both insured and uninsured migrants did not seek formal health services due to the unpredictable nature of out-of-pocket expenses. Catastrophic and impoverishing medical expenses also drove participants' migration in search of work to repay loans and hospital bills. Health insurance can help minimize these expenditures, but only 17.4% of currently insured participants (58.2%) reported holding a valid health insurance card in Accra. The others lost their cards or forgot them when migrating. Access to formal health care in Accra remains largely inaccessible to kayayei migrants who suffer from greater illness/injury than the general female population in Accra and who are hindered in their ability to receive insurance exemptions. With internal migration on the rise in many settings, health systems must recognize the varied needs of populations in multi-ethnic and multilingual countries to ensure that internal migrants can access affordable, quality health services across domestic borders.

Sachet water quality and brand reputation in two low-income urban communities in greater Accra, Ghana.

PubMed

Stoler, Justin; Tutu, Raymond A; Ahmed, Hawa; Frimpong, Lady Asantewa; Bello, Mohammed

2014-02-01

Sachet water has become an important primary source of drinking water in western Africa, but little is known about bacteriologic quality and improvements to quality control given the recent, rapid evolution of this industry. This report examines basic bacteriologic indicators for 60 sachet water samples from two very low-income communities in Accra, Ghana, and explores the relationship between local perceptions of brand quality and bacteriologic quality after controlling for characteristics of the vending environment. No fecal contamination was detected in any sample, and 82% of total heterotrophic bacteria counts were below the recommended limit for packaged water. Sachets from brands with a positive reputation for quality were 90% less likely to present any level of total heterotrophic bacteria after controlling for confounding factors. These results contrast with much of the recent sachet water quality literature and may indicate substantial progress in sachet water regulation and quality control.

Sachet Water Quality and Brand Reputation in Two Low-Income Urban Communities in Greater Accra, Ghana

PubMed Central

Stoler, Justin; Tutu, Raymond A.; Ahmed, Hawa; Frimpong, Lady Asantewa; Bello, Mohammed

2014-01-01

Sachet water has become an important primary source of drinking water in western Africa, but little is known about bacteriologic quality and improvements to quality control given the recent, rapid evolution of this industry. This report examines basic bacteriologic indicators for 60 sachet water samples from two very low-income communities in Accra, Ghana, and explores the relationship between local perceptions of brand quality and bacteriologic quality after controlling for characteristics of the vending environment. No fecal contamination was detected in any sample, and 82% of total heterotrophic bacteria counts were below the recommended limit for packaged water. Sachets from brands with a positive reputation for quality were 90% less likely to present any level of total heterotrophic bacteria after controlling for confounding factors. These results contrast with much of the recent sachet water quality literature and may indicate substantial progress in sachet water regulation and quality control. PMID:24379244

Levels of electric field strength within the immediate vicinity of FM radio stations in Accra, Ghana.

PubMed

Azah, C K; Amoako, J K; Fletcher, J J

2013-10-01

Heightened awareness of the ever-expanding use of radiofrequency (RF) techniques and technology has led to mounting concerns from the general public and the scientific community regarding the possible health effects that may arise as a consequence of exposure to RF radiations and has drawn the attention of many researchers the world over. A survey of the RF electromagnetic radiation at public access points in the vicinity of 20 frequency-modulated (FM) radio stations has been made in Accra, Ghana. The fundamental object was to determine the levels of RF fields from FM broadcast antennae within 10-200 m radius about the foot of the FM base station and at a height of 1.5 m above the ground at selected locations. A spectrum analyser and a bi-conical antenna element sensitive and effective within the frequency band of 30-300 MHz were used. Results obtained indicated that the levels of electric field strength ranged from 5.4E-04 V m(-1) at FM station 'O' to 7.4E-08 V m(-1) at FM station 'D'. At a transmission frequency range of 88-108 MHz, the variation of power densities is from 2.5E-10 to 1.5E-17 Wm(-2). These values are very low and are far below the reference level set by the International Commission on Non-Ionizing Radiation Protection and therefore do not pose any known hazard to the inhabitants of Accra, Ghana. The electric field levels presented in this work are comparable with those reported from epidemiological studies conducted elsewhere.

The cost effectiveness of a quality improvement program to reduce maternal and fetal mortality in a regional referral hospital in Accra, Ghana.

PubMed

Goodman, David M; Ramaswamy, Rohit; Jeuland, Marc; Srofenyoh, Emmanuel K; Engmann, Cyril M; Olufolabi, Adeyemi J; Owen, Medge D

2017-01-01

To evaluate the cost-effectiveness of a quality improvement intervention aimed at reducing maternal and fetal mortality in Accra, Ghana. Quasi-experimental, time-sequence intervention, retrospective cost-effectiveness analysis. Data were collected on the cost and outcomes of a 5-year Kybele-Ghana Health Service Quality Improvement (QI) intervention conducted at Ridge Regional Hospital, a tertiary referral center in Accra, Ghana, focused on systems, personnel, and communication. Maternal deaths prevented were estimated comparing observed rates with counterfactual projections of maternal mortality and case-fatality rates for hypertensive disorders of pregnancy and obstetric hemorrhage. Stillbirths prevented were estimated based on counterfactual estimates of stillbirth rates. Cost-effectiveness was then calculated using estimated disability-adjusted life years averted and subjected to Monte Carlo and one-way sensitivity analyses to test the importance of assumptions inherent in the calculations. Incremental Cost-effectiveness ratio (ICER), which represents the cost per disability-adjusted life-year (DALY) averted by the intervention compared to a model counterfactual. From 2007-2011, 39,234 deliveries were affected by the QI intervention implemented at Ridge Regional Hospital. The total budget for the program was $2,363,100. Based on program estimates, 236 (±5) maternal deaths and 129 (±13) intrapartum stillbirths were averted (14,876 DALYs), implying an ICER of $158 ($129-$195) USD. This value is well below the highly cost-effective threshold of $1268 USD. Sensitivity analysis considered DALY calculation methods, and yearly prevalence of risk factors and case fatality rates. In each of these analyses, the program remained highly cost-effective with an ICER ranging from $97-$218. QI interventions to reduce maternal and fetal mortality in low resource settings can be highly cost effective. Cost-effectiveness analysis is feasible and should regularly be conducted to encourage fiscal responsibility in the pursuit of improved maternal and child health.

Incidence of Sitophilus oryzae and other stored-product pests on cowpea in local markets in Accra: management strategies employed by retailers.

PubMed

Egbon, I N; Ayertey, J N

2013-05-01

In recent times, the unusual presence of Sitophilus on cowpea has become an issue in Ghana as it constitutes a threat to food sufficiency and food security; this, by extension, necessitated the execution of this survey to establish the specific identity of the insect and its incidence, on stored cowpea in Ghana and consequently assess the level of awareness of traders and the management strategies employed. Using internal morphological identification techniques, the insect was identified as Sitophilus oryzae with an incidence rate of 12, 22 and 20% as against 50, 41 and 42% incidence rate of Callosobruchus maculatus after 30, 60 and 90 days respectively, of undisturbed storage of cowpea within the marketing systems in Accra, Ghana. Relatively low number of retailers (35.44%, N = 79) was aware of this occurrence, with 91.14% of this employing the energy-demanding and time-consuming sieving techniques as their main control strategies. This paper draws attention to the possible worsening of food insecurity already eminent in Africa for insects are no respecters of international or geo-political boundaries as they can spread to other countries, should this observation be left unchecked.

Harsh Working Conditions and Poor Eating Habits: Health-Related Concerns of Female Head Porters (Kayayei) in the Mallam Atta Market, Accra, Ghana.

PubMed

Nyarko, Samuel Harrenson; Tahiru, Abdul Majeed

2018-01-01

The kaya business is known to pose significant health-related risks to female migrants. This study sought to explore the health-related concerns of female head porters in the Mallam Atta market, Accra, Ghana. A qualitative study was conducted in which twenty female head porters at the Mallam Atta market in Accra were interviewed. A thematic analysis was performed and the emerging themes were presented and supported with quotations from the respondents. Poor accommodation and eating habits, harsh working conditions, and lack of knowledge about health conditions exposed the respondents to several health-related concerns like neck pains, skin rashes, malaria, cholera, and stomach ache among other infections. The popular means of seeking health care was through purchasing drugs from pharmacies or drug peddlers instead of health facilities. Financial constraints, lack of faith in the National Health Insurance Scheme, and long waiting periods at the health facilities militated against seeking appropriate health care at the hospitals and clinics. Political willpower needs to be strengthened for poverty reduction strategies such as training of hairdressing, dress and soap making, and shea butter processing for women from the Northern regions in order to ameliorate their livelihoods and/or reduce migration to the south.

Environmental and health impacts of household solid waste handling and disposal practices in third world cities: the case of the Accra Metropolitan Area, Ghana.

PubMed

Boadi, Kwasi Owusu; Kuitunen, Markku

2005-11-01

Inadequate provision of solid waste management facilities in Third World cities results in indiscriminate disposal and unsanitary environments, which threatens the health of urban residents. The study reported here examined household-level waste management and disposal practices in the Accra Metropolitan Area, Ghana. The residents of Accra currently generate large amounts of solid waste, beyond the management capabilities of the existing waste management system. Because the solid waste infrastructure is inadequate, over 80 percent of the population do not have home collection services. Only 13.5 percent of respondents are served with door-to-door collection of solid waste, while the rest dispose of their waste at communal collection points, in open spaces, and in waterways. The majority of households store their waste in open containers and plastic bags in the home. Waste storage in the home is associated with the presence of houseflies in the kitchen (r = .17, p < .0001). The presence of houseflies in the kitchen during cooking is correlated with the incidence of childhood diarrhea (r = .36, p < .0001). Inadequate solid waste facilities result in indiscriminate burning and burying of solid waste. There is an association between waste burning and the incidence of respiratory health symptoms among adults (r = .25, p < .0001) and children (r = .22, p < .05). Poor handling and disposal of waste are major causes of environmental pollution, which creates breeding grounds for pathogenic organisms, and the spread of infectious diseases. Improving access to solid waste collection facilities and services will help achieve sound environmental health in Accra.

Options for accounting carbon sequestration in German forests

PubMed Central

Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

2009-01-01

Background The Accra climate change talks held from 21–27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. Results This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 – 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. Conclusion The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences. PMID:19650896

Options for accounting carbon sequestration in German forests.

PubMed

Krug, Joachim; Koehl, Michael; Riedel, Thomas; Bormann, Kristin; Rueter, Sebastian; Elsasser, Peter

2009-08-03

The Accra climate change talks held from 21-27 August 2008 in Accra, Ghana, were part of an ongoing series of meetings leading up to the Copenhagen meeting in December 2009. During the meeting a set of options for accounting carbon sequestration in forestry on a post-2012 framework was presented. The options include gross-net and net-net accounting and approaches for establishing baselines. This article demonstrates the embedded consequences of Accra Accounting Options for the case study of German national GHG accounting. It presents the most current assessment of sequestration rates by forest management for the period 1990 - 2007, provides an outlook of future emissions and removals (up to the year 2042) as related to three different management scenarios, and shows that implementation of some Accra options may reverse sources to sinks, or sinks to sources. The results of the study highlight the importance of elaborating an accounting system that would prioritize the climate convention goals, not national preferences.

Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana.

PubMed

Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

2015-12-01

Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana's national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. A survey instrument was developed using Pechansky and Thomas's model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18-35 years were more likely than older respondents to prefer an ambulance (odds ratio [OR], 2.27; confidence interval [CI], 1.47 to 3.68), as were those with prior ambulance experience (OR, 1.75; CI, 0.98 to 3.09) (compared with those with no prior experience) and those who believed ambulances were safer than taxis (OR, 2.17; CI, 1.1 to 4.2) (compared with those who did not hold such beliefs). Perceptions of public ambulance services in Accra, Ghana, are generally favorable, although use is low. Public health education to improve awareness of the toll-free medical emergency number and about appropriate use of ambulances while simultaneously improving the capacity of ambulance agencies to receive increased caseload could improve use of the EMS system. © Mould-Millman et al.

Family communication about HIV/AIDS and sexual behaviour among senior secondary school students in Accra, Ghana.

PubMed

Adu-Mireku, Samuel

2003-04-01

Sexually active adolescents in Ghana are increasingly at risk of HIV and other sexually transmitted infections. As a primary agent of socialization, the family can exert a strong influence on adolescent sexual behaviour. Therefore, to aid in the design and implementation of effective prevention programmes, it is important to understand the role of the family in influencing sexual behaviour among school-going adolescents. To evaluate the relationship between family communications about HIV/AIDS and sexual activity and condom use among school-going adolescents in Accra, Ghana. A sample of 894 students (56.9% girls, 43.1% boys; mean age = 17.4 years, SD = 1.40) at two senior secondary schools in Accra completed a modified version of the Youth Risk Behavior Survey (YRBS) questionnaire, a self-administered instrument developed by the Centers for Disease Control and Prevention. Analytical techniques utilized included logistic regression and chi-square. Twenty-five percent of the participants reported being sexually experienced, and 73.6% had talked about HIV/AIDS with parents or other family members. Of the sexually experienced students, 64.7% initiated first sexual intercourse by age 16; and 55.7% did not use a condom at last sexual intercourse. Bivariate analysis showed significant gender differences in sexual activity, condom use, and family communication about HIV/AIDS. Logistic regression analysis showed that student-family communication about HIV/AIDS was not associated with sexual activity. However, communication about HIV/AIDS between students and parents or other family members increased the odds of using a condom at last sexual intercourse. The findings of this study suggest that prevention programmes that seek to educate Ghanaian school-going adolescents about sexual risk behaviour must strongly encourage communication about HIV/AIDS between students and family members.

Introduction of Haemophilus influenzae type B conjugate vaccine into routine immunization in Ghana and its impact on bacterial meningitis in children younger than five years.

PubMed

Renner, Lorna Awo; Newman, Mercy J; Ahadzie, Lawson; Antwi-Agyei, Kwadwo Odei; Eshetu, Messeret

2007-04-01

This report shows the impact of a pentavalent vaccine that includes Haemophilus influenzae type b (Hib) conjugate vaccine on bacterial meningitis in children younger than 5 years in Ghana. A review of the first 3 years of a pediatric bacterial meningitis surveillance program, started in August 2001 in Accra, Ghana, was undertaken. There was a significant reduction, P = 0.042 and 0.017, in percentage of purulent meningitis in children younger than 1 year, comparing the first year when the vaccine was introduced, to the second and third years, respectively.

Distance Threshold for the Effect of Urban Agriculture on Elevated Self-reported Malaria Prevalence in Accra, Ghana

PubMed Central

Stoler, Justin; Weeks, John R.; Getis, Arthur; Hill, Allan G.

2009-01-01

Irrigated urban agriculture (UA), which has helped alleviate poverty and increase food security in rapidly urbanizing sub-Saharan Africa, may inadvertently support malaria vectors. Previous studies have not identified a variable distance effect on malaria prevalence from UA. This study examines the relationships between self-reported malaria information for 3,164 women surveyed in Accra, Ghana, in 2003, and both household characteristics and proximity to sites of UA. Malaria self-reports are associated with age, education, overall health, socioeconomic status, and solid waste disposal method. The odds of self-reported malaria are significantly higher for women living within 1 km of UA compared with all women living near an irrigation source, the association disappearing beyond this critical distance. Malaria prevalence is often elevated in communities within 1 km of UA despite more favorable socio-economic characteristics than communities beyond 1 km. Neighborhoods within 1 km of UA should be reconsidered as a priority for malaria-related care. PMID:19346373

Distance threshold for the effect of urban agriculture on elevated self-reported malaria prevalence in Accra, Ghana.

PubMed

Stoler, Justin; Weeks, John R; Getis, Arthur; Hill, Allan G

2009-04-01

Irrigated urban agriculture (UA), which has helped alleviate poverty and increase food security in rapidly urbanizing sub-Saharan Africa, may inadvertently support malaria vectors. Previous studies have not identified a variable distance effect on malaria prevalence from UA. This study examines the relationships between self-reported malaria information for 3,164 women surveyed in Accra, Ghana, in 2003, and both household characteristics and proximity to sites of UA. Malaria self-reports are associated with age, education, overall health, socioeconomic status, and solid waste disposal method. The odds of self-reported malaria are significantly higher for women living within 1 km of UA compared with all women living near an irrigation source, the association disappearing beyond this critical distance. Malaria prevalence is often elevated in communities within 1 km of UA despite more favorable socio-economic characteristics than communities beyond 1 km. Neighborhoods within 1 km of UA should be reconsidered as a priority for malaria-related care.

Factors associated with alcohol consumption: a survey of women childbearing at a national referral hospital in Accra, Ghana.

PubMed

Adeyiga, Georgetta; Udofia, Emilia A; Yawson, Alfred E

2014-06-01

A hospital based cross-sectional study was conducted to identify the factors associated with alcohol consumption in Ghanaian women of childbearing age. The sample consisted of 394 women of reproductive age, of which 234 were pregnant. Systematic random sampling was used to select respondents from the clinics of the Department of Obstetrics and Gynecology outpatient at the Korle Bu Teaching Hospital in Accra, Ghana. Data were collected using structured questionnaires and analyzed using SPSS for Windows version 17.0. In the three months preceding the survey, 37.6% imbibed alcoholic drinks, while 24.4% had ever imbibed an alcoholic herbal brew. Non-Islamic religion, not being in marital union, consuming an alcoholic herbal brew and considering alcohol was beneficial to health were strong predictors of alcohol consumption. We conclude that the prevalence of alcohol consumption is high among this cohort of Ghanaian women. Women should be screened for alcohol consumption and informed about the dangers of heavy alcohol consumption during pregnancy.

Free-range village chickens on the Accra Plains, Ghana: their contribution to households.

PubMed

Aboe, P A T; Boa-Amponsem, K; Okantah, S A; Dorward, P T; Bryant, M J

2006-04-01

A cross-sectional survey investigating the contribution of free-range village chickens to household economies was carried out in four administrative districts within 60 km of Accra. Answers were provided by 101 men and 99 women. Nearly all respondents claimed to keep chickens for meat, with a far smaller percentage claiming to keep them for egg production. Over 80% of respondents kept chickens to supplement their incomes. The proportion of the flock eaten varied between administrative areas (p = 0.009 and p = 0.027), although this was possibly a consequence of differences in consumption patterns between occupation of the respondent, land area cultivated and flock size. The proportion of chickens sold varied as a result of differences in flock size (p = 0.013), the proportion sold increasing with number of birds in the flock. Respondents generally agreed that chickens could be sold without difficulty. A majority of chicken sales were from the farm gate, directly to consumers or traders. Sales were on demand or when the owner needed money. Money from the sale was kept by the owner of the chicken and the money was spent on personal needs. The proportion of the flock sold varied between administrative areas (p = 0.025) and occupation of the respondent (p = 0.040). Respondents describing animal production as their main occupation tended to have greater reliance on chicken sales for their income. Consideration is given to estimating the offtake from the flock and the financial contribution to the household.

Factors influencing householders' access to improved water in low-income urban areas of Accra, Ghana.

PubMed

Mahama, Ayisha Matuamo; Anaman, Kwabena Asomanin; Osei-Akoto, Isaac

2014-06-01

We analysed householders' access to improved water for drinking and other domestic uses in five selected low-income urban areas of Accra, Ghana using a survey of 1,500 households. Our definitions of improved water were different from those suggested by the World Health Organization (WHO). The results revealed that only 4.4% of the respondents had access to improved drinking water compared to 40.7% using the WHO definition. However, 88.7% of respondents had access to improved water for domestic uses compared to 98.3% using the WHO definition. Using logistic regression analysis, we established that the significant determinant of householders' access to improved drinking water was income. However, for access to improved water for other domestic uses, the significant factors were education, income and location of the household. Compared to migrants, indigenous people and people from mixed areas were less likely to have access to improved water for other domestic purposes. For the analysis using the WHO definitions, most of the independent variables were not statistically significant in determining householders' access, and those variables that were significant generated parameter estimates inconsistent with evidence from the literature and anecdotal evidence from officials of public health and water supply companies in Ghana.

Bacteriological quality of the wastewater used for irrigation at the vegetable farms in Korle-bu Teaching Hospital, Accra Metropolis, Ghana.

PubMed

Pesewu, George A; Bentum, Daniel; Olu-Taiwo, Michael A; Glover, Kathreen K; Yirenya-Tawiah, Dzidzo R

2017-01-01

Many developing countries, including Ghana, are water stressed. As such, farmers, particularly those in urban areas, have adopted the use of wastewater for irrigation. This study evaluated the bacteriological water quality of the wastewater used for irrigation in the vegetable farms at Korle-Bu Teaching Hospital (KBTH), Accra Metropolis, Ghana. In all, 40 wastewater samples were collected and analysed bacteriologically using the total aerobic plate count method. The isolated bacteria were identified biochemically using Bergey's manual for determinative bacteriology. Mean total bacterial colony count values in the range of 2.75-4.44 × 10 5 CFU/100 mL were isolated which far exceeds values of 1 × 10 3 /100 mL recommended by the World Health Organization (WHO) for unrestricted irrigation of crops likely to be eaten raw. Enterobacter cloacae (51.4%), Klebsiella sp. (24.1%), Pseudomonas aeruginosa (11.3%), Salmonella typhi (10.6%), Escherichia coli (2.2%) and Proteus sp. (0.4%) were the predominant bacteria isolated. Growers should use treated wastewater for farming while processors and consumers should minimize contamination risks of produce from the vegetable farms/garden to the plate. © The Author(s) 2016.

Multi-trace element levels and arsenic speciation in urine of e-waste recycling workers from Agbogbloshie, Accra in Ghana.

PubMed

Asante, Kwadwo Ansong; Agusa, Tetsuro; Biney, Charles Augustus; Agyekum, William Atuobi; Bello, Mohammed; Otsuka, Masanari; Itai, Takaaki; Takahashi, Shin; Tanabe, Shinsuke

2012-05-01

To understand human contamination by multi-trace elements (TEs) in electrical and electronic waste (e-waste) recycling site at Agbogbloshie, Accra in Ghana, this study analyzed TEs and As speciation in urine of e-waste recycling workers. Concentrations of Fe, Sb, and Pb in urine of e-waste recycling workers were significantly higher than those of reference sites after consideration of interaction by age, indicating that the recycling workers are exposed to these TEs through the recycling activity. Urinary As concentration was relatively high, although the level in drinking water was quite low. Speciation analysis of As in human urine revealed that arsenobetaine and dimethylarsinic acid were the predominant As species and concentrations of both species were positively correlated with total As concentration as well as between each other. These results suggest that such compounds may be derived from the same source, probably fish and shellfish and greatly influence As exposure levels. To our knowledge, this is the first study on human contamination resulting from the primitive recycling of e-waste in Ghana. This study will contribute to the knowledge about human exposure to trace elements from an e-waste site in a less industrialized region so far scantly covered in the literature. Copyright © 2012 Elsevier B.V. All rights reserved.

Implementation of Fee-Free Maternal Health-Care Policy in Ghana: Perspectives of Users of Antenatal and Delivery Care Services From Public Health-Care Facilities in Accra.

PubMed

Anafi, Patricia; Mprah, Wisdom K; Jackson, Allen M; Jacobson, Janelle J; Torres, Christopher M; Crow, Brent M; O'Rourke, Kathleen M

2018-01-01

In 2008, the government of Ghana implemented a national user fee maternal care exemption policy through the National Health Insurance Scheme to improve financial access to maternal health services and reduce maternal as well as perinatal deaths. Although evidence shows that there has been some success with this initiative, there are still issues relating to cost of care to beneficiaries of the initiative. A qualitative study, comprising 12 focus group discussions and 6 interviews, was conducted with 90 women in six selected urban neighborhoods in Accra, Ghana, to examine users' perspectives regarding the implementation of this policy initiative. Findings showed that direct cost of delivery care services was entirely free, but costs related to antenatal care services and indirect costs related to delivery care still limit the use of hospital-based midwifery and obstetric care. There was also misunderstanding about the initiative due to misinformation created by the government through the media.We recommend that issues related to both direct and indirect costs of antenatal and delivery care provided in public health-care facilities must be addressed to eliminate some of the lingering barriers relating to cost hindering the smooth operation and sustainability of the maternal care fee exemption policy.

Measuring regional and district variations in the incidence of pregnancy-induced hypertension in Ghana: challenges, opportunities and implications for maternal and newborn health policy and programmes.

PubMed

Antwi, Edward; Klipstein-Grobusch, Kerstin; Quansah Asare, Gloria; Koram, Kwadwo A; Grobbee, Diederick; Agyepong, Irene A

2016-01-01

The objectives were to assess the quality of health management information system (HMIS) data needed for assessment of local area variation in pregnancy-induced hypertension (PIH) incidence and to describe district and regional variations in PIH incidence. A retrospective review of antenatal and delivery records of 2682 pregnant women in 10 district hospitals in the Greater Accra and Upper West regions of Ghana was conducted in 2013. Quality of HMIS data was assessed by completeness of reporting. The incidence of PIH was estimated for each district. Key variables for routine assessment of PIH such as blood pressure (BP) at antenatal visits, weight and height were 95-100% complete. Fundal height, gestational age and BP at delivery were not consistently reported. The incidence of PIH differed significantly between Greater Accra region (6.1%) and Upper West region (3.2%). Prevalence of obesity among pregnant women in Greater Accra region (13.9%) was significantly higher than that of women in Upper West region (2.2%). More attention needs to be given to understanding local area variations in PIH and possible relationships with urbanisation and lifestyle changes that promote obesity, to inform maternal and newborn health policy. This can be done with good quality routine HMIS data. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Neighborhoods and Fertility in Accra, Ghana: An AMOEBA-based Approach

PubMed Central

Weeks, John R.; Getis, Arthur; Hill, Allan G.; Agyei-Mensah, Samuel; Rain, David

2010-01-01

Fertility levels remain high in most of sub-Saharan Africa, despite recent declines, and even in a large capital city such as Accra, Ghana, women are having children at a pace that is well above replacement level and this will contribute to significant levels of future population growth in the city. Our purpose in this paper is to evaluate the way in which neighborhood context may shape reproductive behavior in Accra. In the process, we introduce several important innovations to the understanding of intra-urban fertility levels in a sub-Saharan African city: (1) despite the near explosion of work on neighborhoods as a spatial unit of analysis, very little of this research has been conducted outside of the richer countries; (2) we characterize neighborhoods on the basis of local knowledge of what we call “vernacular neighborhoods”; (3) we then define what we call “organic neighborhoods” using a new clustering tool—the AMOEBA algorithm—to create these neighborhoods; and then (4) we evaluate and explain which of the neighborhood concepts has the largest measurable contextual effect on an individual woman’s reproductive behavior. Multi-level regression analysis suggests that vernacular neighborhoods are more influential on a woman’s decision to delay marriage, whereas the organic neighborhoods based on socioeconomic status better capture the factors that shape fertility decisions after marriage. PMID:21572914

Characterizing Air Pollution in Two Low-Income Neighborhoods in Accra, Ghana

EPA Science Inventory

Sub-Saharan Africa has the highest rate of urban population growth in the world, with a large number of urban residents living in low-income “slum” neighborhoods. We conducted a study for an initial assessment of the levels and spatial and/or temporal patterns of multiple polluta...

78 FR 24779 - Notice Pursuant to the National Cooperative Research and Production Act of 1993-Telemanagement Forum

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-26

... names: China Comservice Software Technology Co., Ltd. to China Communication Service Application and... GmbH, Potsdam, GERMANY; e. Services Africa Limited, Accra, GHANA; Cognity Consulting, Maroussi, GREECE... Services Sdn Bhd, KL Sentral, MALAYSIA; ING Bank N.V., Amsterdam, NETHERLANDS; Ultrafast Fibre Limited...

HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana.

PubMed

Oppong Asante, Kwaku

2013-03-28

HIV Counselling and Testing (VCT) and knowledge about HIV are some key strategies in the prevention and control of HIV/AIDS in Ghana. However, HIV knowledge and utilization of VCT services among university students is low. The main objective was to determine the level of HIV/AIDS knowledge and to explore factors associated with the use HIV counselling and testing among private university students in Accra, Ghana. A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a privately owned tertiary institution in Accra, Ghana. The respondents consisted of 56.2% males and 43.8% females aged 17 - 37 years. The mean HIV/AIDS knowledge score of was 7.70. There was a significant difference in knowledge of HIV/AIDS by gender where female students had more knowledge about HIV/AIDS than males [t (322) = 2.40, p = 0.017]. The ANOVA results showed that there was a significant difference in HIV/AIDS knowledge according to the age groups [F (3, 321) = 6.26, p = 0. 0001] and marital status [F (3, 321) = 4.86, p = 0. 008] of the sample. Over half of the participants had not tested for HIV, although over 95% of them knew where to access counseling and testing services. The study also revealed a significant association between demographic variables, testing for HIV and intention to test in the future. Participants who were never married (single), aged 17 - 20 years and had knowledge of two routes of HIV transmission were more likely to have taken an HIV test. Males were more likely to take an HIV test in the future than females. Majority of the students receive HIV/AIDS information from both print and electronic media, but few of them received such information from parents. The students HIV knowledge was very good, yet HIV testing were low. Health education and HIV intervention programmes must not only provide accurate information, but must be made to help to equip private university students, especially females to test for HIV consistently.

Comparative studies on growth traits of Sanga and Friesian-Sanga crossbred calves raised on natural pasture on the Accra Plains of Ghana.

PubMed

Sottie, E T; Darfour-Oduro, K A; Okantah, S A

2009-03-01

Data collected from 1993 to 2006 at the Animal Research Institute of Ghana was used to compare the performance of Sanga and Friesian-Sanga crossbred calves on natural pasture. Performance traits analyzed were birth weight (BWT), weaning weight adjusted to 210 days (WW7), preweaning average daily gain to 210 days (ADG 1), weight at 12 months adjusted to 365 days (W12), weight at 18 months adjusted to 540 days (W18) and postweaning average daily gain (ADG 2, from weaning to 540 days). Effects in the model describing these traits were breed, season, sex and first-order interactions between these effects. With the exception of heavier birth weight of Friesian-Sanga crossbred calves (19.98 kg vs. 19.18 kg), body weights of Sangas at weaning, 12 months and 18 months exceeded those of the Friesian-Sanga crossbred calves by 3.76 kg, 35.06 kg and 46.24 kg respectively. The Sangas were also superior in preweaning average daily gain (0.35 kg/day vs. 0.26 kg/day) and postweaning average daily gain (0.28 kg/day vs. 0.21 kg/day). There was a tendency of increasing weight difference between the two breeds with advancing age. It was suggested that improved nutrition such as supplementary feeding would be necessary for crossbreds to express their potential for growth.

Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana: Implications for integrative healthcare.

PubMed

Kretchy, Irene A; Okere, Harry A; Osafo, Joseph; Afrane, Barima; Sarkodie, Joseph; Debrah, Philip

2016-09-01

Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary and alternative medicine (TM-CAM) remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine. A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana. Participants' knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as well as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream allopathic healthcare in Ghana through improving knowledge, training as well as addressing concerns of safety and efficacy. These findings are discussed under the themes: the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants. The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration, practitioners' understanding of TM-CAM must be improved, with specific attention to issues of safety, regulation and evidence-based practice of TM-CAM products and services in Ghana.

Cervical Cancer in the Greater Accra and Ashanti Regions of Ghana

PubMed Central

Nartey, Yvonne; Hill, Philip C.; Amo-Antwi, Kwabena; Nyarko, Kofi M.; Yarney, Joel

2017-01-01

Purpose Cervical cancer is a common cancer among women worldwide. An estimated 528,000 new cases and 266,000 deaths occurred in 2012. More than 85% of invasive cervical cancer cases occur in low- and middle-income countries. Cervical cancer ranks as the most common cancer among women in Ghana. We conducted a retrospective study to assess the descriptive epidemiology of cervical cancer in Ghana. We describe cervical cancer incidence and mortality rates for the regions served by two large hospitals in Ghana. Patients and Methods Information for women diagnosed with invasive cervical cancer between 2010 and 2013 was collected from the Komfo Anokye and Korle Bu Teaching Hospitals through review of medical, computer, and pathology records at the oncology units and the obstetrics and gynecology departments. Telephone interviews were also conducted with patients and relatives. Data were analyzed using summary statistics. Results A total of 1,725 women with cervical cancer were included in the study. Their ages ranged from 11 to 100 years (mean, 56.9 years). The histology of the primary tumor was the basis of diagnosis in 77.5% of women and a clinical diagnosis was made in 22.5% of women. For the 1,336 women for whom tumor grade was available, 34.3% were moderately differentiated tumors. Late stage at presentation was common. The incidence and mortality rates of cervical cancer increased with age up until the 75 to 79–year age group and began to decrease at older ages. The Greater Accra region had higher overall incidence and mortality rates than the Ashanti region. Conclusion Our study suggests that improvements in the application of preventive strategies could considerably reduce the burden of cervical cancer in Ghana and other low- and middle-income countries. The study provides important information to inform policy on cancer prevention and control in Ghana. PMID:29244993

Health worker (internal customer) satisfaction and motivation in the public sector in Ghana.

PubMed

Agyepong, Irene Akua; Anafi, Patricia; Asiamah, Ebenezer; Ansah, Evelyn K; Ashon, Daniel A; Narh-Dometey, Christiana

2004-01-01

This paper describes factors affecting health worker motivation and satisfaction in the public sector in Ghana. The data are from a survey of public sector health care providers carried out in January 2002 and repeated in August 2003 using an interviewer administered structured questionnaire. It is part of a continuous quality improvement (CQI) effort in the health sector in the Greater Accra region of Ghana. Workplace obstacles identified that caused dissatisfaction and de-motivated staff in order of the most frequently mentioned were low salaries such that obtaining basic necessities of daily living becomes a problem; lack of essential equipment, tools and supplies to work with; delayed promotions; difficulties and inconveniences with transportation to work; staff shortages; housing, additional duty allowances and in-service (continuous) training. Others included children's education, vehicles to work with such as ambulances and pickups, staff transfer procedures, staff pre-service education inadequate for job requirements, and the effect of the job on family and other social factors. There were some differences in the percentages of staff selecting a given workplace obstacle between the purely rural districts, the highly urbanized Accra metropolis and the districts that were a mixture of urbanized and rural. It is unlikely that the Ghana Health Service can provide high quality of care to its end users (external customers) if workplace obstacles that de-motivate staff (internal customers) and negatively influence their performance are not properly recognized and addressed as a complex of inter-related problems producing a common result--dissatisfied poorly motivated staff and resulting poor quality services.

Evaluation of cholera surveillance system in Osu Klottey District, Accra, Ghana (2011-2013).

PubMed

Adjei, Eric Yirenkyi; Malm, Keziah Laurencia; Mensah, Kofi Nyarko; Sackey, Samuel Oko; Ameme, Donne; Kenu, Ernest; Abdulai, Marijanatu; Mills, Richael; Afari, Edwin

2017-01-01

Cholera is an acute illness characterized by profuse watery diarrhea. It is caused by vibrio cholera subgroup 01 and 0139. Rapid administration of fluid replacement therapy and supportive treatment can reduce mortality to around 1%. By the close of 2011, 10,628 cases and 100 deaths were reported in Ghana with a case fatality rate of 0.99. It is important to evaluate the cholera surveillance system in Ghana to determine if it is meeting its objective. The study was conducted in Osu Klottey district in the Accra Metropolitan area in January 2014. We assessed the operations (attributes and performance) of the surveillance system for cholera using CDC guidelines (2001). Surveillance data records at the district level from 2011-2013 were extracted and analyzed for frequency using Microsoft excel. Stakeholders and key informants were interviewed using structured questionnaire. Records were also reviewed at some health facilities and at district levels. In 2011 and 2012, case fatality rates (1.3% and 0.65%) respectively. Males were mostly affected. The most affected age group was 20-29. In 2011, Predictive value positive was 69.2% and 50% in 2012.Cholera peaked in March 2011 and April 2012. The Government of Ghana funded the system. The system is sensitive, simple, stable, flexible, acceptable and representative. It was also useful and data quality was relatively good. Predictive Value Positive was also good. The surveillance system is achieving its set out objectives. The system is sensitive, simple, stable, flexible, and acceptable. Predictive value positive was good.

Beneficial outcomes of the air curtain project in Ghana, August 14-27, 2011

USDA-ARS?s Scientific Manuscript database

A number of questions existed about the feasibility of using the air curtain system in West Africa and after the project was completed many of the questions had been answered. Air curtains can be securely mounted on the truck mounted stairs used for passenger planning and deplaning. The Accra Airpor...

Working conditions and environmental exposures among electronic waste workers in Ghana.

PubMed

Akormedi, Matthew; Asampong, Emmanuel; Fobil, Julius N

2013-01-01

To investigate and describe informal e-waste recycling and working conditions at Agbogbloshie, Accra, Ghana. We conducted in-depth interviews which were qualitatively analysed from a grounded theory perspective. Workers obtained e-waste from the various residential areas in Accra, then dismantled and burned them in open air to recover copper, aluminum, steel, and other products for sale to customers on-site or at the nearby Agbogbloshie market. The processers worked under unhealthy conditions often surrounded by refuse and human excreta without any form of protective gear and were thus exposed to frequent burns, cuts, and inhalation of highly contaminated fumes. We observed no form of social security/support system for the workers, who formed informal associations to support one another in times of difficulty. e-waste recycling working conditions were very challenging and presented serious hazards to worker health and wellbeing. Formalizing the e-waste processing activities requires developing a framework of sustainable financial and social security for the e-waste workers, including adoption of low-cost, socially acceptable, easy-to-operate, and cleaner technologies that would safeguard the health of the workers and the general public.

Effect of gamma irradiation on microbial quality of minimally processed carrot and lettuce: A case study in Greater Accra region of Ghana

NASA Astrophysics Data System (ADS)

Frimpong, G. K.; Kottoh, I. D.; Ofosu, D. O.; Larbi, D.

2015-05-01

The effect of ionizing radiation on the microbiological quality on minimally processed carrot and lettuce was studied. The aim was to investigate the effect of irradiation as a sanitizing agent on the bacteriological quality of some raw eaten salad vegetables obtained from retailers in Accra, Ghana. Minimally processed carrot and lettuce were analysed for total viable count, total coliform count and pathogenic organisms. The samples collected were treated and analysed for a 15 day period. The total viable count for carrot ranged from 1.49 to 14.01 log10 cfu/10 g while that of lettuce was 0.70 to 8.5 7 log10 cfu/10 g. It was also observed that total coliform count for carrot was 1.46-7.53 log10 cfu/10 g and 0.14-7.35 log10 cfu/10 g for lettuce. The predominant pathogenic organisms identified were Bacillus cereus, Cronobacter sakazakii, Staphylococcus aureus, and Klebsiella spp. It was concluded that 2 kGy was most effective for medium dose treatment of minimally processed carrot and lettuce.

Factors Influencing Prevention and Control of Malaria among Pregnant Women Resident in Urban Slums, Southern Ghana.

PubMed

Dako-Gyeke, Mavis; Kofie, Humphrey M

2015-03-01

Throughout Africa and particularly in Ghana, there are concerns about malaria infection during pregnancy. This study aimed to investigate factors that influence malaria prevention and control practices among pregnant women residing in Chorkor and Korle-Gonno in Accra, Ghana. One hundred and twenty pregnant women between ages 18-49 were randomly recruited during antenatal sessions at a maternity facility in Accra, as participants for the study. An interviewer-administered questionnaire was used to collect data, which were analysed using SPSS version16.0. It was found that in Chorkor and Korle-Gonno, 57.4% and 42.6% participants respectively reported having been infected with malaria during their current pregnancy. There was no significant relationship between religious beliefs of participants and their malaria prevention and control practices (X2 = 0.28, P = .53). However, there was a significant relationship between malaria prevention and control practices of participants and their income earning (X2 = 53.94, P = .00) and employment (X2 = 61.76, P = .00) statuses. With the exception of ethnicity (X2 = 35.62, P =.22), other socio-cultural conditions had a significant relationship with malaria prevention and control practices of the participants. The findings suggest the need to consider and integrate factors, such as poverty and poor living conditions in malaria prevention and control strategies.

Strengthening malaria prevention and control: integrating West African militaries' malaria control efforts. The inaugural meeting of the West African Malaria Task Force, April 24-26, 2013, Accra, Ghana.

PubMed

McCollum, Jeffrey T; Hanna, Refaat; Halbach, Alaina C; Cummings, James F

2015-01-01

From April 24 to 26, 2013, the Armed Forces Health Surveillance Center and the U.S. Africa Command cosponsored the inaugural meeting of the West Africa Malaria Task Force in Accra, Ghana. The meeting's purpose was to identify common challenges, explore regional and transcontinental collaborations, and to share knowledge about best practices in the fight against malaria in West Africa. Military representatives from Benin, Burkina Faso, Ghana, Liberia, Niger, Nigeria, Senegal, and Togo participated in the Task Force; various U.S. Government agencies were also represented, including the Department of Defense, the Centers for Disease Control and Prevention, and the Agency for International Development. African nation participants presented brief overviews of their military's malaria prevention and control measures, surveillance programs, diagnostic capabilities, and treatment regimens emphasizing gaps within existing programs. Representatives from U.S. agencies discussed activities and capabilities relevant for the region, challenges and lessons learned regarding malaria, and highlighted opportunities for enhanced partnerships to counter malaria in West Africa. This article summarizes the major conclusions of the Task Force meeting, identifies relevant focus areas for future Task Force activities, and outlines opportunities for further inclusion of West African militaries to improve regional malaria surveillance and control efforts. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Probabilistic seismic hazard assessment of southern part of Ghana

NASA Astrophysics Data System (ADS)

Ahulu, Sylvanus T.; Danuor, Sylvester Kojo; Asiedu, Daniel K.

2018-05-01

This paper presents a seismic hazard map for the southern part of Ghana prepared using the probabilistic approach, and seismic hazard assessment results for six cities. The seismic hazard map was prepared for 10% probability of exceedance for peak ground acceleration in 50 years. The input parameters used for the computations of hazard were obtained using data from a catalogue that was compiled and homogenised to moment magnitude (Mw). The catalogue covered a period of over a century (1615-2009). The hazard assessment is based on the Poisson model for earthquake occurrence, and hence, dependent events were identified and removed from the catalogue. The following attenuation relations were adopted and used in this study—Allen (for south and eastern Australia), Silva et al. (for Central and eastern North America), Campbell and Bozorgnia (for worldwide active-shallow-crust regions) and Chiou and Youngs (for worldwide active-shallow-crust regions). Logic-tree formalism was used to account for possible uncertainties associated with the attenuation relationships. OpenQuake software package was used for the hazard calculation. The highest level of seismic hazard is found in the Accra and Tema seismic zones, with estimated peak ground acceleration close to 0.2 g. The level of the seismic hazard in the southern part of Ghana diminishes with distance away from the Accra/Tema region to a value of 0.05 g at a distance of about 140 km.

Burden of malaria in mobile populations in the Greater Accra region, Ghana: a cross- sectional study.

PubMed

Diallo, Nouhoum; Akweongo, Patricia; Maya, Ernest; Aikins, Moses; Sarfo, Bismark

2017-03-09

The burden of malaria in mobile populations remains poorly documented in sub-Saharan Africa. This study determined the prevalence of malaria among hawkers and long-distance truck drivers in the Greater Accra region of Ghana. A cross-sectional design using consecutive sampling method between June and July 2016 in Accra and Tema in Ghana was used in this study. The study population was hawkers who roam and sleep in the Market Streets, and long-distance truck drivers. Participants completed closed ended interview questionnaires on socio-demographic characteristics, primary residence and knowledge about malaria. Rapid diagnostic test and thick blood smears of each participant were stained with Giemsa and read using microscopy. Geographical position system (GPS) was used to collect the station locations of these mobile populations. The overall prevalence of malaria was 15.1% and Plasmodium falciparum was responsible for all malaria infection. The malaria prevalence was 18.9 and 10.9% respectively among hawkers and truck drivers (p < 0.05). The hawkers, the single and the no formal educated participants were more likely to get malaria than the long-distance truck drivers (OR = 1.91, 95% CI 1.07-3.42), the married (OR = 1.94 95% CI 1.11-3.40) and the educated participants (OR = 2.56 95% CI 1.10-5.93), respectively. After controlling for other variables, marital status (OR = 2.60 95% CI 1.43- 4.73) and educational level (OR = 2.70 95% CI 1.08-6.77) were statistically significantly associated with malaria. This study demonstrated that the prevalence of malaria is high among hawkers and long distance truck drivers. Sociodemographic characteristics, such as marital status, occupation and educational level are significantly associated with malaria. The station locations as determined by GPS technology will make these mobile populations easier to reach for any malaria intervention.

Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana

PubMed Central

Mould-Millman, Nee-Kofi; Rominski, Sarah D; Bogus, Joshua; Ginde, Adit A; Zakariah, Ahmed N; Boatemaah, Christiana A; Yancey, Arthur H; Akoriyea, Samuel Kaba; Campbell, Thomas B

2015-01-01

Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana’s national ambulance service has relatively low public utilization in comparison with the large burden of acute disease. Methods: A survey instrument was developed using Pechansky and Thomas’s model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability. The instrument was used in a cross-sectional survey in 2013 in Accra, Ghana; eligible participants were those 18 years and older who spoke English, French, or Twi. Although the analysis was mainly descriptive, logistic regression was used to identify factors associated with reported intention to call for an ambulance in the case of a medical emergency. Results: 468 participants completed surveys, with a response rate of 78.4%. Few (4.5%) respondents had ever used an ambulance in prior emergency situations. A substantial proportion (43.8%) knew about the public access medical emergency telephone number, but of those only 37.1% knew it was a toll-free call. Most (54.7%) respondents believed EMTs offered high-quality care, but 78.0% believed taxis were faster than ambulances and 69.2% thought the number of ambulances in Accra insufficient. Many (23.4%) thought using ambulances to transport corpses would be appropriate. In two hypothetical emergency scenarios, respondents most commonly reported taxis as the preferred transportation (63.6% if a family member were burned in a house fire, 64.7% if a pedestrian were struck by a vehicle). About 1 in 5 respondents said they would call an ambulance in either scenario (20.7% if a family member were burned in a house fire, 23.3% if a pedestrian were struck by a vehicle) while 15.5% and 10.2%, respectively, would use any available vehicle. Those aged 18–35 years were more likely than older respondents to prefer an ambulance (odds ratio [OR], 2.27; confidence interval [CI], 1.47 to 3.68), as were those with prior ambulance experience (OR, 1.75; CI, 0.98 to 3.09) (compared with those with no prior experience) and those who believed ambulances were safer than taxis (OR, 2.17; CI, 1.1 to 4.2) (compared with those who did not hold such beliefs). Conclusions: Perceptions of public ambulance services in Accra, Ghana, are generally favorable, although use is low. Public health education to improve awareness of the toll-free medical emergency number and about appropriate use of ambulances while simultaneously improving the capacity of ambulance agencies to receive increased caseload could improve use of the EMS system. PMID:26681705

Science reporting in Accra, Ghana: sources, barriers and motivational factors.

PubMed

Appiah, Bernard; Gastel, Barbara; Burdine, James N; Russell, Leon H

2015-01-01

In Ghana, as in many other developing countries, most science reporting is done by general reporters. However, few studies have investigated science reporting in such a situation. To understand better the dynamics of science reporting in such context, we surveyed 151 general reporters in Ghana. Respondents' demographic characteristics resembled those found in studies elsewhere. Respondents perceived health professionals and scientists as very important sources of information for reporting science. There was an inverse correlation between journalism experience and the number of science feature stories reported in the past 12 months (p=.017). Most respondents indicated that science journalism training would motivate them to report science more. Likewise, most reported that easier access to research findings would do so. We identify characteristics of reporters, media, scientific, and training institutions that are important influences of Ghanaian reporters' coverage of science. We provide recommendations for advancing science reporting in Ghana. © The Author(s) 2014.

Science reporting in Accra, Ghana: Sources, barriers and motivational factors

PubMed Central

Gastel, Barbara; Burdine, James N.; Russell, Leon H.

2014-01-01

In Ghana, as in many other developing countries, most science reporting is done by general reporters. However, few studies have investigated science reporting in such a situation. To understand better the dynamics of science reporting in such context, we surveyed 151 general reporters in Ghana. Respondents’ demographic characteristics resembled those found in studies elsewhere. Respondents perceived health professionals and scientists as very important sources of information for reporting science. There was an inverse correlation between journalism experience and the number of science feature stories reported in the past 12 months (p = .017). Most respondents indicated that science journalism training would motivate them to report science more. Likewise, most reported that easier access to research findings would do so. We identify characteristics of reporters, media, scientific, and training institutions that are important influences of Ghanaian reporters’ coverage of science. We provide recommendations for advancing science reporting in Ghana. PMID:25193967

Assessing the Predictors of the Content and Pedagogical Knowledge of Fitness Instructors in the Greater Accra Region of Ghana

ERIC Educational Resources Information Center

Sarpong, E. O.; Apaak, D.

2016-01-01

Fitness centers require professional instructors to ensure members obtain the safest and most effective exercise classes. Certification and licensure enable fitness instructors to demonstrate a strong desire to be knowledgeable and committed to expand their capabilities and offer more diverse services to their clientele. This study therefore…

Views from the Streets of Accra on Language Policy in Ghana

ERIC Educational Resources Information Center

Sadat, Mohammed; Kuwornu, Mohammed

2017-01-01

Issues of national language are very complex in Africa because of the multi-lingual situation on the continent. The situation is even more severe when a country attempts to choose one of the indigenous languages as its national language. Most African nations have peacefully chosen foreign languages as their official languages but there is always a…

Schoolchildren's Use of Poetry and Paintings in Conveying Environmental Messages

ERIC Educational Resources Information Center

Gebbels, Susan; Hunter, Jo; Nunoo, Francis K. E.; Tagoe, E.; Evans, Stewart M.

2012-01-01

Pupils aged 12-14 from the University of Ghana Primary and Junior High School conducted studies off the coast adjacent to Accra, including a field visit to explore the effects of climate change on the country's biology, ecology and physical environment. They composed poems and made paintings about the coast and sea as means of conveying their…

Community awareness of stroke in Accra, Ghana

PubMed Central

2014-01-01

Background Community awareness of stroke, especially the risk factors and warning signs is important in the control of the disease. In sub-Saharan Africa, little is known about community awareness of stroke though the brunt of stroke is currently borne in this region. The aim of the study was to evaluate stroke awareness in Accra (capital city of Ghana) particularly, the risk factors and warning signs. Methods This was a cross-sectional study involving systematic sampling of 63 households in each of the 11 sub metropolitan areas of Accra. A structured questionnaire was used to collect stroke awareness data from respondents randomly sampled in the selected households. Logistic regression analyses were done to identify predictors of the main outcome variables including recognition of stroke risk factors, stroke warning signs and the organ affected by stroke. Results Only 40% (n = 277) of the 693 respondents correctly identified the brain as the organ affected in stroke. Similarly, less than half of the respondents could recognize any of the established stroke risk factors as well as any of the established stroke warning signs. Over 70% (n > 485) of the respondents either believed that stroke is a preventable disease, or lifestyle alterations can be made to reduce the risk of stroke, or stroke requires emergency treatment. In multivariate analysis, predictors of stroke awareness were: age <50 years (OR = 0.56, CI = 0.35-0.92, p = 0.021), presence of a stroke risk factor (OR = 2.37, CI = 1.52-3.71, p < 0.001) and Christian Religion (OR = 14.86, CI = 1.37-161.01, p = 0.03). Conclusion Though stroke is perceived as a serious and preventable disease in Accra, community awareness of the risk factors and warning signs is sub-optimal. This indicates that community-based education programs to increase public awareness of stroke could contribute to decreasing the risk of stroke and to increasing the speed of hospital presentation after stroke onset. PMID:24559414

Health insurance and care-seeking behaviours of female migrants in Accra, Ghana

PubMed Central

Lattof, Samantha R

2018-01-01

Abstract People working in Ghana’s informal sector have low rates of enrolment in the publicly funded National Health Insurance Scheme. Informal sector workers, including migrant girls and women from northern Ghana working as head porters (kayayei), report challenges obtaining insurance and seeking formal health care. This article analyses how health insurance status affects kayayei migrants’ care-seeking behaviours. This mixed-methods study involved surveying 625 migrants using respondent-driven sampling and conducting in-depth interviews with a sub-sample of 48 migrants. Analyses explore health status and health seeking behaviours for recent illness/injury. Binary logistic regression modelled the effects of selected independent variables on whether or not a recently ill/injured participant (n = 239) sought health care. Although recently ill/injured participants (38.4%) desired health care, less than half (43.5%) sought care. Financial barriers overwhelmingly limit kayayei migrants from seeking health care, preventing them from registering with the National Health Insurance Scheme, renewing their expired health insurance policies, or taking time away from work. Both insured and uninsured migrants did not seek formal health services due to the unpredictable nature of out-of-pocket expenses. Catastrophic and impoverishing medical expenses also drove participants’ migration in search of work to repay loans and hospital bills. Health insurance can help minimize these expenditures, but only 17.4% of currently insured participants (58.2%) reported holding a valid health insurance card in Accra. The others lost their cards or forgot them when migrating. Access to formal health care in Accra remains largely inaccessible to kayayei migrants who suffer from greater illness/injury than the general female population in Accra and who are hindered in their ability to receive insurance exemptions. With internal migration on the rise in many settings, health systems must recognize the varied needs of populations in multi-ethnic and multilingual countries to ensure that internal migrants can access affordable, quality health services across domestic borders. PMID:29462305

Risk of transmission of viral haemorrhagic fevers and the insecticide susceptibilitystatus of aedes aegypti (linnaeus) in some sites in Accra, Ghana.

PubMed

Suzuki, Takashi; Osei, Joseph H; Sasaki, Akihiro; Adimazoya, Michelle; Appawu, Maxwell; Boakye, Daniel; Ohta, Nobuo; Dadzie, Samuel

2016-09-01

Dengue is one of the emerging diseases that can mostly only be controlled by vector control since there is no vaccine for the disease. Although, Dengue has not been reported in Ghana, movement of people from neighbouring countries where the disease has been reported can facilitate transmission of the disease. This study was carried on the University of Ghana campus to determine the risk of transmission of viral haemorrhagic fevers and the insecticide susceptibility status of Ae. aegypti in some sites in Accra, Ghana. Larval surveys were carried to inspect containers within households and estimate larval indices and adult Aedes mosquitoes were collected using human landing collection technique. WHO tube assays was used to assess the insecticide susceptibility status of Aedes mosquitoes. Ae. aegypti were the most prevalent species, 75.5% and followed by Ae. vittatus , 23.9 %. Ae. albopictus and Ae. granti were in smaller numbers. Household index (HI), Breteau index (BI), and container index were calculated as 8.2%, 11.2% and 10.3% respectively with man-vector contact rate of 0.67 bites/man-hour estimated for the area. The mortalities recorded for Ae. aegypti from WHO tube assays was 88%, 94%, 80% and 99% for DDT (4%), deltamethrin (0.05%), lambdacyhalothrin (0.05%) and permethrin (0.75%) respectively. The survey results indicated that the density of Aedes mosquitoes was considered to be sufficient to promote an outbreak of viral haemorrhagic fevers on Legon Campus. Aedes mosquitoes were found to be resistant to DDT, deltamethrin and lamdacyhalothrin, but susceptible to permethrin. This study was supported in part by Japan Initiative for Global Research Network on Infectious Diseases (J-Grid).

HIV/AIDS knowledge and uptake of HIV counselling and testing among undergraduate private university students in Accra, Ghana

PubMed Central

2013-01-01

Background HIV Counselling and Testing (VCT) and knowledge about HIV are some key strategies in the prevention and control of HIV/AIDS in Ghana. However, HIV knowledge and utilization of VCT services among university students is low. The main objective was to determine the level of HIV/AIDS knowledge and to explore factors associated with the use HIV counselling and testing among private university students in Accra, Ghana. Materials and methods A cross-sectional study was conducted using structured questionnaires among 324 conveniently selected students enrolled at a privately owned tertiary institution in Accra, Ghana. Results The respondents consisted of 56.2% males and 43.8% females aged 17 – 37 years. The mean HIV/AIDS knowledge score of was 7.70. There was a significant difference in knowledge of HIV/AIDS by gender where female students had more knowledge about HIV/AIDS than males [t (322) = 2.40, p = 0.017]. The ANOVA results showed that there was a significant difference in HIV/AIDS knowledge according to the age groups [F (3, 321) = 6.26, p = 0. 0001] and marital status [F (3, 321) = 4.86, p = 0. 008] of the sample. Over half of the participants had not tested for HIV, although over 95% of them knew where to access counseling and testing services. The study also revealed a significant association between demographic variables, testing for HIV and intention to test in the future. Participants who were never married (single), aged 17 – 20 years and had knowledge of two routes of HIV transmission were more likely to have taken an HIV test. Males were more likely to take an HIV test in the future than females. Majority of the students receive HIV/AIDS information from both print and electronic media, but few of them received such information from parents. Conclusion The students HIV knowledge was very good, yet HIV testing were low. Health education and HIV intervention programmes must not only provide accurate information, but must be made to help to equip private university students, especially females to test for HIV consistently. PMID:23537116

Assessment of the municipal solid waste management system in Accra, Ghana: A 'Wasteaware' benchmark indicator approach.

PubMed

Oduro-Appiah, Kwaku; Scheinberg, Anne; Mensah, Anthony; Afful, Abraham; Boadu, Henry Kofi; de Vries, Nanne

2017-11-01

This article assesses the performance of the city of Accra, Ghana, in municipal solid waste management as defined by the integrated sustainable waste management framework. The article reports on a participatory process to socialise the Wasteaware benchmark indicators and apply them to an upgraded set of data and information. The process has engaged 24 key stakeholders for 9 months, to diagram the flow of materials and benchmark three physical components and three governance aspects of the city's municipal solid waste management system. The results indicate that Accra is well below some other lower middle-income cities regarding sustainable modernisation of solid waste services. Collection coverage and capture of 75% and 53%, respectively, are a disappointing result, despite (or perhaps because of) 20 years of formal private sector involvement in service delivery. A total of 62% of municipal solid waste continues to be disposed of in controlled landfills and the reported recycling rate of 5% indicates both a lack of good measurement and a lack of interest in diverting waste from disposal. Drains, illegal dumps and beaches are choked with discarded bottles and plastic packaging. The quality of collection, disposal and recycling score between low and medium on the Wasteaware indicators, and the scores for user inclusivity, financial sustainability and local institutional coherence are low. The analysis suggests that waste and recycling would improve through greater provider inclusivity, especially the recognition and integration of the informal sector, and interventions that respond to user needs for more inclusive decision-making.

Spatial assessment of potential ecological risk of heavy metals in soils from informal e-waste recycling in Ghana.

PubMed

Kyere, Vincent Nartey; Greve, Klaus; Atiemo, Sampson Manukure; Ephraim, James

2017-01-01

The rapidly increasing annual global volume of e-waste, and of its inherently valuable fraction, has created an opportunity for individuals in Agbogbloshie, Accra, Ghana to make a living by using unconventional, uncontrolled, primitive and crude procedures to recycle and recover valuable metals from this waste. The current form of recycling procedures releases hazardous fractions, such as heavy metals, into the soil, posing a significant risk to the environment and human health. Using a handheld global positioning system, 132 soil samples based on 100 m grid intervals were collected and analysed for cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), lead (Pb) and zinc (Zn). Using geostatistical techniques and sediment quality guidelines, this research seeks to assess the potential risk these heavy metals posed to the proposed Korle Ecological Restoration Zone by informal e-waste processing site in Agbogbloshie, Accra, Ghana. Analysis of heavy metals revealed concentrations exceeded the regulatory limits of both Dutch and Canadian soil quality and guidance values, and that the ecological risk posed by the heavy metals extended beyond the main burning and dismantling sites of the informal recyclers to the school, residential, recreational, clinic, farm and worship areas. The heavy metals Cr, Cu, Pb and Zn had normal distribution, spatial variability, and spatial autocorrelation. Further analysis revealed the decreasing order of toxicity, Hg>Cd>Pb> Cu>Zn>Cr, of contributing significantly to the potential ecological risk in the study area.

Spatial assessment of potential ecological risk of heavy metals in soils from informal e-waste recycling in Ghana

PubMed Central

Greve, Klaus; Atiemo, Sampson Manukure

2017-01-01

The rapidly increasing annual global volume of e-waste, and of its inherently valuable fraction, has created an opportunity for individuals in Agbogbloshie, Accra, Ghana to make a living by using unconventional, uncontrolled, primitive and crude procedures to recycle and recover valuable metals from this waste. The current form of recycling procedures releases hazardous fractions, such as heavy metals, into the soil, posing a significant risk to the environment and human health. Using a handheld global positioning system, 132 soil samples based on 100 m grid intervals were collected and analysed for cadmium (Cd), chromium (Cr), copper (Cu), mercury (Hg), lead (Pb) and zinc (Zn). Using geostatistical techniques and sediment quality guidelines, this research seeks to assess the potential risk these heavy metals posed to the proposed Korle Ecological Restoration Zone by informal e-waste processing site in Agbogbloshie, Accra, Ghana. Analysis of heavy metals revealed concentrations exceeded the regulatory limits of both Dutch and Canadian soil quality and guidance values, and that the ecological risk posed by the heavy metals extended beyond the main burning and dismantling sites of the informal recyclers to the school, residential, recreational, clinic, farm and worship areas. The heavy metals Cr, Cu, Pb and Zn had normal distribution, spatial variability, and spatial autocorrelation. Further analysis revealed the decreasing order of toxicity, Hg>Cd>Pb> Cu>Zn>Cr, of contributing significantly to the potential ecological risk in the study area. PMID:29056034

Dress Fashion in Feminist and Child Rights Campaigns in Ghanaian Public Sculptures of the 1990s

ERIC Educational Resources Information Center

Essel, Osuanyi Quaicoo; Opoku-Mensah, Isaac

2017-01-01

This article examines how dress fashion in outdoor sculptures of the 1990s in the Accra cityscape accentuated feminist activism, sensitised child right campaigns, and encouraged girl-child education in support of governmental efforts and activism of civil society organisations in Ghana. It gives attention to how dress fashion of the time was used…

In-Service Science Teachers' and the Use of Multimedia as a Teaching Tool

ERIC Educational Resources Information Center

Ameyaw, Y.; Quansah, E.

2013-01-01

The study investigated the attitudes of in-service teachers' towards the use of multimedia as a tool for science teaching in Junior High Schools in the Greater Accra Region of Ghana. The population sample consisted of 100 Junior High School (JHS) science teachers made up of 60 urban teachers and 40 rural teachers from three selected districts…

How community physical, structural, and social stressors relate to mental health in the urban slums of Accra, Ghana.

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

Urban health in developing counties is a major public health challenge. It has become increasingly evident that the dialog must expand to include mental health outcomes, and to shift focus to the facets of the urban environment that shape them. Population-based research is necessary, as empirical findings linking the urban environment and mental health have primarily derived from developed countries, and may not be generalizable to developing countries. Thus, the current study assesses the prevalence of mental health problems (i.e., depression, perceived powerlessness), as well as their community-based predictors (i.e., crime, disorder, poverty, poor sanitation, local social capital and cohesion), among a sample of 690 residents in three poor urban communities in Accra, Ghana. It uncovers that residents in poor urban communities in developing countries suffer from mental health problems as a result of local stressors, which include not only physical and structural factors but social ones. Social capital and social cohesion show complex, often unhealthy, relationships with mental health, suggesting considerable drawbacks in making social capital a key focus among policymakers. Copyright © 2015. Published by Elsevier Ltd.

Epidemiological Transition and the Double Burden of Disease in Accra, Ghana

PubMed Central

de-Graft Aikins, Ama

2010-01-01

It has long been recognized that as societies modernize, they experience significant changes in their patterns of health and disease. Despite rapid modernization across the globe, there are relatively few detailed case studies of changes in health and disease within specific countries especially for sub-Saharan African countries. This paper presents evidence to illustrate the nature and speed of the epidemiological transition in Accra, Ghana’s capital city. As the most urbanized and modernized Ghanaian city, and as the national center of multidisciplinary research since becoming state capital in 1877, Accra constitutes an important case study for understanding the epidemiological transition in African cities. We review multidisciplinary research on culture, development, health, and disease in Accra since the late nineteenth century, as well as relevant work on Ghana’s socio-economic and demographic changes and burden of chronic disease. Our review indicates that the epidemiological transition in Accra reflects a protracted polarized model. A “protracted” double burden of infectious and chronic disease constitutes major causes of morbidity and mortality. This double burden is polarized across social class. While wealthy communities experience higher risk of chronic diseases, poor communities experience higher risk of infectious diseases and a double burden of infectious and chronic diseases. Urbanization, urban poverty and globalization are key factors in the transition. We explore the structures and processes of these factors and consider the implications for the epidemiological transition in other African cities. PMID:20803094

The influence of socio-cultural interpretations of pregnancy threats on health-seeking behavior among pregnant women in urban Accra, Ghana.

PubMed

Dako-Gyeke, Phyllis; Aikins, Moses; Aryeetey, Richmond; McCough, Laura; Adongo, Philip Baba

2013-11-19

Although antenatal care coverage in Ghana is high, there exist gaps in the continued use of maternity care, especially utilization of skilled assistance during delivery. Many pregnant women seek care from different sources aside the formal health sector. This is due to negative perceptions resulting from poor service quality experiences in health facilities. Moreover, the socio-cultural environment plays a major role for this care-seeking behavior. This paper seeks to examine beliefs, knowledge and perceptions about pregnancy and delivery and care-seeking behavior among pregnant women in urban Accra, Ghana. A qualitative study with 6 focus group discussions and 13 in-depth interviews were conducted at Taifa-Kwabenya and Madina sub-districts, Accra. Participants included mothers who had delivered within the past 12 months, pregnant women, community members, religious and community leaders, orthodox and non-orthodox healthcare providers. Interviews and discussions were audio-taped, transcribed and coded into larger themes and categories. Evidence showed perceived threats, which are often given socio-cultural interpretations, increased women's anxieties, driving them to seek multiple sources of care. Crucially, care-seeking behavior among pregnant women indicated sequential or concurrent use of biomedical care and other forms of care including herbalists, traditional birth attendants, and spiritual care. Use of multiple sources of care in some cases disrupted continued use of skilled provider care. Furthermore, use of multiple forms of care is encouraged by a perception that facility-based care is useful only for antenatal services and emergencies. It also highlights the belief among some participants that care from multiple sources are complementary to each other. Socio-cultural interpretations of threats to pregnancy mediate pregnant women's use of available healthcare services. Efforts to encourage continued use of maternity care, especially skilled birth assistance at delivery, should focus on addressing generally perceived dangers to pregnancy. Also, the attractiveness of facility-based care offers important opportunities for building collaborations between orthodox and alternative care providers with the aim of increasing use of skilled obstetric care. Conventional antenatal care should be packaged to provide psychosocial support that helps women deal with pregnancy-related fear.

Monitoring of organic micropollutants in Ghana by combination of pellet watch with sediment analysis: e-waste as a source of PCBs.

PubMed

Hosoda, Junki; Ofosu-Anim, John; Sabi, Edward Benjamin; Akita, Lailah Gifty; Onwona-Agyeman, Siaw; Yamashita, Rei; Takada, Hideshige

2014-09-15

Plastic resin pellets collected at 11 beaches covering the whole Ghanaian coastline were analyzed for polychlorinated biphenyls (PCBs). PCB concentrations (∑13 congeners) were higher in Accra, capital city, and Tema (39-69 ng/g-pellets) than those in rural coastal towns (1-15 ng/g-pellets) which are close to global background, indicating local inputs of PCBs. River sediments were also analyzed for PCBs together with molecular markers. Sedimentary PCBs concentrations were highest at a site (AR02) downstream of an electronic waste (e-waste) scrapyard. At the site (AR02), concentration of linear alkylbenzenes (LABs), a marker of municipal wastewater, was lower than another site (AR03) which is located at the downstream of downtown Accra. This result suggests that PCBs are introduced more to the river from the e-waste site than from activities in downtown Accra. PAHs concentrations were relatively higher in urban areas with strong petrogenic signature. Abundance of triphenylbenzenes suggested plastic combustion near e-waste scrapyard. Copyright © 2014 Elsevier Ltd. All rights reserved.

Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana.

PubMed

Amoakoh-Coleman, Mary; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Klipstein-Grobusch, Kerstin; Ansah, Evelyn K

2016-09-21

Lack of resources has been identified as a reason for non-adherence to clinical guidelines. Our aim was to describe public health facility resource availability in relation to provider adherence to first antenatal visit guidelines. A cross-sectional analysis of the baseline data of a prospective cohort study on adherence to first antenatal care visit guidelines was carried out in 11 facilities in the Greater Accra Region of Ghana. Provider adherence was studied in relation to health facility resource availability such as antenatal workload for clinical staffs, routine antenatal drugs, laboratory testing, protocols, ambulance and equipment. Eleven facilities comprising 6 hospitals (54.5 %), 4 polyclinics (36.4 %) and 1 health center were randomly sampled. Complete provider adherence to first antenatal guidelines for all the 946 participants was 48.1 % (95 % CI: 41.8-54.2 %), varying significantly amongst the types of facilities, with highest rate in the polyclinics. Average antenatal workload per month per clinical staff member was higher in polyclinics compared to the hospitals. All facility laboratories were able to conduct routine antenatal tests. Most routine antenatal drugs were available in all facilities except magnesium sulphate and sulphadoxine-pyrimethamine which were lacking in some. Antenatal service protocols and equipment were also available in all facilities. Although antenatal workload varies across different facility types in the Greater Accra region, other health facility resources that support implementation of first antenatal care guidelines are equally available in all the facilities. These factors therefore do not adequately account for the low and varying proportions of complete adherence to guidelines across facility types. Providers should be continually engaged for a better understanding of the barriers to their adherence to these guidelines.

Migration, sexual networks, and HIV in Agbogbloshie, Ghana

PubMed Central

Cassels, Susan; Jenness, Samuel M.; Biney, Adriana A. E.; Ampofo, William Kwabena; Dodoo, F. Nii-Amoo

2014-01-01

BACKGROUND HIV is spread through structured sexual networks, which are influenced by migration patterns, but network-oriented studies of mobility and HIV risk behavior have been limited. OBJECTIVE We present a comprehensive description and initial results from our Migration & HIV in Ghana (MHG) study in Agbogbloshie, an urban slum area within Accra, Ghana. METHODS The MHG study was a population-based cross-sectional study of adults aged 18–49 in Agbogbloshie in 2012. We used a one-year retrospective relationship history calendar to collect egocentric network data on sexual partners as well as migration and short-term mobility, and tested for prevalent HIV-1/2 infection. RESULTS HIV prevalence was 5.5%, with prevalence among women (7.2%) over twice that of men (2.8%). Three-quarters of residents were born outside the Greater Accra region, but had lived in Agbogbloshie an average of 10.7 years. Only 7% had moved housing structures within the past year. However, short-term mobility was common. Residents had an average of 7.3 overnight trips in the last year, with women reporting more travel than men. Thirty-seven percent of men and 9% of women reported more than one sexual partner in the last year. CONCLUSIONS Population-based surveys of migration and sexual risk behavior using relationship history calendars in low-resource settings can produce high quality data. Residents in Agbogbloshie are disproportionately affected by HIV, and have high levels of short-term mobility. HIV prevention interventions targeted to highly mobile populations in high prevalence settings may have far-reaching and long-term implications. PMID:25364298

Trends in Urbanization and Implications for Peri-Urban Livelihoods in Accra, Ghana

NASA Astrophysics Data System (ADS)

Adom, Cynthia

Urbanization is a common occurrence in both developed and developing worlds. Similar to occurrences in other developing world cities, Accra's urbanization is marked by fast, unplanned and uneven growth into mostly peripheral lands (Grant and Yankson 2002; Yeboah 2001; Ghana Statistical Service (GSS) 2002). Such trends in urbanization in places where data on the urbanization process is seriously inadequate and infrequent, (Rakodi 1997a; Ohadika 1991; Fasona and Omojola 2004) pose a major challenge to urban planning and management (Henderson 2002), and affect the livelihood base of several peri-urban households. Properly monitoring the urbanization process in the developing world and understanding its effects on people's lives depends on the availability of useful and up-to- date data (Weber and Puissant 2003; Mundia and Aniya 2006) that could be obtained using new and robust analytical techniques (Yang 2003). In addition, in the urban environment, differences in rates of urbanization, income, employment status, and gender dynamics across neighborhoods suggest that the impacts of increasing urbanization on peri-urban livelihoods are likely to vary across peoples and places. Against this backdrop, this dissertation uses Accra as a case study to, first, measures the nature and extent of urban expansion using a non-conventional technique, and then analyzes neighborhood - and gender-differentiated impacts of increasing urbanization on household livelihoods in peri-urban Accra. Study findings reveal: 1) major conversion of vegetated land to urban lands uses and support the effectiveness of the Self-Organizing Map and Landsat data to map complex and hazy urban tropical environments; 2) that the impacts of urbanization on peri-urban livelihoods are structured along the lines of neighborhood-level urbanization; changes brought by a higher rate of urbanization are more beneficial than harmful to household livelihoods; 3) that positive livelihood outcomes in high-growth neighborhoods as a result of increasing urbanization have disproportionately benefited male-headed households compared to female-headed households. Although study findings do not match some of the prior thinking about impacts of urbanization on livelihoods, it corroborates recent urban theory that asserts that urbanization does not necessarily result in the perpetuation of urban poverty.

Chemical composition and sources of particle pollution in affluent and poor neighborhoods of Accra, Ghana

NASA Astrophysics Data System (ADS)

Zhou, Zheng; Dionisio, Kathie L.; Verissimo, Thiago G.; Kerr, Americo S.; Coull, Brent; Arku, Raphael E.; Koutrakis, Petros; Spengler, John D.; Hughes, Allison F.; Vallarino, Jose; Agyei-Mensah, Samuel; Ezzati, Majid

2013-12-01

The highest levels of air pollution in the world now occur in developing country cities, where air pollution sources differ from high-income countries. We analyzed particulate matter (PM) chemical composition and estimated the contributions of various sources to particle pollution in poor and affluent neighborhoods of Accra, Ghana. Elements from earth’s crust were most abundant during the seasonal Harmattan period between late December and late January when Saharan dust is carried to coastal West Africa. During Harmattan, crustal particles accounted for 55 μg m-3 (37%) of fine particle (PM2.5) mass and 128 μg m-3 (42%) of PM10 mass. Outside Harmattan, biomass combustion, which was associated with higher black carbon, potassium, and sulfur, accounted for between 10.6 and 21.3 μg m-3 of fine particle mass in different neighborhoods, with its contribution largest in the poorest neighborhood. Other sources were sea salt, vehicle emissions, tire and brake wear, road dust, and solid waste burning. Reducing air pollution in African cities requires policies related to energy, transportation and urban planning, and forestry and agriculture, with explicit attention to impacts of each strategy in poor communities. Such cross-sectoral integration requires emphasis on urban environment and urban poverty in the post-2015 Development Agenda.

Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra.

PubMed

Rokicki, Slawa; Montana, Livia; Fink, Günther

2014-12-01

Over the last few decades, total fertility rates, child morbidity, and child mortality rates have declined in most parts of sub-Saharan Africa. Among the most striking trends observed are the rapid rate of urbanization and the often remarkably large gaps in fertility between rural and urban areas. Although a large literature has highlighted the importance of migration and urbanization within countries' demographic transitions, relatively little is known regarding the impact of migration on migrants' reproductive health outcomes in general and abortion in particular. In this article, we use detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. We find that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated. Our results suggest that recent migrants have an increased risk of pregnancy but not an increased risk of live birth in the first years post-move compared with those who had never moved. This gap seems to be largely explained by an increased risk of miscarriage or abortion among recent migrants. Increasing access to contraceptives for recent migrants has the potential to reduce the incidence of unwanted pregnancies, lower the prevalence of unsafe abortion, and contribute to improved maternal health outcomes.

Drinking Water in Transition: A Multilevel Cross-sectional Analysis of Sachet Water Consumption in Accra.

PubMed

Stoler, Justin; Weeks, John R; Appiah Otoo, Richard

2013-01-01

Rapid population growth in developing cities often outpaces improvements to drinking water supplies, and sub-Saharan Africa as a region has the highest percentage of urban population without piped water access, a figure that continues to grow. Accra, Ghana, implements a rationing system to distribute limited piped water resources within the city, and privately-vended sachet water-sealed single-use plastic sleeves-has filled an important gap in urban drinking water security. This study utilizes household survey data from 2,814 Ghanaian women to analyze the sociodemographic characteristics of those who resort to sachet water as their primary drinking water source. In multilevel analysis, sachet use is statistically significantly associated with lower overall self-reported health, younger age, and living in a lower-class enumeration area. Sachet use is marginally associated with more days of neighborhood water rationing, and significantly associated with the proportion of vegetated land cover. Cross-level interactions between rationing and proxies for poverty are not associated with sachet consumption after adjusting for individual-level sociodemographic, socioeconomic, health, and environmental factors. These findings are generally consistent with two other recent analyses of sachet water in Accra and may indicate a recent transition of sachet consumption from higher to lower socioeconomic classes. Overall, the allure of sachet water displays substantial heterogeneity in Accra and will be an important consideration in planning for future drinking water demand throughout West Africa.

The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients' views.

PubMed

Barke, Antonia; Nyarko, Seth; Klecha, Dorothee

2011-11-01

Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. A convenience sample of 403 participants (210 men, mean age 32.4±12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9±11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes.

Consumer knowledge, preference, and perceived quality of dried tomato products in Ghana.

PubMed

Owureku-Asare, Mavis; Ambrose, R P Kingsly; Oduro, Ibok; Tortoe, Charles; Saalia, Firibu K

2017-05-01

Postharvest losses (PHL) are incurred in the tomato value chain in Ghana and solar drying of tomato is a promising technology for reducing the loss. However, there are concerns on the usage, functionality and sensory appeal of the dried products to consumers, compounded with the lack of information and research on dried tomato processing in Ghana. A survey was carried out by administering semistructured questionnaires to 395 randomly selected and willing respondents in the Accra Metropolis. Information was obtained on the socioeconomic profile, consumption pattern, knowledge, and acceptance of tomato processing technologies and assessment of quality attributes important to consumers. Most consumers (74%) preferred tomato powder that is conveniently packaged to retain the characteristic intense taste and the flavor using Friedman's rank mean procedure. The study indicated that consumers were more concerned about good manufacturing practices during the production of solar-dried tomato (48.8%) rather than the quality attributes (8.6%). These findings indicate the need for safe solar drying procedures in order to increase consumer acceptability of solar-dried tomato products in Ghana.

Constructions of masculinity and femininity and sexual risk negotiation practices among women in urban Ghana.

PubMed

Fiaveh, Daniel Y; Izugbara, Chimaraoke O; Okyerefo, Michael P K; Reysoo, Fenneke; Fayorsey, Clara K

2015-01-01

Using qualitative data gathered through in-depth interviews with women in Accra, Ghana, this paper explores narratives of masculinity and femininity and sexual risk negotiation practices among women. While women framed 'proper' masculinity in terms of stereotypical reproductive norms, they also acknowledged the fluidity and multiplicity of masculinities. Femininity was more uniformly characterised in terms of physical attractiveness and beauty, responsibility and reproduction. These features, especially those related to adherence to morally and socially appropriate sexual norms (e.g., menstrual and bodily hygiene, unplanned pregnancy etc.), influenced women's approach to sexual negotiation. Work aiming to support women to negotiate sex safely needs to pay attention to their notions of gender and practices of sexual negotiation.

Access to health in city slum dwellers: The case of Sodom and Gomorrah in Accra, Ghana.

PubMed

Owusu-Ansah, Frances E; Tagbor, Harry; Togbe, Mabel Afi

2016-03-29

Rapid rural-urban migration of people to cities is a reality around the globe that has increased city slum dwellers. Sodom and Gomorrah is a city slum located in the heart of Accra, Ghana. Like other slums, it lacks basic amenities necessary for dwellers' quality of life. This study describes residents' access to health and factors associated with the use of healthcarefacilities. Questionnaires were administered in systematically selected shacks across the entire slum. Data on demographic characteristics, existent health facilities and number of users, health-insured residents and knowledge of common diseases were collected. Majority of the residents were from the northern parts of Ghana, relative to the south and a few of them come from other parts of West Africa. Seventy-one percent of residents had never visited a health facility in the last 5 years. When necessary, they access health care from drug stores (61.1%) or hospitals (33.1%). Residents' age, educational status, income, health knowledge and membership of National Health Insurance Scheme were significantly (p < 0.05) associated with the use of healthcare facilities. Younger residents and those without National Health Insurance Scheme membership, formal education, no knowledge of common illnesses and regular income were significantly less likely to use a healthcare facility. For most residents, neither distance (73.2%) nor transportation to health facilities was a problem (74.1%). Conditions of profound environmental hazards, overcrowding, poor-quality housing and lack of health care in Sodom and Gomorrah pose grave threats to the health of the inhabitants. Multisectoral interventions and resource mobilisation championed by the Ministry of Local Government and Rural Development are needed to alter the trend.

Perception, experience, and indigenous knowledge of climate change and variability: the case of Accra, a sub-Saharan African city

USGS Publications Warehouse

Codjoe, Samuel N.A.; Owusu, George; Burkett, Virginia

2014-01-01

Several recent international assessments have concluded that climate change has the potential to reverse the modest economic gains achieved in many developing countries over the past decade. The phenomenon of climate change threatens to worsen poverty or burden populations with additional hardships, especially in poor societies with weak infrastructure and economic well-being. The importance of the perceptions, experiences, and knowledge of indigenous peoples has gained prominence in discussions of climate change and adaptation in developing countries and among international development organizations. Efforts to evaluate the role of indigenous knowledge in adaptation planning, however, have largely focused on rural people and their agricultural livelihoods. This paper presents the results of a study that examines perceptions, experiences, and indigenous knowledge relating to climate change and variability in three communities of metropolitan Accra, which is the capital of Ghana. The study design is based on a three-part conceptual framework and interview process involving risk mapping, mental models, and individual stressor cognition. Most of the residents interviewed in the three communities of urban Accra attributed climate change to the combination of deforestation and the burning of firewood and rubbish. None of the residents associated climate change with fossil fuel emissions from developed countries. Numerous potential adaptation strategies were suggested by the residents, many of which have been used effectively during past drought and flood events. Results suggest that ethnic residential clustering as well as strong community bonds in metropolitan Accra have allowed various groups and long-settled communities to engage in the sharing and transmission of knowledge of weather patterns and trends. Understanding and building upon indigenous knowledge may enhance the design, acceptance, and implementation of climate change adaptation strategies in Accra and urban regions of other developing nations.

Vs30 mapping at selected sites within the Greater Accra Metropolitan Area

NASA Astrophysics Data System (ADS)

Nortey, Grace; Armah, Thomas K.; Amponsah, Paulina

2018-06-01

A large part of Accra is underlain by a complex distribution of shallow soft soils. Within seismically active zones, these soils hold the most potential to significantly amplify seismic waves and cause severe damage, especially to structures sited on soils lacking sufficient stiffness. This paper presents preliminary site classification for the Greater Accra Metropolitan Area of Ghana (GAMA), using experimental data from two-dimensional (2-D) Multichannel Analysis of Surface Wave (MASW) technique. The dispersive characteristics of fundamental mode Rayleigh type surface waves were utilized for imaging the shallow subsurface layers (approx. up to 30 m depth) by estimating the 1D (depth) and 2D (depth and surface location) shear wave velocities at 5 selected sites. The average shear wave velocity for 30 m depth (Vs30), which is critical in evaluating the site response of the upper 30 m, was estimated and used for the preliminary site classification of the GAM area, as per NEHRP (National Earthquake Hazards Reduction Program). Based on the Vs30 values obtained in the study, two common site types C, and D corresponding to shallow (>6 m < 30 m) weathered rock and deep (up 30 m thick) stiff soils respectively, have been identified within the study area. Lower velocity profiles are inferred for the residual soils (sandy to silty clays), derived from the Accraian Formation that lies mainly within Accra central. Stiffer soil sites lie to the north of Accra, and to the west near Nyanyano. The seismic response characteristics over the residual soils in the GAMA have become apparent using the MASW technique. An extensive site effect map and a more robust probabilistic seismic hazard analysis can now be efficiently built for the metropolis, by considering the site classes and design parameters obtained from this study.

Drinking Water in Transition: A Multilevel Cross-sectional Analysis of Sachet Water Consumption in Accra

PubMed Central

Stoler, Justin; Weeks, John R.; Appiah Otoo, Richard

2013-01-01

Rapid population growth in developing cities often outpaces improvements to drinking water supplies, and sub-Saharan Africa as a region has the highest percentage of urban population without piped water access, a figure that continues to grow. Accra, Ghana, implements a rationing system to distribute limited piped water resources within the city, and privately-vended sachet water–sealed single-use plastic sleeves–has filled an important gap in urban drinking water security. This study utilizes household survey data from 2,814 Ghanaian women to analyze the sociodemographic characteristics of those who resort to sachet water as their primary drinking water source. In multilevel analysis, sachet use is statistically significantly associated with lower overall self-reported health, younger age, and living in a lower-class enumeration area. Sachet use is marginally associated with more days of neighborhood water rationing, and significantly associated with the proportion of vegetated land cover. Cross-level interactions between rationing and proxies for poverty are not associated with sachet consumption after adjusting for individual-level sociodemographic, socioeconomic, health, and environmental factors. These findings are generally consistent with two other recent analyses of sachet water in Accra and may indicate a recent transition of sachet consumption from higher to lower socioeconomic classes. Overall, the allure of sachet water displays substantial heterogeneity in Accra and will be an important consideration in planning for future drinking water demand throughout West Africa. PMID:23840643

Awareness of Environmental Change, Climate Variability, and Their Role in Prevalence of Mosquitoes among Urban Dwellers in Southern Ghana.

PubMed

Mattah, Precious Agbeko Dzorgbe; Futagbi, Godfred; Mattah, Memuna Mawusi

2018-01-01

This study evaluates the extent to which urban residents of Accra and Sekondi-Takoradi (all of southern Ghana) were aware of environment and climate-related variability. A total of 150 questionnaires were given to adults of 40 years and above who lived in the cities for at least 35 years. SPSS version 16 was used to process the data. Results show that all respondents in Accra Metropolitan Area (AMA) and 96% of them in Sekondi-Takoradi Metropolitan Area (STMA) noted the deteriorating vegetation cover over the cities. Similarly, 93% and 83% of them in AMA and STMA, respectively, observed that land use pattern of the two cities has changed considerably. There was positive and statistically significant correlation between respondents' educational attainment and their awareness of changes in land use/land cover ( r = 0.18, n = 140, p = 0.03). Also, 71% in AMA and 89% in STMA stated that temperature of the cities had been increasing over the years. In all, 82.9% of the respondents mentioned that they had problem with the increasing population of mosquitoes. Respondents demonstrated ample knowledge of environment and climate variability and should be engaged in preventing further environmental degradation. The top-down approach to environmental issues has failed; the bottom-up approach to environmental maintenance is needed.

Prevalence of Intestinal Helminths Infestation in Children Attending Princess Marie Louise Children's Hospital in Accra, Ghana

PubMed Central

Mirisho, Robert; Neizer, Margaret L.

2017-01-01

The deworming exercise program does not cover all children who are not in school. This study determined the prevalence and species type of helminth infestation and associated factors among children attending Princess Marie Louise Children's Hospital in Accra, Ghana. Children (225) below the age of 10 who have not taken antihelminthic drugs prior to the study period were recruited between May and June 2015. Children or guardians were interviewed using structured questionnaires and fresh stools were collected and processed for helminths species identification using microscopy. Data were analyzed using Stata version 12. Overall helminths infestation prevalence was 17.33% (39/225). The identified species were hookworm (10.22% (23/225)) and Ascaris lumbricoides (7.11% (16/225)). No double infestation was observed. Significant associations were observed between infestation and age group beyond 4 years (48 months) (aOR = 16.72, 95% CI 1.00–279.72), place of residence (aOR = 7.35, 95% CI 1.68–32.11), washing hands after using toilet (0.04, 95% CI 0.01–0.20), and dirt on fingernails of children (7.96, 95% CI 1.73–36.65). This study demonstrates high prevalence of helminths parasites, hookworm, and Ascaris lumbricoides in children attending PMLCH. Deworming exercise should be extended to children hospitals in developing countries. PMID:29057116

Between moral infraction and existential crisis: Exploring physicians and nurses' attitudes to suicide and the suicidal patient in Ghana.

PubMed

Osafo, Joseph; Akotia, Charity S; Boakye, Kofi E; Dickson, Erica

2018-05-26

Negative attitudes of health professionals towards suicide may hamper their willingness and skills to work with attempt survivors. The purpose of this study was to explore the attitudes of physicians and nurses towards suicide and the suicidal patient. A semi-structured qualitative interview was conducted on Twenty five (25) health professionals: (15 physicians and 10 casualty nurses) from five hospitals in Accra, the capital of Ghana. Findings showed that while majority of physicians viewed suicide as an existential crisis, most of the nurses viewed it as a moral infraction. Three key attitudes towards suicide and the suicidal patient were observed: stable, dissonant and transitioned. The findings are discussed under three main themes: Contexts, Theorizing suicide, and Shades of attitudes. Nurses and Physicians are key gatekeepers in suicide prevention in Ghana. Training is however, needed to improve both attitudes (especially for nurses) and competence towards suicide prevention in the country. Copyright © 2018 Elsevier Ltd. All rights reserved.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keese, G.O.

Nearly half of the total area of the Republic of Ghana is covered by sedimentary rocks. These rocks are found mainly in four different parts of the country: Tano basin, Keta basin, Voltaian basin, and the continental shelf. Because oil seeps in saturated superficial sands were found in the Tano basin, efforts to find oil in Ghana started as far back as 1896 in this basin, which is located at the extreme southwestern part of Ghana and has an area of 1165 km/sup 2/ (450 mi/sup 2/). The Keta basin, located at the extreme southeastern part of Ghana, has anmore » area of 2200 km/sup 2/ (850 mi/sup 2/). The continental shelf of Ghana is at the southern part of the country and has an area of 27,562 km/sup 2/ (10,640 mi/sup 2/). The possibility of finding oil and/or gas at the extreme western part of the continental shelf cannot be overemphasized. The expansive Voltaian sedimentary basin, located in the central part of Ghana, covers an area of about 103,600 km/sup 2/ (40,000 mi/sup 2/). Although no trace of hydrocarbon was found in the only well that has been drilled so far in this basin, the presence of traces of bitumen in some parts of the basin indicates that, despite of its age, the basin might prove to be an oil province. The recent discovery of oil in the Ivory Coast means that it is possible to find oil or gas in Ghana, inasmuch as Ghana's petroleum potential is closely associated with that of the Ivory Coast basin, which extends for 560 km (300 mi) along the entire Ivory Coast and persists eastward into Ghana for an additional 320 km (200 mi), terminating in the area directly west of Accra.« less

'Zero is not good for me': implications of infertility in Ghana.

PubMed

Fledderjohann, J J

2012-05-01

Given the high value placed on children in sub-Saharan Africa, previous research suggests that infertility increases the risk of psychological distress and marital conflict, encourages risky sexual behavior and deprives infertile individuals and couples of an important source of economic and social capital. This paper explores the implications of infertility for women in Ghana, West Africa. Semi-structured interview data collected from 107 women (aged 21-48 years, mean 33 years) seeking treatment in gynecological and obstetric clinics in Accra, Ghana, are analyzed. Based on iterative open coding of the interviews, the focus of the analysis is on mental health, marital instability, social interaction and gendered experiences. Infertile women report facing severe social stigma, marital strain and a range of mental health difficulties. Many women feel that they shoulder a disproportionate share of the blame for infertility and, by extension, face greater social consequences than male partners for difficulties conceiving. Women who do not self-identify as infertile corroborate these findings, asserting that the social consequences of infertility are severe, particularly for women. Infertility in Ghana has important consequences for social interactions, marital stability and mental health. These consequences are not perceived to be shared equally by Ghanaian men.

Child feeding knowledge and practices among women participating in growth monitoring and promotion in Accra, Ghana

PubMed Central

2014-01-01

Background Child undernutrition and poor feeding practices remain a concern in Ghana. The Growth Monitoring and Promotion (GMP) programme seeks to empower mothers to provide appropriate child care. Although the program has been implemented in Ghana for over four decades, little is known about its impact on child feeding outcomes. The current study assessed the association between GMP exposure and mothers' child feeding knowledge and practices in the Accra Metropolitan Area (AMA), Ghana. Methods A cross-sectional survey of 199 mother-child pairs accessing child welfare services in six public health facilities in the AMA was conducted. A structured questionnaire was used to collect data on respondent characteristics and child feeding knowledge; a 24-hour dietary recall tool was used to record child feeding practices. Linear regression analysis was used to determine the association between mothers' exposure to GMP and their knowledge and practices on child feeding. Results Seventy four percent of mothers had not missed any scheduled child welfare clinic sessions. Over 60% of mothers knew the appropriate age of introduction of foods; 86% also gave correct response regarding minimum number of times their child should be fed daily. About 81% of children less than 6 months were exclusively breastfed in the preceding 24 hours, although 36% had received water since birth. Forty two percent of children 6–23 months received dietary diverse meals while 64% were fed the required number of times in a day. Overall, only 32% of children 6–23 months received a minimum acceptable diet in the preceding 24 hours. A higher GMP exposure was positively associated with feeding knowledge scores among mothers with children below 6 months (p < 0.05). Conclusion Although most mothers were knowledgeable about recommendations, feeding practices were suboptimal, especially complementary feeding. GMP exposure was associated with feeding knowledge only among mothers with children less than 6 months. Strengthening of feeding counselling focused on children above 6 months is recommended. PMID:24886576

The Accra experience.

PubMed

Nuno-amarteifio, N

1995-11-01

This case study by the Mayor of Accra, Ghana, discusses urban growth and government efforts at city management of education, town councils, the environment, health, and business. Accra struggles to balance city population growth with infrastructure and services. Suburbs are formed daily. The central Municipal Authority is creating a new system of government that aims to include a broad segment of the population. Departments and agencies have been decentralized. Sub-metro governments were created with town councils as the governing bodies. Town councils are elected by the residents and are comprised of unit committees, which are formed from one or two neighborhoods. Each level of government sends representatives to the next level of government. The neighborhoods are in charge of environmental management. Public tribunals are oversight bodies that adjudicate violations of municipal by-laws. The Health Department has new equipment and vehicles, detects sanitation violations, and participates in the arraignment of violators before tribunals. Health inspectors are encouraged to live in the communities that they supervise and to participate in community activities. The city is investing in education. The city has subcontracted with a mass media firm to produce a package of films on topical events that will be taken to densely populated areas for informing the community about city affairs. The city encourages private business development.

Implementation of a nutrition assessment, counseling and support program and its association with body mass index among people living with HIV in Accra, Ghana.

PubMed

Sackey, Joachim; Zhang, Fang Fang; Rogers, Beatrice; Aryeetey, Richmond; Wanke, Christine

2018-05-01

In spite of the important role nutrition plays in the management of HIV, access to nutrition services is inadequate, especially in resource limited settings. In addition, nutrition programs for people living with HIV (PLWH) have not been sufficiently evaluated for efficacy and this study was conducted to address this gap. This study aimed to evaluate the implementation of the nutrition assessment, counseling and support (NACS) program in Accra, Ghana, and to assess whether the level of implementation of NACS was associated with the body mass index (BMI) of PLWH. A cross-sectional study was conducted in six HIV clinics (3 NACS designated and 3 non-NACS). Study participants were 152 adult PLWH at least 6 months on antiretroviral therapy and not pregnant or breastfeeding. Using a NACS implementation scale developed for this study ranging from 0 to 8 (a higher score indicating better NACS implementation), median NACS implementation score was not different between NACS-designated, and non-NACS HIV clinics (5 vs 4, p = 0.14). Almost half (47%) of the respondents were overweight or obese. A higher score on the NACS implementation scale was not significantly associated with overweight or obesity (BMI >24.9 kg/m 2 ) after adjusting for other covariates. It was concluded that, there was poor implementation of NACS in the NACS designated HIV clinics surveyed with no nutrition counseling offered nor food support available to those who might need it.

Chlorine treatment effectiveness and physico-chemical and bacteriological characteristics of treated water supplies in distribution networks of Accra-Tema Metropolis, Ghana

NASA Astrophysics Data System (ADS)

Karikari, A. Y.; Ampofo, J. A.

2013-06-01

Drinking water quality from two major treatment plants in Ghana; Kpong and Weija Plants, and distribution networks in the Accra-Tema Metropolis were monitored monthly for a year at fifteen different locations. The study determined the relationship between chlorine residual, other physico-chemical qualities of the treated water, and, bacteria regrowth. Results indicated that the treated water at the Kpong and Weija Treatment Plants conformed to WHO guidelines for potable water. However, the water quality deteriorated bacteriologically, from the plants to the delivery points with high numbers of indicator and opportunistic pathogens. This could be due to inadequate disinfection residual, biofilms or accidental point source contamination by broken pipes, installation and repair works. The mean turbidity ranged from 1.6 to 2.4 NTU; pH varied from 6.8 to 7.4; conductivity fluctuated from 71.1 to 293 μS/cm. Chlorine residual ranged from 0.13 to 1.35 mg/l. High residual chlorine was observed at the treatment plants, which decreased further from the plants. Results showed that additional chlorination does not take place at the booster stations. Chlorine showed inverse relationship with microbial counts. Total coliform bacteria ranged from 0 to 248 cfu/100 ml, and faecal coliform values varied from 0 to 128 cfu/100 ml. Other microorganisms observed in the treated water included Aeromonas spp., Clostridium spp. and Pseudomonas spp. Boiling water in the household before consumption will reduce water-related health risks.

Interplay of metals and bromine with dioxin-related compounds concentrated in e-waste open burning soil from Agbogbloshie in Accra, Ghana.

PubMed

Fujimori, Takashi; Itai, Takaaki; Goto, Akitoshi; Asante, Kwadwo A; Otsuka, Masanari; Takahashi, Shin; Tanabe, Shinsuke

2016-02-01

Open burning of electronic waste (e-waste) releases various metals and organohalogen compounds in the environment. Here we investigated the interplay of metals (Cu, Pb, Zn, Fe, Co, and Sr) and bromine (Br) in the formation of dioxin-related compounds (DRCs), including polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs), as well as non-regulated DRCs such as polybrominated dibenzo-p-dioxins/furans (PBDD/Fs) and their monobrominated PCDD/Fs in soils sampled from open burning e-waste sites at Agbogbloshie in Accra, Ghana. The predominant DRCs were PBDFs, PCDFs, PCDDs, and DL-PCBs. Statistical analyzes, X-ray absorption spectroscopy, and the PCDF/PCDD ratio suggested possible formation paths of PCDD/Fs and DL-PCBs by catalytic behaviors of copper chlorides (CuCl, CuCl2, and Cu2(OH)3Cl) and thermal breakdown of polyvinyl chloride. Predominant formation of brominated furans may be derived from electron transfer from intermediates of PBDE to copper, Cu(II) → Cu(I). Lead chloride also contributed to generate DRCs and may become highly bioaccessible through the open burning of e-waste. The main zinc species (ZnCl2 and ZnS) suggested a possible relationship to generate DRCs and specific zinc source such as tire burning. Cu, Pb, Zn, and Br contained in various e-wastes, wires/cables, plastics, and tires strongly influenced generation of many DRCs. Copyright © 2015 Elsevier Ltd. All rights reserved.

A ground-water reconnaissance of the Republic of Ghana, with a description of geohydrologic provinces

USGS Publications Warehouse

Gill, H.E.

1969-01-01

This report gives a general summary of the availability and use of ground water and describes the occurrence of ground water in five major geohydrologic provinces lying in the eight administrative regions of Ghana. The identification and delineation of the geohydrologic provinces are based on their distinctive characteristics with respect to the occurrence and availability of ground water. The Precambrian province occupies the southern, western, and northern parts of Ghana and is underlain largely by intrusive crystalline and metasedimentary rocks. The Voltaian province includes that part of the Voltaian sedimentary basin in central Ghana and is underlain chiefly by consolidated sandstone, mudstone, and shale. Narrow discontinuous bands of consolidated Devonian and Jurassic sedimentary rocks near the coast constitute the Coastal Block Fault province. The Coastal Plain province includes semiconsolidated to unconsolidated sediments of Cretaceous to Holocene age that underlie coastal plain areas in southwestern and southeastern Ghana. The Alluvial province includes the Quaternary alluvial deposits in the principal river valleys and on the delta of the Volta River. Because of the widespread distribution of crystalline and consolidated sedimentary rocks of low permeability in the Precambrian, Voltaian, and Coastal Block Fault provinces, it is difficult to develop large or event adequate groundwater supplies in much of Ghana. On the other hand, small (1 to 50 gallons per minute) supplies of water of usable quality are available from carefully sited boreholes in most parts of the country. Also, moderate (50 to 200 gpm) supplies of water are currently (1964) obtained from small-diameter screened boreholes tapping sand and limestone aquifers in the Coastal Plain province in southwestern and southeastern Ghana, but larger supplies could be obtained through properly constructed boreholes. In the Alluvial province, unconsolidated deposits in the larger stream valleys that are now largely undeveloped offer desirable locations for shallow vertical or horizontal wells, which can induce infiltration from streams and yield moderate to large water supplies. The principal factors that limit development of ground-water supplies in Ghana are (1) prevailing low permeability and water-yielding potential of the crystalline and consolidated sedimentary rocks that underlie most of the country, (2) highly mineralized ground water which appears to be widely distributed in the northern part of the Voltaian province, and (3) potential problems of salt-water encroachment in the Coastal Plain province in the Western Region and in the Keta area. On the other hand, weathering has increased porosity and has thus substantially increased the water-yielding potential of the crystalline and consolidated sedimentary rocks in much of central and northern Ghana. Also, with proper construction and development, much larger yields than those now (1964) prevalent could be obtained from boreholes tapping sand and limestone aquifers in the Coastal Plain province.

HIV antiretroviral medication stock-outs in Ghana: contributors and consequences.

PubMed

Poku, Rebecca A; Owusu, Adobea Yaa; Mullen, Patricia Dolan; Markham, Christine; McCurdy, Sheryl A

2017-09-01

Drug stock-outs are an unfortunate yet common reality for patients living in low and middle income countries, particularly in sub-Saharan Africa where trouble with consistent stock of antiretroviral medications (ARVs) continues. Our study takes a snapshot of this problem in Ghana. Although the country launched its antiretroviral therapy (ART) programme in 2003, progress toward realising the full benefit of ART for treated individuals has been limited, in part, because of stock-outs. In Ghana's Greater Accra region, we conducted semi-structured interviews with 40 women living with HIV (WLHIV) and 15 individuals with a history of HIV-related work in government or non-governmental organisations, or healthcare facilities. We used repeated review with coding and mapping techniques to analyse the transcripts and identify common themes. Stock-outs of ARVs result in inconsistent administration of therapy, increased indirect medical costs for WLHIV, and negative labelling of patients. Inefficiencies in drug supply, poor coordination with port authorities, inadequate government funding and dependence on international aid contribute to the stock-outs experienced in Ghana. Although using ARVs produced in-country could reduce supply problems, the domestically-manufactured product currently does not meet World Health Organization (WHO) standards. We recommend focused efforts to produce WHO standard ARVs in Ghana, and a review of current supply chain management to identify and mend pitfalls in the system.

Challenges in the use of the mental health information system in a resource-limited setting: lessons from Ghana.

PubMed

Kpobi, Lily; Swartz, Leslie; Ofori-Atta, Angela L

2018-02-08

One of the most successful modes of record-keeping and data collection is the use of health management information systems, where patient information and management plans are uniformly entered into a database to streamline the information and for ease of further patient management. For mental healthcare, a Mental Health Information System (MHIS) has been found most successful since a properly established and operational MHIS is helpful for developing equitable and appropriate mental health care systems. Until 2010, the system of keeping patient records and information in the Accra Psychiatric Hospital of Ghana was old and outdated. In light of this and other factors, a complete reforming of the mental health information systems in three psychiatric hospitals in Ghana was undertaken in 2010. Four years after its implementation, we explored user experiences with the new system, and report here the challenges that were identified with use of the new MHIS. Individual semi-structured interviews were conducted with nine clinical and administrative staff of the Accra Psychiatric Hospital to examine their experiences with the new MHIS. Participants in the study were in three categories: clinical staff, administrator, and records clerk. Participants' knowledge of the system and its use, as well as the challenges they had experienced in its use were explored using an interpretative phenomenological approach. The data suggest that optimal use of the current MHIS had faced significant implementation challenges in a number of areas. Central challenges reported by users included increased workload, poor staff involvement and training, and absence of logistic support to keep the system running. Setting up a new system does not guarantee its success. As important as it is to have a mental health information system, its usefulness is largely dependent on proper implementation and maintenance. Further, the system can facilitate policy transformation only when the place of mental health in district, regional and national health discourse improves.

Socio-cultural and economic factors influencing adolescents' resilience against the threat of teenage pregnancy: a cross-sectional survey in Accra, Ghana.

PubMed

Ahorlu, Collins K; Pfeiffer, Constanze; Obrist, Brigit

2015-12-23

Adolescent pregnancy exposes female adolescents to medical, social and economic risks. In Ghana, adolescent mothers are more likely to experience complications during pregnancy and delivery as compared to older mothers. This study examined the competencies of adolescent girls to either proactively prevent teenage pregnancy or reactively cope effectively with it. A cross-sectional survey approach was used to interview 820 adolescent girls aged 15-19 years in Accra, Ghana. The main focus of the study was to examine how social capital (various kinds of valued relations with significant others), economic capital (command over economic resources, mainly cash and assets), cultural capital (personal dispositions and habits; knowledge and tradition stored in material forms and institutionalized) and symbolic capital (honour, recognition and prestige) contribute to the development of competencies of adolescents to deal with the threat of teenage pregnancy and childbirth. Out of 820 adolescents interviewed, 128 (16%) were pregnant or mothers. Adolescents in both groups (62% never pregnant girls and 68% pregnant/young mothers) have access to social support, especially from their parents. Parents are taking the place of aunts and grandmothers in providing sexual education to their adolescent girls due to changing social structures where extended families no longer reside together in most cases. More (79%) pregnant girls and young mothers compared to never pregnant girls (38%) have access to economic support (P = <0.001). Access to social, economic and cultural capitals was associated with high competence to either prevent or deal with pregnancy among adolescent girls. Findings showed that adolescent girls, especially those that get pregnant should not be viewed as weak and vulnerable because many of them have developed competencies to cope with pregnancy and childbirth effectively. Thus, focusing on developing the competencies of girls to access social, economic and cultural capitals may be an effective way of tackling the threat of teenage pregnancy than focusing only on their vulnerability and associated risks.

Quantifying the Validity of Routine Neonatal Healthcare Data in the Greater Accra Region, Ghana

PubMed Central

Kayode, Gbenga A.; Amoakoh-Coleman, Mary; Brown-Davies, Charles; Grobbee, Diederick E.; Agyepong, Irene Akua; Ansah, Evelyn; Klipstein-Grobusch, Kerstin

2014-01-01

Objectives The District Health Information Management System–2 (DHIMS–2) is the database for storing health service data in Ghana, and similar to other low and middle income countries, paper-based data collection is being used by the Ghana Health Service. As the DHIMS-2 database has not been validated before this study aimed to evaluate its validity. Methods Seven out of ten districts in the Greater Accra Region were randomly sampled; the district hospital and a polyclinic in each district were recruited for validation. Seven pre-specified neonatal health indicators were considered for validation: antenatal registrants, deliveries, total births, live birth, stillbirth, low birthweight, and neonatal death. Data were extracted on these health indicators from the primary data (hospital paper-registers) recorded from January to March 2012. We examined all the data captured during this period as these data have been uploaded to the DHIMS-2 database. The differences between the values of the health indicators obtained from the primary data and that of the facility and DHIMS–2 database were used to assess the accuracy of the database while its completeness was estimated by the percentage of missing data in the primary data. Results About 41,000 data were assessed and in almost all the districts, the error rates of the DHIMS-2 data were less than 2.1% while the percentages of missing data were below 2%. At the regional level, almost all the health indicators had an error rate below 1% while the overall error rate of the DHIMS-2 database was 0.68% (95% C I = 0.61–0.75) and the percentage of missing data was 3.1% (95% C I = 2.96–3.24). Conclusion This study demonstrated that the percentage of missing data in the DHIMS-2 database was negligible while its accuracy was close to the acceptable range for high quality data. PMID:25144222

The introduction of a midwife-led obstetric triage system into a regional referral hospital in Ghana.

PubMed

Floyd, Liz; Bryce, Fiona; Ramaswamy, Rohit; Olufolabi, Adeyemi; Srofenyoh, Emmanuel; Goodman, David; Pearson, Nancy; Morgan, Kerry; Tetteh, Cecilia; Ahwireng, Victoria; Owen, Medge

2018-06-01

to introduce and embed a midwife-led obstetric triage system in a busy labour ward in Accra, Ghana to improve the quality of care and to reduce delay. the study utilized a participatory action research design. Local staff participated in baseline data collection, the triage training course design and delivery, and post-training monitoring and evaluation. a regional referral hospital in Accra, Ghana undertaking 11,032 deliveries in 2012. all midwives and medical staff. measurements included maternal health outcomes, observations of labour ward activity, structured assessments of midwife actions during admission, waiting times, focus group discussions, and learning needs assessments which informed the course content. During training, two quality improvement tools were developed; coloured risk acuity wristbands and a one page triage assessment form. Participants measured compliance and accuracy in the use of these tools following course completion. initially, no formal triage system was in place. The environment was chaotic with poor compliance to existing protocols. Sixty-two midwives received triage training between 2013 and 2014. Two Triage Champions became responsible for triage implementation, monitoring and further training. Following training, the 'in-charge' midwives recorded a cumulative average of 83.4% of women wearing coloured wristbands. A separate audit by the Triage Champions found that 495/535 (93%) of the wristbands were correctly applied based on the diagnosis. Quarterly monitoring of the triage assessment forms by Kybele trainers, showed that 92% recorded the risk acuity colour, 85% a 'working diagnosis' and 82% a 'plan.' Median (interquartile range) waiting times were reduced from 40 (15-100) to 29 (11-60) minutes (p = 007). Twenty of 25 of the staff reported that the wristbands were helpful. an interactive triage training course led to the development of a triage assessment form and the use of coloured patient wristbands which resulted in delay reduction and improved quality of maternity care. Copyright © 2018 Elsevier Ltd. All rights reserved.

The influence of institutions and organizations on urban waste collection systems: an analysis of waste collection system in Accra, Ghana (1985-2000).

PubMed

Fobil, Julius N; Armah, Nathaniel A; Hogarh, Jonathan N; Carboo, Derick

2008-01-01

Urban waste collection system is a pivotal component of all waste management schemes around the world. Therefore, the efficient performance and the success of these schemes in urban pollution control rest on the ability of the collection systems to fully adapt to the prevailing cultural and social contexts within which they operate. Conceptually, institutions being the rules guiding the conduct of public service provision and routine social interactions, waste collection systems embedded in institutions can only realize their potentials if they fully evolve continuously to reflect evolving social and technical matrices underlying the cultures, organizations, institutions and social conditions they are designed to address. This paper is a product of an analysis of waste collection performance in Ghana under two different institutional and/or organizational regimes; from an initial entirely public sector dependence to a current mix of public-private sector participation drawing on actual planning data from 1985 to 2000. The analysis found that the overall performance of waste collection services in Ghana increased under the coupled system, with efficiency (in terms of total waste clearance and coverage of service provision) increasing rapidly with increased private-sector controls and levels of involvement, e.g. for solid waste, collection rate and disposal improved from 51% in 1998 to about 91% in the year 2000. However, such an increase in performance could not be sustained beyond 10 years of public-private partnerships. This analysis argues that the sustainability of improved waste collection efficiency is a function of the franchise and lease arrangements between private sector group on the one hand and public sector group (local authorities) on the other hand. The analysis therefore concludes that if such franchise and lease arrangements are not conceived out of an initial transparent process, such a provision could undermine the overall sustainability of private sector initiatives in collection services delivery in the long term, as in the case of the Accra example.

Occupational and Personal Determinants of Musculoskeletal Disorders among Urban Taxi Drivers in Ghana

PubMed Central

Abledu, J. K.; Offei, E. B.; Abledu, G. K.

2014-01-01

Background. There is a lack of epidemiological data on musculoskeletal disorders (MSDs) among occupational drivers in Ghana. The present study seeks to estimate the prevalence, body distribution, and occupational and personal determinants of MSDs in a sample of taxi drivers in the Accra Metropolis of Ghana. Methods. A total of 210 participants were enrolled in this cross-sectional study. All the participants were evaluated by using a semistructured questionnaire and the standardized Nordic Musculoskeletal Disorder Questionnaire. Results. The estimated prevalence of MSDs was 70.5%. The prevalence of the various MSD domains was as follows: lower back pain (34.3%), upper back pain (16.7%), neck pain (15.2%), shoulder pain (11.0%), knee pain (10.0%), hip/thigh pain (2.9%), elbow pain (4.8%), ankle/feet pain (2.4%), and wrist/hand pain (1.9%). Multiple logistic regression analysis of the data showed that participants who were employee drivers, drove taxi more than 12 hours per day or at least 5 days per week, perceived their job as stressful, and were dissatisfied with their job were at a greater risk of developing MSDs. Conclusions. These findings call for preventive strategies and safety guidelines in order to reduce the incidence of MSDs among urban taxi drivers in Ghana. PMID:27379297

Occupational and Personal Determinants of Musculoskeletal Disorders among Urban Taxi Drivers in Ghana.

PubMed

Abledu, J K; Offei, E B; Abledu, G K

2014-01-01

Background. There is a lack of epidemiological data on musculoskeletal disorders (MSDs) among occupational drivers in Ghana. The present study seeks to estimate the prevalence, body distribution, and occupational and personal determinants of MSDs in a sample of taxi drivers in the Accra Metropolis of Ghana. Methods. A total of 210 participants were enrolled in this cross-sectional study. All the participants were evaluated by using a semistructured questionnaire and the standardized Nordic Musculoskeletal Disorder Questionnaire. Results. The estimated prevalence of MSDs was 70.5%. The prevalence of the various MSD domains was as follows: lower back pain (34.3%), upper back pain (16.7%), neck pain (15.2%), shoulder pain (11.0%), knee pain (10.0%), hip/thigh pain (2.9%), elbow pain (4.8%), ankle/feet pain (2.4%), and wrist/hand pain (1.9%). Multiple logistic regression analysis of the data showed that participants who were employee drivers, drove taxi more than 12 hours per day or at least 5 days per week, perceived their job as stressful, and were dissatisfied with their job were at a greater risk of developing MSDs. Conclusions. These findings call for preventive strategies and safety guidelines in order to reduce the incidence of MSDs among urban taxi drivers in Ghana.

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana

PubMed Central

Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas. PMID:27807453

Comparative Analysis of Households Solid Waste Management in Rural and Urban Ghana.

PubMed

Boateng, Simon; Amoako, Prince; Appiah, Divine Odame; Poku, Adjoa Afriyie; Garsonu, Emmanuel Kofi

2016-01-01

The comparative analysis of solid waste management between rural and urban Ghana is largely lacking. This study investigated the solid waste situation and the organisation of solid waste management in both urban and rural settings from the perspective of households. The study employed cross-sectional survey covering both rural and urban districts in the Ashanti and Greater Accra Regions of Ghana. The study systematically sampled houses from which 400 households and respondents were randomly selected. Pearson's Chi square test was used to compare demographic and socioeconomic variables in rural and urban areas. Multivariate Test, Tests of Between-Subjects Effects, and Pair-Wise Comparisons were performed through one-way MANOVA to determine whether or not solid waste situations in rural and urban areas are significantly different. The results revealed that location significantly affects solid waste management in Ghana. Urban communities had lower mean scores than rural communities for poor solid waste situation in homes. However, urban communities had higher mean scores than rural communities for poor solid waste situation in principal streets and dumping sites. The study recommends that the local government authorities implement very comprehensive policies (sanitary inspection, infrastructure development, and community participation) that will take into consideration the specific solid waste management needs of both urban and rural areas.

Public private partnership in in-service training of physicians: the millennium development goal 6-partnership for African clinical training (M-PACT) approach.

PubMed

Oleribe, Obinna Ositadimma; Salako, Babatunde Lawal; Akpalu, Albert; Anteyi, Emmanuel; Ka, Mamadou Mourtalla; Deen, Gibrilla; Akande, Temilola; Abellona U, Mei Ran; Lemoine, Maud; McConnochie, Mairi; Foster, Matthew; Walker, Richard; Taylor-Robinson, Simon David; Jawad, Ali

2018-01-01

in-service training of healthcare workers is essential for improving healthcare services and outcome. The Millennium Development Goal (MDG) 6 Partnership for African Clinical Training (M-PACT) program was an innovative in-service training approach designed and implemented by the Royal College of Physicians (RCP) and West African College of Physicians (WACP) with funding from Eco Bank Foundation. The goal was to develop sustainable capacity to tackle MDG 6 targets in West Africa through better postgraduate medical education. Five training centres were establised: Nigeria (Abuja, Ibadan), Ghana (Accra), Senegal (Dakar) and Sierra Leone (Freetown) for training 681 physicians from across West Africa. A curriculum jointly designed by the RCP-WACP team was used to deliver biannual 5-day training courses over a 3-year period. Of 602 trained in clinical medicine, 358 (59.5%) were males and 535 (88.9%) were from hosting countries. 472 (78.4%) of participants received travel bursaries to participate, while 318 (52.8%) were residents in Internal Medicine in the respective institutions. Accra had the highest number of participants (29.7%) followed by Ibadan, (28.7%), Dakar, (24.9%), Abuja, (11.0%) and Freetown, (5.6%). Pre-course clinical knowledge scores ranged from 35.1% in the Freetown Course to 63.8% in Accra Course 1; whereas post-course scores ranged from 50.5% in the Freetown course to 73.8% in Accra course 1. M-PACT made a positive impact to quality and outcome of healthcare services in the region and is a model for continued improvement for healthcare outcomes, e.g malaria, HIV and TB incidence and mortality in West Africa.

Perception and practice of breastfeeding in public in an urban community in Accra, Ghana.

PubMed

Coomson, Justine Boatemaa; Aryeetey, Richmond

2018-01-01

Reported stigmatization and confrontation (verbal and aggressive), of women when breastfeeding in public spaces constitutes a barrier to the recommendation to breastfeed infants on demand. While such stigma of breastfeeding in public has been reported more commonly in Western country media, there is no documented evidence of this stigma in developing country settings. The current study describes community perception and experience of breastfeeding in public in Accra, Ghana. A secondary objective is to explore factors associated with breastfeeding in public. A mixed methods design comprising a survey ( n  = 300), five Focus Group Discussions (FGD) with lactating women ( n  = 50), and nine In-Depth Interviews (IDI) with adult males ( n  = 5) and female health workers ( n  = 4) were also conducted. All data were collected between May and June, 2016 in the Ayawaso-West Sub-Metropolis, Accra. Data on sociodemographic characteristics; obstetric and breastfeeding history; and also perception, experience, and practice of breastfeeding in public, were collected. FGDs and IDI data were triangulated with survey data and presented using descriptive and analytical statistics and content analysis. Majority of the survey respondents (92%) reported ever practicing breastfeeding in public. However, some reported feeling uncomfortable (52%), embarrassed (27%), or stigmatized (15%). Nevertheless, 72% of respondents felt they should be able to breastfeed anywhere. Almost all respondents (81%) reported covering their breasts when breastfeeding in public, and 70% felt private places should be used when they breastfed in public. Women in FGDs and IDI mentioned that they bottle feed their children in public places as a way to overcome the challenges of breastfeeding in public. Otherwise, they breastfeed in public because their children need to feed. Women were more likely to breastfeed in public if they reported support from a spouse (OR 3.99, 95% CI 1.50, 10.57) or other family members (OR 3.27, 95% CI 1.31, 8.18). Although women reported discomfort associated with breastfeeding in public, the practice is common. Awareness creation is needed to empower women to comfortably breastfeed and to sustain societal support of breastfeeding in public.

Facilitators and barriers of herbal medicine use in Accra, Ghana: an inductive exploratory study.

PubMed

Aziato, Lydia; Antwi, Hannah Ohemeng

2016-05-26

The use of complementary and alternative medicine including herbal medicine is increasing in many countries including Ghana. However, there is paucity of research on the perspectives of patrons of herbal medicine regarding the facilitators and barriers of herbal medicine use. This study sought to investigate the facilitators and barriers of herbal medicine among Ghanaian adults who use one form of herbal medicine or the other. The study employed an inductive exploratory qualitative approach. It was conducted at a private herbal clinic in Accra. Purposive sampling was employed to recruit 16 participants. Data collection was through individual face-to-face interviews and these were transcribed and analysed using content analysis procedures. It was realized that the factors that enhanced the use of herbal medicine included use of convincing information to enhance the initiation of herbal medicine use, effectiveness of herbal medicine, personal preference for herbal medicine, perceived ineffectiveness of western medicine and integration of spirituality in herbal medicine. The factors that hindered herbal medicine use included negative perceptions and attitudes about herbal medicine, poor vending environment, poor knowledge of vendors, high cost of herbal products at credible herbal clinics and inconsistent effectiveness of some herbal products. Participants desired that the national health insurance scheme will cover the cost of herbal medicine to alleviate the financial burden associated with herbal medicine use. Although some Ghanaians patronize herbal medicine, the negative perceptions about herbal medicine resulting from deceitful producers and vendors call for enhanced education and monitoring to ensure that effective herbal products are used.

Factors influencing use of analgesics among construction workers in the Ga-Eastmunicipality of the Greater Accra region, Ghana.

PubMed

Badzi, Caroline D; Ackumey, Mercy M

2017-12-01

Analgesics also known as painkillers are widely used for pain relief. There are severe health implications associated with excessive use of analgesics. This paper examines factors influencing the use of analgesics among construction workers in the Ga-East Municipality (GEM) of the Greater Accra region of Ghana. This is a cross-sectional study involving 206 construction workers randomly sampled from 7 construction sites in the GEM. A structured questionnaire was used to elicit responses on knowledge of analgesics, types of analgesics used and factors influencing the use of analgesics. Chi-square test analysis was used to examine factors influencing analgesic use. The majority of workers were aged between 15 to 44 years (89.8%) and 51.9 percent of respondents had completed Junior high school. Many respondents (68.0%) used Brand 1 a locally manufactured analgesic with paracetamol, aspirin and caffeine as the active ingredients and 31.6 percent of respondents had no knowledge of possible side effects of continuous use of analgesics. Chi square analysis showed that age was significantly associated with use of analgesics (p<0.01). Knowledge of the types of analgesics, dosage and side effects did not influence use (p>0.05). Television and radio advertisements influenced use of analgesics (p<0.01). Knowledge on analgesic use and knowledge of probable serious side effects was inadequate. Pharmacists and chemists involvement in education of clients of the side effects of analgesics is highly recommended to minimise misuse. The Food and Drugs Authority should regulate the proliferation of advertisements for analgesics in the media. None declared.

Application of Quantitative Microbial Risk Assessment to analyze the public health risk from poor drinking water quality in a low income area in Accra, Ghana.

PubMed

Machdar, E; van der Steen, N P; Raschid-Sally, L; Lens, P N L

2013-04-01

In Accra, Ghana, a majority of inhabitants lives in over-crowded areas with limited access to piped water supply, which is often also intermittent. This study assessed in a densely populated area the risk from microbial contamination of various sources of drinking water, by conducting a Quantitative Microbiological Risk Assessment (QMRA) to estimate the risk to human health from microorganism exposure and dose-response relationships. Furthermore the cost-effectiveness in reducing the disease burden through targeted interventions was evaluated. Five risk pathways for drinking water were identified through a survey (110 families), namely household storage, private yard taps, communal taps, communal wells and water sachets. Samples from each source were analyzed for Escherichia coli and Ascaris contamination. Published ratios between E. coli and other pathogens were used for the QMRA and disease burden calculations. The major part of the burden of disease originated from E. coli O157:H7 (78%) and the least important contributor was Cryptosporidium (0.01%). Other pathogens contributed 16% (Campylobacter), 5% (Rotavirus) and 0.3% (Ascaris). The sum of the disease burden of these pathogens was 0.5 DALYs per person per year, which is much higher than the WHO reference level. The major contamination pathway was found to be household storage. Disinfection of water at household level was the most cost-effective intervention (<5 USD/DALY-averted) together with hygiene education. Water supply network improvements were significantly less cost-effective. Copyright © 2013 Elsevier B.V. All rights reserved.

Landscape and environmental influences on Mycobacterium ulcerans distribution among aquatic sites in Ghana.

PubMed

Pileggi, Shannon M; Jordan, Heather; Clennon, Julie A; Whitney, Ellen; Benbow, M Eric; Merritt, Richard; McIntosh, Mollie; Kimbirauskas, Ryan; Small, Pamela; Boakye, Daniel; Quaye, Charles; Qi, Jiaguo; Campbell, Lindsay; Gronseth, Jenni; Ampadu, Edwin; Opare, William; Waller, Lance A

2017-01-01

Buruli ulcer, caused by Mycobacterium ulcerans, is highly endemic in West Africa. While the mode of transmission is unknown, many studies associate Buruli ulcer with different types of water exposure. We present results from the largest study to date to test for M. ulcerans in aquatic sites and identify environmental attributes associated with its presence. Environmental samples from 98 aquatic sites in the Greater Accra, Ashanti, and Volta regions of Ghana were tested for the presence of M. ulcerans DNA by polymerase chain reaction. The proportion of aquatic sites positive for M. ulcerans varied by region: Ashanti 66% (N = 39), Greater Accra 34% (N = 29), and Volta 0% (N = 30). We explored the spatial distribution of M. ulcerans positive and negative water bodies and found no significant clusters. We also determined both highly localized water attributes and broad scale remotely sensed land cover and terrain environmental characteristics associated with M. ulcerans presence through logistic regression. Our results concur with published results regarding conditions suitable for M. ulcerans growth and associations with Buruli ulcer disease burden with regards to water characteristics and disturbed environments, but differ from others with regards to spatial associations and topographic effects such as elevation and wetness. While our results suggest M. ulcerans is an environmental organism existing in a specific ecological niche, they also reveal variation in the elements defining this niche across the sites considered. In addition, despite the causal association between Buruli ulcer and M. ulcerans, we observed no significant statistical association between case reports of Buruli ulcer and presence of M. ulcerans in nearby waterbodies.

What are the characteristics of 'sexually ready' adolescents? Exploring the sexual readiness of youth in urban poor Accra.

PubMed

Biney, Adriana A E; Dodoo, F Nii-Amoo

2016-01-05

Adolescent sexual activity, especially among the urban poor, remains a challenge. Despite numerous interventions and programs to address the negative consequences arising from early and frequent sexual activity among youth in sub-Saharan Africa, including Ghana, only slight progress has been made. A plausible explanation is that our understanding of what adolescents think about sex and about their own sexuality is poor. In that sense, examining how adolescents in urban poor communities think about their sexual readiness, and identifying characteristics associated with that sexual self-concept dimension, should deepen our understanding of this topical issue. A total of 196 male and female adolescents, ages 12 to 19, were surveyed in the 2011 RIPS Urban Health and Poverty Project in Accra, Ghana. The youth responded to three statements which determined their levels of sexual readiness. Other background characteristics were also obtained enabling the assessment of the correlates of their preparedness to engage in sex. The data were analyzed using ordered logistic regression models. Overall, the majority of respondents did not consider themselves ready for sex. Multivariate analyses indicated that sexual experience, exposure to pornographic movies, gender, ethnicity and household wealth were significantly linked to their readiness for sex. Sexual readiness is related to sexual activity as well as other characteristics of the adolescents, suggesting the need to consider these factors in the design of programs and interventions to curb early sex. The subject of sexual readiness has to be investigated further to ensure adolescents do not identify with any negative effects of this sexual self-view.

Pedestrians’ adherence to road traffic regulations on the N1 Highway in Accra, Ghana

PubMed Central

Noora, Charles Lwanga; Afari, Edwin Andrews; Nuoh, Robert Domo; Adjei, Eric Yirenkyi; Anthony, Gershon Kobla; Abdulai, Marijanatu; Sackey, Samuel Oko; Kenu, Ernest; Nyarko, Kofi Mensah

2016-01-01

Introduction Pedestrian behavior and adherence to road traffic regulation is vital in the prevention and control of road traffic accidents (RTA) especially on highways in Ghana. We assessed pedestrians’ adherence to road crossing regulations on the George Walker Bush (N1) Highway in Accra. Methods We conducted a cross sectional study of pedestrians crossing the N1 highway from both sides of the road between 7:00 am and 11:00am. We observed all pedestrians using a checklist and interviewed 413 using a structured questionnaire. We collected data on basic demographics, and pedestrians’ knowledge on road crossing (exposures). Data was, cleaned and analyzed using Epi-info version 3.5.4. Pearson Chi-square was used to assess differences in proportions for categorical variables. Binary logistic regression was used to test for association between pedestrian choice of route and exposures. Results We observed (n = 1856) pedestrians crossing the road during the study period; 1155 (62.2%) males, 461 (24.8%) did not use the approved route(s). Majority 317(76.8%) were adults between the ages of 20-49, mostly males 265 (56.4%). Most people (92.7%) had at least basic education. AOR for sex (male) was 1.7(1.1-2.6), and regular use of Highway (always) was 0.4(0.2-0.8) at 95% CI. Conclusion One out of every 4pedestrians using the N1 Highway used an unapproved route. Majority of pedestrians who regularly cross the Highway at unapproved routes were males. We recommend vigorous public education and addition of more footbridges. PMID:28149436

Pedestrians' adherence to road traffic regulations on the N1 Highway in Accra, Ghana.

PubMed

Noora, Charles Lwanga; Afari, Edwin Andrews; Nuoh, Robert Domo; Adjei, Eric Yirenkyi; Anthony, Gershon Kobla; Abdulai, Marijanatu; Sackey, Samuel Oko; Kenu, Ernest; Nyarko, Kofi Mensah

2016-01-01

Pedestrian behavior and adherence to road traffic regulation is vital in the prevention and control of road traffic accidents (RTA) especially on highways in Ghana. We assessed pedestrians' adherence to road crossing regulations on the George Walker Bush (N1) Highway in Accra. We conducted a cross sectional study of pedestrians crossing the N1 highway from both sides of the road between 7:00 am and 11:00am. We observed all pedestrians using a checklist and interviewed 413 using a structured questionnaire. We collected data on basic demographics, and pedestrians' knowledge on road crossing (exposures). Data was, cleaned and analyzed using Epi-info version 3.5.4. Pearson Chi-square was used to assess differences in proportions for categorical variables. Binary logistic regression was used to test for association between pedestrian choice of route and exposures. We observed (n = 1856) pedestrians crossing the road during the study period; 1155 (62.2%) males, 461 (24.8%) did not use the approved route(s). Majority 317(76.8%) were adults between the ages of 20-49, mostly males 265 (56.4%). Most people (92.7%) had at least basic education. AOR for sex (male) was 1.7(1.1-2.6), and regular use of Highway (always) was 0.4(0.2-0.8) at 95% CI. One out of every 4pedestrians using the N1 Highway used an unapproved route. Majority of pedestrians who regularly cross the Highway at unapproved routes were males. We recommend vigorous public education and addition of more footbridges.

Birth weight, birth type and pre-weaning survivability of West African Dwarf goats raised in the Dangme West District of the Greater Accra Region of Ghana.

PubMed

Baiden, R Y

2007-02-01

A study was conducted on 441 West African Dwarf goat (WADG) kids born from September 1999 to August 2002 at three locations in the Dangme West District of the Greater Accra Region in Ghana to determine the effect of environmental factors on birth weight, birth type and pre-weaning survivability. The overall mean birth weight was 1.32 +/- 0.01 kg. Birth weights were similar (p > 0.05) between single births (1.43 +/- 0.04 kg) and twins (1.34 +/- 0.03 kg), but singles were significantly heavier (p < 0.05) than triplets (1.24 +/- 0.05 kg). Kids born in the major wet season recorded the best mean birth weight (1.37 +/- 0.04 kg). Sex, parity of does, and year of birth of kids had no significant (p > 0.05) effect on birth weight. Mean litter size was 1.93 +/- 0.03. Does that kidded in the dry season had a significantly (p < 0.05) higher litter size (2.05 +/- 0.06) than those that kidded in the minor wet season (1.80 +/- 0.10). Litter size of first-parity kids was significantly smaller (p < 0.05) than in subsequent parities. Litter size dropped significantly (p < 0.05) from year 2 (2.03 +/- 0.07) to year 3 (1.83 +/- 0.07). Pre-weaning survivability was 79.1% and season of kidding had a significant (p < 0.05) effect on survivability. Survivability of quadruplets (61.8%) was significantly (p < 0.05) lower than in the other birth types.

Prevalence and predictors of suicidal ideations and attempts among homeless children and adolescents in Ghana.

PubMed

Oppong Asante, Kwaku; Meyer-Weitz, Anna

2017-05-01

This study aimed to determine the prevalence and risk factors associated with suicidal ideations and attempts among a sample of homeless street children and adolescents found in Accra, Ghana. A cross-sectional survey of a convenience sample of 227 (122 male and 105 female) homeless youth was conducted in Ghana. An interviewer-administered questionnaire was used to collect data due to a low level of literacy among the study population. Bivariate and multivariate logistic regressions were fitted to analyse the data. The results indicated that 26.4% and 26.0% of the participants had attempted suicide and reported suicidal ideations respectively. The multivariate logistic regression showed that smoking, past and present use of alcohol, use of marijuana, and engagement in prostitution, were associated with suicidal ideations and suicide attempts. Suicidal ideations were associated with having been physically beaten, robbed, and assaulted with a weapon; while a suicide attempt was predicted by having been robbed and physically beaten. This study increased our understanding of the determinants of suicidal ideations and attempts among homeless youth. These findings suggest urgency to up-skill mental health workers to assess for risk factors and offer pathways to care for this vulnerable group.

Determination of levels of polychlorinated biphenyl in transformers oil from some selected transformers in parts of the Greater Accra Region of Ghana.

PubMed

Buah-Kwofie, Archibold; Yeboah, Philip O; Pwamang, John

2011-01-01

Although polychlorinated biphenyls have never been manufactured in Ghana, it has been used extensively as dielectric fluid in electric transformers and capacitors. However, very little is known of its health and environmental impacts by both managers of these transformers and capacitors and also the general public. This work therefore seeks to explore INAA as a possible alternative to screening transformer oils for PCBs by determining the total chlorine content. The total chlorine content of transformer oil samples from Ghana that tested positive and some randomly selected samples that tested negative from screening using CLOR-N-OIL test kits, have had their total chlorine estimated. INAA using the Research Reactor located at the Ghana Atomic Energy Commission was used to estimate the total chlorine content of the oil samples. Neutron Activation and gamma ray spectroscopy using HPGe detector coupled to MAESTRO 32 software was used to determine the total chlorine content by integrating the peak area of the spectrum into a simplified program that was developed from the activation equation. Instrumental Neutron Activation Analysis was able to validate the result obtained from the test kits screening with accuracy 7.5%. The minimum total chlorine content of the positive samples determined by NAA was 71.34 μg g⁻¹. Copyright © 2010 Elsevier Ltd. All rights reserved.

Levels of polychlorinated dibenzo-p-dioxins, dibenzofurans (PCDD/Fs) and biphenyls (PCBs) in blood of informal e-waste recycling workers from Agbogbloshie, Ghana, and controls.

PubMed

Wittsiepe, Jürgen; Fobil, Julius N; Till, Holger; Burchard, Gerd-Dieter; Wilhelm, Michael; Feldt, Torsten

2015-06-01

The formation and environmental release of highly toxic organohalogen compounds associated with informal recycling of waste electric and electronic equipment (e-waste) is a growing problem at e-waste dumps/recycling sites (EWRSs) in many developing countries worldwide. We chose a cross-sectional study design to measure the internal exposure to polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) as well as polychlorinated biphenyls (PCBs) of individuals working on one of the largest EWRSs of Africa, located at Agbogbloshie, Accra, Ghana, and in controls from a suburb of Accra without direct exposure to EWRS activities. In whole blood samples of 21 age matched male exposed individuals (mean age: 24.7 years, SD 6.0) and 21 male controls (mean age: 24.4 years, SD 5.7) 17 PCDD/F congeners were determined. Moreover three indicator PCB congeners (#138, #153 and #180) were measured in blood of 39 exposed (mean age: 27.5 years, SD 11.7) and 19 non-exposed (mean age: 26.8 years, SD 9.7) patients. Besides a health examination, biometric and demographic data, residential and occupational history, occupational exposures and working conditions were recorded using a standardized questionnaire. In the exposed group, median PCDD/F-concentrations were 6.18 pg/g lipid base WHO2005-TEq (range: 2.1-42.7) and significantly higher compared to the control group with 4.60 pg/g lipid base WHO2005-TEq (range: 1.6-11.6). Concentrations were different for 2,3,7,8-TetraCDD, three HexaCDD and all 10 PCDF congeners, indicating a combustion pattern. Using a multivariate regression analysis exposure to EWRS activities was the most important determinant for PCDD/F exposure. Median PCB levels for the indicator congeners #138, #153 and #180 were 0.011, 0.019 and 0.008 μg/l whole blood (ranges: 0.002-0.18, 0.003-0.16, 0.002-0.078) in the exposed group and, surprisingly, significantly higher in the controls (0.037, 0.062 and 0.022; ranges: 0.005-0.46, 0.010-0.46, 0.004-0.21). In a multivariate regression approach e-waste related activities had no positive influence on internal PCB exposure, but rather the time living in Accra. The internal PCB exposure is in particular notable for a country where PCBs have historically never been produced or used. The impact of EWRS activities on organohalogen compound exposure of individuals working at and living in the surroundings of the Agbogbloshie EWRS, and the surprisingly high PCB exposure of people living in Accra not involved in e-waste activities require further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Experiencing challenges when implementing Active Management of Third Stage of Labor (AMTSL): a qualitative study with midwives in Accra, Ghana

PubMed Central

2014-01-01

Background Post-partum hemorrhage (PPH) is the major cause of maternal mortality in Ghana and worldwide. Active management of the third stage of labor (AMTSL) is a globally recommended three-step method that in clinical trials has been proven effective in prevention of PPH. The AMTSL guidelines were introduced in 2003, modified in 2006, and has been part of the national guidelines in Ghana since 2008. In 2012, the guidelines were modified a second time. Despite its positive effects on the incidence of PPH, the level of adherence to the guidelines seems to be low in the studied area. This appears to be a problem shared by several countries in the region. An in-depth understanding of midwives’ experiences about AMTSL is important as it can provide a basis for further interventions in order to reach a higher grade of implementation. Methods Twelve in-depth interviews were conducted with labor ward midwives who all had previous training in AMTSL. The interviews took place in 2011 at three hospitals in Accra Metropolis and data was analyzed using qualitative latent content analysis. Results Our main finding was that the third step of AMTSL, uterine massage, was not implemented, even though the general attitude towards AMTSL was positive. Thus, despite regular training sessions, the midwives did not follow the Ghanaian national guidelines. Some contributing factors to difficulties in providing AMTSL to all women have been pointed out in this study, the most important being insufficiency in staff coverage. This led to a need for delegating certain steps of AMTSL to other health care staff, i.e. task shifting. The fact that the definition of AMTSL has changed several times since the introduction in 2003 might also be an aggravating factor. Conclusions The results from this study highlight the need for continuous updates of national guidelines, extended educational interventions and recurrent controls of adherence to guidelines. AMTSL is an important tool in preventing PPH, however, it must be clarified how it should be used in countries with scarce resources. Also, considering the difficulties in implementing already existing guidelines, further modifications must be made with careful consideration. PMID:24903893

Comparison of Object-Based Image Analysis Approaches to Mapping New Buildings in Accra, Ghana Using Multi-Temporal QuickBird Satellite Imagery

PubMed Central

Tsai, Yu Hsin; Stow, Douglas; Weeks, John

2013-01-01

The goal of this study was to map and quantify the number of newly constructed buildings in Accra, Ghana between 2002 and 2010 based on high spatial resolution satellite image data. Two semi-automated feature detection approaches for detecting and mapping newly constructed buildings based on QuickBird very high spatial resolution satellite imagery were analyzed: (1) post-classification comparison; and (2) bi-temporal layerstack classification. Feature Analyst software based on a spatial contextual classifier and ENVI Feature Extraction that uses a true object-based image analysis approach of image segmentation and segment classification were evaluated. Final map products representing new building objects were compared and assessed for accuracy using two object-based accuracy measures, completeness and correctness. The bi-temporal layerstack method generated more accurate results compared to the post-classification comparison method due to less confusion with background objects. The spectral/spatial contextual approach (Feature Analyst) outperformed the true object-based feature delineation approach (ENVI Feature Extraction) due to its ability to more reliably delineate individual buildings of various sizes. Semi-automated, object-based detection followed by manual editing appears to be a reliable and efficient approach for detecting and enumerating new building objects. A bivariate regression analysis was performed using neighborhood-level estimates of new building density regressed on a census-derived measure of socio-economic status, yielding an inverse relationship with R2 = 0.31 (n = 27; p = 0.00). The primary utility of the new building delineation results is to support spatial analyses of land cover and land use and demographic change. PMID:24415810

Monitoring of arsenic levels in some ready-to-use anti-malaria herbal products from drug sales outlets in the Madina area of Accra, Ghana.

PubMed

Affum, A O; Shiloh, D O; Adomako, D

2013-06-01

In Ghana anti-malaria herbal medicines or products are used to compliment commercial drugs in treatment and prevention of Plasmodium falciparum infections. In this study, four common aqueous based anti-malaria herbal products (coded HEB, KFE, MDM and NIB) which are used by Ghanaian population from pharmacy/herbal stores in the Madina area, Accra were blindly and randomly sampled for cadmium (Cd), arsenic (As) and Lead (Pb) analysis using Atomic Absorption Spectrophotometry technique. Arsenic concentrations were 1.087 μg/mL (108.7%), 1.027 μg/mL (102.7%), 0.330 μg/mL (33.0%) and 0.274 μg/mL (27.4%) in MDM, KFE, NIB and HEB respectively. Arsenic concentration determined in MDM and KFE were above the maximum permissible limit of 1.0 ppm determined by WHO/FAO. Cadmium concentration in each of the four products as well as lead concentration in KFE, NIB and HEB were below the detection limit of <0.002 mg/mL (Cd) and <0.005 mg/mL (Pb) respectively. The maximum permissible limits for Pb and Cd determined by WHO/FAO are 10.0 ppm and 0.3 ppm respectively. Thus, random assessment on the safety of some ready-to-use aqueous based anti-malaria herbal products on the market is necessary to prevent public health hazards associated with consuming these plant extracts. Although lead and cadmium concentration in the anti-malaria herbal products were below the maximum permissible limits, their cumulative effect on the health of an individual which consume recommended volume of not less than 1000 mL for effective malaria parasite clearance cannot be ignored. Copyright © 2013 Elsevier Ltd. All rights reserved.

Variation and distribution of metals and metalloids in soil/ash mixtures from Agbogbloshie e-waste recycling site in Accra, Ghana.

PubMed

Itai, Takaaki; Otsuka, Masanari; Asante, Kwadwo Ansong; Muto, Mamoru; Opoku-Ankomah, Yaw; Ansa-Asare, Osmund Duodu; Tanabe, Shinsuke

2014-02-01

Illegal import and improper recycling of electronic waste (e-waste) are an environmental issue in developing countries around the world. African countries are no exception to this problem and the Agbogbloshie market in Accra, Ghana is a well-known e-waste recycling site. We have studied the levels of metal(loid)s in the mixtures of residual ash, formed by the burning of e-waste, and the cover soil, obtained using a portable X-ray fluorescence spectrometer (P-XRF) coupled with determination of the 1M HCl-extractable fraction by an inductively coupled plasma mass spectrometer. The accuracy and precision of the P-XRF measurements were evaluated by measuring 18 standard reference materials; this indicated the acceptable but limited quality of this method as a screening tool. The HCl-extractable levels of Al, Co, Cu, Zn, Cd, In, Sb, Ba, and Pb in 10 soil/ash mixtures varied by more than one order of magnitude. The levels of these metal(loid)s were found to be correlated with the color (i.e., soil/ash ratio), suggesting that they are being released from disposed e-waste via open burning. The source of rare elements could be constrained using correlation to the predominant metals. Human hazard quotient values based on ingestion of soil/ash mixtures exceeded unity for Pb, As, Sb, and Cu in a high-exposure scenario. This study showed that along with common metals, rare metal(loid)s are also enriched in the e-waste burning site. We suggest that risk assessment considering exposure to multiple metal(loid)s should be addressed in studies of e-waste recycling sites. © 2013. Published by Elsevier B.V. All rights reserved.

Assessment of Fecal Exposure Pathways in Low-Income Urban Neighborhoods in Accra, Ghana: Rationale, Design, Methods, and Key Findings of the SaniPath Study

PubMed Central

Robb, Katharine; Null, Clair; Teunis, Peter; Yakubu, Habib; Armah, George; Moe, Christine L.

2017-01-01

Abstract. Rapid urbanization has contributed to an urban sanitation crisis in low-income countries. Residents in low-income, urban neighborhoods often have poor sanitation infrastructure and services and may experience frequent exposure to fecal contamination through a range of pathways. There are little data to prioritize strategies to decrease exposure to fecal contamination in these complex and highly contaminated environments, and public health priorities are rarely considered when planning urban sanitation investments. The SaniPath Study addresses this need by characterizing pathways of exposure to fecal contamination. Over a 16 month period, an in-depth, interdisciplinary exposure assessment was conducted in both public and private domains of four neighborhoods in Accra, Ghana. Microbiological analyses of environmental samples and behavioral data collection techniques were used to quantify fecal contamination in the environment and characterize the behaviors of adults and children associated with exposure to fecal contamination. Environmental samples (n = 1,855) were collected and analyzed for fecal indicators and enteric pathogens. A household survey with 800 respondents and over 500 hours of structured observation of young children were conducted. Approximately 25% of environmental samples were collected in conjunction with structured observations (n = 441 samples). The results of the study highlight widespread and often high levels of fecal contamination in both public and private domains and the food supply. The dominant fecal exposure pathway for young children in the household was through consumption of uncooked produce. The SaniPath Study provides critical information on exposure to fecal contamination in low-income, urban environments and ultimately can inform investments and policies to reduce these public health risks. PMID:28722599

Multipathway Quantitative Assessment of Exposure to Fecal Contamination for Young Children in Low-Income Urban Environments in Accra, Ghana: The SaniPath Analytical Approach

PubMed Central

Wang, Yuke; Moe, Christine L.; Null, Clair; Raj, Suraja J.; Baker, Kelly K.; Robb, Katharine A.; Yakubu, Habib; Ampofo, Joseph A.; Wellington, Nii; Freeman, Matthew C.; Armah, George; Reese, Heather E.; Peprah, Dorothy; Teunis, Peter F. M.

2017-01-01

Abstract. Lack of adequate sanitation results in fecal contamination of the environment and poses a risk of disease transmission via multiple exposure pathways. To better understand how eight different sources contribute to overall exposure to fecal contamination, we quantified exposure through multiple pathways for children under 5 years old in four high-density, low-income, urban neighborhoods in Accra, Ghana. We collected more than 500 hours of structured observation of behaviors of 156 children, 800 household surveys, and 1,855 environmental samples. Data were analyzed using Bayesian models, estimating the environmental and behavioral factors associated with exposure to fecal contamination. These estimates were applied in exposure models simulating sequences of behaviors and transfers of fecal indicators. This approach allows us to identify the contribution of any sources of fecal contamination in the environment to child exposure and use dynamic fecal microbe transfer networks to track fecal indicators from the environment to oral ingestion. The contributions of different sources to exposure were categorized into four types (high/low by dose and frequency), as a basis for ranking pathways by the potential to reduce exposure. Although we observed variation in estimated exposure (108–1016 CFU/day for Escherichia coli) between different age groups and neighborhoods, the greatest contribution was consistently from food (contributing > 99.9% to total exposure). Hands played a pivotal role in fecal microbe transfer, linking environmental sources to oral ingestion. The fecal microbe transfer network constructed here provides a systematic approach to study the complex interaction between contaminated environment and human behavior on exposure to fecal contamination. PMID:29031283

Contemporary evolution of resistance at the major insecticide target site gene Ace-1 by mutation and copy number variation in the malaria mosquito Anopheles gambiae

PubMed Central

Weetman, David; Mitchell, Sara N; Wilding, Craig S; Birks, Daniel P; Yawson, Alexander E; Essandoh, John; Mawejje, Henry D; Djogbenou, Luc S; Steen, Keith; Rippon, Emily J; Clarkson, Christopher S; Field, Stuart G; Rigden, Daniel J; Donnelly, Martin J

2015-01-01

Functionally constrained genes are ideal insecticide targets because disruption is often fatal, and resistance mutations are typically costly. Synaptic acetylcholinesterase (AChE) is an essential neurotransmission enzyme targeted by insecticides used increasingly in malaria control. In Anopheles and Culex mosquitoes, a glycine–serine substitution at codon 119 of the Ace-1 gene confers both resistance and fitness costs, especially for 119S/S homozygotes. G119S in Anopheles gambiae from Accra (Ghana) is strongly associated with resistance, and, despite expectations of cost, resistant 119S alleles are increasing significantly in frequency. Sequencing of Accra females detected only a single Ace-1 119S haplotype, whereas 119G diversity was high overall but very low at non-synonymous sites, evidence of strong purifying selection driven by functional constraint. Flanking microsatellites showed reduced diversity, elevated linkage disequilibrium and high differentiation of 119S, relative to 119G homozygotes across up to two megabases of the genome. Yet these signals of selection were inconsistent and sometimes weak tens of kilobases from Ace-1. This unexpected finding is attributable to apparently ubiquitous amplification of 119S alleles as part of a large copy number variant (CNV) far exceeding the size of the Ace-1 gene, whereas 119G alleles were unduplicated. Ace-1 CNV was detectable in archived samples collected when the 119S allele was rare in Ghana. Multicopy amplification of resistant alleles has not been observed previously and is likely to underpin the recent increase in 119S frequency. The large CNV compromised localization of the strong selective sweep around Ace-1, emphasizing the need to integrate CNV analysis into genome scans for selection. PMID:25865270

Soil concentrations of polybrominated diphenyl ethers and trace metals from an electronic waste dump site in the Greater Accra Region, Ghana: Implications for human exposure.

PubMed

Akortia, Eric; Olukunle, Olubiyi I; Daso, Adegbenro P; Okonkwo, Jonathan O

2017-03-01

Unregulated electronic waste (e-waste) recycling operations have become a significant environmental issue as well as human health risk in developing countries across the world. The present study evaluated the extent of pollution in Agbogbloshie e-waste recycling site in Accra, Ghana. The concentrations of polybrominated diphenyl ethers (PBDEs) and some selected trace metals were determined using gas chromatography electron impact ionization mass spectrometry and flame atomic absorption spectrophotometry, respectively. The concentrations of ∑ PBDEs ranged from 15.6 to 96.8ngg -1 dry weight, with an overall mean of 54.8ngg -1 dw. BDE-28 was the dominant congener followed by BDE-209 and BDE-47. The order of mean concentrations of the abundant trace metals was Fe>Cu>Pb≫Mn, with a mean range of .531-289mgkg -1 . Geoaccumulation index suggested that the surface soils deteriorated from moderate to high metal pollution, particularly for Cu, Pb and Fe. Of the trace metals analysed, Fe exhibited the highest concentration ranging from 3.97 to 918mgkg -1 . Correlation and principal component analyses suggested possible interactions between PBDEs and the trace metals analysed, while source assessment suggested that PBDEs and trace metals were mostly derived from inputs from the e-waste recycling activities. Average daily dose (ADD) was estimated using concentrations corresponding to 5th percentile, median and 95th percentile. Hazard quotients of 380 and 862 were obtained for adults and children respectively, for Cu and Pb which is a cause for concern especially for local children. Copyright © 2016. Published by Elsevier Inc.

Sociodemographic variations in obesity among Ghanaian adults.

PubMed

Amoah, Albert G B

2003-12-01

To determine the sociodemographic associations of obesity in Ghana. A cross-sectional descriptive study was conducted on a sample of 6300 adults aged 25 years and over who were selected by random cluster sampling. Two urban (high-class and low-class suburbs) and a rural community in Accra, Ghana. In total, 4731 (1857 males, 2874 females) subjects participated. Demographic data were obtained by a questionnaire and height and weight were determined with subjects in light clothing and without shoes. The overall crude prevalence of overweight and obesity was 23.4 and 14.1%, respectively. The rates of overweight (27.1 vs. 17.5%) and obesity (20.2 vs. 4.6%) were higher in females than males. Obesity increased with age up to 64 years. There were more overweight and obesity in the urban high-class residents compared with the low-class residents and in urban than rural subjects. Overweight and obesity were highest among the Akan and Ga tribes and relatively low among Ewes. Subjects with tertiary education had the highest prevalence of obesity (18.8%) compared with less literate and illiterate subjects (12.5-13.8%). Subjects whose jobs were of a sedentary nature had higher levels of obesity (15%) than subjects whose jobs involved heavy physical activity (10%). Subjects who did not engage in leisure-time physical activity were more obese than those who had three or more sessions of leisure-time physical activity per week (15.3 vs. 13.5%). Overweight and obesity are common among residents in the Accra area. Older age, female gender, urban, high-class residence, sedentary occupation and tertiary education were associated with higher levels of obesity. Policies and programmes that promote healthy lifestyles may prove beneficial.

Decision-Making for Induced Abortion in the Accra Metropolis, Ghana.

PubMed

Gbagbo, Fred Yao; Amo-Adjei, Joshua; Laar, Amos

2015-06-01

Decision-making for induced abortion can be influenced by various circumstances including those surrounding onset of a pregnancy. There are various dimensions to induced abortion decision-making among women who had an elective induced abortion in a cosmopolitan urban setting in Ghana, which this paper examined. A cross-sectional mixed method study was conducted between January and December 2011 with 401 women who had undergone an abortion procedure in the preceding 12 months. Whereas the quantitative data were analysed with descriptive statistics, thematic analysis was applied to the qualitative data. The study found that women of various profiles have different reasons for undergoing abortion. Women considered the circumstances surrounding onset of pregnancy, person responsible for the pregnancy, gestational age at decision to terminate, and social, economic and medical considerations. Pressures from partners, career progression and reproductive intentions of women reinforced these reasons. First time pregnancies were mostly aborted regardless of gestational ages and partners' consent. Policies and programmes targeted at safe abortion care are needed to guide informed decisions on induced abortions.

E-waste disposal effects on the aquatic environment: Accra, Ghana.

PubMed

Huang, Jingyu; Nkrumah, Philip Nti; Anim, Desmond Ofosu; Mensah, Ebenezer

2014-01-01

The volume of e-waste is growing around the world, and, increasingly, it is being disposed of by export from developed to developing countries. This is the situation in Ghana, and, in this paper we address the potential consequences of such e-waste disposal. Herein, we describe how e-waste is processed in Ghana, and what the fate is of e-waste-chemical contaminants during recycling and storage. Finally, to the extent it is known, we address the prospective adverse effects of e-waste-related contaminants on health and aquatic life downstream from a large e-waste disposal facility in Accra, Ghana.In developing countries, including Ghana, e-waste is routinely disassembled by unprotected workers that utilize rudimentary methods and tools. Once disassembled,e-waste components are often stored in large piles outdoors. These processing and storage methods expose workers and local residents to several heavy metals and organic chemicals that exist in e-waste components. The amount of e-waste dumped in Ghana is increasing annually by about 20,000 t. The local aquatic environment is at a potential high risk, because the piles of e-waste components stored outside are routinely drenched or flooded by rainfall, producing run-off from storage sites to local waterways. Both water and sediment samples show that e-waste-related contaminant shave entered Ghana's water ways.The extent of pollution produced in key water bodies of Ghana (Odaw River and the Korle Lagoon) underscores the need for aquatic risk assessments of the many contaminants released during e-waste processing. Notwithstanding the fact that pollutants from other sources reach the water bodies, it is clear that these water bodies are also heavily impacted by contaminants that are found in e-waste. Our concern is that such exposures have limited and will continue to limit the diversity of aquatic organisms.There have also been changes in the abundance and biomass of surviving species and changes in food chains. Therefore, the need for actions to be taken to reduce entry of e-waste pollutants into Ghana's aquatic environment is real and is immediate.Heavy metals (e.g., lead, cadmium, copper and zinc) and organic pollutants (e.g.,PCDD/Fs and PBDEs) have been detected in the sediments of local water bodies in quantities that greatly exceed background levels. This fact alone suggests that aquatic organisms that live in the affected water bodies are highly exposed to these toxic, bio-accumulative, and persistent contaminants. These contaminants have been confirmed to result from the primitive methods used to recycle and process e-waste within the local environment.Only limited local data exist on the threats posed by these e-waste-related contaminants on nearby natural resources, especially aquatic organisms. In this review,we have addressed the potential toxicity of selected heavy metals and organic pollutants on aquatic organisms. Since there are no data on concentrations of contaminants in the water column, we have based our predictions of effects on pollutant release rates from sediments. Pollutants that are attached to sediments are routinely released into the water column from diffusion and advection, the rate of which depends on pH and Eh of the sediments. E-waste contaminants have the potential to produce deleterious effects on the behavior, physiology, metabolism, reproduction,development and growth of many aquatic organisms. Because it is confirmed that both heavy metal and organic contaminants are reaching the biota of Ghana's local waterways, we presume that they are producing adverse effects. Because local data on the aquatic toxicity of these contaminants are as yet unavailable, we strongly recommend that future research be undertaken to examine, on a large scale and long-term basis, both contamination levels in biota, and adverse effects on biota of the nearby water bodies.

Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

2016-12-01

The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015. To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health care in health facilities accredited by the National Health Insurance Authority in Ghana. This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health care standards. Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts in urban facilities (p < 0.05), quality of health care and patient safety standards were relatively better in rural facilities. For Ghana to attain the newly formulated sustainable development goals on health, there is the need for health authorities to address the existing rural-urban imbalances in health worker motivation and quality health care standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the National Health Insurance Authority.

Anti-malarial drug quality in Lagos and Accra - a comparison of various quality assessments

PubMed Central

2010-01-01

Background Two major cities in West Africa, Accra, the capital of Ghana, and Lagos, the largest city of Nigeria, have significant problems with substandard pharmaceuticals. Both have actively combated the problem in recent years, particularly by screening products on the market using the Global Pharma Health Fund e.V. Minilab® protocol. Random sampling of medicines from the two cities at least twice over the past 30 months allows a tentative assessment of whether improvements in drug quality have occurred. Since intelligence provided by investigators indicates that some counterfeit producers may be adapting products to pass Minilab tests, the results are compared with those from a Raman spectrometer and discrepancies are discussed. Methods Between mid-2007 and early-2010, samples of anti-malarial drugs were bought covertly from pharmacies in Lagos on three different occasions (October 2007, December 2008, February 2010), and from pharmacies in Accra on two different occasions (October 2007, February 2010). All samples were tested using the Minilab® protocol, which includes disintegration and active ingredient assays as well as visual inspection, and most samples were also tested by Raman spectrometry. Results In Lagos, the failure rate in the 2010 sampling fell to 29% of the 2007 finding using the Minilab® protocol, 53% using Raman spectrometry, and 46% using visual inspection. In Accra, the failure rate in the 2010 sampling fell to 54% of the 2007 finding using the Minilab® protocol, 72% using Raman spectrometry, and 90% using visual inspection. Conclusions The evidence presented shows that drug quality is probably improving in both cities, especially Lagos, since major reductions of failure rates over time occur with all means of assessment. Many more samples failed when examined by Raman spectrometry than by Minilab® protocol. The discrepancy is most likely caused by the two techniques measuring different aspects of the medication and hence the discrepancy may be the natural variation in these techniques. But other explanations are possible and are discussed. PMID:20537190

The Local Food Environment and Body Mass Index among the Urban Poor in Accra, Ghana.

PubMed

Dake, Fidelia A A; Thompson, Amanda L; Ng, Shu Wen; Agyei-Mensah, Samuel; Codjoe, Samuel N A

2016-06-01

Obesity in the sub-Saharan Africa region has been portrayed as a problem of affluence, partly because obesity has been found to be more common in urban areas and among the rich. Recent findings, however, reveal rising prevalence among the poor particularly the urban poor. A growing body of literature mostly in Western countries shows that obesity among the poor is partly the result of an obesogenic-built environment. Such studies are lacking in the African context. This study examines the characteristics of the local food environment in an urban poor setting in Accra, Ghana and further investigates the associated risk of obesity for residents. Data on the local food environment was collected using geographic positioning system (GPS) technology. The body mass indices (BMI) of females (15-49 years) and males (15-59 years) were calculated from measured weight and height. Data on the socio-demographic characteristics and lifestyle behaviors of respondents was also collected through a household survey. Spatial analysis tools were used to examine the characteristics of the local food environment while the influence of the food environment on BMI was examined using a two-level multilevel model. The measures of the food environment constituted the level 2 factors while individual socio-demographic characteristics and lifestyle behaviors constituted the level 1 factors. The local food environment in the study communities is suggestive of an obesogenic food environment characterized by an abundance of out-of-home cooked foods, convenience stores, and limited fruits and vegetables options. The results of the multilevel analysis reveal a 0.2 kg/m(2) increase in BMI for every additional convenience store and a 0.1 kg/m(2) reduction in BMI for every out-of-home cooked food place available in the study area after controlling for individual socio-demographic characteristics, lifestyle behaviors, and community characteristics. The findings of this study indicate that the local food environment in urban poor Accra is associated with increased risk of obesity through providing access to convenience stores. In order to reduce the risk of obesity in these urban poor communities, there is the need to regulate the availability of and access to convenience stores while also encouraging healthier offerings in convenience stores.

The effect of input data transformations on object-based image analysis

PubMed Central

LIPPITT, CHRISTOPHER D.; COULTER, LLOYD L.; FREEMAN, MARY; LAMANTIA-BISHOP, JEFFREY; PANG, WYSON; STOW, DOUGLAS A.

2011-01-01

The effect of using spectral transform images as input data on segmentation quality and its potential effect on products generated by object-based image analysis are explored in the context of land cover classification in Accra, Ghana. Five image data transformations are compared to untransformed spectral bands in terms of their effect on segmentation quality and final product accuracy. The relationship between segmentation quality and product accuracy is also briefly explored. Results suggest that input data transformations can aid in the delineation of landscape objects by image segmentation, but the effect is idiosyncratic to the transformation and object of interest. PMID:21673829

Dengue expansion in Africa-not recognized or not happening?

PubMed

Jaenisch, Thomas; Junghanss, Thomas; Wills, Bridget; Brady, Oliver J; Eckerle, Isabella; Farlow, Andrew; Hay, Simon I; McCall, Philip J; Messina, Jane P; Ofula, Victor; Sall, Amadou A; Sakuntabhai, Anavaj; Velayudhan, Raman; Wint, G R William; Zeller, Herve; Margolis, Harold S; Sankoh, Osman

2014-10-01

An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the healthcare setting in Africa. Second, representative data need to be collected across Africa to uncover the true burden of dengue. Third, established networks should collaborate to produce these types of data. Fourth, policy needs to be informed so the necessary steps can be taken to provide dengue vector control and health services.

Dengue Expansion in Africa—Not Recognized or Not Happening?

PubMed Central

Junghanss, Thomas; Wills, Bridget; Brady, Oliver J.; Eckerle, Isabella; Farlow, Andrew; Hay, Simon I.; McCall, Philip J.; Messina, Jane P.; Ofula, Victor; Sall, Amadou A.; Sakuntabhai, Anavaj; Velayudhan, Raman; Wint, G.R. William; Zeller, Herve; Margolis, Harold S.; Sankoh, Osman

2014-01-01

An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the healthcare setting in Africa. Second, representative data need to be collected across Africa to uncover the true burden of dengue. Third, established networks should collaborate to produce these types of data. Fourth, policy needs to be informed so the necessary steps can be taken to provide dengue vector control and health services. PMID:25271370

Understanding the knowledge and attitudes of commercial drivers in Ghana regarding alcohol impaired driving

PubMed Central

Asiamah, G; Mock, C; Blantari, J

2002-01-01

Objectives: The knowledge and attitudes of commercial drivers in Ghana as regards alcohol impaired driving were investigated. This was done in order to provide information that could subsequently be used to develop antidrunk driving social marketing messages built upon the intrinsic values and motivation of these drivers. Methods: Focus group discussions were held with 43 bus and minibus drivers in the capital city, Accra. A structured discussion guide was used to capture information related to values, risk perceptions, leisure time activities, and attitudes on alcohol impaired driving. Results: The majority of drivers expressed an understanding that drunk driving was a significant risk factor for crashes. There was a significant under-appreciation of the extent of the problem, however. Most believed that it was only rare, extremely intoxicated drivers who were the problem. The drivers also had a minimal understanding of the concept of blood alcohol concentration and related legal limits. Despite these factors, there was widespread support for increased enforcement of existing antidrunk driving laws. Conclusions: In Ghana, commercial drivers understand the basic danger of drunk driving and are motivated to assist in antidrunk driving measures. There are misconceptions and deficits in knowledge that need to be addressed in subsequent educational campaigns. PMID:11928975

Outcomes of a Postexposure Prophylaxis Program at the Korle-Bu Teaching Hospital in Ghana: A Retrospective Cohort Study.

PubMed

Tetteh, Raymond A; Nartey, Edmund T; Lartey, Margaret; Mantel-Teeuwisse, Aukje K; Leufkens, Hubert G M; Nortey, Priscilla A; Dodoo, Alexander N O

2015-01-01

The risk for occupational exposure to HIV is a serious public health problem that is well characterized in the developed world, but less so in the developing countries such as Ghana. This study was undertaken to examine the characteristics of occupational exposure to HIV and the utilization of a risk assessment system (RAS)-based postexposure prophylaxis (PEP) among health care workers (HCWs) and health care students (HCSs) in the Korle-Bu Teaching Hospital (KBTH). During the study period (January 2005-December 2010), a total of 260 and 35 exposures were reported by HCWs and HCSs, respectively. Ward attendants reported the highest incidence rate of 6.46 of 100 person-years (P-Y). The incidence of high-risk exposures was 0.33 of 100 P-Y (n = 65); 60.0% occurred during a procedure of disposing of a needle and 24.6% during a cannula insertion. A total of 289 of the 295 individuals were administered PEP, of which 181 (62.6%) completed the 6-month follow-up testing schedule and none sero-converted. This shows that with a good RAS in place, it is possible to deploy an effective PEP program in a typical African teaching hospital like the KBTH in Accra, Ghana. © The Author(s) 2013.

Ebola-related stigma in Ghana: Individual and community level determinants.

PubMed

Tenkorang, Eric Y

2017-06-01

Although Ebola-related stigmatization continues to undermine efforts to re-integrate survivors, few studies have examined what influences such stigmatizing attitudes. This paper explores the effects of both individual- and community-level factors on Ebola-related stigma in Ghana. Data were collected from a cross-section of 800 respondents, nested within 40 communities in the Greater Accra Region of Ghana. Multi-level modelling was employed for analysis. Both individual- and community-level factors were significant determinants of stigma. Respondents who endorsed myths about Ebola were significantly more likely to also endorse Ebola-related stigma. Similarly, those who were worried about a potential outbreak of Ebola in the future, had moderate risk perceptions of contracting Ebola, had primary and secondary education, and were not confident of the quality of health care in the event of an outbreak, were more likely to endorse Ebola-related stigma. Knowledge of Ebola was significant at the community level, but not at the individual level. Communities with more knowledge were less likely to endorse Ebola-related stigma. These findings underscore the need to increase the knowledge base while countering myths that undermine preventive behaviours to fight Ebola-related stigma. It is equally important to adopt multi-level interventions that emphasize community-based strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control

PubMed Central

Beyere, Christopher B.; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P.

2017-01-01

Background The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. Methods This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Results Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. Conclusions There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards. PMID:28982194

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control.

PubMed

Alhassan, Robert Kaba; Beyere, Christopher B; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P

2017-01-01

The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards.

Impact of urban agriculture on malaria vectors in Accra, Ghana

PubMed Central

Klinkenberg, Eveline; McCall, PJ; Wilson, Michael D; Amerasinghe, Felix P; Donnelly, Martin J

2008-01-01

To investigate the impact of urban agriculture on malaria transmission risk in urban Accra larval and adult stage mosquito surveys, were performed. Local transmission was implicated as Anopheles spp. were found breeding and infected Anopheles mosquitoes were found resting in houses in the study sites. The predominant Anopheles species was Anopheles gambiae s.s.. The relative proportion of molecular forms within a subset of specimens was 86% S-form and 14% M-form. Anopheles spp. and Culex quinquefasciatus outdoor biting rates were respectively three and four times higher in areas around agricultural sites (UA) than in areas far from agriculture (U). The annual Entomological Inoculation Rate (EIR), the number of infectious bites received per individual per year, was 19.2 and 6.6 in UA and U sites, respectively. Breeding sites were highly transitory in nature, which poses a challenge for larval control in this setting. The data also suggest that the epidemiological importance of urban agricultural areas may be the provision of resting sites for adults rather than an increased number of larval habitats. Host-seeking activity peaked between 2–3 am, indicating that insecticide-treated bednets should be an effective control method. PMID:18680565

Impact of urban agriculture on malaria vectors in Accra, Ghana.

PubMed

Klinkenberg, Eveline; McCall, Pj; Wilson, Michael D; Amerasinghe, Felix P; Donnelly, Martin J

2008-08-04

To investigate the impact of urban agriculture on malaria transmission risk in urban Accra larval and adult stage mosquito surveys, were performed. Local transmission was implicated as Anopheles spp. were found breeding and infected Anopheles mosquitoes were found resting in houses in the study sites. The predominant Anopheles species was Anopheles gambiae s.s.. The relative proportion of molecular forms within a subset of specimens was 86% S-form and 14% M-form. Anopheles spp. and Culex quinquefasciatus outdoor biting rates were respectively three and four times higher in areas around agricultural sites (UA) than in areas far from agriculture (U). The annual Entomological Inoculation Rate (EIR), the number of infectious bites received per individual per year, was 19.2 and 6.6 in UA and U sites, respectively. Breeding sites were highly transitory in nature, which poses a challenge for larval control in this setting. The data also suggest that the epidemiological importance of urban agricultural areas may be the provision of resting sites for adults rather than an increased number of larval habitats. Host-seeking activity peaked between 2-3 am, indicating that insecticide-treated bednets should be an effective control method.

Social capital and active membership in the Ghana National Health Insurance Scheme - a mixed method study.

PubMed

Fenenga, Christine J; Nketiah-Amponsah, Edward; Ogink, Alice; Arhinful, Daniel K; Poortinga, Wouter; Hutter, Inge

2015-11-02

People's decision to enroll in a health insurance scheme is determined by socio-cultural and socio-economic factors. On request of the National health Insurance Authority (NHIA) in Ghana, our study explores the influence of social relationships on people's perceptions, behavior and decision making to enroll in the National Health Insurance Scheme. This social scheme, initiated in 2003, aims to realize accessible quality healthcare services for the entire population of Ghana. We look at relationships of trust and reciprocity between individuals in the communities (so called horizontal social capital) and between individuals and formal health institutions (called vertical social capital) in order to determine whether these two forms of social capital inhibit or facilitate enrolment of clients in the scheme. Results can support the NHIA in exploiting social capital to reach their objective and strengthen their policy and practice. We conducted 20 individual- and seven key-informant interviews, 22 focus group discussions, two stakeholder meetings and a household survey, using a random sample of 1903 households from the catchment area of 64 primary healthcare facilities. The study took place in Greater Accra Region and Western Regions in Ghana between June 2011 and March 2012. While social developments and increased heterogeneity seem to reduce community solidarity in Ghana, social networks remain common in Ghana and are valued for their multiple benefits (i.e. reciprocal trust and support, information sharing, motivation, risk sharing). Trusting relations with healthcare and insurance providers are, according healthcare clients, based on providers' clear communication, attitude, devotion, encouragement and reliability of services. Active membership of the NHIS is positive associated with community trust, trust in healthcare providers and trust in the NHIS (p-values are .009, .000 and .000 respectively). Social capital can motivate clients to enroll in health insurance. Fostering social capital through improving information provision to communities and engaging community groups in health care and NHIS services can facilitate peoples' trust in these institutions and their active participation in the scheme.

Policy talk: incentives for rural service among nurses in Ghana.

PubMed

Kwansah, Janet; Dzodzomenyo, Mawuli; Mutumba, Massy; Asabir, Kwesi; Koomson, Elizabeth; Gyakobo, Mawuli; Agyei-Baffour, Peter; Kruk, Margaret E; Snow, Rachel C

2012-12-01

Like many countries in sub-Saharan Africa, Ghana is faced with the simultaneous challenges of increasing its health workforce, retaining them in country and promoting a rational distribution of staff in remote or deprived areas of the country. Recent increases in both public-sector doctor and nurse salaries have contributed to a decline in international out-migration, but problems of geographic mal-distribution remain. As part of a research project on human resources in the Ghanaian health sector, this study was conducted to elicit in-depth views from nursing leaders and practicing nurses in rural and urban Ghana on motivations for urban vs rural practice, job satisfaction and potential rural incentives. In-depth interviews were conducted with 115 nurses selected using a stratified sample of public, private and Christian Health Association of Ghana (CHAG) facilities in three regions of the country (Greater Accra, Brong Ahafo and Upper West), and among 13 nurse managers from across Ghana. Many respondents reported low satisfaction with rural practice. This was influenced by the high workload and difficult working conditions, perception of being 'forgotten' in rural areas by the Ministry of Health (MOH), lack of professional advancement and the lack of formal learning or structured mentoring. Older nurses without academic degrees who were posted to remote areas were especially frustrated, citing a lack of opportunities to upgrade their skills. Nursing leaders echoed these themes, emphasizing the need to bring learning and communication technologies to rural areas. Proposed solutions included clearer terms of contract detailing length of stay at a post, and transparent procedures for transfer and promotion; career opportunities for all cadres of nursing; and benefits such as better on-the-job housing, better mentoring and more recognition from leaders. An integrated set of recruitment and retention policies focusing on career development may improve job satisfaction and retention of nurses in rural Ghana.

Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study

PubMed Central

Enuameh, Yeetey Akpe Kwesi; Okawa, Sumiyo; Asante, Kwaku Poku; Kikuchi, Kimiyo; Mahama, Emmanuel; Ansah, Evelyn; Tawiah, Charlotte; Adjei, Kwame; Shibanuma, Akira; Nanishi, Keiko; Yeji, Francis; Agyekum, Enoch Oti; Yasuoka, Junko; Gyapong, Margaret; Oduro, Abraham Rexford; Quansah Asare, Gloria; Hodgson, Abraham; Jimba, Masamine; Owusu-Agyei, Seth

2016-01-01

Background Maternal and neonatal mortality indicators remain high in Ghana and other sub-Saharan African countries. Both maternal and neonatal health outcomes improve when skilled personnel provide delivery services within health facilities. Determinants of delivery location are crucial to promoting health facility deliveries, but little research has been done on this issue in Ghana. This study explored factors influencing delivery location in predominantly rural communities in Ghana. Methods Data were collected from 1,500 women aged 15–49 years with live or stillbirths that occurred between January 2011 and April 2013. This was done within the three sites operating Health and Demographic Surveillance Systems, i.e., the Dodowa (Greater Accra Region), Kintampo (Brong Ahafo Region), and Navrongo (Upper-East Region) Health Research Centers in Ghana. Multivariable logistic regression was used to identify the determinants of delivery location, controlling for covariates that were statistically significant in univariable regression models. Results Of 1,497 women included in the analysis, 75.6% of them selected health facilities as their delivery location. After adjusting for confounders, the following factors were associated with health facility delivery across all three sites: healthcare provider’s influence on deciding health facility delivery, (AOR = 13.47; 95% CI 5.96–30.48), place of residence (AOR = 4.49; 95% CI 1.14–17.68), possession of a valid health insurance card (AOR = 1.90; 95% CI 1.29–2.81), and socio-economic status measured by wealth quintiles (AOR = 2.83; 95% CI 1.43–5.60). Conclusion In addition to known factors such as place of residence, socio-economic status, and possession of valid health insurance, this study identified one more factor associated with health facility delivery: healthcare provider’s influence. Ensuring care provider’s counseling of clients could improve the uptake of health facility delivery in rural communities in Ghana. PMID:27031301

Correlates of psychological functioning of homeless youth in Accra, Ghana: a cross-sectional study.

PubMed

Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

2015-01-01

Research on homeless youth has shown that this population is at high risk for various mental health problems. Previous studies conducted among homeless young adults in Ghana have focused primarily on economic, social and cultural causes of homelessness, their engagement in risky sexual behaviours and the prevalence of STI including HIV/AIDS. We are therefore not fully informed of the prevalence of psychological symptoms and their associated factors. The aim of the study was to determine the association between psychological functioning and social and health risk behaviours among a sample of homeless youth in Ghana. A cross-sectional survey of a convenience sample of 227 (122 male and 105 female) homeless youth was conducted in Ghana in 2013. An interviewer-administered questionnaire was used to collect data due to low level of literacy among the study population. Pearson-moment correlation coefficient (r) and multiple standard regression models were fitted to analyse the data. Approximately 87% of the participants in this study exhibited moderate to severe psychosocial symptoms. Specifically, emotional, conduct, hyperactivity and peer relationship problems among the participants were 69%, 74%, 54% and 89% respectively. Overall psychosocial functioning was predicted by stigma (self-stigma and experienced stigma), violent behaviours and suicidal ideation. Substance use and perceived resilience were significantly associated with emotional problems. There is a need for holistic interventions to help improve the psychological and social functioning of homeless youth. Such programmes should strengthen socio-emotional coping strategies in street youth as well as address contextual risk factors such as stigma and discrimination by the public.

Exploring factors influencing health-seeking decisions and retention in childhood cancer treatment programmes: perspectives of parents in Ghana.

PubMed

Renner, Lorna Awo; McGill, Deborah

2016-09-01

Developing countries such as Ghana have very poor childhood cancer survival rates. There is a need to determine reasons for late presentation and treatment abandonment which are major causes of poor survival. Understanding these issues could inform effective strategies for childhood cancer control in resource-constrained settings. To explore factors influencing parental decision-making for children with cancer in Ghana with regard to health seeking and retention in treatment, in order to provide information that will guide Public Health interventions for childhood cancer control. This exploratory qualitative study was conducted based on an interpretative epistemology using a social constructionist approach. Purposive sampling of parents attending the Paediatric Oncology Unit, Korle Bu Teaching Hospital in Accra, Ghana was undertaken. Twelve semi-structured moderate interviews and two small focus group discussions with a total of seven participants were undertaken. Data analysis was through thematic content analysis. Five major themes emerged. Knowledge and perceptions revealed a total lack of appropriate knowledge prior to diagnosis. Health-seeking behaviour was determined by interplay of individual and environmental factors. Orthodox medical treatment was largely perceived favourably. The impact of cancer on parents and children included psychological, physical and socioeconomic effects. Financial, spiritual and psychosocial support helped in coping. Parents recommended public education and health financing to address the major barriers. Broad social determinants and experiences influence parental decision making for children with cancer. This implies Health Promotion strategies with multi-sectorial involvement will be required for effective implementation of the National Strategy for Cancer Control. Funded by authors.

Rainfall and temperature changes and variability in the Upper East Region of Ghana

NASA Astrophysics Data System (ADS)

Issahaku, Abdul-Rahaman; Campion, Benjamin Betey; Edziyie, Regina

2016-08-01

The aim of the research was to assess the current trend and variation in rainfall and temperature in the Upper East Region, Ghana, using time series moving average analysis and decomposition methods. Meteorological data obtained from the Ghana Meteorological Agency in Accra, Ghana, from 1954 to 2014 were used in the models. The additive decomposition model was used to analyze the rainfall because the seasonal variation was relatively constant over time, while the multiplicative model was used for both the daytime and nighttime temperatures because their seasonal variations increase over time. The monthly maximum and the minimum values for the entire period were as follows: rainfall 455.50 and 0.00 mm, nighttime temperature 29.10°C and 13.25°C and daytime temperature 41.10°C and 26.10°C, respectively. Also, while rainfall was decreasing, nighttime and daytime temperatures were increasing in decadal times. Since both the daytime and nighttime temperatures were increasing and rainfall was decreasing, climate extreme events such as droughts could result and affect agriculture in the region, which is predominantly rain fed. Also, rivers, dams, and dugouts are likely to dry up in the region. It was also observed that there was much variation in rainfall making prediction difficult. Day temperatures were generally high with the months of March and April have been the highest. The months of December recorded the lowest night temperature. Inhabitants are therefore advised to sleep in well-ventilated rooms during the warmest months and wear protective clothing during the cold months to avoid contracting climate-related diseases.

Imported Lassa fever: a report of 2 cases in Ghana.

PubMed

Kyei, Nicholas N A; Abilba, Mark M; Kwawu, Foster K; Agbenohevi, Prince G; Bonney, Joseph H K; Agbemaple, Thomas K; Nimo-Paintsil, Shirley C; Ampofo, William; Ohene, Sally-Ann; Nyarko, Edward O

2015-05-29

Lassa fever is a potentially fatal acute viral illness caused by Lassa virus which is carried by rodents and is endemic in some West African countries. Importation of emerging infections such as Lassa fever, Ebola Virus Disease and other viral hemorrhagic fevers into non endemic regions is a growing threat particularly as international travel and commitments in resolving conflicts in endemic countries in the West Africa sub-region continue. We report the first two recorded imported cases of Lassa fever among Ghanaian Peace keepers in rural Liberia, who became ill while on Peace keeping mission. They were subsequently evacuated to the UN level IV hospital in Accra, where their illnesses were laboratory confirmed. One of the patients recovered with ribavirin treatment and supportive therapy. No secondary clinical cases occurred in Ghana. Healthcare providers at all levels of care should thus have a high index of suspicion for these infectious diseases and adopt standard infection control measures when treating patients in endemic regions or returning travelers from an endemic region with a febrile illness even of a known etiology.

Elevated Proangiogenic Markers are Associated with Vascular Complications within Ghanaian Sickle Cell Disease Patients.

PubMed

Antwi-Boasiako, Charles; Frimpong, Emmanuel; Gyan, Ben; Kyei-Baafour, Eric; Sey, Fredericka; Dzudzor, Bartholomew; Abdul-Rahman, Mubarak; Dankwah, Gifty B; Otu, Kate H; Ndanu, Tom A; Campbell, Andrew D; Ekem, Ivy; Donkor, Eric S

2018-06-27

: Sickle cell disease (SCD) is an inherited blood disorder that can result in vasculopathy and end organ damage. Angiogenesis has been implicated as a key contributing factor to vascular mediated tissue injury in SCD. The relative plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) greatly influence angiogenesis. Dysregulation of these growth factors, leading to a pro-angiogenic state in SCD patients, has been documented in the developed world but there is very little data in Africa. There is the need, therefore, for studies in Ghanaian SCD patients. The aim of this study was to assess plasma levels of Ang-1, Ang-2, and VEGF in homozygous (HbSS) SCD patients with or without complications and healthy controls (HbAA) in Ghana. The study was a case-control study involving 544 participants: 396 HbSS SCD patients and 148 HbAA healthy controls. The study was conducted at the Center for Clinical Genetics (Sickle Cell Clinic) and Accra Area Blood Centre for National Blood transfusion at the Korle-Bu Teaching Hospital, Accra, Ghana. The plasma levels of Ang-1, Ang-2, and VEGF of study participants were measured with a double sandwich enzyme-linked immunosorbent assay (ELISA) technique. Complete blood count (CBC) was measured with an autoanalyser. The mean plasma Ang-1, Ang-2, and VEGF were significantly higher in HbSS SCD patients with or without complications than healthy controls ( p < 0.001). The Ang-2/Ang-1 ratio was significantly lower in the controls than the HbSS patients ( p < 0.001). The Ang-2/Ang-1 ratio was higher in the HbSS patients with leg ulcers as compared with patients with other complications and healthy controls ( p < 0.001). There were higher leucocyte counts in HbSS patients than healthy controls. Overall, there was elevated plasma levels of Ang-1, Ang-2, and VEGF in SCD patients. The higher Ang-2/Ang-1 plasma levels in patients with leg ulcers suggests a possible ongoing angiogenesis and response to inflammatory stimuli. The study provides a first report on plasma levels of angiopoietin-1, angiopoietin-2, and vascular endothelial growth factors in homozygous sickle cell disease patients in Ghana.

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

PubMed

Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

2018-04-02

Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

Prevalence and predictors of overweight and obesity among school-aged children in urban Ghana.

PubMed

Aryeetey, Richmond; Lartey, Anna; Marquis, Grace S; Nti, Helena; Colecraft, Esi; Brown, Patricia

2017-01-01

Childhood overnutrition is a serious public health problem, with consequences that extend into adulthood. The aim of this study was to determine the prevalence and determinants of overweight and obesity among school-age children in two urban settings in Ghana. This cross-sectional study involved 3089 children (9-15 years) recruited between December 2009 and February 2012 in Accra and Kumasi, Ghana. Socio-demographic, dietary, and physical activity data were collected using pretested questionnaires. BMI-for-age z-scores were used to categorize anthropometric data of the children as thin, normal, or overweight/obese. Determinants of overweight were examined using multiple logistic regressions. Seventeen percent of children were overweight or obese. Children who reported lower participation (< 3 times/week) in sports activity were 44% more likely to be overweight or obese (AOR = 1.44; 95% CI: 1.07, 1.94). Maternal tertiary education (AOR = 1.91, 95% CI: 1.07, 3.42), higher household socioeconomic status (AOR = 1.56, 95% CI: 1.18, 2.06), and attending private school (AOR = 1.74, 95% CI: 1.31, 2.32) were also associated with elevated risk of overweight and obesity. Physical inactivity is a modifiable independent determinant of overweight or obesity among Ghanaian school-aged children. Promoting and supporting a physically active lifestyle in this population is likely to reduce risk of childhood overnutrition.

An overview of the nutrition transition in West Africa: implications for non-communicable diseases.

PubMed

Bosu, William K

2015-11-01

The nutrition landscape in West Africa has been dominated by the programmes to address undernutrition. However, with increasing urbanisation, technological developments and associated change in dietary patterns and physical activity, childhood and adult overweight, and obesity are becoming more prevalent. There is an evidence of increasing intake of dietary energy, fat, sugars and protein. There is low consumption of fruit and vegetables universally in West Africa. Overall, the foods consumed are predominantly traditional with the component major food groups within recommended levels. Most of the West African countries are at the early stages of nutrition transition but countries such as Cape Verde, Ghana and Senegal are at the latter stages. In the major cities of the region, children consume energy-dense foods such as candies, ice cream and sweetened beverages up to seven times as frequently as fruit and vegetables. Adult obesity rates have increased by 115 % in 15 years since 2004. In Ghana, the prevalence of overweight/obesity in women has increased from 12·8 % in 1993 to 29·9 % in 2008. In Accra, overweight/obesity in women has increased from 62·2 % in 2003 to 64·9 % in 2009. The age-standardised proportion of adults who engage in adequate levels of physical activity ranges from 46·8 % in Mali to 94·7 % in Benin. The lingering stunting in children and the rising overweight in adults have resulted to a dual burden of malnutrition affecting 16·2 % of mother-child pairs in Cotonou. The prevalence of hypertension has been increased and ranges from 17·6 % in Burkina Faso to 38·7 % in Cape Verde. The prevalence is higher in the cities: 40·2 % in Ougadougou, 46·0 % in St Louis and 54·6 % in Accra. The prevalence of diabetes ranges from 2·5 to 7·9 % but could be as high as 17·9 % in Dakar, Senegal. The consequences of nutrition transition are not only being felt by the persons in the high socioeconomic class, but also in cities such as Accra and Ouagadougou, where at least 19 % of adults from the poorest households are overweight and 19-28 % have hypertension. Concerted national action involving governments, partners, private sector and civil society is needed to re-orient health systems and build capacity to address the dual burden of malnutrition, to regulate the food and beverage industry and to encourage healthy eating throughout the life course.

A cross-sectional study of tuberculosis drug resistance among previously treated patients in a tertiary hospital in Accra, Ghana: public health implications of standardized regimens.

PubMed

Forson, Audrey; Kwara, Awewura; Kudzawu, Samuel; Omari, Michael; Otu, Jacob; Gehre, Florian; de Jong, Bouke; Antonio, Martin

2018-04-02

Mycobacterium tuberculosis drug resistance is a major challenge to the use of standardized regimens for tuberculosis (TB) therapy, especially among previously treated patients. We aimed to investigate the frequency and pattern of drug resistance among previously treated patients with smear-positive pulmonary tuberculosis at the Korle-Bu Teaching Hospital Chest Clinic, Accra. This was a cross-sectional survey of mycobacterial isolates from previously treated patients referred to the Chest Clinic Laboratory between October 2010 and October 2013. The Bactec MGIT 960 system for mycobactrerial culture and drug sensitivity testing (DST) was used for sputum culture of AFB smear-positive patients with relapse, treatment failure, failure of smear conversion, or default. Descriptive statistics were used to summarize patient characteristics, and frequency and patterns of drug resistance. A total of 112 isolates were studied out of 155 from previously treated patients. Twenty contaminated (12.9%) and 23 non-viable isolates (14.8%) were excluded. Of the 112 studied isolates, 53 (47.3%) were pan-sensitive to all first-line drugs tested Any resistance (mono and poly resistance) to isoniazid was found in 44 isolates (39.3%) and any resistance to streptomycin in 43 (38.4%). Thirty-one (27.7%) were MDR-TB. Eleven (35.5%) out of 31 MDR-TB isolates were pre-XDR. MDR-TB isolates were more likely than non-MDR isolates to have streptomycin and ethambutol resistance. The main findings of this study were the high prevalence of MDR-TB and streptomycin resistance among previously treated TB patients, as well as a high prevalence of pre-XDR-TB among the MDR-TB patients, which suggest that first-line and second-line DST is essential to aid the design of effective regimens for these groups of patients in Ghana.

Occupational hearing loss of market mill workers in the city of Accra, Ghana.

PubMed

Kitcher, Emmanuel D; Ocansey, Grace; Abaidoo, Benjamin; Atule, Alidu

2014-01-01

Noise induced hearing loss (NIHL) is an irreversible sensorineural hearing loss associated with exposure to high levels of excessive noise. Prevention measures are not well established in developing countries. This comparative cross sectional study aims to determine the prevalence of hearing loss in both a group of high risk workers and a control group and to assess their knowledge of the effects of noise on hearing health. A total of 101 market mill workers and 103 controls employed within markets in the city of Accra, Ghana, were evaluated using a structured questionnaire and pure tone audiometry. The questionnaire assessed factors including self-reported hearing loss, tinnitus, knowledge on the effects of noise on hearing health and the use of hearing protective devices. Pure tone audiometric testing was conducted for both mill workers and controls. Noise levels at the work premises of the mill workers and controls were measured. Symptoms of hearing loss were reported by 24 (23.76%) and 8 (7.7%) mill workers and controls respectively. Fifty-five (54.5%) and fifty-four (52.37%) mill workers and controls exhibited knowledge of the effects of noise on hearing health. Five (5.0%) mill workers used hearing protective devices. There was significant sensorineural hearing loss and the presence of a 4 kHz audiometric notch among mill workers when compared with controls for the mean thresholds of 2 kHz, 3 kHz and 4 kHz (P = 0. 001). The prevalence of hearing loss in the better hearing ears of the mill workers and controls was 24.8% and 4.8% respectively (P < 0.5). The prevalence of hearing loss, which may be characteristic of NIHL in the better hearing ears of the mill workers and controls was 24.8% and 4.8% respectively. The majority of mill workers did not use hearing protection.

Contemporary evolution of resistance at the major insecticide target site gene Ace-1 by mutation and copy number variation in the malaria mosquito Anopheles gambiae.

PubMed

Weetman, David; Mitchell, Sara N; Wilding, Craig S; Birks, Daniel P; Yawson, Alexander E; Essandoh, John; Mawejje, Henry D; Djogbenou, Luc S; Steen, Keith; Rippon, Emily J; Clarkson, Christopher S; Field, Stuart G; Rigden, Daniel J; Donnelly, Martin J

2015-06-01

Functionally constrained genes are ideal insecticide targets because disruption is often fatal, and resistance mutations are typically costly. Synaptic acetylcholinesterase (AChE) is an essential neurotransmission enzyme targeted by insecticides used increasingly in malaria control. In Anopheles and Culex mosquitoes, a glycine-serine substitution at codon 119 of the Ace-1 gene confers both resistance and fitness costs, especially for 119S/S homozygotes. G119S in Anopheles gambiae from Accra (Ghana) is strongly associated with resistance, and, despite expectations of cost, resistant 119S alleles are increasing significantly in frequency. Sequencing of Accra females detected only a single Ace-1 119S haplotype, whereas 119G diversity was high overall but very low at non-synonymous sites, evidence of strong purifying selection driven by functional constraint. Flanking microsatellites showed reduced diversity, elevated linkage disequilibrium and high differentiation of 119S, relative to 119G homozygotes across up to two megabases of the genome. Yet these signals of selection were inconsistent and sometimes weak tens of kilobases from Ace-1. This unexpected finding is attributable to apparently ubiquitous amplification of 119S alleles as part of a large copy number variant (CNV) far exceeding the size of the Ace-1 gene, whereas 119G alleles were unduplicated. Ace-1 CNV was detectable in archived samples collected when the 119S allele was rare in Ghana. Multicopy amplification of resistant alleles has not been observed previously and is likely to underpin the recent increase in 119S frequency. The large CNV compromised localization of the strong selective sweep around Ace-1, emphasizing the need to integrate CNV analysis into genome scans for selection. © 2015 The Authors. Molecular Ecology published by John Wiley & Sons Ltd.

Work as a street vendor, associated traffic-related air pollution exposures and risk of adverse pregnancy outcomes in Accra, Ghana.

PubMed

Amegah, Adeladza Kofi; Jaakkola, Jouni J K

2014-03-01

Street vending, a dominant occupation in urban areas of developing countries exposes the vendors to several environmental pollutants. We investigated whether work as street vendor impairs foetal growth and shortens gestational duration, and evaluated to what extent exposure to traffic-related air pollution is responsible for these adverse effects. A cross-sectional study was conducted among mothers and their newborns accessing postnatal services at the Korle Bu Teaching Hospital in Accra, Ghana in 2010, focusing on 105 street vendors and a reference group of 281 mothers. We categorized exposure to traffic-related air pollution on the basis of street vending activity patterns and traffic density in the working area. Multivariate linear regression analysis adjusting for age, social class, marital status and gravidity of mothers, sex of neonate, and indoor air pollution, indicated a 177 g (95% CI: 324, 31) reduction in birth weight among street vendors. Sensitivity analysis performed by restricting the analysis to term births showed further reductions in birth weight. Generalized linear models adjusting for confounders indicated a 35% (risk ratio (RR)=1.35; 95% CI: 0.87, 2.12) increased risk of LBW, albeit statistically not significant. LBW risk increased in the sensitivity analysis but was also not statistically significant. The risk of PTB was not associated with street vending (RR=1.03; 95% CI: 0.67, 1.58). The exposure-response relations observed were not consistent. Moderate activity patterns and high traffic density jointly was associated with a statistically significant 84% (RR=1.84; 95% CI: 1.05, 3.24) increased risk of LBW. Street vending during pregnancy is a determinant of average foetal growth and risk of LBW. More research is required to further quantify their effects on pregnancy outcomes and safeguard maternal and perinatal health in developing countries. Copyright © 2013 Elsevier GmbH. All rights reserved.

Experiences of pregnancy and motherhood among teenage mothers in a suburb of Accra, Ghana: a qualitative study

PubMed Central

Gyesaw, Nana Yaa Konadu; Ankomah, Augustine

2013-01-01

Background The proportion of teenage girls who are mothers or who are currently pregnant in sub-Saharan African countries is staggering. There are many studies regarding teenage pregnancy, unsafe abortions, and family planning among teenagers, but very little is known about what happens after pregnancy, ie, the experience of teenage motherhood. Several studies in Ghana have identified the determinants of early sexual activity, contraception, and unsafe abortion, with teenage motherhood only mentioned in passing. Few studies have explored the experiences of adolescent mothers in detail with regard to their pregnancy and childbirth. This qualitative study explores the experiences of adolescent mothers during pregnancy, childbirth, and care of their newborns. Methods This qualitative study was based on data from focus group discussions and indepth interviews with teenage mothers in a suburb in Accra. Participants were recruited from health facilities as well as by snowball sampling. Results Some of the participants became pregnant as a result of transactional sex in order to meet their basic needs, while others became pregnant as a result of sexual violence and exploitation. A few others wanted to become pregnant to command respect from people in society. In nearly all cases, parents and guardians of the adolescent mothers were upset in the initial stages when they heard the news of the pregnancy. One key finding, quite different from in other societies, was how often teenage pregnancies are eventually accepted, by both the young women and their families. Also observed was a rarity of willingness to resort to induced abortion. Conclusion Special programs should be initiated by the government and the various responsible departments to address ignorance on sexual matters, and the challenges and risks associated with pregnancy and parenting by adolescents. Parenting techniques should be taught in sex education programs. PMID:24250233

Using High Resolution Commercial Satellite Imagery to Quantify Spatial Features of Urban Areas and their Relationship to Quality of Life Indicators in Accra, Ghana

NASA Astrophysics Data System (ADS)

Sandborn, A.; Engstrom, R.; Yu, Q.

2014-12-01

Mapping urban areas via satellite imagery is an important task for detecting and anticipating land cover and land use change at multiple scales. As developing countries experience substantial urban growth and expansion, remotely sensed based estimates of population and quality of life indicators can provide timely and spatially explicit information to researchers and planners working to determine how cities are changing. In this study, we use commercial high spatial resolution satellite imagery in combination with fine resolution census data to determine the ability of using remotely sensed data to reveal the spatial patterns of quality of life in Accra, Ghana. Traditionally, spectral characteristics are used on a per-pixel basis to determine land cover; however, in this study, we test a new methodology that quantifies spatial characteristics using a variety of spatial features observed in the imagery to determine the properties of an urban area. The spatial characteristics used in this study include histograms of oriented gradients, PanTex, Fourier transform, and line support regions. These spatial features focus on extracting structural and textural patterns of built-up areas, such as homogeneous building orientations and straight line indices. Information derived from aggregating the descriptive statistics of the spatial features at both the fine-resolution census unit and the larger neighborhood level are then compared to census derived quality of life indicators including information about housing, education, and population estimates. Preliminary results indicate that there are correlations between straight line indices and census data including available electricity and literacy rates. Results from this study will be used to determine if this methodology provides a new and improved way to measure a city structure in developing cities and differentiate between residential and commercial land use zones, as well as formal versus informal housing areas.

A Farm to Fork Risk Assessment for the Use of Wastewater in Agriculture in Accra, Ghana

PubMed Central

Antwi-Agyei, Prince; Cairncross, Sandy; Peasey, Anne; Price, Vivien; Bruce, Jane; Baker, Kelly; Moe, Christine; Ampofo, Joseph; Armah, George; Ensink, Jeroen

2015-01-01

The need to minimise consumer risk, especially for food that can be consumed uncooked, is a continuing public health concern, particularly in places where safe sanitation and hygienic practices are absent. The use of wastewater in agriculture has been associated with disease risks, though its relative significance in disease transmission remains unclear. This study aimed at identifying key risk factors for produce contamination at different entry points of the food chain. Over 500 produce and ready-to-eat salad samples were collected from fields, markets, and kitchens during the dry and wet seasons in Accra, Ghana, and over 300 soil and irrigation water samples were collected. All samples were analysed for E. coli, human adenovirus and norovirus using standard microbiological procedures, and real time RT-PCR. Finally, critical exposures associated with microbial quality of produce were assessed through observations and interviews. The study found that over 80% of produce samples were contaminated with E. coli, with median concentrations ranging from 0.64 to 3.84 Log E. coli/g produce. Prepared salad from street food vendors was found to be the most contaminated (4.23 Log E. coli/g), and that consumption of salad exceeded acceptable health limits. Key risk factors identified for produce contamination were irrigation water and soil at the farm level. Storage duration and temperature of produce had a significant influence on the quality of produce sold at markets, while observations revealed that the washed water used to rinse produce before sale was dirty. The source of produce and operating with a hygiene permit were found to influence salad microbial quality at kitchens. This study argues for a need to manage produce risk factors at all domains along the food chain, though it would be more effective to prioritise at markets and kitchens due to cost, ease of implementation and public health significance. PMID:26556044

Pilot study on the internal exposure to heavy metals of informal-level electronic waste workers in Agbogbloshie, Accra, Ghana.

PubMed

Wittsiepe, Jürgen; Feldt, Torsten; Till, Holger; Burchard, Gerd; Wilhelm, Michael; Fobil, Julius N

2017-01-01

Informal-level electronic waste (e-waste)-processing activities are performed at hotspots in developing countries such as India, China, and Ghana. These activities increase the ambient burden of heavy metals and contribute to the toxic exposure of the general population. However, few data exist on the internal exposure of populations involved in these informal activities and in close contact with fumes from the direct combustion of electronic waste products in these countries. Therefore, in a cross-sectional study design, we analyzed blood, urine, and hair samples from 75 e-waste workers residing in and/or working on a large e-waste recycling site in Agbogbloshie, Accra, Ghana, and compared the results against those of 40 individuals living in a suburb of Accra without direct exposure to e-waste recycling activities. A comparative analysis using the Mann-Whitney U test showed significantly higher median concentrations of blood lead (88.5 vs. 41.0 μg/l, p < 0.001), cadmium (0.12 vs. 0.10 μg/g crea , p = 0.023), chromium (0.34 vs. 0.23 μg/g crea , p < 0.001), and nickel (3.18 vs. 2.03 μg/g crea , p < 0.001) in the urine of e-waste workers than those of controls. There was no difference in blood cadmium concentrations between the groups (0.51 vs. 0.57 μg/l, p = 0.215) or in urine mercury levels (0.18 vs. 0.18 μg/g crea , p = 0.820). Hair mercury levels were higher in the controls than in the e-waste workers (0.43 vs. 0.72, p < 0.001). We compared our data with those from European populations, specifically using the German reference values, and found that the internal concentrations of the participants exceeded the German reference values in 59.3 vs. 3.1% (e-waste workers vs. controls) for blood lead, 56.9 vs. 52.5% for urine nickel, 22.2 vs. 20.0% for urine chromium, and 17.8 vs. 62.2% for hair mercury. In particular, the high blood lead levels of up to several hundred micrograms per liter are a cause for concern because many of the workers in Agbogbloshie are children or adolescents who are in developmental stages and are at a particular risk for negative health effects. We conclude that exposure to some of the heavy metals tended to be a citywide phenomenon, but populations directly exposed to e-waste recycling are experiencing higher exposure levels and have concentration levels much higher than those of the general population and much higher than those found in European populations. To achieve environmental sustainability and to minimize the impact of e-waste-processing activities in developing countries, national authorities must formalize the rapidly growing informal-level e-waste management sector in these countries by deploying cleaner and easy-to-operate e-waste processing technologies.

Long-Term Survival of an Urban Fruit Bat Seropositive for Ebola and Lagos Bat Viruses

PubMed Central

Hayman, David T. S.; Emmerich, Petra; Yu, Meng; Wang, Lin-Fa; Suu-Ire, Richard; Fooks, Anthony R.; Cunningham, Andrew A.; Wood, James L. N.

2010-01-01

Ebolaviruses (EBOV) (family Filoviridae) cause viral hemorrhagic fevers in humans and non-human primates when they spill over from their wildlife reservoir hosts with case fatality rates of up to 90%. Fruit bats may act as reservoirs of the Filoviridae. The migratory fruit bat, Eidolon helvum, is common across sub-Saharan Africa and lives in large colonies, often situated in cities. We screened sera from 262 E. helvum using indirect fluorescent tests for antibodies against EBOV subtype Zaire. We detected a seropositive bat from Accra, Ghana, and confirmed this using western blot analysis. The bat was also seropositive for Lagos bat virus, a Lyssavirus, by virus neutralization test. The bat was fitted with a radio transmitter and was last detected in Accra 13 months after release post-sampling, demonstrating long-term survival. Antibodies to filoviruses have not been previously demonstrated in E. helvum. Radio-telemetry data demonstrates long-term survival of an individual bat following exposure to viruses of families that can be highly pathogenic to other mammal species. Because E. helvum typically lives in large urban colonies and is a source of bushmeat in some regions, further studies should determine if this species forms a reservoir for EBOV from which spillover infections into the human population may occur. PMID:20694141

Long-term survival of an urban fruit bat seropositive for Ebola and Lagos bat viruses.

PubMed

Hayman, David T S; Emmerich, Petra; Yu, Meng; Wang, Lin-Fa; Suu-Ire, Richard; Fooks, Anthony R; Cunningham, Andrew A; Wood, James L N

2010-08-04

Ebolaviruses (EBOV) (family Filoviridae) cause viral hemorrhagic fevers in humans and non-human primates when they spill over from their wildlife reservoir hosts with case fatality rates of up to 90%. Fruit bats may act as reservoirs of the Filoviridae. The migratory fruit bat, Eidolon helvum, is common across sub-Saharan Africa and lives in large colonies, often situated in cities. We screened sera from 262 E. helvum using indirect fluorescent tests for antibodies against EBOV subtype Zaire. We detected a seropositive bat from Accra, Ghana, and confirmed this using western blot analysis. The bat was also seropositive for Lagos bat virus, a Lyssavirus, by virus neutralization test. The bat was fitted with a radio transmitter and was last detected in Accra 13 months after release post-sampling, demonstrating long-term survival. Antibodies to filoviruses have not been previously demonstrated in E. helvum. Radio-telemetry data demonstrates long-term survival of an individual bat following exposure to viruses of families that can be highly pathogenic to other mammal species. Because E. helvum typically lives in large urban colonies and is a source of bushmeat in some regions, further studies should determine if this species forms a reservoir for EBOV from which spillover infections into the human population may occur.

Explanatory models of diabetes in urban poor communities in Accra, Ghana.

PubMed

de-Graft Aikins, Ama; Awuah, Raphael Baffour; Pera, Tuula Anneli; Mendez, Montserrat; Ogedegbe, Gbenga

2015-01-01

The objective of the study was to examine explanatory models of diabetes and diabetes complications among urban poor Ghanaians living with diabetes and implications for developing secondary prevention strategies. Twenty adults with type 2 diabetes were recruited from three poor communities in Accra. Qualitative data were obtained using interviews that run between 40 and 90 minutes. The interviews were audio-taped, transcribed and analysed thematically, informed by the 'explanatory model of disease' concept. Respondents associated diabetes and its complications with diet, family history, lifestyle factors (smoking, excessive alcohol consumption and physical inactivity), psychological stress and supernatural factors (witchcraft and sorcery). These associations were informed by biomedical and cultural models of diabetes and disease. Subjective experience, through a process of 'body-listening,' constituted a third model on which respondents drew to theorise diabetes complications. Poverty was an important mediator of poor self-care practices, including treatment non-adherence. The biomedical model of diabetes was a major source of legitimate information for self-care practices. However, this was understood and applied through a complex framework of cultural theories of chronic disease, the biopsychological impact of everyday illness experience and the disempowering effects of poverty. An integrated biopsychosocial approach is proposed for diabetes intervention in this research community.

Report on the 6th African Society of Human Genetics (AfSHG) Meeting, March 12-15, 2009, Yaounde, Cameroon.

PubMed

Sirugo, Giorgio; Williams, Scott M; Royal, Charmaine D M; Newport, Melanie J; Hennig, Branwen J; Mariani-Costantini, Renato; Buonaguro, Franco M; Velez Edwards, Digna R; Ibrahim, Muntaser; Soodyall, Himla; Wonkam, Ambroise; Ramesar, Raj; Rotimi, Charles N

2010-08-01

The African Society of Human Genetics (AfSHG), founded in 2003 with its inaugural meeting in Accra, Ghana,1 has the stated missions of (1) disseminating information about human genetics research in Africa, (2) establishing a mentorship network providing educational resources, including the development of appropriate technology transfer, (3) providing advocacy for human genetic research in Africa, and (4) encouraging collaborative research. Despite its young age, the AfSHG has developed a strong cadre of active researchers, both within and outside of Africa, with more than 400 members (from 16 countries across Africa as well as 8 other countries), and has held six successful meetings, five in Africa and one in the United States.

Food safety concerns of fast food consumers in urban Ghana.

PubMed

Omari, Rose; Frempong, Godfred

2016-03-01

In Ghana, out-of-home ready-to-eat foods including fast food generally have been associated with food safety problems. Notwithstanding, fast food production and consumption are increasing in Ghana and therefore this study sought to determine the food safety issues of importance to consumers and the extent to which they worry about them. First, through three focus group discussions on consumers' personal opinions about food safety issues, some emergent themes were obtained, which were used to construct an open-ended questionnaire administered face-to-face to 425 respondents systematically sampled from 20 fast food restaurants in Accra. Findings showed that most fast food consumers were concerned about food hazards such as pesticide residue in vegetables, excessive use of artificial flavour enhancers and colouring substances, bacterial contamination, migrated harmful substances from plastic packages, and general unhygienic conditions under which food is prepared and sold. Consumers also raised concerns about foodborne diseases such as cholera, typhoid, food poisoning, diarrhoea, bird flu and swine flu. The logistic regression model showed that being male increased the likelihood of worrying about general food safety issues and excessive use of flavour enhancers than in females while being youthful increased the likelihood of being worried about typhoid fever than in older consumers. These findings imply that consumers in urban Ghana are aware and concerned about current trends of food safety and foodborne disease challenges in the country. Therefore, efforts targeted at improving food safety and reducing incidences of foodborne diseases should not only focus on public awareness creation but should also design more comprehensive programmes to ensure the making of food safety rules and guidelines and enforcing compliance to facilitate availability and consumers' choice of safe foods. Copyright © 2015 Elsevier Ltd. All rights reserved.

Self-help and help-seeking for communication disability in Ghana: implications for the development of communication disability rehabilitation services.

PubMed

Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Amponsah, Clement; Bampoe, Josephine Ohenewa

2017-12-29

In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors - including the Western healthcare, religious, and traditional sectors. Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.

Perspectives of frontline health workers on Ghana's National Health Insurance Scheme before and after community engagement interventions.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

2016-05-28

Barely a decade after introduction of Ghana's National Health Insurance Scheme (NHIS), significant successes have been recorded in universal access to basic healthcare services. However, sustainability of the scheme is increasingly threatened by concerns on quality of health service delivery in NHIS-accredited health facilities coupled with stakeholders' discontentment with the operational and administrative challenges confronting the NHIS. The study sought to ascertain whether or not Systematic Community Engagement (SCE) interventions have a significant effect on frontline health workers' perspectives on the NHIS and its impact on quality health service delivery. The study is a randomized cluster trial involving clinical and non-clinical frontline health workers (n = 234) interviewed at baseline and follow-up in the Greater Accra and Western regions of Ghana. Individual respondents were chosen from within each intervention and control groupings. Difference-in-difference estimations and propensity score matching were performed to determine impact of SCE on staff perceptions of the NHIS. The main outcome measure of interest was staff perception of the NHIS based on eight (8) factor-analyzed quality service parameters. Staff interviewed in intervention facilities appeared to perceive the NHIS more positively in terms of its impact on "availability and quality of drugs (p < 0.05)" and "workload on health staff/infrastructure" than those interviewed in control facilities (p < 0.1). Delayed reimbursement of service providers remained a key concern to over 70 % of respondents in control and intervention health facilities. Community engagement in quality service assessment is a potential useful strategy towards empowering communities while promoting frontline health workers' interest, goodwill and active participation in Ghana's NHIS.

Valuing and Sustaining (or Not) the Ability of Volunteer Community Health Workers to Deliver Integrated Community Case Management in Northern Ghana: A Qualitative Study.

PubMed

Daniels, Karen; Sanders, David; Daviaud, Emmanuelle; Doherty, Tanya

2015-01-01

Within the integrated community case management of childhood illnesses (iCCM) programme, the traditional health promotion and prevention role of community health workers (CHWs) has been expanded to treatment. Understanding both the impact and the implementation experience of this expanded role are important. In evaluating UNICEF's implementation of iCCM, this qualitative case study explores the implementation experience in Ghana. Data were collected through a rapid appraisal using focus groups and individual interviews during a field visit in May 2013 to Accra and the Northern Region of Ghana. We sought to understand the experience of iCCM from the perspective of locally based UNICEF staff, their partners, researchers, Ghana health services management staff, CHWs and their supervisors, nurses in health facilities and mothers receiving the service. Our analysis of the findings showed that there is an appreciation both by mothers and by facility level staff for the contribution of CHWs. Appreciation was expressed for the localisation of the treatment of childhood illness, thus saving mothers from the effort and expense of having to seek treatment outside of the village. Despite an overall expression of value for the expanded role of CHWs, we also found that there were problems in supporting and sustaining their efforts. The data showed concern around CHWs being unpaid, poorly supervised, regularly out of stock, lacking in essential equipment and remaining outside the formal health system. Expanding the roles of CHWs is important and can be valuable, but contextual and health system factors threaten the sustainability of iCCM in Ghana. In this and other implementation sites, policymakers and key donors need to take into account historical lessons from the CHW literature, while exploring innovative and sustainable mechanisms to secure the programme as part of a government owned and government led strategy.

Transnational connections of health professionals: medicoscapes and assisted reproduction in Ghana and Uganda.

PubMed

Hörbst, Viola; Gerrits, Trudie

2016-08-01

Based on our comparative fieldwork in two private fertility clinics in Accra (Ghana) and Kampala (Uganda), we explore the transnational mobility of providers involved in assisted reproductive technologies (ARTs) and analyze how resulting transnational networks influence the realization and appropriation of these therapeutic treatments. By exploring these case studies from developing countries, this article intends to contribute to the field of studies that examine the diversification and complexity of migration and health care. We first summarize the dynamics affecting the health-care systems in Ghana and Uganda over the last decades. Then, we describe the transnational mobility engaged in the two clinics. Through the case studies, we highlight how ARTs are realized and appropriated in the two receiving countries, and the role transnational contacts play within the negotiations of medical ethos and financial interests. By using the concept of medicoscapes, we analyze the worldwide connections between ART providers, the institutions they work in, their medical practices, artifacts, and their regimes of medical knowledge. Transnational professional contacts have been essential to the setup of both clinics offering ARTs in Ghana and Uganda. These contacts developed along colonial and post-colonial links, integrating also south-south relationship. The clinics' directors act as entrepreneurs and creative decision-makers who capitalize on their transnational professional network. The case studies show the diverse transnational entanglements in both clinics and demonstrate the frictions between the doctors' entrepreneurial interests, medical concerns and cultural values. The transnational professional contacts expose both clinics to varying practices and debates, and make them into sites for negotiating distinct clinical practices. They provoke frictions between entrepreneurial interests and medical concerns including cultural values. In current medicoscapes, in a situation of full absence of any form of financial support and of any national ART regulation in Ghana and Uganda, clinic directors are in the position to apply those practices that fit their interests and local circumstances best.

Economic burden of malaria on businesses in Ghana: a case for private sector investment in malaria control.

PubMed

Nonvignon, Justice; Aryeetey, Genevieve Cecilia; Malm, Keziah L; Agyemang, Samuel Agyei; Aubyn, Vivian N A; Peprah, Nana Yaw; Bart-Plange, Constance N; Aikins, Moses

2016-09-06

Despite the significant gains made globally in reducing the burden of malaria, the disease remains a major public health challenge, especially in sub-Saharan Africa (SSA) including Ghana. There is a significant gap in financing malaria control globally. The private sector could become a significant source of financing malaria control. To get the private sector to appreciate the need to invest in malaria control, it is important to provide evidence of the economic burden of malaria on businesses. The objective of this study, therefore, was to estimate the economic burden on malaria on businesses in Ghana, so as to stimulate the sector's investment in malaria control. Data covering 2012-2014 were collected from 62 businesses sampled from Greater Accra, Ashanti and Western Regions of Ghana, which have the highest concentration of businesses in the country. Data on the cost of businesses' spending on treatment and prevention of malaria in staff and their dependants as well as staff absenteeism due to malaria and expenditure on other health-related activities were collected. Views of business leaders on the effect of malaria on their businesses were also compiled. The analysis was extrapolated to cover 5828 businesses across the country. The results show that businesses in Ghana lost about US$6.58 million to malaria in 2014, 90 % of which were direct costs. A total of 3913 workdays were lost due to malaria in firms in the study sample during the period 2012-2014. Businesses in the study sample spent an average of 0.5 % of the annual corporate returns on treatment of malaria in employees and their dependants, 0.3 % on malaria prevention, and 0.5 % on other health-related corporate social responsibilities. Again business leaders affirmed that malaria affects their businesses' efficiency, employee attendance and productivity and expenses. Finally, about 93 % of business leaders expressed the need private sector investment in malaria control. The economic burden of malaria on businesses in Ghana cannot be underestimated. This, together with business leaders' acknowledgement that it is important for private sector investment in malaria control, provides motivation for engagement of the private sector in financing malaria control activities.

Adolescents' Responses to an Unintended Pregnancy in Ghana: A Qualitative Study.

PubMed

Aziato, Lydia; Hindin, Michelle J; Maya, Ernest Tei; Manu, Abubakar; Amuasi, Susan Ama; Lawerh, Rachel Mahoe; Ankomah, Augustine

2016-12-01

To investigate the experiences and perceptions of adolescents who have experienced a recent pregnancy and undergone a termination of pregnancy. A vignette-based focus group approach was used to have adolescents reflect on scenarios that happen to others during an unwanted pregnancy. The study was conducted in public health facilities in the 3 major urban areas of Ghana-Accra, Kumasi, and Tamale. Adolescents, aged 10-19 years, who had a recent termination of pregnancy were recruited from public health facilities in the 3 sites. Fifteen focus groups were conducted and digitally recorded in English, Twi, Ga, and Dagbani. Transcripts were transcribed and translated, and thematic analysis was used for the analysis. Adolescents reported that the characters in the vignettes would feel sadness, depression, and regret from an unintended pregnancy and some male partners would "deny" the pregnancy or suggest an abortion. They suggested some parents would "be angry" and "sack" their children for becoming pregnant while others would "support" them. Parents might send the pregnant girl to a distant friend or grandparents until she delivers to avoid shame and gossip. Health professionals might encourage the pregnant girl or insult/gossip about the girl. Adolescent unintended pregnancies in Ghana are met with a range of reactions and these reactions influence the pregnancy choices young women make for continuation or termination of pregnancy. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Anthropogenic plumes from metropolitan areas and biomass burning emissions in West Africa during DACCIWA - airborne measurements on board the DLR Falcon 20

NASA Astrophysics Data System (ADS)

Stratmann, Greta; Schlager, Hans; Sauer, Daniel; Brocchi, Vanessa; Catoire, Valery; Baumann, Robert

2017-04-01

The DACCIWA (Dynamics-Aerosol-Chemistry-Cloud Interactions over West Africa) airborne field campaign was conducted in Southern West Africa in June/July 2016. Three European research aircraft (DLR - Falcon 20, SAFIRE - ATR 42 and BAS - Twin Otter) were deployed from Lomé/Togo and conducted research flights across Ivory Coast, Ghana, Togo and Benin. On board the DLR Falcon O3, SO2, CO, NO2 and aerosol fine mode particle number concentration and size distribution were measured during a total of 12 scientific flights. Until now only few airborne trace gas measurements were conducted in Southern West Africa. Therefore, this field experiment contributes to the knowledge of the chemical composition of the lower troposphere between 0 - 4 km. During several flights pollution plumes from major population centers - Lomé/Togo, Accra/Ghana, Kumasi/Ghana, and Abidjan/Ivory Coast - were probed below, inside and above clouds. Here, enhanced trace gas and particle concentrations were observed. In addition, plumes from biomass burning emissions were detected which were transported to West Africa. The composition of the pollution plumes are presented as well as transport pathways using HYSPLIT (Hybrid Single-Particle Lagrangian Integrated Trajectories) trajectory calculations. Ozone enhancements in the biomass burning pollution plumes of up to 70 ppb were observed compared to background concentrations of 30-40 ppb. Furthermore, HYSPLIT atmospheric dispersion simulations are used to estimate anthropogenic SO2 city emissions.

Irrigated urban vegetable production in Ghana: microbiological contamination in farms and markets and associated consumer risk groups.

PubMed

Amoah, P; Drechsel, P; Henseler, M; Abaidoo, R C

2007-09-01

Ghana is a typical low-income sub-Saharan African country facing significant sanitation challenges. In Ghana, fresh salads are not part of the normal diet, but have become a common supplement to urban fast food served in streets, canteens and restaurants. In Accra, about 200 000 people consume from such supplements every day. The figure also describes the size of the risk group from contamination, which comprises all income classes including the poor and children. The purpose of this study was to investigate widespread water pollution in urban and peri-urban areas, where 95% of the lettuce consumed in the city is produced. Over 12 months (April 2004-June 2005), lettuce samples from the same production sites in two cities were followed and analyzed along the "farm to fork" pathway for total and faecal coliform (FC) and helminth egg numbers. Questionnaire surveys were conducted among producers, sellers and consumers to quantify lettuce flows to the final risk group. The study identified the farm as the main point of lettuce contamination. Besides the irrigation water, contamination was also attributed to manure application and already contaminated soil. Despite poor sanitary conditions in markets, post-harvest handling and marketing did not further increase the farm-gate contamination levels. To reduce the health risk associated with the consumption of contaminated lettuce; safer farming and irrigation practices are required while the remaining risk could best be addressed where lettuce is prepared for consumption.

Medication Administration Errors in an Adult Emergency Department of a Tertiary Health Care Facility in Ghana.

PubMed

Acheampong, Franklin; Tetteh, Ashalley Raymond; Anto, Berko Panyin

2016-12-01

This study determined the incidence, types, clinical significance, and potential causes of medication administration errors (MAEs) at the emergency department (ED) of a tertiary health care facility in Ghana. This study used a cross-sectional nonparticipant observational technique. Study participants (nurses) were observed preparing and administering medication at the ED of a 2000-bed tertiary care hospital in Accra, Ghana. The observations were then compared with patients' medication charts, and identified errors were clarified with staff for possible causes. Of the 1332 observations made, involving 338 patients and 49 nurses, 362 had errors, representing 27.2%. However, the error rate excluding "lack of drug availability" fell to 12.8%. Without wrong time error, the error rate was 22.8%. The 2 most frequent error types were omission (n = 281, 77.6%) and wrong time (n = 58, 16%) errors. Omission error was mainly due to unavailability of medicine, 48.9% (n = 177). Although only one of the errors was potentially fatal, 26.7% were definitely clinically severe. The common themes that dominated the probable causes of MAEs were unavailability, staff factors, patient factors, prescription, and communication problems. This study gives credence to similar studies in different settings that MAEs occur frequently in the ED of hospitals. Most of the errors identified were not potentially fatal; however, preventive strategies need to be used to make life-saving processes such as drug administration in such specialized units error-free.

Informal processing of electronic waste at Agbogbloshie, Ghana: workers' knowledge about associated health hazards and alternative livelihoods.

PubMed

Yu, Emily A; Akormedi, Matthew; Asampong, Emmanuel; Meyer, Christian G; Fobil, Julius N

2017-12-01

This study was conducted to investigate the electronic waste workers' knowledge about the potential health hazards associated with their work as well as the livelihood alternatives that they would prefer if they were given the opportunity. A qualitative cross-sectional study was conducted to gather empirical information on e-waste workers' knowledge about the potential hazards associated with their work and the livelihood alternatives to e-waste recycling with a sample consisting of twenty all-male electronic waste workers at the Agbogbloshie scrap metal yard in Accra, Ghana. Electronic waste workers at Agbogbloshie were found to be exposed to a variety of injuries and illnesses. The workers' knowledge of the association between their health status and their work was generally poor. Apart from the physical injuries, they did not believe their work played any negative role in their health conditions. They preferred occupations such as farming or professional driving located in the northern region of Ghana to be closer to their families. The study concludes that the low knowledge level of the workers on the hazards that are associated with their work has implications for them accepting technologies to protect them and the natural environment from contamination. It is therefore imperative for any intervention to consider the current low level of knowledge and actively educate the workers to raise their awareness level, taking into account the provision of opportunities for workers to acquire applicable skills for future employment in other fields.

Health seeking behaviours among electronic waste workers in Ghana.

PubMed

Asampong, Emmanuel; Dwuma-Badu, Kwaku; Stephens, Judith; Srigboh, Roland; Neitzel, Richard; Basu, Niladri; Fobil, Julius N

2015-10-16

Electronic waste workers are prone to various illnesses and injuries from numerous hazards thus the need for them to seek health care. The aim of this study was to describe health-seeking behavior, and social and other factors affecting this behavior, among electronic waste workers at Agbogbloshie, Accra, Ghana. In-depth interviews were conducted and analyzed qualitatively from a grounded theory perspective. Workers experienced various kinds of ailments. These included physical injuries, chest and respiratory tract associated symptoms, malaria, headaches, body pains and stomach discomfort. They reported seeking health care from multiple sources, and the main determinants of health seeking behaviour were severity of illness, perceived benefit of treatment, accessibility of service, quality of service, ease of communication with service provider and cost of health care. Multiple sources of health care were used by the e-waste workers. As cost was a major barrier to accessing formal health care, most of the workers did not subscribe to health insurance. Since enrollment in health insurance is low amongst the workers, education campaigns on the need to register with the National Health Insurance Scheme would facilitate access to formal health care and could result in improved health outcomes among e-waste workers.

The West Africa Disaster Preparedness Initiative: Strengthening National Capacities for All-Hazards Disaster Preparedness.

PubMed

Morton Hamer, Melinda J; Reed, Paul L; Greulich, Jane D; Kelen, Gabor D; Bradstreet, Nicole A; Beadling, Charles W

2017-08-01

The Ebola outbreak demonstrated the need for improved disaster response throughout West Africa. The West Africa Disaster Preparedness Initiative was a training and assessment effort led by US Africa Command and partners to strengthen capacities among 12 West African partner nations (PNs). Series of 3-week training sessions with representatives from each PN were held from 13 July through 20 November 2015 at the Kofi Annan International Peacekeeping Training Centre in Accra, Ghana. A team conducted Disaster Management Capabilities Assessments (DMCAs) for each PN, including a review of key data, a survey for leaders, and in-person interviews of key informants. All 12 PNs generated a national Ebola Preparedness and Response Plan and Emergency Operations Center standard operating procedures. DMCA metrics were generated for each PN. Top performers included Ghana, with a plan rated good/excellent, and Benin and Burkina Faso, which both achieved a satisfactory rating for their plans. More than 800 people from 12 nations were trained. PNs have improved disaster management capabilities and awareness of their strengths and weaknesses. The Economic Community of West African States has increased its lead role in this and future planned initiatives. (Disaster Med Public Health Preparedness. 2017;11:431-438).

Intermittent Preventive Treatment with Sulfadoxine-Pyrimethamine against Malaria and Anemia in Pregnant Women

PubMed Central

Wilson, Nana O.; Ceesay, Fatou K.; Obed, Samuel A.; Adjei, Andrew A.; Gyasi, Richard K.; Rodney, Patricia; Ndjakani, Yassa; Anderson, Winston A.; Lucchi, Naomi W.; Stiles, Jonathan K.

2011-01-01

The effectiveness of intermittent preventive treatment during pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) against malaria and anemia is unclear because of the spread of SP-resistant Plasmodium falciparum. This study evaluates the effectiveness of IPTp-SP among pregnant women attending the antenatal clinic at Korle-Bu Teaching Hospital in Accra, Ghana. A cross-sectional study comparing malaria and anemia prevalence among pregnant women using IPTp-SP with non-IPTp-SP users was conducted during June–August 2009. A total of 363 pregnant women (202 of IPTp users and 161 non-IPTp users) were recruited. A total of 15.3% of IPTp users had malaria compared with 44.7% of non-IPTp users (P < 0.001). A total of 58.4% of non-IPTp users were anemic compared with 22.8% of IPTp users (P < 0.001). When we controlled for other variables, the difference in the prevalence of malaria (odds ratio = 0.18, 95% confidence interval = 0.08–0.37) and anemia (odds ratio = 0.20, 95% confidence interval = 0.12–0.34) remained significant. The recommended IPTp-SP regimen is useful in preventing malaria and anemia among pregnant women in Ghana. PMID:21734118

Validation of QuEChERS method for the determination of 36 pesticide residues in fruits and vegetables from Ghana, using gas chromatography with electron capture and pulsed flame photometric detectors.

PubMed

Donkor, Augustine; Osei-Fosu, Paul; Nyarko, Stephen; Kingsford-Adaboh, Robert; Dubey, Brajesh; Asante, Isaac

2015-01-01

In this study, "Quick, Easy, Cheap, Effective, Rugged and Safe" 'QuEChERS' method was modified for the determination of 36 pesticides fortified at (0.01-1.0) mg kg(-1) in three vegetables and a fruit (lettuce, carrot, tomatoes and pineapples respectively) from Ghana. The method involved extraction with acetonitrile, phase separation with primary secondary amine and magnesium sulfate; the final injection solution was reconstituted in ethyl acetate. Organochlorine and synthetic pyrethroids residues were detected with electron capture detector whereas organophosphorus, pulsed flame photometric detector was used. The recoveries at different concentration levels (0.01, 0.1 and 1.0 mg kg(-1)) were in the range of 83% and 93% with relative standard deviation ranging from 2% to 10% (n = 5) and the coefficient of determination (R(2)) was greater than 0.99 for all the 36 pesticides. The method was successfully tested on 120 real samples from Accra markets and this proved to be useful for monitoring purposes particularly in laboratories that have no gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry.

Health workers perceptions and attitude about Ghana's preparedness towards preventing, containing, and managing Ebola Virus Disease.

PubMed

Adongo, Philip Baba; Tabong, Philip Teg-Nefaah; Asampong, Emmanuel; Ansong, Joana; Robalo, Magda; Adanu, Richard M

2017-04-12

Ebola virus is highly infectious and the disease can be very fatal. The World Health Organization has declared the 2014-2015 Ebola Virus Disease outbreak a Public Health Emergency of International Concern. In response to this, preparations were made in various health facilities and entry points across Ghana. This study explored health workers perceptions, and attitude about Ghana's preparedness towards preventing and containing Ebola Virus Disease. We conducted a qualitative study in five (5) of the ten (10) regions in Ghana. Five focus group discussions (N = 44) were conducted among nurses; one in each region. In addition, ten (10) health workers (2 in each region) who are members of regional Ebola Virus Disease task force were recruited and interviewed. In the Greater Accra, Volta and Western regions that have ports, six (6) port health officials: two in each of these regions were also interviewed. The interviews were recorded digitally and transcribed verbatim. Thematic content analysis was used to analyze the transcripts with the aid of NVivo 10 software. The results of this study showed that Ghanaian health workers perceived the screening at various ports as important and ongoing but felt that the screenings at in-land ports were being undermined by the use of unapproved routes. Training of health workers was also being carried out in all the regions, however, there was a general perception among 33 out of 44 nurses that majority of health workers have not received training on Ebola Virus Disease prevention and management. Logistical challenges were also reported as some health facilities did not have adequate Personal Protective Equipment. In facilities where equipment was available, they were stored in places which are not easily accessible to health workers at all times of the day. Human resource preparation was also perceived to be a challenge as health workers (38/44 of nurses) generally expressed fear and unwillingness to work in Ebola treatment centres in the event of an outbreak in Ghana. Our study concludes that preparatory work for Ebola Virus Disease prevention and containment in Ghana is perceived as inadequate by health workers. Ghana needs to strengthen preparation in the area of training of health workers, provision and accessibility of Personal Protective Equipment and incentives for health workers to better position her to contain and manage any Ebola Virus Disease outbreak.

The experience of dysmenorrhoea among Ghanaian senior high and university students: pain characteristics and effects.

PubMed

Aziato, Lydia; Dedey, Florence; Clegg-Lamptey, Joe Nat A

2014-07-26

Dysmenorrhoea is a common problem of women at the reproductive age and may have negative effect on the education of females at various stages on the educational ladder. This study sought to gain an in-depth understanding of the experience of dysmenorrhoea and its effect on female students in a secondary and a tertiary institution in Accra, Ghana. The study employed a descriptive phenomenology design and was conducted at a University and a Senior High School (SHS) in Accra. Purposive and snowball sampling techniques were used to recruit participants and data was saturated with 16 participants. Concurrent analysis was done by applying the processes of content analysis and the NVivo software was used to manage the data. It was realized that dysmenorrhoea is associated with symptoms such as diarrhoea, headache and vomiting. Pain may start one week to the day of menstruation and the severity differed across the days of menstruation. The effect of dysmenorrhoea included activity intolerance, altered emotion and interaction, altered sleep pattern, absenteeism and inattentiveness, wishes and regrets, and misconceptions. It was concluded that severe dysmenorrhoea has a debilitating effect on female students and is associated with misconceptions that could result in drastic action with fatal consequences. Thus, there is the need to enhance education on dysmenorrhoea, and an aggressive step should be taken to effectively manage dysmenorrhoea.

The experience of dysmenorrhoea among Ghanaian senior high and university students: pain characteristics and effects

PubMed Central

2014-01-01

Background Dysmenorrhoea is a common problem of women at the reproductive age and may have negative effect on the education of females at various stages on the educational ladder. Context and purpose This study sought to gain an in-depth understanding of the experience of dysmenorrhoea and its effect on female students in a secondary and a tertiary institution in Accra, Ghana. Methods The study employed a descriptive phenomenology design and was conducted at a University and a Senior High School (SHS) in Accra. Purposive and snowball sampling techniques were used to recruit participants and data was saturated with 16 participants. Concurrent analysis was done by applying the processes of content analysis and the NVivo software was used to manage the data. Results It was realized that dysmenorrhoea is associated with symptoms such as diarrhoea, headache and vomiting. Pain may start one week to the day of menstruation and the severity differed across the days of menstruation. The effect of dysmenorrhoea included activity intolerance, altered emotion and interaction, altered sleep pattern, absenteeism and inattentiveness, wishes and regrets, and misconceptions. Conclusions It was concluded that severe dysmenorrhoea has a debilitating effect on female students and is associated with misconceptions that could result in drastic action with fatal consequences. Thus, there is the need to enhance education on dysmenorrhoea, and an aggressive step should be taken to effectively manage dysmenorrhoea. PMID:25064081

Dynamics of cholera epidemics from Benin to Mauritania.

PubMed

Moore, Sandra; Dongdem, Anthony Zunuo; Opare, David; Cottavoz, Paul; Fookes, Maria; Sadji, Adodo Yao; Dzotsi, Emmanuel; Dogbe, Michael; Jeddi, Fakhri; Bidjada, Bawimodom; Piarroux, Martine; Valentin, Ouyi Tante; Glèlè, Clément Kakaï; Rebaudet, Stanislas; Sow, Amy Gassama; Constantin de Magny, Guillaume; Koivogui, Lamine; Dunoyer, Jessica; Bellet, Francois; Garnotel, Eric; Thomson, Nicholas; Piarroux, Renaud

2018-04-01

The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania. We conducted a series of field visits as well as multilocus variable tandem repeat analysis and whole-genome sequencing analysis of V. cholerae isolates throughout the study region. During this period, Ghana accounted for 52% of the reported cases in the entire study region (coastal countries from Benin to Mauritania). From 2009 to 2015, we found that one major wave of cholera outbreaks spread from Accra in 2011 northwestward to Sierra Leone and Guinea in 2012. Molecular epidemiology analysis confirmed that the 2011 Ghanaian isolates were related to those that seeded the 2012 epidemics in Guinea and Sierra Leone. Interestingly, we found that many countries deemed "cholera endemic" actually suffered very few outbreaks, with multi-year lulls. This study provides the first cohesive vision of the dynamics of cholera epidemics in a major portion of West Africa. This epidemiological overview shows that from 2009 to 2015, at least 54% of reported cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. These findings may serve as a guide to better target cholera prevention and control efforts in the identified cholera hotspots in West Africa.

Urban Household Characteristics and Dietary Diversity: An Analysis of Food Security in Accra, Ghana.

PubMed

Codjoe, Samuel Nii Ardey; Okutu, David; Abu, Mumuni

2016-06-01

The world's population is increasingly becoming urbanized. If the current urban growth rate is to continue, new and unprecedented challenges for food security will be inevitable. Dietary diversity has been used to ascertain food security status albeit at the multicountry and country levels. Thus, household-level studies in urban settings, particularly in sub-Sahara African, are few. Yet, it is imperative that assessments of food security are undertaken particularly in urban settings, due to the projected fast rate of urbanization and the challenges of attaining food security. To examine household characteristics and dietary diversity. The study uses data from 452 households from the second round of the Regional Institute for Population Studies (RIPS) EDULINK urban poverty and health study. Bivariate and multivariate analyses are undertaken. Mean dietary diversity for all households is 6.8. Vegetables have the highest diversity, followed by cereal-based and grain products. Household characteristics that have statistically significant associations with dietary diversity include sex and level of education of household head, household wealth quintile, and source of food. There is high dietary diversity in the study communities of Accra but low consumption of foods rich in micronutrient, such as fruits and milk/dairy products. The study brings to fore issues related to resource-disadvantaged entities of the urban system, namely, females, poor households, and the non-educated who have food insecurity problems. © The Author(s) 2016.

Quality evaluation of processed clay soil samples.

PubMed

Steiner-Asiedu, Matilda; Harrison, Obed Akwaa; Vuvor, Frederick; Tano-Debrah, Kwaku

2016-01-01

This study assessed the microbial quality of clay samples sold on two of the major Ghanaian markets. The study was a cross-sectional assessing the evaluation of processed clay and effects it has on the nutrition of the consumers in the political capital town of Ghana. The items for the examination was processed clay soil samples. Staphylococcus spp and fecal coliforms including Klebsiella, Escherichia, and Shigella and Enterobacterspp were isolated from the clay samples. Samples from the Kaneshie market in Accra recorded the highest total viable counts 6.5 Log cfu/g and Staphylococcal count 5.8 Log cfu/g. For fecal coliforms, Madina market samples had the highest count 6.5 Log cfu/g and also recorded the highest levels of yeast and mould. For Koforidua, total viable count was highest in the samples from the Zongo market 6.3 Log cfu/g. Central market samples had the highest count of fecal coliforms 4.6 Log cfu/g and yeasts and moulds 6.5 Log cfu/g. "Small" market recorded the highest staphylococcal count 6.2 Log cfu/g. The water activity of the clay samples were low, and ranged between 0.65±0.01 and 0.66±0.00 for samples collected from Koforidua and Accra respectively. The clay samples were found to contain Klebsiella spp. Escherichia, Enterobacter, Shigella spp. staphylococcus spp., yeast and mould. These have health implications when consumed.

Neighborhood food retail environment and health outcomes among urban Ghanaian women

NASA Astrophysics Data System (ADS)

Taflin, Helena Janet

Over the past several decades there has been a global dietary shift, occurring at different rates across time and space. These changes are reflective of the nutrition transition--a series of potentially adverse changes in diet, health and physical activity. These dietary shifts have been associated with significant health consequences, as seen by the global rise in nutrition-related non-communicable diseases (NR-NCDs) such as diabetes, hypertension, cancer, coronary heart disease as well as obesity. Clinical studies have confirmed that overweight and obese individuals are at increased risk for diabetes and hypertension, among other cardiovascular diseases. However, these linkages between the nutrition transition and health are not spatially random. They vary according to personal characteristics ("who you are") and the neighborhood environment in which you live ("where you are"). Leveraging existing demographic and health resources, in this project I aim to investigate the relationship between the food retail environment and health outcomes among a representative sample of urban Ghanaian women ages 18 and older, normally resident in the Accra Metropolitan Area (AMA), using a mixed methods spatial approach. Data for this study are drawn primarily from the 2008-09 Women's Health Study of Accra (WHSA II) which was funded by the U.S. National Institute of Child Health and Human Development (NICHD) (John R. Weeks, Project Director/Principal Investigator). It was conducted as a joint collaboration between the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana, the Harvard School of Public Health and San Diego State University. Results from this study highlights the importance of addressing the high prevalence of hypertension among adult women in Accra and should be of concern to both stakeholders and the public. Older populations, overweight and obese individuals, those with partners living at home, limited number of food retailers in one's neighborhood and living in close proximity to a modern food retailer all increase the risk of hypertension among women sampled in WHSA-II.

Mapping Spatial Variability in Health and Wealth Indicators in Accra, Ghana Using High Spatial Resolution Imagery

NASA Astrophysics Data System (ADS)

Engstrom, R.; Ashcroft, E.

2014-12-01

There has been a tremendous amount of research conducted that examines disparities in health and wealth of persons between urban and rural areas however, relatively little research has been undertaken to examine variations within urban areas. A major limitation to elucidating differences with urban areas is the lack of social and demographic data at a sufficiently high spatial resolution to determine these differences. Generally the only available data that contain this information are census data which are collected at most every ten years and are often difficult to obtain at a high enough spatial resolution to allow for examining in depth variability in health and wealth indicators at high spatial resolutions, especially in developing countries. High spatial resolution satellite imagery may be able to provide timely and synoptic information that is related to health and wealth variability within a city. In this study we use two dates of Quickbird imagery (2003 and 2010) classified into the vegetation-impervious surface-soil (VIS) model introduced by Ridd (1995). For 2003 we only have partial coverage of the city, while for 2010 we have a mosaic, which covers the entire city of Accra, Ghana. Variations in the VIS values represent the physical variations within the city and these are compared to variations in economic, and/or sociodemographic data derived from the 2000 Ghanaian census at two spatial resolutions, the enumeration area (approximately US Census Tract) and the neighborhood for the city. Results indicate a significant correlation between both vegetation and impervious surface to type of cooking fuel used in the household, population density, housing density, availability of sewers, cooking space usage, and other variables. The correlations are generally stronger at the neighborhood level and the relationships are stable through time and space. Overall, the results indicate that information derived from high resolution satellite data is related to indicators of health and wealth within a developing world city and that the even if the imagery is collected 10 years after the census information, the relationships are still significant.

A comparative survey of the prevalence of human parasites found in fresh vegetables sold in supermarkets and open-aired markets in Accra, Ghana.

PubMed

Duedu, Kwabena O; Yarnie, Elizabeth A; Tetteh-Quarcoo, Patience B; Attah, Simon K; Donkor, Eric S; Ayeh-Kumi, Patrick F

2014-11-25

Consuming raw vegetables offers essential nutrients that one may not get when such vegetables are usually cooked. However, eating them raw may pose a great risk for transmissions of pathogens. Such risks may be influenced by the sources of the vegetables and washing techniques used. The aim of the study was to compare the prevalence and diversity of parasitic pathogens associated with vegetables sold at the two types of markets in Ghana and compare effectiveness of various washing techniques. We purchased two batches of samples of cabbage, sweet bell pepper, carrot, lettuce, tomato and onion within a two week interval. The vegetables were washed by three methods and the wash solution was concentrated and analyzed for parasites. The prevalent parasites detected were Strongyloides stercoralis larvae (43%) and Cryptosporidium parvum oocyst (16%). Others present were Hookworm ova, Entamoeba histolytica cysts, Giardia lamblia cysts, Cyclospora cayetanensis oocysts, Entamoeba coli cysts, Trichuris trichiuria ova, Enterobius vermicularis ova, Isospora belli oocysts and Fasciolopsis buski ova. Contamination was highest in lettuce (61%) and cabbage and the least contaminated was tomato (18%). Contamination of vegetables sold at the open-aired markets was about ten-times that of the supermarkets. In Ghana, the large open-aired markets are the most patronized and serve as a supply point for most corner shops and stalls. The results thus highlight the potential of fresh vegetables serving as a major source of food-borne disease outbreaks and the contribution of open-aired markets to their transmission. Urgent public education on handling of fresh vegetables is recommended.

Measuring Coverage in MNCH: Validating Women’s Self-Report of Emergency Cesarean Sections in Ghana and the Dominican Republic

PubMed Central

Tunçalp, Özge; Stanton, Cynthia; Castro, Arachu; Adanu, Richard; Heymann, Marilyn; Adu-Bonsaffoh, Kwame; Lattof, Samantha R.; Blanc, Ann; Langer, Ana

2013-01-01

Background Cesarean section is the only surgery for which we have nearly global population-based data. However, few surveys provide additional data related to cesarean sections. Given weaknesses in many health information systems, health planners in developing countries will likely rely on nationally representative surveys for the foreseeable future. The objective is to validate self-reported data on the emergency status of cesarean sections among women delivering in teaching hospitals in the capitals of two contrasting countries: Accra, Ghana and Santo Domingo, Dominican Republic (DR). Methods and Findings This study compares hospital-based data, considered the reference standard, against women’s self-report for two definitions of emergency cesarean section based on the timing of the decision to operate and the timing of the cesarean section relative to onset of labor. Hospital data were abstracted from individual medical records, and hospital discharge interviews were conducted with women who had undergone cesarean section in two hospitals. The study assessed sensitivity, specificity, and positive predictive value of responses to questions regarding emergency versus non-emergency cesarean section and estimated the percent of emergency cesarean sections that would be obtained from a survey, given the observed prevalence, sensitivity, and specificity from this study. Hospital data were matched with exit interviews for 659 women delivered via cesarean section for Ghana and 1,531 for the Dominican Republic. In Ghana and the Dominican Republic, sensitivity and specificity for emergency cesarean section defined by decision time were 79% and 82%, and 50% and 80%, respectively. The validity of emergency cesarean defined by operation time showed less favorable results than decision time in Ghana and slightly more favorable results in the Dominican Republic. Conclusions Questions used in this study to identify emergency cesarean section are promising but insufficient to promote for inclusion in international survey questionnaires. Additional studies which confirm the accuracy of key facility-based indicators in advance of data collection and which use a longer recall period are warranted. PMID:23667428

Role-players in abortion decision-making in the Accra Metropolis, Ghana.

PubMed

Kumi-Kyereme, Akwasi; Gbagbo, Fred Yao; Amo-Adjei, Joshua

2014-09-16

Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana. A retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data. The findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and "Others" (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations. A number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision.

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana

PubMed Central

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K.; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K.; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-01-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15–24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women’s SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH. PMID:28296626

Determination of the Extent of Trace Metals Pollution in Soils, Sediments and Human Hair at e-Waste Recycling Site in Ghana.

PubMed

Tokumaru, Takashi; Ozaki, Hirokazu; Onwona-Agyeman, Siaw; Ofosu-Anim, John; Watanabe, Izumi

2017-10-01

The concentrations of trace elements (Mg, Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Ga, As, Se, Rb, Sr, Y, Mo, Cd, In, Sn, Sb, Cs, Ba, Tl, Pb, and Bi) in soils, sediment, human hair, and foodstuff collected around the electronic waste (e-waste) recycling sites in Accra, Ghana were detected using inductively coupled plasma-mass spectrometry (ICP-MS). High levels of Cu, Zn, Mo, Cd, In, Sn, Sb, and Pb were observed in soils collected from the e-waste recycling sites. Four sequential extraction procedures were used to evaluate the mobility and bioavailability of metals (Cu, Zn, Cd, Sb, and Pb). Especially, the results showed that Cd and Zn in soils were mostly recovered in exchangeable fraction (respectively 58.9 and 62.8%). Sediment collected from around the site had enrichment of Zn, Sn, Sb, Mo, In, Pb, and Bi. The concentrations of Cu, Mo, Cd, Sb, and Pb in human hair were significantly higher than those collected from the control site (p < 0.01). Additionally, hierarchical cluster analysis reviewed that these elements were derived from e-waste activities. The results of Pb isotopic ratios in the samples indicate that Pb in human hair possibly originated from contaminated soils, fish, and foodstuff.

Multiple levels of social influence on adolescent sexual and reproductive health decision-making and behaviors in Ghana.

PubMed

Challa, Sneha; Manu, Abubakar; Morhe, Emmanuel; Dalton, Vanessa K; Loll, Dana; Dozier, Jessica; Zochowski, Melissa K; Boakye, Andrew; Adanu, Richard; Hall, Kelli Stidham

2018-04-01

Little is known about the multilevel social determinants of adolescent sexual and reproductive health (SRH) that shape the use of family planning (FP) among young women in Africa. We conducted in-depth, semi-structured, qualitative interviews with 63 women aged 15-24 years in Accra and Kumasi, Ghana. We used purposive, stratified sampling to recruit women from community-based sites. Interviews were conducted in English or local languages, recorded, and transcribed verbatim. Grounded theory-guided thematic analysis identified salient themes. Three primary levels of influence emerged as shaping young women's SRH experiences, decision-making, and behaviors. Interpersonal influences (peers, partners, and parents) were both supportive and unsupportive influences on sexual debut, contraceptive (non) use, and pregnancy resolution. Community influences included perceived norms about acceptability/unacceptability of adolescent sexual activity and its consequences (pregnancy, childbearing, abortion). Macro-social influences involved religion and abstinence and teachings about premarital sex, lack of comprehensive sex education, and limited access to confidential, quality SRH care. The willingness and ability of young women in our study to use FP methods and services were affected, often negatively, by factors operating within and across each level. These findings have implications for research, programs, and policies to address social determinants of adolescent SRH.

Proceedings of the 2013 AFENET Scientific Conference - Posters sessions

PubMed Central

Gitta, Sheba Nakacubo; Kamadjeu, Raoul; Mwesiga, Allan

2015-01-01

Biennially, trainees and graduates of Field Epidemiology and Laboratory Training Programs (FELTPs) are presented with a platform to share investigations and projects undertaken during their two-year training in Applied Epidemiology. The African Field Epidemiology Network (AFENET) Scientific Conference, is a perfect opportunity for public health professionals from various sectors and organizations to come together to discuss issues that impact on public health in Africa. This year's conference was organized by the Ethiopian Health and Nutrition Research Institute in collaboration with the Ethiopia Ministry of Health, Ethiopian Public Health Association (EPHA), Ethiopia Field Epidemiology Training Program (EFETP), Addis Ababa University (AAU), Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) and AFENET. Participants at this year's conference numbered 400 from over 20 countries including; Angola, Burkina Faso, Cameroon, Central African Republic, Democratic Republic of the Congo, Ethiopia, Ghana, Indonesia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Sudan, Tanzania, Uganda, Yemen and Zimbabwe. The topics covered in the 58 presentations include: emergency response, immunization, outbreak investigation and public health surveillance. The theme for the 5th AFENET Scientific Conference was; “Addressing Public Health Priorities in Africa through FELTPs.” Previous AFENET Scientific conferences have been held in: Accra, Ghana (2005), Kampala, Uganda (2007), Mombasa, Kenya (2009) and Dar es Salaam, Tanzania (2011).

Dysmenorrhea Management and Coping among Students in Ghana: A Qualitative Exploration.

PubMed

Aziato, Lydia; Dedey, Florence; Clegg-Lamptey, Joe Nat A

2015-06-01

The study sought to gain an in-depth understanding of primary dysmenorrhea management and coping strategies for dysmenorrhea among adolescents and young adults who were in school. The study adopted a qualitative exploratory approach using a descriptive phenomenology to explore the phenomenon of interest. The study was conducted in two educational institutions in Accra, Ghana: a Senior High School (SHS) and a University. Sixteen participants were purposively recruited (8 SHS and 8 University students) through snowball sampling. Individual interviews were conducted in English, audio-taped, transcribed and analysed using content analysis procedures. Informed consent was obtained from all participants and rigor was ensured through prolonged engagement and member checking. Participants employed both pharmacologic (orthodox and herbal) and nonpharmacologic approaches such as warm compress, exercise, and water and diet therapy for their dysmenorrhea. Students' dysmenorrhea was managed at the school clinic and the hospital. Health professionals demonstrated negative attitudes towards dysmenorrhea management. Students coped with dysmenorrhea by planning activities before the onset of pain, receiving social and spiritual support, and developing a mind-set to bear pain. Individualized approaches should be employed to enhance dysmenorrhea management. Health professionals should be educated on dysmenorrhea to improve their attitude and skills for dysmenorrhea management. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Relative Susceptibilities of ABO Blood Groups to Plasmodium falciparum Malaria in Ghana.

PubMed

Afoakwah, Richmond; Aubyn, Edmond; Prah, James; Nwaefuna, Ekene Kwabena; Boampong, Johnson N

2016-01-01

The clinical outcome of falciparum malaria in endemic areas is influenced by erythrocyte polymorphisms including the ABO blood groups. Studies have reported association of ABO blood group to resistance, susceptibility, and severity of P. falciparum malaria infection. Individuals with blood group "A" have been found to be highly susceptible to falciparum malaria whereas blood group "O" is said to confer protection against complicated cases. We analyzed samples from 293 young children less than six years old with malaria in the Korle-Bu Teaching Hospital in Accra, Ghana. It was observed that group O was present in about 16.1% of complicated cases weighed against 40.9% of uncomplicated controls. Individuals with complicated malaria were about twice likely to be of blood groups A and B compared to group O (A versus O, OR = 1.90, 95% CI = 1.59-2.26, P < 0.0001; B versus O, OR = 1.82. 95% CI = 1.57-2.23, P < 0.0001). Blood group O participants with complicated diseases had low parasitaemia compared to the other blood groups (P < 0.0001). This may give blood group O individuals a survival advantage over the other groups in complicated malaria as suggested. Participants with complicated falciparum malaria were generally anaemic and younger than those with uncomplicated disease.

Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana.

PubMed

Kwamie, Aku; van Dijk, Han; Agyepong, Irene Akua

2014-06-16

Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP 'works' when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP's underlying goal of organisational control. Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with their contexts may strengthen the institutionalisation of the LDP in the future.

Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana

PubMed Central

2014-01-01

Background Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP ‘works’ when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. Methods We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. Results The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP’s underlying goal of organisational control. Conclusions Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with their contexts may strengthen the institutionalisation of the LDP in the future. PMID:24935521

Factors that influence the clinical utilization of the nursing process at a hospital in Accra, Ghana.

PubMed

Agyeman-Yeboah, Joana; Korsah, Kwadwo Ameyaw; Okrah, Jane

2017-01-01

The nursing process is a tool that is recommended for use by all professional nurses working in Ghana, in order to provide nursing care. However, there is currently a limited use of this tool by nurses in Ghana. The purpose of this research study was to explore the various factors that influence the utilization of this nursing process. An exploratory descriptive qualitative-research design was employed. Ten participants were involved by using the purposive sampling method. A semi-structured interview guide was used to collect the data from the research participants; and the data were analysed by using content analysis. One main theme, with five subthemes, emerged from the analysis. It was found that there are factors, such as nurses not having a better understanding of the nursing process, whilst in school; the absence of the care plan in the ward, as well as the lack of adequate staff, with limited time being available for coping with contributed to the non-usage of the nursing process. We conclude that the clinical utilization of the Nursing process at the clinical setting is influenced by lack of understanding of Nurses on the Nursing process and care plan as well as lack of adequate nurses and time. We recommend that the care-plan form be made officially a part of the admission documents. Furthermore, the nursing administration should put measures in place to provide nurses with the needed resources to implement the nursing process. Additionally, they should ensure that the care-plan forms and other resources needed by the nurses are regularly and adequately provided. Nurses should further see the nursing process as a means of providing comprehensive care to their patients and addressing their specific problems. They should therefore make time despite their busy schedules to use it in order to improve quality of care and the image of nursing in Ghana.

Dynamics of cholera epidemics from Benin to Mauritania

PubMed Central

Dongdem, Anthony Zunuo; Opare, David; Cottavoz, Paul; Fookes, Maria; Sadji, Adodo Yao; Dzotsi, Emmanuel; Dogbe, Michael; Jeddi, Fakhri; Bidjada, Bawimodom; Piarroux, Martine; Valentin, Ouyi Tante; Glèlè, Clément Kakaï; Rebaudet, Stanislas; Sow, Amy Gassama; Constantin de Magny, Guillaume; Koivogui, Lamine; Dunoyer, Jessica; Bellet, Francois; Garnotel, Eric; Thomson, Nicholas; Piarroux, Renaud

2018-01-01

Background The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. Methodology/Principal findings To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania. We conducted a series of field visits as well as multilocus variable tandem repeat analysis and whole-genome sequencing analysis of V. cholerae isolates throughout the study region. During this period, Ghana accounted for 52% of the reported cases in the entire study region (coastal countries from Benin to Mauritania). From 2009 to 2015, we found that one major wave of cholera outbreaks spread from Accra in 2011 northwestward to Sierra Leone and Guinea in 2012. Molecular epidemiology analysis confirmed that the 2011 Ghanaian isolates were related to those that seeded the 2012 epidemics in Guinea and Sierra Leone. Interestingly, we found that many countries deemed “cholera endemic” actually suffered very few outbreaks, with multi-year lulls. Conclusions/Significance This study provides the first cohesive vision of the dynamics of cholera epidemics in a major portion of West Africa. This epidemiological overview shows that from 2009 to 2015, at least 54% of reported cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. These findings may serve as a guide to better target cholera prevention and control efforts in the identified cholera hotspots in West Africa. PMID:29630632

Quality evaluation of processed clay soil samples

PubMed Central

Steiner-Asiedu, Matilda; Harrison, Obed Akwaa; Vuvor, Frederick; Tano-Debrah, Kwaku

2016-01-01

Introduction This study assessed the microbial quality of clay samples sold on two of the major Ghanaian markets. Methods The study was a cross-sectional assessing the evaluation of processed clay and effects it has on the nutrition of the consumers in the political capital town of Ghana. The items for the examination was processed clay soil samples. Results Staphylococcus spp and fecal coliforms including Klebsiella, Escherichia, and Shigella and Enterobacterspp were isolated from the clay samples. Samples from the Kaneshie market in Accra recorded the highest total viable counts 6.5 Log cfu/g and Staphylococcal count 5.8 Log cfu/g. For fecal coliforms, Madina market samples had the highest count 6.5 Log cfu/g and also recorded the highest levels of yeast and mould. For Koforidua, total viable count was highest in the samples from the Zongo market 6.3 Log cfu/g. Central market samples had the highest count of fecal coliforms 4.6 Log cfu/g and yeasts and moulds 6.5 Log cfu/g. “Small” market recorded the highest staphylococcal count 6.2 Log cfu/g. The water activity of the clay samples were low, and ranged between 0.65±0.01 and 0.66±0.00 for samples collected from Koforidua and Accra respectively. Conclusion The clay samples were found to contain Klebsiella spp. Escherichia, Enterobacter, Shigella spp. staphylococcus spp., yeast and mould. These have health implications when consumed. PMID:27642456

Large cholera outbreak in Brong Ahafo Region, Ghana.

PubMed

Noora, Charles Lwanga; Issah, Kofi; Kenu, Ernest; Bachan, Emmanuel George; Nuoh, Robert Domo; Nyarko, Kofi Mensah; Appiah, Paulina; Letsa, Timothy

2017-08-10

A nationwide outbreak of Vibrio cholerae occurred in Ghana in 2014 with Accra, the nation's capital as the epi-center. The outbreak spread to the Brong Ahafo Region (BAR) which is geographically located in the middle of the country. In this region a review of data collected during the outbreak was carried out and analyzed descriptively to determine the hot spots and make recommendations for effective response to future outbreaks. A review of patient records and line lists of cases of cholera reported in all hospitals during the period of the outbreak (July-December 2014) was conducted. Hospitals used IDSR (Integrated Disease Surveillance and Response system) standard case definitions to detect and report cases for management. The GPS coordinates of all districts and health facilities were collected and utilized in the construction of spot maps. We also obtained populations (denominators) from the BAR Health surveillance unit of the Ghana Health Service. All the data thus collected was analyzed descriptively and expressed as frequencies and rates. A total of 1035 cases were reported, 550 (53.4%) were males and the rest females. Their ages ranged from 1 to 95 years; (mean age of 28.2 ± 19.6 years). The most affected (23.5%) was the 20-29 year old age group. On the 30th July, 2014, a 26 year old male (recorded as the index case of the cholera outbreak in the Brong Ahafo region) with a history of travel from Accra reported to the Nkoranza district hospital with a history of symptoms suggestive of cholera. The reporting of cholera cases reached their peak (17.3%) in week 15 of the outbreak (this lasted 25 weeks). An overall attack rate of 71/100,000 population, and a case fatality rate of 2.4% was recorded in the region. Asutifi South district however recorded a case fatality of 9.1%, the highest amongst all the districts which recorded outbreaks. The majority of the cases reported in the region were from Atebubu-Amanten, Sene West, Pru, and Asunafo North districts with 31.1, 26.0, 18.2 and 9.9% respectively. Vibrio cholerae serotype O1 was isolated from rectal swabs/stool samples tested. Vibrio cholerae serotype O1 caused the cholera-outbreak in the Brong Ahafo Region and mainly affected young adult-males. The most affected districts were Atebubu-Amanten, Sene west, Pru (located in the eastern part of the region), and Asunafo North districts (located in the south west of the region). Case Fatality Rate was higher (2.4%) than the WHO recommended rate (<1%). Active district level public health education is recommended on prevention and effective response for future outbreaks of cholera.

Inclusion of men in maternal and safe motherhood services in inner-city communities in Ghana: evidence from a descriptive cross-sectional survey.

PubMed

Atuahene, Margaret Duah; Arde-Acquah, Sylvia; Atuahene, Nana Frema; Adjuik, Martin; Ganle, John Kuumuori

2017-12-14

There has been a growing realisation of the need to enhance men's inclusion in maternal and safe motherhood services, especially in low-income settings. However, empirical studies on the extent to which men are involved in maternal and safe motherhood services especially in poor inner-city communities are lacking. The purpose of this study was to describe the level of men's inclusion in maternal and safe-motherhood services in inner-city communities in Ghana, and to assess the barriers of men's involvement. A descriptive cross-sectional quantitative survey was conducted among a total of 256 randomly selected adult men in Chorkor, an inner-city fishing community in Accra, the capital city of Ghana. A multistage sampling strategy was used to select houses, households and respondents. Descriptive statistical techniques were used to analyse the data. Data analysis was done with the aid of SPSS version 20. Although almost all (96.6%) respondents knew the meaning of family planning, as high as 236(92.2%) have never accompanied their wives/partners to clinics to seek family planning services. Also 242(94.5%) and 251(98%) of men, respectively, knew the importance of antenatal services and supervised delivery. However, only 114(44.5%) of men ever accompanied their wives/partners to seek skilled delivery services. Men's involvement was hindered by barriers such as attitude of health workers, long waiting time and socio-cultural beliefs. The study revealed a gap between men's awareness of the importance of maternal and safe motherhood services and their actual involvement in accessing these services with their female partners. There is a need to create a supportive environment that encourages men to be involved in maternal health services to help reduce maternal/neonatal morbidity and mortality.

Structural barriers to coping with type 1 diabetes mellitus in Ghana: experiences of diabetic youth and their families.

PubMed

Kratzer, J

2012-06-01

To explore the structural barriers faced by families coping with type 1 diabetes mellitus (T1DM) in Ghana, and to provide insight for policy development. Qualitative study conducted with families with a child with T1DM, receiving care in the greater Accra area. Total of 17 individuals were interviewed using individual and dyadic approaches: 7 youth with T1DM, 9 parents of children with T1DM, and one medical doctor. 5 key barriers emerged from the data: primary care, schools, financial burden, lack of formal support, and access to information. Participants expressed concern over the misdiagnosis of T1DM at primary care facilities, resulting in some of the children going into a diabetic coma before receiving proper care. Children and parents noted discrimination and poor care at school. Financial burden was due to the high costs of medications and appliances needed for proper diabetes management. A lack of formal support was credited by participants to be the result of the lethargy of advocacy groups or resource centers. Finally, there was a lack of readily available and accessible information for children and parents on T1DM. Awareness of T1DM needs to be increased, by incorporating lessons on recognition into already existing campaigns for type 2 diabetes mellitus (T2DM). Schools need to be more engaged with their responsibility for children with diabetes. Pressuring policy makers and pharmaceutical companies to make diabetes supplies more affordable and accessible could ease the financial burden. Social support networks need to be explored and strengthened. Study into the experiences of youth with T1DM in rural settings and other parts of Ghana, as well as, youth from low socioeconomic backgrounds is necessary.

Assessing the Relationship between Socioeconomic Conditions and Urban Environmental Quality in Accra, Ghana

PubMed Central

Fobil, Julius; May, Juergen; Kraemer, Alexander

2010-01-01

The influence of socioeconomic status (SES) on health inequalities is widely known, but there is still poor understanding of the precise relationship between area-based socioeconomic conditions and neighborhood environmental quality. This study aimed to investigate the socioeconomic conditions which predict urban neighbourhood environmental quality. The results showed wide variation in levels of association between the socioeconomic variables and environmental conditions, with strong evidence of a real difference in environmental quality across the five socioeconomic classes with respect to total waste generation (p < 0.001), waste collection rate (p < 0.001), sewer disposal rate (p < 0.001), non-sewer disposal (p < 0.003), the proportion of households using public toilets (p = 0.005). Socioeconomic conditions are therefore important drivers of change in environmental quality and urban environmental interventions aimed at infectious disease prevention and control if they should be effective could benefit from simultaneous implementation with other social interventions. PMID:20195437

Urbanisation, poverty and sexual behaviour: the tale of five African cities.

PubMed

Greif, Meredith J; Dodoo, F Nii-Amoo; Jayaraman, Anuja

2011-01-01

The question of how urbanisation and poverty are linked in sub-Saharan Africa is an increasingly pressing one. The urban character of the HIV epidemic in sub-Saharan Africa exacerbates concern about the urbanisation - poverty relationship. Recent empirical work has linked urban poverty, and particularly slum residence, to risky sexual behaviour in Kenya's capital city, Nairobi. This paper explores the generalisability of these assertions about the relationship between urban poverty and sexual behaviour using Demographic and Health Survey data from five African cities: Accra (Ghana), Dar-es-Salaam (Tanzania), Harare (Zimbabwe), Kampala (Uganda) and Nairobi (Kenya). The study affirms that, although risky behaviour varies across the five cities, slum residents demonstrate riskier sexual behaviour compared with non-slum residents. There is earlier sexual debut, lower condom usage and more multiple sexual partners among women residing in slum households regardless of setting, suggesting a relatively uniform effect of urban poverty on sexual risk behaviour.

Molecular confirmation of Lassa fever imported into Ghana.

PubMed

Bonney, Joseph H K; Nyarko, Edward O; Ohene, Sally-Ann; Amankwa, Joseph; Ametepi, Ralph K; Nimo-Paintsil, Shirley C; Sarkodie, Badu; Agbenohevi, Prince; Adjabeng, Michael; Kyei, Nicholas N A; Bel-Nono, Samuel; Ampofo, William K

2016-01-01

Recent reports have shown an expansion of Lassa virus from the area where it was first isolated in Nigeria to other areas of West Africa. Two Ghanaian soldiers on a United Nations peacekeeping mission in Liberia were taken ill with viral haemorrhagic fever syndrome following the death of a sick colleague and were referred to a military hospital in Accra, Ghana, in May 2013. Blood samples from the soldiers and five asymptomatic close contacts were subjected to laboratory investigations. We report the results of these investigations to highlight the importance of molecular diagnostic applications and the need for heightened awareness about Lassa fever in West Africa. We used molecular assays on sera from the two patients to identify the causative organism. Upon detection of positive signals for Lassa virus ribonucleic material by two different polymerase chain reaction assays, sequencing and phylogenetic analyses were performed. The presence of Lassa virus in the soldiers' blood samples was shown by L-gene segment homology to be the Macenta and las803792 strains previously isolated in Liberia, with close relationships then confirmed by phylogenetic tree construction. The five asymptomatic close contacts were negative for Lassa virus. The Lassa virus strains identified in the two Ghanaian soldiers had molecular epidemiological links to strains from Liberia. Lassa virus was probably responsible for the outbreak of viral haemorrhagic fever in the military camp. These data confirm Lassa fever endemicity in West Africa.

Modern contraceptive use among women living with HIV/AIDS at the Korle Bu Teaching Hospital in Ghana.

PubMed

Samba, Ali; Mumuni, Kareem; Adu, Joseph A; Sefogah, Promise E; Kudzi, William; Nartey, Edmund T

2018-04-01

To examine factors influencing contraceptive use among women living with HIV/AIDS. The present cross-sectional study included a randomly selected sample of sexually active females aged 15-60 years who were living with HIV/AIDS and receiving care at the HIV Clinic, Korle Bu Teaching Hospital, Accra, Ghana, between September 1 and November 31, 2016. Data were collected via a structured interviewer-administered questionnaire. Among 202 women who completed the survey, 50 (24.7%) were using contraceptives. Of the women using contraception, 39 (78%) were married and 6 (12%) were cohabiting. Twenty-eight (56%) reported that their primary sexual partners were HIV-positive, 14 (28%) had HIV-negative partners, and 8 (16%) did not know their partner's HIV status. Condoms were used by 42 (84%) women and the majority (41 [82%]) wanted to have more children; almost all (47 [94%]) had received counseling on contraceptive use. Overall, 133 (65.8%) and 45 (22.3%) women reported that they would prefer to share their family planning concerns with a doctor and nurse, respectively, at the HIV clinic. Women living with HIV/AIDS desired more children but preferred to share their family planning concerns with their clinician at the HIV clinic. Integrating HIV care and reproductive health services could help these women achieve childbearing goals safely. © 2018 International Federation of Gynecology and Obstetrics.

Factors influencing the decision to drop out of health insurance enrolment among urban slum dwellers in Ghana.

PubMed

Atinga, Roger A; Abiiro, Gilbert Abotisem; Kuganab-Lem, Robert Bella

2015-03-01

To identify the factors influencing dropout from Ghana's health insurance scheme among populations living in slum communities. Cross-sectional data were collected from residents of 22 slums in the Accra Metropolitan Assembly. Cluster and systematic random sampling techniques were used to select and interview 600 individuals who had dropped out from the scheme 6 months prior to the study. Descriptive statistics and multivariate logistic regression models were computed to account for sample characteristics and reasons associated with the decision to dropout. The proportion of dropouts in the sample increased from the range of 6.8% in 2008 to 34.8% in 2012. Non-affordability of premium was the predominant reason followed by rare illness episodes, limited benefits of the scheme and poor service quality. Low-income earners and those with low education were significantly more likely to report premium non-affordability. Rare illness was a common reason among younger respondents, informal sector workers and respondents with higher education. All subgroups of age, education, occupation and income reported nominal benefits of the scheme as a reason for dropout. Interventions targeted at removing bottlenecks to health insurance enrolment are salient to maximising the size of the insurance pool. Strengthening service quality and extending the premium exemption to cover low-income families in slum communities is a valuable strategy to achieve universal health coverage. © 2014 John Wiley & Sons Ltd.

Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster-Randomized Trial in Ghana.

PubMed

Rokicki, Slawa; Cohen, Jessica; Salomon, Joshua A; Fink, Günther

2017-02-01

To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. We conducted a cluster-randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI] = 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR = 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

Experiences of frontline nursing staff on workplace safety and occupational health hazards in two psychiatric hospitals in Ghana.

PubMed

Alhassan, Robert Kaba; Poku, Kwabena Adu

2018-06-06

Psychiatric hospitals need safe working environments to promote productivity at the workplace. Even though occupational health and safety is not completely new to the corporate society, its scope is largely limited to the manufacturing/processing industries which are perceived to pose greater dangers to workers than the health sector. This paper sought to explore the experiences of frontline nursing personnel on the occupational health and safety conditions in two psychiatric hospitals in Ghana. This is an exploratory cross-sectional study among 296 nurses and nurse-assistants in Accra (n = 164) and Pantang (n = 132) psychiatric hospitals using the proportional stratified random sampling technique. Multivariate Ordinary Least Squares (OLS) regression test was conducted to ascertain the determinants of staff exposure to occupational health hazards and the frequency of exposure to these occupational health hazards on daily basis. Knowledge levels on occupational health hazards was high in Accra and Pantang psychiatric hospitals (i.e. 92 and 81% respectively), but barely 44% of the 296 interviewed staff in the two hospitals said they reported their most recent exposure to an occupational health hazard to hospital management. It was found that staff who worked for more years on the ward had higher likelihood of exposure to occupational health hazards than those who worked for lesser years (p = 0.002). The category of occupational health hazards reported most were the physical health hazards. Psychosocial hazards were the least reported health hazards. Frequency of exposure to occupational health hazards on daily basis was positively associated with work schedules of staff particularly, staff on routine day schedule (Coef = 4.49, p = 0.011) and those who alternated between day and night schedules (Coef = 4.48, p = 0.010). Occupational health and safety conditions in the two hospitals were found to be generally poor. Even though majority of the staff knew about occupational health and safety, less than half of them reported exposure to workplace health hazards. Key stakeholders such as the Ministry of Health in collaboration with the Mental Health Authority should intensify efforts towards effective enforcement of existing policies on safety in healthcare institutions, particularly psychiatric hospitals where exposure to occupational health hazards is more prevalent.

Concentration profiles, source apportionment and risk assessment of polycyclic aromatic hydrocarbons (PAHs) in dumpsite soils from Agbogbloshie e-waste dismantling site, Accra, Ghana.

PubMed

Daso, Adegbenro P; Akortia, Eric; Okonkwo, Jonathan O

2016-06-01

The concentrations of eighteen (18) polycyclic aromatic hydrocarbons (PAHs), including the 16 USEPA's priority PAHs as well as two alkyl-substituted naphthalenes were determined in dumpsite soils collected from different sampling sites within the Agbogbloshie e-waste dismantling site in Accra, Ghana. Following their isolation with ultrasonic-assisted extraction technique, the concentrations of the PAHs were determined by gas chromatography mass spectrometry (GC-MS). Loss-on-ignition (LOI) method was employed for the determination of total organic carbon (TOC) of the soil samples. The mean Σ18PAHs obtained were 3006, 5627, 3046, 5555, and 7199 ng g(-1) dry weight (dw) for sampling sites A (mosque), B (dismantling site), C (residential house/police station), D (personal computer repairers' shop) and E (e-waste open burning area), respectively. In all cases, the prevalence of phenanthrene, fluoranthene and pyrene was generally observed across the sampling sites. In this study, PAHs with two to three rings and four to six rings exhibited strong positive correlations, whereas BbF and BkF showed weak positive and negative correlations with other PAHs investigated. With the exception of BbF and BkF, all the PAHs had moderate to strong positive correlations with the TOC. Benzo[a]pyrene equivalent (BaPeq) concentration is a useful indicator of the carcinogenic potency of environmental matrices and these ranged between 111 and 454 ng g(-1), which are generally below the 'safe' level of 600 ng g(-1) established for the protection of the environment and human health. Interestingly, the seven carcinogenic PAHs were the major contributors to the BaPeq concentrations accounting between 97.7 and 98.3 %. Despite the minimal risk to cancer via exposure to the investigated dumpsite soil as indicated in the present study, the prolonged exposure to these pollutants via various exposure pathways may result in increased risk to cancer over time. The application of several methodological approaches for PAH source apportionment, including the use of molecular diagnostic ratios, mostly implicated pyrogenic processes as the main sources of PAHs into the investigated dumpsite soils. Furthermore, their compositional profiles across the sampling sites also suggest similar sources of PAHs into the dumpsite soil.

Cooking fuel choices and garbage burning practices as determinants of birth weight: a cross-sectional study in Accra, Ghana

PubMed Central

2012-01-01

Background Effect of indoor air pollution (IAP) on birth weight remains largely unexplored but yet purported as the most important environmental exposure for pregnant women in developing countries due to the effects of second-hand smoke. We investigated the associations between the determinants of indoor air quality in households and birth weight. Methods A cross-sectional study of 592 mothers and their newborns using postnatal services at the Korle Bu Teaching Hospital located in Accra, Ghana was conducted in 2010 to collect information on characteristics of indoor environment and other potential determinants of fetal growth. Birth weight was recorded from hospital records. Results Household cooking fuel choices and garbage burning practices were determinants of birth weight. Multivariate linear regression analysis adjusting for age, social class, marital status and gravidity of mothers, and sex of neonate resulted in a 243g (95% CI: 496, 11) and 178g (95% CI: 421, 65) reduction in birth weight for use of charcoal, and garbage burning respectively compared with use of LPG only. The estimated reductions in birth weight was not statistically significant. Applying the ordinal scale exposure parameter nonetheless revealed a significant exposure-response relationship between maternal exposures from charcoal use and garbage burning, and birth weight. Generalized linear models adjusting for confounders resulted in a 41% (risk ratio [RR] = 1.41; 95% CI: 0.62, 3.23) and 195% (RR=2.95; 95% CI: 1.10, 7.92) increase in the risk of low birth weight (LBW) for use of charcoal, and garbage burning respectively compared with use of LPG only. A combination of charcoal use and household garbage burning during pregnancy on fetal growth resulted in a 429g (95% CI: 259, 599) reduction in birth weight and 316% (RR=4.16; 95% CI: 2.02, 8.59) excess risk of LBW. Sensitivity analysis performed by restricting the analysis to term births produced similar results. Conclusions Maternal use of charcoal as a cooking fuel during pregnancy and burning of garbage at home are strong determinants of average fetal growth and risk of LBW. Efforts to reduce maternal exposures to IAP are thus important to improve birth outcomes. PMID:23075225

When the clinic becomes a home. Successful VCT and ART services in a stressful environment.

PubMed

Dapaah, Jonathan Mensah; Spronk, Rachel

2016-12-01

With the upscaling of antiretroviral therapy (ART) in resource-poor countries, many HIV-positive persons in Ghana have been accessing treatment in hospitals. Prevalence is relatively low compared to other African countries, 1.30%. HIV/AIDS remains heavily stigmatised in Ghana, which influences the provision and use of ART. This article investigates how HIV-positive persons accessing care and treatment go about their everyday lives in the ART clinic and how they have eventually come to see the clinic as a safe place that they call 'home'. The study took place in two Ghanaian hospitals in the Ashanti Region which in 2013 had the country's highest HIV prevalence rate of 1.30% [Ghana Health Service [GHS]/National AIDS Control Programme [NACP] (2013). 2013 HIV Sentinel Survey Report, Accra, Ghana]. It was conducted through ethnographic research, with data gathered in the two facilities through participant observation, conversations and in-depth interviews. It took place over a period of 15 months, between 2007 and 2010. In all, 24 health workers and 22 clients were interviewed in depth, while informal conversations were held with many others. The findings show that clients have adopted the clinic as a second home and used it to carry out various activities in order to avoid identification and stigmatisation as People Living with AIDS (PLWA). The most dramatic outcome was that, contrary to Ghanaian norms and values, people turned to non-kin for assistance. Accordingly, fellow clients and health personnel, rather than relatives, have become their 'therapy management group' [Janzen, J. M. (1987). Therapy Management: Concept, Reality, Process. Medical Anthropology Quarterly, 1(1), 68-84]. The clients have thus created a fictive family within the clinic - made up of health workers (as 'parents'), the clients themselves (as 'children') and the peer educators (as 'aunts' and 'uncles'). In the face of persistent stigma associated with HIV infection in Ghana, the use of the clinic as a 'home' has on the one hand helped those receiving treatment to maintain their position, respect and reputation within their families and community, while on the other it prevents PLWA from disclosing. The study concludes that compassion is an important element in the professionalisation of healthcare workers in low-prevalence countries.

When the clinic becomes a home. Successful VCT and ART services in a stressful environment

PubMed Central

Dapaah, Jonathan Mensah; Spronk, Rachel

2016-01-01

Abstract With the upscaling of antiretroviral therapy (ART) in resource-poor countries, many HIV-positive persons in Ghana have been accessing treatment in hospitals. Prevalence is relatively low compared to other African countries, 1.30%. HIV/AIDS remains heavily stigmatised in Ghana, which influences the provision and use of ART. This article investigates how HIV-positive persons accessing care and treatment go about their everyday lives in the ART clinic and how they have eventually come to see the clinic as a safe place that they call ‘home’. The study took place in two Ghanaian hospitals in the Ashanti Region which in 2013 had the country’s highest HIV prevalence rate of 1.30% [Ghana Health Service [GHS]/National AIDS Control Programme [NACP] (2013). 2013 HIV Sentinel Survey Report, Accra, Ghana]. It was conducted through ethnographic research, with data gathered in the two facilities through participant observation, conversations and in-depth interviews. It took place over a period of 15 months, between 2007 and 2010. In all, 24 health workers and 22 clients were interviewed in depth, while informal conversations were held with many others. The findings show that clients have adopted the clinic as a second home and used it to carry out various activities in order to avoid identification and stigmatisation as People Living with AIDS (PLWA). The most dramatic outcome was that, contrary to Ghanaian norms and values, people turned to non-kin for assistance. Accordingly, fellow clients and health personnel, rather than relatives, have become their ‘therapy management group’ [Janzen, J. M. (1987). Therapy Management: Concept, Reality, Process. Medical Anthropology Quarterly, 1(1), 68–84]. The clients have thus created a fictive family within the clinic – made up of health workers (as ‘parents’), the clients themselves (as ‘children’) and the peer educators (as ‘aunts’ and ‘uncles’). In the face of persistent stigma associated with HIV infection in Ghana, the use of the clinic as a ‘home’ has on the one hand helped those receiving treatment to maintain their position, respect and reputation within their families and community, while on the other it prevents PLWA from disclosing. The study concludes that compassion is an important element in the professionalisation of healthcare workers in low-prevalence countries. PMID:27598327

The role of family size, employment and education of parents in the prevalence of intestinal parasitic infections in school children in Accra.

PubMed

Forson, Akua Obeng; Arthur, Isaac; Ayeh-Kumi, Patrick F

2018-01-01

Intestinal parasitic infections (IPIs) in school children are a public health problem in most developing countries. A cross sectional survey was conducted from May to July 2016 with school children living in overcrowded urban slums in Accra, Ghana. A simple random sample of 300 children aged 2-9 years was collected. The study used structured pre-tested questionnaire and stool tests to obtain information on epidemiological, sanitation habits, employment and education status of parents and children. Data were analysed using appropriate descriptive, univariate and multivariable logistic tools of analyses. The mean age of participants was 6.9 years and 49% were males and 51.3% were females. Giardia lamblia was found in males (10.95%) and females (7.79%). Very low prevalences for Schistosoma mansoni, Ascaris lumbricoides, Taenia species, and Entamoeba coli were detected. Whilst children from mothers (62.2%) and fathers (55.6%) with no education were often infected, a few children from fathers (22.2%) and mothers (6.7%) with no jobs were infected. Most of the infected children's (93.7%) parents did not have any knowledge of IPIs. The educational and employment status of the mothers [p = 1.0 and p = 0.422] was not significant, however, the family size was a predisposing factor (p = 0.031) for parasitic infections. Intestinal parasites were prevalent in children from overcrowded families and with no knowledge of IPIs. Educative programmes on IPIs, improving hygiene, and application of supportive programmes to elevate socioeconomic conditions may help reduce the burden of intestinal parasite carriage in children.

Lumbar Spine X-Ray as a Standard Investigation for all Low back Pain in Ghana: Is It Evidence Based?

PubMed

Tannor, Abena Y

2017-03-01

Low back pain (LBP) has a prevalence of 84% in Africa. The commonest form of imaging is plain lumbar spine x-ray. It gives a radiation dose equivalent to 65 times a chest x-ray dose and sends one of the highest doses to the human reproductive organs. The commonest cause of LBP in Africa is degenerative disease. X-ray findings do not change mode of treatment yet most physicians still routinely request for x-rays. This is a systematic review of databases including The Cochrane, CINAHL plus, AMED, and MEDLINE. Key evidence was clinical guidelines on x-ray use for low back pain. Key search terms included low back pain, x-rays, guidelines, Ghana. Four clinical guidelines on LBP emerged from two Systematic Reviews rated excellent and four good Randomized Controlled Trials: The European guidelines for acute and sub-acute non-specific Low Back Pain, The American College of Physicians and the American Pain Society guideline for diagnostic imaging for Low Back Pain, The NICE guidelines for persistent non-specific Low Back Pain and the Ghana Standard Treatment Guidelines (GSTG). All the guidelines agree that a good history and clinical examination for all LBP patients helps in diagnosing. Only GSTG recommends routine plain spinal x-rays. There is strong evidence indicating very little benefit from routine lumbar spine x-rays for all LBP. The GSTG needs to be revised considering the increased risks of radiation exposure and the x-ray costs. None declared.

Sanitation investments in Ghana: An ethnographic investigation of the role of tenure security, land ownership and livelihoods.

PubMed

Awunyo-Akaba, Y; Awunyo-Akaba, J; Gyapong, M; Senah, K; Konradsen, F; Rheinländer, T

2016-07-18

Ghana's low investment in household sanitation is evident from the low rates of improved sanitation. This study analysed how land ownership, tenancy security and livelihood patterns are related to sanitation investments in three adjacent rural and peri-urban communities in a district close to Accra, Ghana's capital. Qualitative data was gathered for this comparative ethnographic study over seven months, (June, 2011-January, 2012) using an average of 43 (bi-weekly) participant observation per community and 56 in-depth interviews. Detailed observational data from study communities were triangulated with multiple interview material and contextual knowledge on social structures, history of settlement, land use, livelihoods, and access to and perceptions about sanitation. This study shows that the history of settlement and land ownership issues are highly correlated with people's willingness and ability to invest in household sanitation across all communities. The status of being a stranger i.e. migrant in the area left some populations without rights over the land they occupied and with low incentives to invest in sanitation, while indigenous communities were challenged by the increasing appropriation of their land for commercial enterprises and for governmental development projects. Interview responses suggest that increasing migrant population and the high demand for housing in the face of limited available space has resulted in general unwillingness and inability to establish private sanitation facilities in the communities. The increasing population has also created high demand for cheap accommodation, pushing tenants to accept informal tenancy agreements that provided for poor sanitation facilities. In addition, poor knowledge of tenancy rights leaves tenants in no position to demand sanitation improvements and therefore landlords feel no obligation or motivation to provide and maintain domestic sanitation facilities. The study states that poor land rights, the history of settlements, in-migration and insecure tenancy are key components that are associated with local livelihoods and investments in private sanitation in rapidly changing rural and peri-urban communities of Ghana. Sanitation policy makers and programme managers must acknowledge that these profound local, ethnic and economic forces are shaping people's abilities and motivations for sanitation investments.

Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F

2015-01-01

Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa.

Gender and occupational perspectives on adaptation to climate extremes in the Afram Plains of Ghana

USGS Publications Warehouse

Codjoe, Samuel N.A.; Atidoh, Lucy K.; Burkett, Virginia

2012-01-01

Although sub-Saharan Africa does not contribute significantly to greenhouse gas emissions, significant adverse impacts of climate change are anticipated in this region. Countries in West Africa, which are heavily dependent on rain-fed agriculture, are projected to experience more frequent and intense droughts, altered rainfall patterns and increases in temperature through the end of this century. Changes in hydrology and temperature are likely to affect crop yields, thereby placing pressure on scarce resources in a region that is characterised by limited social, political, technical and financial resources. The success with which communities cope with the impacts of climate change is influenced by existing conditions, forces and characteristics which are peculiar to each of these communities. This paper assesses the preferred adaptation strategies during floods and droughts of males and females in three different occupations (farming, fishing, and charcoal production). Findings are based upon an analysis of focus group discussions and a ranking of preferred adaptation options in three communities in the Afram Plains of Ghana. Assessments of this nature should aid in the selection and implementation of adaptation options for communities and households, which is the level at which climate change adaptation is likely to occur in West Africa.

Molecular confirmation of Lassa fever imported into Ghana

PubMed Central

Nyarko, Edward O.; Ohene, Sally-Ann; Amankwa, Joseph; Ametepi, Ralph K.; Nimo-Paintsil, Shirley C.; Sarkodie, Badu; Agbenohevi, Prince; Adjabeng, Michael; Kyei, Nicholas N.A.; Bel-Nono, Samuel; Ampofo, William K.

2016-01-01

Background Recent reports have shown an expansion of Lassa virus from the area where it was first isolated in Nigeria to other areas of West Africa. Two Ghanaian soldiers on a United Nations peacekeeping mission in Liberia were taken ill with viral haemorrhagic fever syndrome following the death of a sick colleague and were referred to a military hospital in Accra, Ghana, in May 2013. Blood samples from the soldiers and five asymptomatic close contacts were subjected to laboratory investigations. Objective We report the results of these investigations to highlight the importance of molecular diagnostic applications and the need for heightened awareness about Lassa fever in West Africa. Methods We used molecular assays on sera from the two patients to identify the causative organism. Upon detection of positive signals for Lassa virus ribonucleic material by two different polymerase chain reaction assays, sequencing and phylogenetic analyses were performed. Results The presence of Lassa virus in the soldiers’ blood samples was shown by L-gene segment homology to be the Macenta and las803792 strains previously isolated in Liberia, with close relationships then confirmed by phylogenetic tree construction. The five asymptomatic close contacts were negative for Lassa virus. Conclusions The Lassa virus strains identified in the two Ghanaian soldiers had molecular epidemiological links to strains from Liberia. Lassa virus was probably responsible for the outbreak of viral haemorrhagic fever in the military camp. These data confirm Lassa fever endemicity in West Africa. PMID:28879105

Aetiological agents of ear discharge: a two year review in a teaching hospital in Ghana.

PubMed

Appiah-Korang, L; Asare-Gyasi, S; Yawson, A E; Searyoh, K

2014-06-01

The discharging ear is a common presentation in medical practice affecting all age groups but primarily children. This study shows the current aetiological causes of ear discharge and their antibiograms, data which would guide empirical treatment of ear infections, and also form a basis for further research. This was a retrospective review of laboratory records of all ear swabs submitted for culture over a two year period in the Korle Bu Teaching Hospital Accra, Ghana. Data was obtained on demographic characteristics of patients, clinical diagnosis, isolated organisms and antibiotic susceptibility patterns of the isolated organisms. Data was analyzed by simple descriptive statistics. A total of 351 ear swabs were received by the laboratory for processing over the two year period. Of these 277(78.9%) had microorganisms isolated. A significant number127 (47%) was obtained from children under five years. Pseudomonas spp was the commonly isolated organism 121(46%) followed by Staphylococcus aureus 33(12.5%) and Proteus spp 32(12.2%). Candida was the commonest isolated fungi 9 (69.2%). Susceptibility of Pseudomonas spp to commonly used ototopics (ciprofloxacin & gentamicin) was 93% and 74% respectively. Most cases of the discharging ear were found in children under the age of five years. The most common bacteriologic cause of the discharging ear was Pseudomonas spp followed by Staphylococcus aureus. Candida species was the commonest fungal cause of ear discharge. Ciprofloxacin and gentamicin are effective ototopic antimicrobial agents for empirical treatment of the discharging ear.

Assessment of groundwater quality by unsaturated zone study due to migration of leachate from Abloradjei waste disposal site, Ghana

NASA Astrophysics Data System (ADS)

Egbi, Courage Davidson; Akiti, Tetteh Thomas; Osae, Shiloh; Dampare, Samuel Boakye; Abass, Gibrilla; Adomako, Dickson

2017-05-01

Leachate generated by open solid waste disposal sites contains substances likely to contaminate groundwater. The impact of potential contaminants migrating from leachate on groundwater can be quantified by monitoring their concentration and soil properties at specific points in the unsaturated zone. In this study, physical and chemical analyses were carried out on leachate, soil and water samples within the vicinity of the municipal solid waste disposal site at Abloradjei, a suburb of Accra, Ghana. The area has seen a massive increase in population and the residents depend on groundwater as the main source of water supply. Results obtained indicate alkaline pH for leachate and acidic conditions for unsaturated zone water. High EC values were recorded for leachate and unsaturated zone water. Major ions (Ca2+, Na+, Mg2+, K+, NO3 -, SO4 2-, Cl-, PO4 3- were analysed in leachate, unsaturated zone water, soil solution and groundwater while trace metals (Al, Fe, Cu, Zn, Pb) were analysed in both soil and extracted soil solution. Concentrations of major ions were high in all samples indicating possible anthropogenic origin. Mean % gravel, % sand, % clay, bulk density, volumetric water content and porosity were 28.8, 63.93, 6.6, 1 g cm-3, 35 and 62.7 %, respectively. Distribution of trace elements showed Kd variation of Al > Cu > Fe > Pb > Zn in the order of sequential increasing solubility. It was observed that the quality of groundwater is not suitable for drinking.

Implementation science in low-resource settings: using the interactive systems framework to improve hand hygiene in a tertiary hospital in Ghana.

PubMed

Kallam, Brianne; Pettitt-Schieber, Christie; Owen, Medge; Agyare Asante, Rebecca; Darko, Elizabeth; Ramaswamy, Rohit

2018-05-19

Low-resource clinical settings often face obstacles that challenge the implementation of recommended evidence-based practices (EBPs). Implementation science approaches are useful in identifying barriers and developing strategies to address them. Ridge Regional Hospital (RRH), a tertiary referral hospital in Accra, Ghana experienced a spike in rates of neonatal sepsis and launched a quality improvement (QI) initiative that identified poor adherence to hand hygiene in the neonatal intensive care unit as a potential source of infections. A multi-modal change package of World Health Organization-recommended solutions was created to address this issue. To ensure that the outputs of the QI effort were adopted within the organization, leaders at RRH and Kybele, Inc. used an implementation science framework called the 'Interactive Systems Framework for Dissemination and Implementation' (ISF) to create a package of locally acceptable implementation strategies. The ISF has never been used before to guide implementation in low-resource settings. Hand hygiene compliance rose from 67% to 92% overall, including a 36% increase during the night shifts-a group of healthcare workers with typically very low levels of compliance. The drastic improvement in adherence to hand hygiene suggests the potential value of the joint use of QI and implementation science to promote the creation and application of contextually appropriate EBPs in low-resource settings. Our results also suggest that using an implementation framework such as the ISF could rapidly increase the uptake of other evidence-based interventions in low-resource settings.

Proceedings of the African Field Epidemiology Network (AFENET) Scientific Conference 17-22 November 2013 Addis Ababa, Ethiopia: plenaries and oral presentations.

PubMed

Gitta, Sheba Nakacubo; Mwesiga, Allan; Kamadjeu, Raoul

2015-01-01

Biennially, trainees and graduates of Field Epidemiology and Laboratory Training Programs (FELTPs) are presented with a platform to share investigations and projects undertaken during their two-year training in Applied Epidemiology. The African Field Epidemiology Network (AFENET) Scientific Conference, is a perfect opportunity for public health professionals from various sectors and organizations to come together to discuss issues that impact on public health in Africa. This year's conference was organized by the Ethiopian Health and Nutrition Research Institute in collaboration with the Ethiopia Ministry of Health, Ethiopian Public Health Association (EPHA), Ethiopia Field Epidemiology Training Program (EFETP), Addis Ababa University (AAU), Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET) and AFENET. Participants at this year's conference numbered 400 from over 20 countries including; Angola, Burkina Faso, Cameroon, Central African Republic, Democratic Republic of the Congo, Ethiopia, Ghana, Indonesia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Sudan, Tanzania, Uganda, Yemen and Zimbabwe. The topics covered in the 144 oral presentations included: global health security, emergency response, public health informatics, vaccine preventable diseases, immunization, outbreak investigation, Millennium Development Goals, Non-Communicable Diseases, and public health surveillance. The theme for the 5th AFENET Scientific Conference was; "Addressing Public Health Priorities in Africa through FELTPs." Previous AFENET Scientific conferences have been held in: Accra, Ghana (2005), Kampala, Uganda (2007), Mombasa, Kenya (2009) and Dar es Salaam, Tanzania (2011).

Training Ghanaian frontline healthcare workers in public health surveillance and disease outbreak investigation and response

PubMed Central

Ameme, Donne Kofi; Nyarko, Kofi Mensah; Afari, Edwin Andrews; Antara, Simon; Sackey, Samuel Oko; Wurapa, Fred

2016-01-01

Introduction Beyond initial formal academic education, the need for continuous professional development through in-service workforce capacity improvement programs that are aimed at enhancing knowledge and skills of public healthcare workers has assumed immense priority worldwide. This has been heightened by the on-going Ebola Virus Disease outbreak, which is exposing the weak public health systems in West Africa. In response to this need, the Ghana Field Epidemiology and Laboratory Program organized a short-course for frontline health workers in the Greater Accra region of Ghana in order to augment their surveillance and outbreak response capacity. Methods Human and veterinary health workers were trained using Field Epidemiology and Laboratory Training Program short course model. A two-week didactic course was conducted with a 10-week field placement. Evaluation of the course was done by assessment of participants’ outputs during the training as well as pretest and posttest methods. Results A total of 32 frontline health workers from both the human and veterinary health services benefited from the two-week initial training of the 12-week course. There was a significant gain in knowledge by the participants after the training course. Participants developed concept papers and implemented their fieldwork projects. Overall assessment of the workshop by the participants was very good. Conclusion Capacity of the health workers has been improved in the area of public health surveillance, outbreak investigation and response. We recommend a scale-up of this training course to other regions. PMID:28149433

Patterns of health service utilization at a medical school clinic in Ghana.

PubMed

Yawson, A E; Malm, K L; Adu, A A; Wontumi, G-M; Biritwum, R B

2012-09-01

The University of Ghana Medical School (UGMS) Clinic provides healthcare service which is free at point of service to students, staff, retired staff and dependents of staff of the College of Health Sciences. However, since 1983, no in-depth review of health service provision or utilization has been undertaken. This study reviewed client characteristics, utilization and disease patterns at the clinic and also compared the disease patterns to that of other primary health facilities nationwide. This was an analytical cross-sectional study undertaken at the UGMS clinic in Korle-Bu. It was a retrospective review of records of all clients attending the facility from January 2002 to December, 2004. More males than females attended the clinic and majority (63.9%) of clients were between 15-44 years (median age was 26 years). Dependents of staff constituted the highest attendants (41%) to the clinic. Among staff, junior staffs were in the majority. Malaria, respiratory tract infection and musculoskeletal pain were the most common conditions seen. Overall, 83% of clients were treated and discharged per visit without the need for review visits. Dependents of staff used the facility the most and they live in many different part of the city of Accra, and to ask them to attend the clinic for care is not efficient. It will be better to provide or supplement their securing of insurance so that they could access health care close to their homes and save time and attention to students and staff.

Quality of life, optimism/pessimism, and knowledge and attitudes toward HIV Screening among pregnant women in Ghana.

PubMed

Moyer, Cheryl A; Ekpo, Geraldine; Calhoun, Cecilia L; Greene, Jonathan; Naik, Sujata; Sippola, Emily; Stern, David T; Adanu, Richard M; Koranteng, Isaac O; Kwawukume, Enyonam Yao; Anderson, Frank J

2008-01-01

We sought to explore optimism/pessimism, knowledge of HIV, and attitudes toward HIV screening and treatment among Ghanaian pregnant women. Pregnant women in Accra, Ghana, completed a self-administered questionnaire including the Life Orientation Test-Revised (LOT-R, an optimism/pessimism measure), an HIV knowledge and screening attitudes questionnaire, the Short Form 12 (SF-12, a measure of health-related quality of life [HRQOL]), and a demographic questionnaire. Data were analyzed using t-tests, ANOVA, correlations, and the chi2 test. There were 101 participants; 28% were nulliparous. Mean age was 29.7 years, and mean week of gestation was 31.8. All women had heard of AIDS, 27.7% had been tested for HIV before this pregnancy, 46.5% had been tested during this pregnancy, and 59.4% of the sample had ever been tested for HIV. Of those not tested during this pregnancy, 64.2% were willing to be tested. Of all respondents, 89% said they would get tested if antiretroviral drugs (ARVs) were readily available and might prevent maternal-to-child transmission. Neither optimism/pessimism nor HRQOL was associated with attitudes toward HIV screening. Optimism was negatively correlated with HIV knowledge (p = .001) and was positively correlated with having never been tested before this pregnancy (p = .007). The relationship between optimism/pessimism and HIV knowledge and screening behavior is worthy of further study using larger samples and objective measures of testing beyond self-report.

Measurement of air pollutant emissions from Lome, Cotonou and Accra

NASA Astrophysics Data System (ADS)

Lee, James; Vaughan, Adam; Nelson, Bethany; Young, Stuart; Evans, Mathew; Morris, Eleanor; Ladkin, Russel

2017-04-01

High concentrations of airborne pollutants (e.g. the oxides of nitrogen, sulphur dioxide and carbon monoxide) in existing and evolving cities along the Guinea Coast cause respiratory diseases with potentially large costs to human health and the economic capacity of the local workforce. It is important to understand the rate of emission of such pollutants in order to model current and future air quality and provide guidance to the potential outcomes of air pollution abatement strategies. Often dated technologies and poor emission control strategies lead to substantial uncertainties in emission estimates calculated from vehicle and population number density statistics. The unreliable electrical supply in cities in the area has led to an increased reliance on small-scale diesel powered generators and these potentially present a significant source of emissions. The uncontrolled open incineration of waste adds a further very poorly constrained emission source within the cities. The DACCIWA (Dynamics-Aerosol-Chemistry-Cloud Interactions in West Africa) project involved a field campaign which used highly instrumented aircraft capable of in situ measurements of a range of air pollutants. Seven flights using the UK British Antarctic Survey's Twin Otter aircraft specifically targeted air pollution emissions from cities in West Africa (4 x Accra, Ghana; 2 x Lome, Togo and 1 x Cotonou, Benin). Measurements of NO, NO2, SO2, CO, CH4 and CO2 were made at multiple altitudes upwind and downwind of the cities, with the mass balance technique used to calculate emission rates. These are then compared to the Emissions Database for Global Atmospheric Research (EDGAR) estimates. Ultimately the data will be used to inform on and potentially improve the emission estimates, which in turn should lead to better forecasting of air pollution in West African cities and help guide future air pollution abatement strategy.

Subsidized Sachet Water to Reduce Diarrheal Disease in Young Children: A Feasibility Study in Accra, Ghana

PubMed Central

Wright, James; Dzodzomenyo, Mawuli; Fink, Günther; Wardrop, Nicola A.; Aryeetey, Genevieve C.; Adanu, Richard M.; Hill, Allan G.

2016-01-01

Use of drinking water sold in plastic bags (sachet water) is growing rapidly in west Africa. The impact on water consumption and child health remains unclear, and a debate on the taxation and regulation of sachet water is ongoing. This study assessed the feasibility of providing subsidized sachet water to low-income urban households in Accra and measured the resultant changes in water consumption. A total of 86 children, 6–36 months of age in neighborhoods lacking indoor piped water, were randomized to three study arms. The control group received education about diarrhea. The second arm received vouchers for 15 L/week/child of free water sachets (value: $0.63/week) plus education. The third arm received vouchers for the same water sachet volume at half price plus education. Water consumption was measured at baseline and followed for 4 months thereafter. At baseline, 66 of 81 children (82%) drank only sachet water. When given one voucher/child/week, households redeemed an average 0.94 vouchers/week/child in the free-sachet-voucher arm and 0.82 vouchers/week/child in the half-price arm. No change in water consumption was observed in the half-price arm, although the study was not powered to detect such differences. In the free-sachet-voucher arm, estimated sachet water consumption increased by 0.27 L/child/day (P = 0.03). The increase in sachet water consumption by children in the free-sachet-voucher arm shows that provision of fully subsidized water sachets might improve the quality of drinking water consumed by children. Further research is needed to quantify this and any related child health impacts. PMID:27215298

Subsidized Sachet Water to Reduce Diarrheal Disease in Young Children: A Feasibility Study in Accra, Ghana.

PubMed

Wright, James; Dzodzomenyo, Mawuli; Fink, Günther; Wardrop, Nicola A; Aryeetey, Genevieve C; Adanu, Richard M; Hill, Allan G

2016-07-06

Use of drinking water sold in plastic bags (sachet water) is growing rapidly in west Africa. The impact on water consumption and child health remains unclear, and a debate on the taxation and regulation of sachet water is ongoing. This study assessed the feasibility of providing subsidized sachet water to low-income urban households in Accra and measured the resultant changes in water consumption. A total of 86 children, 6-36 months of age in neighborhoods lacking indoor piped water, were randomized to three study arms. The control group received education about diarrhea. The second arm received vouchers for 15 L/week/child of free water sachets (value: $0.63/week) plus education. The third arm received vouchers for the same water sachet volume at half price plus education. Water consumption was measured at baseline and followed for 4 months thereafter. At baseline, 66 of 81 children (82%) drank only sachet water. When given one voucher/child/week, households redeemed an average 0.94 vouchers/week/child in the free-sachet-voucher arm and 0.82 vouchers/week/child in the half-price arm. No change in water consumption was observed in the half-price arm, although the study was not powered to detect such differences. In the free-sachet-voucher arm, estimated sachet water consumption increased by 0.27 L/child/day (P = 0.03). The increase in sachet water consumption by children in the free-sachet-voucher arm shows that provision of fully subsidized water sachets might improve the quality of drinking water consumed by children. Further research is needed to quantify this and any related child health impacts. © The American Society of Tropical Medicine and Hygiene.

Street foods in Accra, Ghana: how safe are they?

PubMed Central

Mensah, Patience; Yeboah-Manu, Dorothy; Owusu-Darko, Kwaku; Ablordey, Anthony

2002-01-01

OBJECTIVE: To investigate the microbial quality of foods sold on streets of Accra and factors predisposing to their contamination. METHODS: Structured questionnaires were used to collect data from 117 street vendors on their vital statistics, personal hygiene, food hygiene and knowledge of foodborne illness. Standard methods were used for the enumeration, isolation, and identification of bacteria. FINDINGS: Most vendors were educated and exhibited good hygiene behaviour. Diarrhoea was defined as the passage of > or =3 stools per day) by 110 vendors (94.0%), but none associated diarrhoea with bloody stools; only 21 (17.9%) associated diarrhoea with germs. The surroundings of the vending sites were clean, but four sites (3.4%) were classified as very dirty. The cooking of food well in advance of consumption, exposure of food to flies, and working with food at ground level and by hand were likely risk factors for contamination. Examinations were made of 511 menu items, classified as breakfast/snack foods, main dishes, soups and sauces, and cold dishes. Mesophilic bacteria were detected in 356 foods (69.7%): 28 contained Bacillus cereus (5.5%), 163 contained Staphylococcus aureus (31.9%) and 172 contained Enterobacteriaceae (33.7%). The microbial quality of most of the foods was within the acceptable limits but samples of salads, macaroni, fufu, omo tuo and red pepper had unacceptable levels of contamination. Shigella sonnei and enteroaggregative Escherichia coli were isolated from macaroni, rice, and tomato stew, and Salmonella arizonae from light soup. CONCLUSION: Street foods can be sources of enteropathogens. Vendors should therefore receive education in food hygiene. Special attention should be given to the causes of diarrhoea, the transmission of diarrhoeal pathogens, the handling of equipment and cooked food, hand-washing practices and environmental hygiene. PMID:12163918

Street foods in Accra, Ghana: how safe are they?

PubMed

Mensah, Patience; Yeboah-Manu, Dorothy; Owusu-Darko, Kwaku; Ablordey, Anthony

2002-01-01

To investigate the microbial quality of foods sold on streets of Accra and factors predisposing to their contamination. Structured questionnaires were used to collect data from 117 street vendors on their vital statistics, personal hygiene, food hygiene and knowledge of foodborne illness. Standard methods were used for the enumeration, isolation, and identification of bacteria. Most vendors were educated and exhibited good hygiene behaviour. Diarrhoea was defined as the passage of > or =3 stools per day) by 110 vendors (94.0%), but none associated diarrhoea with bloody stools; only 21 (17.9%) associated diarrhoea with germs. The surroundings of the vending sites were clean, but four sites (3.4%) were classified as very dirty. The cooking of food well in advance of consumption, exposure of food to flies, and working with food at ground level and by hand were likely risk factors for contamination. Examinations were made of 511 menu items, classified as breakfast/snack foods, main dishes, soups and sauces, and cold dishes. Mesophilic bacteria were detected in 356 foods (69.7%): 28 contained Bacillus cereus (5.5%), 163 contained Staphylococcus aureus (31.9%) and 172 contained Enterobacteriaceae (33.7%). The microbial quality of most of the foods was within the acceptable limits but samples of salads, macaroni, fufu, omo tuo and red pepper had unacceptable levels of contamination. Shigella sonnei and enteroaggregative Escherichia coli were isolated from macaroni, rice, and tomato stew, and Salmonella arizonae from light soup. Street foods can be sources of enteropathogens. Vendors should therefore receive education in food hygiene. Special attention should be given to the causes of diarrhoea, the transmission of diarrhoeal pathogens, the handling of equipment and cooked food, hand-washing practices and environmental hygiene.

Menstrual characteristics in some adolescent girls in Accra, Ghana.

PubMed

Gumanga, S K; Kwame-Aryee, R A

2012-03-01

Menstruation has a variable pattern within a few years of menarche which may not be well understood by many adolescent girls. Providing accurate information on menstruation is necessary to reduce anxiety, menstrual morbidity and improve reproductive health of these adolescents. To determine the age at menarche, duration of menstruation, length of menstrual cycle, regularity of menstrual cycle, prevalence of dysmenorrhoea and sources of information on menstruation. S(T) Mary's Senior Secondary School, Accra. Cross-sectional descriptive study using self-administered questionnaire. Four hundred and fifty six girls whose ages ranged from 14-19 years with mean and median ages of 16 ± 0.93 years and 16 years respectively were surveyed. Their ages at menarche ranged from 9 years to 16 years and the mean age at menarche was 12.5 ±1.28 years. Their menstrual cycle lengths ranged from 21-35 days with mean menstrual cycle length of 27.9± 0.9 days; the mode and median were both 28 days. The mean duration of menstrual flow was 4.9 days with mode and median of 5 days. Seventy one percent (n=449) had menses lasting 3-5 days while 27.2% had menses lasting over 5 days. Some 24% (n=409) had irregular menses six months after their menarche and 59.6% (n=453) were experiencing menses with clots. The prevalence of dysmenorrhoea was 74.4% (n=453). Some 80.2% (n=378) of the girls got counselling and education on care for their menses from their parents. The age at menarche and other menstrual characteristics observed in this study are similar to adolescent menstrual characteristics described by studies in other populations in the world.

Involving women.

PubMed

Agbo, J

1994-01-01

I am a primary health care (PHC) coordinator working with the May Day Rural project, a local NGO involved in integrated approaches and programs with rural communities in the Ga District of the Greater-Accra region in Ghana. When we talk about the community development approach we must first and foremost recognize that we are talking about women, because in the developing world frequent childbirths mean that her burden of mortality is higher than a man's; her workload is extremely heavy--whether in gardening, farming, other household duties, caring for the sick, or the rearing of children; she has a key role in PHC and community development, because men are always looking for greener pastures elsewhere, leaving the women behind. Women's concerns are critical in most health care projects and women and children are their main beneficiaries. Why not include women in the management team, project design, implementation and evaluation processes? That is what the May Day Rural project is practicing, encouraging women's participation and creating a relationship of trust. full text

Willingness to pay for small solar powered bed net fans: results of a Becker-DeGroot-Marschak auction in Ghana.

PubMed

Yukich, Joshua O; Briët, Olivier J T; Ahorlu, Collins K; Nardini, Peter; Keating, Joseph

2017-08-07

Long-lasting insecticidal nets (LLINs) are one of the main interventions recommended by the World Health Organization for malaria vector control. LLINs are ineffective if they are not being used. Subsequent to the completion of a cluster randomized cross over trial conducted in rural Greater Accra where participants were provided with the 'Bɔkɔɔ System'-a set of solar powered net fan and light consoles with a solar panel and battery-or alternative household water filters, all trial participants were invited to participate in a Becker-DeGroot-Marschak auction to determine the mean willingness to pay (WTP) for the fan and light consoles and to estimate the demand curve for the units. Results demonstraed a mean WTP of approximately 55 Cedis (~13 USD). Demand results suggested that at a price which would support full manufacturing cost recovery, a majority of households in the area would be willing to purchase at least one such unit.

Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana.

PubMed

Blumenthal, Paul D; Gaffikin, Lynne; Deganus, Sylvia; Lewis, Robbyn; Emerson, Mark; Adadevoh, Sydney

2007-04-01

The purpose of this study was to assess the safety and acceptability of a single-visit approach to cervical cancer prevention combining visual inspection of the cervix with acetic acid wash (VIA) and cryotherapy. The study was observational. Nine clinicians were trained in VIA and cryotherapy. Over 18 months 3665 women were VIA-tested. If positive and eligible, cryotherapy was offered immediately. Treated women were followed-up at 3 months and 1 year. The test-positive rate was 13.2%. Of those eligible, 70.2% and 21% received immediate or delayed treatment, respectively. No major complications were recorded, and 5.6% presented for a perceived problem post-cryotherapy. Among those treated over 90% expressed satisfaction with their experience, and 96% had an indentifiable squamo-columnar junction. Only 2.6% (6/232) were test positive, 1-year posttreatment. A single-visit approach using VIA and cryotherapy proved to be safe, acceptable, and feasible in an urban African setting.

Building an alliance for a green revolution in Africa.

PubMed

Toenniessen, Gary; Adesina, Akinwumi; DeVries, Joseph

2008-01-01

Most of Africa's people live in rural areas and depend on agriculture for their livelihoods. These predominantly small-scale farmers face many challenges, including food insecurity, rising poverty, and natural resource degradation. To increase the productivity, profitability, and sustainability of their farms, they need greater access to affordable yield-enhancing inputs, including well-adapted seeds and new methods for integrated soil fertility management, as well as to output markets where they can convert surplus production into cash. To address these needs, the Rockefeller Foundation and the Bill and Melinda Gates Foundation established the Alliance for a Green Revolution in Africa (AGRA). AGRA is now African led and is working within the context of the comprehensive agricultural development program established by Africa's leaders. From offices in Nairobi, Kenya, and Accra, Ghana, AGRA will support work across all key aspects of the African agricultural value chain to help millions of small-scale farmers and their families lift themselves out of poverty and hunger.

Solid medical waste: a cross sectional study of household disposal practices and reported harm in Southern Ghana.

PubMed

Udofia, Emilia Asuquo; Gulis, Gabriel; Fobil, Julius

2017-05-18

Solid medical waste (SMW) in households is perceived to pose minimal risks to the public compared to SMW generated from healthcare facilities. While waste from healthcare facilities is subject to recommended safety measures to minimize risks to human health and the environment, similar waste in households is often untreated and co-mingled with household waste which ends up in landfills and open dumps in many African countries. In Ghana, the management of this potentially hazardous waste stream at household and community level has not been widely reported. The objective of this study was to investigate household disposal practices and harm resulting from SMW generated in households and the community. A cross-sectional questionnaire survey of 600 households was undertaken in Ga South Municipal Assembly in Accra, Ghana from mid-April to June, 2014. Factors investigated included socio-demographic characteristics, medication related practices, the belief that one is at risk of diseases associated with SMW, SMW disposal practices and reported harm associated with SMW at home and in the community. Eighty percent and 89% of respondents discarded unwanted medicines and sharps in household refuse bins respectively. A corresponding 23% and 35% of respondents discarded these items without a container. Harm from SMW in the household and in the community was reported by 5% and 3% of respondents respectively. Persons who believed they were at risk of diseases associated with SMW were nearly three times more likely to report harm in the household (OR 2.75, 95%CI 1.15-6.54). The belief that one can be harmed by diseases associated with SMW influenced reporting rates in the study area. Disposal practices suggest the presence of unwanted medicines and sharps in the household waste stream conferring on it hazardous properties. Given the low rates of harm reported, elimination of preventable harm might justify community intervention.

Universal financial protection through National Health Insurance: a stakeholder analysis of the proposed one-time premium payment policy in Ghana.

PubMed

Abiiro, Gilbert Abotisem; McIntyre, Di

2013-05-01

Extending coverage to the informal sector is a key challenge to achieving universal coverage through contributory health insurance schemes. Ghana introduced a mandatory National Health Insurance system in 2004 to provide financial protection for both the formal and informal sectors through a combination of taxes and annual premium payments. As part of its election promise in 2008, the current government (then in opposition) promised to make the payment of premiums 'one-time'. This has been a very controversial policy issue in Ghana. This study sought to contribute to assessing the feasibility of the proposed policy by exploring the understandings of various stakeholders on the policy, their interests or concerns, potential positions, power and influences on it, as well as the general prospects and challenges for its implementation. Data were gathered from a review of relevant documents in the public domain, 28 key informant interviews and six focus group discussions with key stakeholders in Accra and two other districts. The results show that there is a lot of confusion in stakeholders' understanding of the policy issue, and, because of the uncertainties surrounding it, most powerful stakeholders are yet to take clear positions on it. However, stakeholders raised concerns that revolved around issues such as: the meaning of a one-time premium within an insurance scheme context, the affordability of the one-time premium, financing sources and sustainability of the policy, as well as the likely impact of the policy on equity in access to health care. Policy-makers need to clearly explain the meaning of the one-time premium policy and how it will be funded, and critically consider the concerns raised by stakeholders before proceeding with further attempts to implement it. For other countries planning universal coverage reforms, it is important that the terminology of their reforms clearly reflects policy objectives.

Educational status and beliefs regarding non-communicable diseases among children in Ghana.

PubMed

Badasu, Delali M; Abuosi, Aaron A; Adzei, Francis A; Anarfi, John K; Yawson, Alfred E; Atobrah, Deborah A

2018-03-05

Increasing prevalence of non-communicable diseases (NCDs) has been observed in Ghana as in other developing countries. Past research focused on NCDs among adults. Recent researches, however, provide evidence on NCDs among children in many countries, including Ghana. Beliefs about the cause of NCDs among children may be determined by the socioeconomic status of parents and care givers. This paper examines the relationship between educational status of parents and/or care givers of children with NCDs on admission and their beliefs regarding NCDs among children. A total of 225 parents and/or care givers of children with NCDS hospitalized in seven hospitals in three regions (Greater Accra, Ashanti and Volta) were selected for the study. Statistical techniques, including the chi-square and multinomial logistic regression, were used for the data analysis. Educational status is a predictor of care giver's belief about whether enemies can cause NCDs among children or not. This is the only belief with which all the educational categories have significant relationship. Also, post-secondary/polytechnic (p-value =0.029) and university (p-value = 0.009) levels of education are both predictors of care givers being undecided about the belief that NCDs among children can be caused by enemies, when background characteristics are controlled for. Significant relationship is found between only some educational categories regarding the other types of beliefs and NCDs among children. For example, those with Middle/Juniour Secondary School (JSS)/Juniour High School (JHS) education are significantly undecided about the belief that the sin of parents can cause NCDs among children. Education is more of a predictor of the belief that enemies can cause NCDs among children than the other types of beliefs. Some categories of ethnicity, residential status and age have significant relationship with the beliefs when background characteristics of the parents and/or care givers were controlled for.

Substance use and risky sexual behaviours among street connected children and youth in Accra, Ghana.

PubMed

Oppong Asante, Kwaku; Meyer-Weitz, Anna; Petersen, Inge

2014-11-27

Research on street children and youth has shown that this population is at high risk for substance use. Though risky sexual behaviours have been investigated and widely reported among street youth in resource constrained-settings, few studies have explored the relationship between substance use and other risk behaviours. This study was therefore conducted to examine the association between substance use and risky sexual behaviours among homeless youth in Ghana. A cross-sectional survey of a convenient sample of 227 (122 male and 105 female) street connected children and youth was conducted in Ghana in 2012. Using self-report measures, the relationship between substance use and risky sexual behaviours was examined using logistic regression. Substance use was relatively high as 12% and 16.2% reported daily use of alcohol and marijuana respectively. There were age and sex differences in substance use among the sample. As compared to males, more females had smoked cigarettes, used alcohol and marijuana. While alcohol use decrease with age, marijuana use on the other hand increases with age. Results from multivariate analysis revealed that having ever drunk alcohol and alcohol use in the past one month were independently associated with all the four indices of risky sexual behaviour (ever had sex, non-condom use, multiple sexual partners and survival sex). Both marijuana use and smoking of cigarettes were associated with having ever had sex, multiple sexual partners and survival sex. Other drug use was independently associated with non-condom use. Substance use seems to serve as a possible risk factor for sexual risk behaviours among homeless youth. Harm reduction interventions are needed to prevent street children and youth from engaging in substance use and risky sexual behaviours. Such programmes should pay special attention to females and younger children who are highly susceptible to the adverse conditions on the street.

Examining domains of community health nurse satisfaction and motivation: results from a mixed-methods baseline evaluation in rural Ghana.

PubMed

Sacks, Emma; Alva, Soumya; Magalona, Sophia; Vesel, Linda

2015-10-08

A strong health system requires a competent and caring workforce. A more satisfied and motivated health workforce should be more willing to serve in difficult areas, have lower turnover, and theoretically provide better care to patients. This paper examines the motivation, satisfaction, and correlation with clinical knowledge, of community health nurses (CHNs), a cadre of provider focused on maternal, newborn and child health in rural Ghana. This study employed three methods of evaluation. Two quantitative measurements were used: (1) a survey of health worker satisfaction and motivation and (2) a clinical knowledge assessment focusing on maternal, newborn and child health. Both were administered to all rostered CHNs working in the five sampled districts in the Greater Accra and Volta regions in Eastern Ghana (N = 205). Qualitative interviews (N = 29) and focus group discussions (N = 4) were held with selected CHNs in the same districts. These data were analysed using NVivo (Version 10) and Stata (Version 13.0) based on domains of extrinsic and intrinsic motivation including general satisfaction, work environment and access to resources, respect and recognition received and opportunities for advancement. CHNs desired more training, especially those who were posted at the community level (a Community-based Health Planning and Services post or "CHPS") versus at a health facility. CHNs working at CHPS believed their work to be more difficult than those posted at health facilities, due to challenges associated with foot travel to visit patients at home, and they were more likely to report having insufficient resources to do their jobs (48% vs 36%). However, CHNs posted at health facilities were more likely to report insufficient opportunities for career advancement than the CHPS nurses (49% vs 33%). CHNs generally reported good relationships with colleagues and being respected by patients but desired more respect from supervisors. The median score on the knowledge assessment was 78%. On average, subgroups of CHNs with different reported levels of satisfaction did not perform differently on the knowledge assessment. CHNs in Ghana were satisfied overall but desired more training, more guidance and supervision, fair pay and opportunities to advance in their career. Improving health worker satisfaction and morale may be important for health worker retention and certain aspects of care but may not have a significant influence on clinical knowledge or performance.

Shaping legal abortion provision in Ghana: using policy theory to understand provider-related obstacles to policy implementation

PubMed Central

2013-01-01

Background Unsafe abortion is a major public health problem in Ghana; despite its liberal abortion law, access to safe, legal abortion in public health facilities is limited. Theory is often neglected as a tool for providing evidence to inform better practice; in this study we investigated the reasons for poor implementation of the policy in Ghana using Lipsky’s theory of street-level bureaucracy to better understand how providers shape and implement policy and how provider-level barriers might be overcome. Methods In-depth interviews were conducted with 43 health professionals of different levels (managers, obstetricians, midwives) at three hospitals in Accra, as well as staff from smaller and private sector facilities. Relevant policy and related documents were also analysed. Results Findings confirm that health providers’ views shape provision of safe-abortion services. Most prominently, providers experience conflicts between their religious and moral beliefs about the sanctity of (foetal) life and their duty to provide safe-abortion care. Obstetricians were more exposed to international debates, treaties, and safe-abortion practices and had better awareness of national research on the public health implications of unsafe abortions; these factors tempered their religious views. Midwives were more driven by fundamental religious values condemning abortion as sinful. In addition to personal views and dilemmas, ‘social pressures’ (perceived views of others concerning abortion) and the actions of facility managers affected providers’ decision to (openly) provide abortion services. In order to achieve a workable balance between these pressures and duties, providers use their ‘discretion’ in deciding if and when to provide abortion services, and develop ‘coping mechanisms’ which impede implementation of abortion policy. Conclusions The application of theory confirmed its utility in a lower-middle income setting and expanded its scope by showing that provider values and attitudes (not just resource constraints) modify providers’ implementation of policy; moreover their power of modification is constrained by organisational hierarchies and mid-level managers. We also revealed differing responses of ‘front line workers’ regarding the pressures they face; whilst midwives are seen globally as providers of safe-abortion services, in Ghana the midwife cadre displays more negative attitudes towards them than doctors. These findings allow the identification of recommendations for evidence-based practice. PMID:23829555

Overweight and obesity epidemic in Ghana-a systematic review and meta-analysis.

PubMed

Ofori-Asenso, Richard; Agyeman, Akosua Adom; Laar, Amos; Boateng, Daniel

2016-12-09

In many low and middle income countries (LMICs), the distribution of adulthood nutritional imbalance is shifting from a predominance of undernutrition to overnutrition. This complex problem poses a huge challenge to governments, non-state actors, and individuals desirous of addressing the problem of malnutrition in LMICs. The objective of this study was to systematically review the literature towards providing an estimate of the prevalence of overweight and obesity among adult Ghanaians. This study followed the recommendations outlined in the PRISMA statement. Searches were performed in PubMed, Science Direct, google scholar, Africa Journals Online (AJOL) and the WHO African Index Medicus database. This retrieved studies (published up to 31st March 2016) that reported overweight and obesity prevalence among Ghanaians. All online searches were supplemented by reference screening of retrieved papers to identify additional studies. Forty-three (43) studies involving a total population of 48,966 sampled across all the ten (10) regions of Ghana were selected for the review. Our analysis indicates that nearly 43% of Ghanaian adults are either overweight or obese. The national prevalence of overweight and obesity were estimated as 25.4% (95% CI 22.2-28.7%) and 17.1% (95% CI = 14.7-19.5%), respectively. Higher prevalence of overweight (27.2% vs 16.7%) and obesity (20.6% vs 8.0%) were estimated for urban than rural dwellers. Prevalence of overweight (27.8% vs 21.8%) and obesity (21.9% vs 6.0%) were also significantly higher in women than men. About 45.6% of adult diabetes patients in Ghana are either overweight or obese. At the regional level, about 43.4%, 36.9%, 32.4% and 55.2% of residents in Ashanti, Central, Northern and Greater Accra region, respectively are overweight or obese. These patterns generally mimic the levels of urbanization. Per studies' publication years, consistent increases in overweight and obesity prevalence were observed in Ghana in the period 1998-2016. There is a high and rising prevalence of overweight and obesity among Ghanaian adults. The possible implications on current and future population health, burden of chronic diseases, health care spending and broader economy could be enormous for a country still battling many infectious and parasitic diseases. Public health preventive measures that are appropriate for the Ghanaian context, culturally sensitive, cost-effective and sustainable are urgently needed to tackle this epidemic.

Improving the Measurement of Fertility Regulation Practices: Findings from Qualitative Research in Ghana.

PubMed

Marston, Cicely; Renedo, Alicia; Nyaaba, Gertrude Nsorma; Machiyama, Kazuyo; Tapsoba, Placide; Cleland, John

2017-09-01

According to Demographic and Health Survey (DHS) data, highly educated urban women in some West African countries simultaneously have low rates of both contraceptive use and fertility-suggesting that the DHS may not be capturing a complete picture of women's contraceptive practices. Individual in-depth interviews and focus group discussions were conducted with a total of 48 women aged 18-49 in Accra, Ghana, who had at least a secondary education to explore their reproductive lives and relationships, and their views on and use of fertility regulation strategies. Data were analyzed using iterative thematic techniques. Women commonly reported using combinations of contraceptive methods, including "counting days" (using a calendar and the date of one's last menstrual period to estimate "unsafe" days-those on which the risk of conception is high), as well as withdrawal, condoms and frequent use of emergency contraceptive pills. Women described practicing "periodic contraception": for example, counting days to determine unsafe days and practicing contraception ad hoc on such days. Method use combinations varied from cycle to cycle-forming a "mosaic" of method use combinations over time. The fertility control strategies commonly reported by the study respondents-periodic contraception, and frequent use of traditional methods and emergency contraceptive pills-are likely not adequately captured in general surveys such as the DHS. Such surveys are also not well suited to measuring combinations of methods and mosaics of method combinations. New ways of capturing women's fertility regulation practices should be considered, including additional survey items, new question modules and specialist studies.

Addressing the third delay: implementing a novel obstetric triage system in Ghana.

PubMed

Goodman, David M; Srofenyoh, Emmanuel K; Ramaswamy, Rohit; Bryce, Fiona; Floyd, Liz; Olufolabi, Adeyemi; Tetteh, Cecilia; Owen, Medge D

2018-01-01

Institutional delivery has been proposed as a method for reducing maternal morbidity and mortality, but little is known about how referral hospitals in low-resource settings can best manage the expected influx of patients. In this study, we assess the impact of an obstetric triage improvement programme on reducing hospital-based delay in a referral hospital in Accra, Ghana. An Active Implementation Framework is used to describe a 5-year intervention to introduce and monitor obstetric triage capabilities. Baseline data, collected from September to November 2012, revealed significant delays in patient assessment on arrival. A triage training course and monitoring of quality improvement tools occurred in 2013 and 2014. Implementation barriers led to the construction of a free-standing obstetric triage pavilion, opened January 2015, with dedicated midwives. Data were collected at three time intervals following the triage pavilion opening and compared with baseline including: referral indications, patient and labour characteristics, waiting time from arrival to assessment and the documentation of a care plan. An obstetric triage improvement programme reduced the median (IQR) patient waiting time from facility arrival to first assessment by a midwife from 40 min (15-100) to 5 min (2-6) (p<0.001) over the 5-year intervention. The triage pavilion enhanced performance resulting in the elimination of previous delays associated with the time of admission and disease acuity. Care plan documentation increased from 51% to 96%. Obstetric triage, when properly implemented, reduced delay in a busy, low-resource hospital. The implementation process was sustained under local leadership during transition to a new hospital.

Release of chlorinated, brominated and mixed halogenated dioxin-related compounds to soils from open burning of e-waste in Agbogbloshie (Accra, Ghana).

PubMed

Tue, Nguyen Minh; Goto, Akitoshi; Takahashi, Shin; Itai, Takaaki; Asante, Kwadwo Ansong; Kunisue, Tatsuya; Tanabe, Shinsuke

2016-01-25

Although complex mixtures of dioxin-related compounds (DRCs) can be released from informal e-waste recycling, DRC contamination in African e-waste recycling sites has not been investigated. This study examined the concentrations of DRCs including chlorinated, brominated, mixed halogenated dibenzo-p-dioxins/dibenzofurans (PCDD/Fs, PBDD/Fs, PXDD/Fs) and dioxin-like polychlorinated biphenyls (DL-PCBs) in surface soil samples from the Agbogbloshie e-waste recycling site in Ghana. PCDD/F and PBDD/F concentrations in open burning areas (18-520 and 83-3800 ng/g dry, respectively) were among the highest reported in soils from informal e-waste sites. The concentrations of PCDFs and PBDFs were higher than those of the respective dibenzo-p-dioxins, suggesting combustion and PBDE-containing plastics as principal sources. PXDFs were found as more abundant than PCDFs, and higher brominated analogues occurred at higher concentrations. The median total WHO toxic equivalent (TEQ) concentration in open burning soils was 7 times higher than the U.S. action level (1000 pg/g), with TEQ contributors in the order of PBDFs>PCDD/Fs>PXDFs. DRC emission to soils over the e-waste site as of 2010 was estimated, from surface soil lightness based on the correlations between concentrations and lightness, at 200mg (95% confidence interval 93-540 mg) WHO-TEQ over three years. People living in Agbogbloshie are potentially exposed to high levels of not only chlorinated but also brominated DRCs, and human health implications need to be assessed in future studies. Copyright © 2015 Elsevier B.V. All rights reserved.

Understanding handpump sustainability: Determinants of rural water source functionality in the Greater Afram Plains region of Ghana.

PubMed

Fisher, Michael B; Shields, Katherine F; Chan, Terence U; Christenson, Elizabeth; Cronk, Ryan D; Leker, Hannah; Samani, Destina; Apoya, Patrick; Lutz, Alexandra; Bartram, Jamie

2015-10-01

Safe drinking water is critical to human health and development. In rural sub-Saharan Africa, most improved water sources are boreholes with handpumps; studies suggest that up to one third of these handpumps are nonfunctional at any given time. This work presents findings from a secondary analysis of cross-sectional data from 1509 water sources in 570 communities in the rural Greater Afram Plains (GAP) region of Ghana; one of the largest studies of its kind. 79.4% of enumerated water sources were functional when visited; in multivariable regressions, functionality depended on source age, management, tariff collection, the number of other sources in the community, and the district. A Bayesian network (BN) model developed using the same data set found strong dependencies of functionality on implementer, pump type, management, and the availability of tools, with synergistic effects from management determinants on functionality, increasing the likelihood of a source being functional from a baseline of 72% to more than 97% with optimal management and available tools. We suggest that functionality may be a dynamic equilibrium between regular breakdowns and repairs, with management a key determinant of repair rate. Management variables may interact synergistically in ways better captured by BN analysis than by logistic regressions. These qualitative findings may prove generalizable beyond the study area, and may offer new approaches to understanding and increasing handpump functionality and safe water access.

Challenges of medicines management in the public and private sector under Ghana's National Health Insurance Scheme - A qualitative study.

PubMed

Ashigbie, Paul G; Azameti, Devine; Wirtz, Veronika J

2016-01-01

Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers. This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes. Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS. Health providers generally perceive the NHIS to have had a largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.

Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana

PubMed Central

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Spieker, Nicole; Arhinful, Daniel Kojo; Ogink, Alice; van Ostenberg, Paul; Rinke de Wit, Tobias F.

2015-01-01

Background Patient safety and quality care remain major challenges to Ghana’s healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE) in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed. Purpose This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities. Methods A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities. Findings Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05) and staff competencies (Coef. = 7.1, p<0.05). Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period. Community groups that were gender balanced, religious/faith-based, and had structured leadership appeared to be better options for effective SCE in healthcare quality assessment. Conclusion Community engagement in healthcare quality assessment is a feasible client-centered quality improvement option that should be discussed for possible scale-up in Ghana and other resource poor countries in Africa. PMID:26619143

Ethical issues in the export, storage and reuse of human biological samples in biomedical research: perspectives of key stakeholders in Ghana and Kenya.

PubMed

Tindana, Paulina; Molyneux, Catherine S; Bull, Susan; Parker, Michael

2014-10-18

For many decades, access to human biological samples, such as cells, tissues, organs, blood, and sub-cellular materials such as DNA, for use in biomedical research, has been central in understanding the nature and transmission of diseases across the globe. However, the limitations of current ethical and regulatory frameworks in sub-Saharan Africa to govern the collection, export, storage and reuse of these samples have resulted in inconsistencies in practice and a number of ethical concerns for sample donors, researchers and research ethics committees. This paper examines stakeholders' perspectives of and responses to the ethical issues arising from these research practices. We employed a qualitative strategy of inquiry for this research including in-depth interviews and focus group discussions with key research stakeholders in Kenya (Nairobi and Kilifi), and Ghana (Accra and Navrongo). The stakeholders interviewed emphasised the compelling scientific importance of sample export, storage and reuse, and acknowledged the existence of some structures governing these research practices, but they also highlighted the pressing need for a number of practical ethical concerns to be addressed in order to ensure high standards of practice and to maintain public confidence in international research collaborations. These concerns relate to obtaining culturally appropriate consent for sample export and reuse, understanding cultural sensitivities around the use of blood samples, facilitating a degree of local control of samples and sustainable scientific capacity building. Drawing on these findings and existing literature, we argue that the ethical issues arising in practice need to be understood in the context of the interactions between host research institutions and local communities and between collaborating institutions. We propose a set of 'key points-to-consider' for research institutions, ethics committees and funding agencies to address these issues.

School-based participatory health education for malaria control in Ghana: engaging children as health messengers.

PubMed

Ayi, Irene; Nonaka, Daisuke; Adjovu, Josiah K; Hanafusa, Shigeki; Jimba, Masamine; Bosompem, Kwabena M; Mizoue, Tetsuya; Takeuchi, Tsutomu; Boakye, Daniel A; Kobayashi, Jun

2010-04-18

School children have been increasingly recognized as health messengers for malaria control. However, little evidence is available. The objective of this study was to determine the impact of school-based malaria education intervention on school children and community adults. This study was conducted in the Dangme-East district of the Greater Accra Region, Ghana, between 2007 and 2008. Trained schoolteachers designed participatory health education activities and led school children to disseminate messages related to malaria control to their communities. Three schools and their respective communities were chosen for the study and assigned to an intervention group (one school) and a control group (two schools). Questionnaire-based interviews and parasitological surveys were conducted before and after the intervention, with the intervention group (105 children, 250 community adults) and the control group (81 children, 133 community adults). Chi-square and Fisher's Exact tests were used to analyse differences in knowledge, practices, and parasite prevalence between pre- and post-intervention. After the intervention, the misperception that malaria has multiple causes was significantly improved, both among children and community adults. Moreover, the community adults who treated a bed net with insecticide in the past six months, increased from 21.5% to 50.0% (p < 0.001). Parasite prevalence in school children decreased from 30.9% to 10.3% (p = 0.003). These positive changes were observed only in the intervention group. This study suggests that the participatory health education intervention contributed to the decreased malaria prevalence among children. It had a positive impact not only on school children, but also on community adults, through the improvement of knowledge and practices. This strategy can be applied as a complementary approach to existing malaria control strategies in West African countries where school health management systems have been strengthened.

Blood pressure patterns and body mass index status in pregnancy: An assessment among women reporting for antenatal care at the Korle-Bu Teaching hospital, Ghana.

PubMed

Amoakoh-Coleman, Mary; Ogum-Alangea, Deda; Modey-Amoah, Emefa; Ntumy, Michael Yao; Adanu, Richard M; Oppong, Samuel A

2017-01-01

Maternal obesity in pregnancy has been linked with increased risk of pregnancy induced hypertension (PIH). In some tertiary referral hospitals in Ghana, PIH is the leading cause of institutional maternal mortality. To evaluate blood pressure changes during pregnancy amongst different body mass index (BMI) groups and how this relates to the risk of developing PIH. Women who had a dating ultrasound before 20 weeks gestation and registering for antenatal care at the Korle-Bu Teaching Hospital in Accra, between February and December 2013 and met the inclusion criteria were recruited into a cohort study. BMI was assessed at baseline. Blood pressure measurements were taken at (±2) 24, 28 and 36 weeks. Primary outcome measure of interest during follow-up was a diagnosis of PIH at these points. BP changes during follow up at the three points were measured. Descriptive analysis of baseline factors was carried out and compared for the BMI groups. Relative risk (RR) of PIH was estimated at 95% confidence interval. Mean (SD) age for the 361 women was 30.9 (4.8) years. Incidence of PIH amongst the cohort was 10.5% (95% CI: 7.45% - 14.45%) and 40.4% and 33.0% of them were overweight and obese respectively at baseline. Pregnant women who were obese at baseline had a three-fold increased risk of PIH compared to those with normal BMI [RR = 3.01 (1.06-8.52), p = 0.04]. Obese women have a significantly increased risk of PIH. Women should be screened at booking for obesity status. Antenatal protocols should have interventions for prevention or early detection of obesity and management of obesity to improve outcomes.

Plasmodium falciparum diagnostic tools in HIV-positive under-5-year-olds in two ART clinics in Ghana: are there missed infections?

PubMed

Owusu, Ewurama D A; Djonor, Samson K; Brown, Charles A; Grobusch, Martin P; Mens, Petra F

2018-02-23

Plasmodium falciparum, the most dominant species in sub-Saharan Africa, causes the most severe clinical malaria manifestations. In resource-limited Ghana, where malaria and HIV geographically overlap, histidine-rich protein 2 (HRP2)-based rapid diagnostic test (RDT) is a faster, easier and cheaper alternative to clinical gold standard light microscopy. However, mutations in parasite hrp2 gene may result in missed infections, which have severe implications for malaria control. The performance of a common HRP2-based RDT and expert light microscopy in HIV-positive and HIV-negative children under 5 years old was compared with PCR as laboratory gold standard. Finger-prick capillary blood was tested with First Response ® Malaria Ag P. falciparum (HRP2). Giemsa-stained thick and thin blood films were examined with ≥ 200 high power fields and parasites counted per 200 white blood cells. Nested PCR species identification of P. falciparum was performed and resolved on agarose gel. False negatives from RDT were further tested for deleted pfhrp2/3 and flanking genes, using PCR. The study was performed in two anti-retroviral therapy clinics in Accra and Atibie. Out of 401 participants enrolled, 150 were HIV positive and 251 HIV negative. Malaria was more prevalent in children without HIV. Microscopy had a higher sensitivity [100% (99-100)] than RDT [83% (53.5-100)]. Parasites with pfhrp2/3 deletions contributed to missed infections from RDT false negatives. Circulation of malaria parasites with pfrhp2/3 deletions in this population played a role in missed infections with RDT. This ought to be addressed if further strides in malaria control are to be made.

Assessing the reach and effectiveness of mHealth: evidence from a reproductive health program for adolescent girls in Ghana.

PubMed

Rokicki, Slawa; Fink, Günther

2017-12-20

While mobile health (mHealth) programs are increasingly used to provide health information and deliver interventions, little is known regarding the relative reach and effectiveness of these programs across sociodemographic characteristics. We use data from a recent trial of a text-messaging intervention on adolescent sexual and reproductive health (SRH) to assess the degree to which mHealth programs reach target adolescent subpopulations who may be at higher risk of poor SRH outcomes. The study was conducted among girls aged 14-24 in 22 secondary schools in Accra, Ghana. The mHealth intervention was an interactive mobile phone quiz in which participants could win phone credit for texting correct answers to SRH questions. We use detailed data on individuals' level of engagement with the program, SRH knowledge scores, and self-reported pregnancy collected as part of the original trial to assess the extent to which engagement and program impact vary across parental education, sexual experience, SRH knowledge deficit, and parental support. Eighty-one percent of participants engaged with the mHealth program, with no evidence that the program disproportionally reached better-off groups. The program was effective at increasing knowledge of SRH across all strata. Higher levels of engagement were associated with higher knowledge scores up to year later. There was no significant impact of the program on self-reported pregnancy within subgroups. mHealth programs for adolescents have the potential to engage and increase SRH knowledge of adolescent girls across sociodemographic strata, including those who may be at higher risk of poor SRH outcomes. ClinicalTrials.gov NCT02031575 . Registered 07 Jan 2014.

Prevalence, detection, management, and control of hypertension in Ghanaian civil servants.

PubMed

Addo, Juliet; Smeeth, Liam; Leon, David A

2008-01-01

The goal of this study was to determine the prevalence of hypertension and establish the levels of detection, treatment, and control among urban civil servants in Ghana. A cross-sectional study was conducted on 1015 urban civil servants aged > or = 25 years from seven randomly selected central government ministries in Accra, Ghana. Hypertension was diagnosed when the mean of a second and third blood pressure reading was > or = 140/90 mm Hg or participants reported that they used antihypertensive medication. The age-adjusted (world standard population) prevalence of hypertension was 27.4% (95% CI 24.7%-30.1%). The prevalence of hypertension increased with age. The proportion of hypertensive participants with severe hypertension (blood pressure > or = 180/ 110mm Hg) was 19.2%. Among the 307 participants with hypertension, 54.1% had been previously detected, 31.3% were on treatment, and 12.7% had their blood pressure controlled (< 140/90 mm Hg). Female sex was independently associated with higher detection and treatment of hypertension and better control. Hypertension was positively associated with age and body mass index and negatively associated with physical activity. The high prevalence of hypertension in this population with considerable underdiagnosis and low levels of treatment and control is of great concern. It is important to introduce health education measures that will promote prevention and early detection of hypertension and encourage better compliance to treatment. The reasons for inadequate control must be investigated to enable implementation of appropriate measures to improve control and reduce the risk of developing complications. There is a need to encourage healthier lifestyles with emphasis on preventing obesity and increasing level of activity.

Factors associated with sexual and reproductive health stigma among adolescent girls in Ghana.

PubMed

Hall, Kelli Stidham; Morhe, Emmanuel; Manu, Abubakar; Harris, Lisa H; Ela, Elizabeth; Loll, Dana; Kolenic, Giselle; Dozier, Jessica L; Challa, Sneha; Zochowski, Melissa K; Boakye, Andrew; Adanu, Richard; Dalton, Vanessa K

2018-01-01

Using our previously developed and tested Adolescent Sexual and Reproductive Health (SRH) Stigma Scale, we investigated factors associated with perceived SRH stigma among adolescent girls in Ghana. We drew upon data from our survey study of 1,063 females 15-24yrs recruited from community- and clinic-based sites in two Ghanaian cities. Our Adolescent SRH Stigma Scale comprised 20 items and 3 sub-scales (Internalized, Enacted, Lay Attitudes) to measure stigma occurring with sexual activity, contraceptive use, pregnancy, abortion and family planning service use. We assessed relationships between a comprehensive set of demographic, health and social factors and SRH Stigma with multi-level multivariable linear regression models. In unadjusted bivariate analyses, compared to their counterparts, SRH stigma scores were higher among girls who were younger, Accra residents, Muslim, still in/dropped out of secondary school, unemployed, reporting excellent/very good health, not in a relationship, not sexually experienced, never received family planning services, never used contraception, but had been pregnant (all p-values <0.05). In multivariable models, higher SRH stigma scores were associated with history of pregnancy (β = 1.53, CI = 0.51,2.56) and excellent/very good self-rated health (β = 0.89, CI = 0.20,1.58), while lower stigma scores were associated with older age (β = -0.17, 95%CI = -0.24,-0.09), higher educational attainment (β = -1.22, CI = -1.82,-0.63), and sexual intercourse experience (β = -1.32, CI = -2.10,-0.55). Findings provide insight into factors contributing to SRH stigma among this young Ghanaian female sample. Further research disentangling the complex interrelationships between SRH stigma, health, and social context is needed to guide multi-level interventions to address SRH stigma and its causes and consequences for adolescents worldwide.

Factors associated with sexual and reproductive health stigma among adolescent girls in Ghana

PubMed Central

Morhe, Emmanuel; Manu, Abubakar; Harris, Lisa H.; Ela, Elizabeth; Loll, Dana; Kolenic, Giselle; Dozier, Jessica L.; Challa, Sneha; Zochowski, Melissa K.; Boakye, Andrew; Adanu, Richard; Dalton, Vanessa K.

2018-01-01

Objective Using our previously developed and tested Adolescent Sexual and Reproductive Health (SRH) Stigma Scale, we investigated factors associated with perceived SRH stigma among adolescent girls in Ghana. Methods We drew upon data from our survey study of 1,063 females 15-24yrs recruited from community- and clinic-based sites in two Ghanaian cities. Our Adolescent SRH Stigma Scale comprised 20 items and 3 sub-scales (Internalized, Enacted, Lay Attitudes) to measure stigma occurring with sexual activity, contraceptive use, pregnancy, abortion and family planning service use. We assessed relationships between a comprehensive set of demographic, health and social factors and SRH Stigma with multi-level multivariable linear regression models. Results In unadjusted bivariate analyses, compared to their counterparts, SRH stigma scores were higher among girls who were younger, Accra residents, Muslim, still in/dropped out of secondary school, unemployed, reporting excellent/very good health, not in a relationship, not sexually experienced, never received family planning services, never used contraception, but had been pregnant (all p-values <0.05). In multivariable models, higher SRH stigma scores were associated with history of pregnancy (β = 1.53, CI = 0.51,2.56) and excellent/very good self-rated health (β = 0.89, CI = 0.20,1.58), while lower stigma scores were associated with older age (β = -0.17, 95%CI = -0.24,-0.09), higher educational attainment (β = -1.22, CI = -1.82,-0.63), and sexual intercourse experience (β = -1.32, CI = -2.10,-0.55). Conclusions Findings provide insight into factors contributing to SRH stigma among this young Ghanaian female sample. Further research disentangling the complex interrelationships between SRH stigma, health, and social context is needed to guide multi-level interventions to address SRH stigma and its causes and consequences for adolescents worldwide. PMID:29608595

Dying for water.

PubMed

Yeboah-afari, A

1993-01-01

In Danchira village in Ghana for the last 5 years, women and children rise before dawn every day to fetch water from a tributary or the River Densu, which is 5 miles from the village. Diminished rainfall has dried the village's 3 ponds and bore-hole where the women and children used to fetch water. To exacerbate the water problem, the Ghana Water and Sewerage Corporation no longer comes to fill the huge water tank it brought to Danchira when water scarcity first occurred. The villagers could not afford to pay for the water. A 55-year-old mother of 5, Dede Aryehteye, takes her morning bath at the river. When she has dirty laundry, she cleans it in the river. She returns to the village around 8 am. She uses the next hour to filter the dark water 2 times with a device provided free of charge by the national Guinea Worm Eradication Programme to keep the larvae out of the water. Next she sort the water for 3 uses: drinking, household use, and evening bath. Dede then does other domestic chores. She would rather go to her cassava farm in the early morning when it is cool but has to fetch water instead. When she is not too tired and after finishing domestic chores, she goes to the farm. Water-fetching also exhausts the children and gets them to school rather late. Children make up the majority of the 500 people living in Danchira. Water scarcity forced most of the young villagers to flee to the cities. For example, Dede's 4 older children now live in Accra. The water scarcity keeps the farmers from growing maize, cassava, and vegetables.

In search of susceptibility genes for type 2 diabetes in West Africa: the design and results of the first phase of the AADM study.

PubMed

Rotimi, C N; Dunston, G M; Berg, K; Akinsete, O; Amoah, A; Owusu, S; Acheampong, J; Boateng, K; Oli, J; Okafor, G; Onyenekwe, B; Osotimehin, B; Abbiyesuku, F; Johnson, T; Fasanmade, O; Furbert-Harris, P; Kittles, R; Vekich, M; Adegoke, O; Bonney, G; Collins, F

2001-01-01

The purpose of this study is to map type 2 diabetes susceptibility genes in West African ancestral populations of African-Americans, through an international collaboration between West African and US investigators. Affected sib-pairs (ASP) along with unaffected spouse controls are being enrolled and examined in West Africa, with two sites established in Ghana (Accra and Kumasi) and three in Nigeria (Enugu, Ibadan, and Lagos). Eligible participants are invited to study clinics to obtain detailed epidemiologic, family, and medical history information. Blood samples are drawn from each participant to measure glucose, insulin, C-peptide, total cholesterol, LDL, HDL, triglycerides, albumin, creatinine, urea, uric acid, total calcium and to detect autoantibodies to glutamic acid decarboxylase (GAD). DNA is isolated from frozen white blood cells obtained from 20 ml of EDTA whole blood samples. With full informed consent, 162 individuals from 78 families have been enrolled and examined since the Africa America Diabetes Mellitus (AADM) study began in June of 1997. Logistics of field examinations and specimen shipping have been successfully established. At the end of the third year of field activity (September 2000) the AADM study will have enrolled and performed comprehensive examination on 400 ASP with type 2 diabetes, for a minimum of 800 cases and 200 controls from Ghana and Nigeria. At the current participation rate, the goal of 400 sib-pairs and 200 controls will be met before the scheduled closing date. The AADM study will create a comprehensive epidemiologic and genetic resource that will facilitate a powerful genome-wide search for West African susceptibility genes to type 2 diabetes.

Microbiological quality and antimicrobial resistance characterization of Salmonella spp. in fresh milk value chains in Ghana.

PubMed

Parry-Hanson Kunadu, Angela; Holmes, Mark; Miller, Eric L; Grant, Andrew J

2018-07-20

Consumer perception of poor hygiene of fresh milk products is a major barrier to promotion of milk consumption as an intervention to alleviate the burden of malnutrition in Ghana. Fresh milk is retailed raw, boiled, or processed into unfermented cheese and spontaneously fermented products in unlicensed outlets. In this study, we have determined microbiological quality of informally retailed fresh milk products and characterized the genomic diversity and antimicrobial resistance (AMR) patterns of non-typhoidal Salmonella (NTS) in implicated products. A total of 159 common dairy products were purchased from five traditional milk markets in Accra. Samples were analysed for concentrations of aerobic bacteria, total and fecal coliforms, Escherichia coli, staphylococci, lactic acid bacteria and yeast and moulds. The presence of Salmonella, E. coli O157:H7, Listeria monocytogenes and Staphylococcus aureus were determined. AMR of Salmonella against 18 antibiotics was experimentally determined. Genome sequencing of 19 Salmonella isolates allowed determination of serovars, antigenic profiles, prediction of AMR genes in silico and inference of phylogenetic relatedness between strains. Raw and heat-treated milk did not differ significantly in overall bacterial quality (P = 0.851). E. coli O157:H7 and Staphylococcus aureus were present in 34.3% and 12.9% of dairy products respectively. Multidrug resistant (MDR) Salmonella enterica serovars Muenster and Legon were identified in 11.8% and 5.9% of unfermented cheese samples respectively. Pan genome analysis revealed a total of 3712 core genes. All Salmonella strains were resistant to Trimethoprim/Sulfamethoxazole, Cefoxitin, Cefuroxime Axetil and Cefuroxime. Resistance to Chloramphenicol (18%) and Ciprofloxacin (100%), which are first line antibiotics used in treatment of NTS bacteremia in Ghana, was evident. AMR was attributed to presence and/or mutations in the following genes: golS, sdiA for cephalosporins, aac(6')-Iy, ant(9) for aminoglycosides, mdtK, gyrA, gyrB, parC, parE for quinolones and cat1, cat4 for phenicols. Phylogenetic analysis based on accessory genes clustered S. Legon strains separately from the S. Muenster strains. These strains were from different markets suggesting local circulation of related strains. Our study justifies consumer resistance to consumption of unripened soft cheese without further lethal heat treatment, and provides evidence that supports the Ghana Health Service recommendation for use of 3rd generation cephalosporins for the treatment of MDR NTS infections. Copyright © 2018 Elsevier B.V. All rights reserved.

Understanding handpump sustainability: Determinants of rural water source functionality in the Greater Afram Plains region of Ghana

NASA Astrophysics Data System (ADS)

Fisher, Michael B.; Shields, Katherine F.; Chan, Terence U.; Christenson, Elizabeth; Cronk, Ryan D.; Leker, Hannah; Samani, Destina; Apoya, Patrick; Lutz, Alexandra; Bartram, Jamie

2015-10-01

Safe drinking water is critical to human health and development. In rural sub-Saharan Africa, most improved water sources are boreholes with handpumps; studies suggest that up to one third of these handpumps are nonfunctional at any given time. This work presents findings from a secondary analysis of cross-sectional data from 1509 water sources in 570 communities in the rural Greater Afram Plains (GAP) region of Ghana; one of the largest studies of its kind. 79.4% of enumerated water sources were functional when visited; in multivariable regressions, functionality depended on source age, management, tariff collection, the number of other sources in the community, and the district. A Bayesian network (BN) model developed using the same data set found strong dependencies of functionality on implementer, pump type, management, and the availability of tools, with synergistic effects from management determinants on functionality, increasing the likelihood of a source being functional from a baseline of 72% to more than 97% with optimal management and available tools. We suggest that functionality may be a dynamic equilibrium between regular breakdowns and repairs, with management a key determinant of repair rate. Management variables may interact synergistically in ways better captured by BN analysis than by logistic regressions. These qualitative findings may prove generalizable beyond the study area, and may offer new approaches to understanding and increasing handpump functionality and safe water access. This article was corrected on 11 Nov 2015. See the end of the full text for details.

Commuting fruit bats beneficially modulate their flight in relation to wind.

PubMed

Sapir, Nir; Horvitz, Nir; Dechmann, Dina K N; Fahr, Jakob; Wikelski, Martin

2014-05-07

When animals move, their tracks may be strongly influenced by the motion of air or water, and this may affect the speed, energetics and prospects of the journey. Flying organisms, such as bats, may thus benefit from modifying their flight in response to the wind vector. Yet, practical difficulties have so far limited the understanding of this response for free-ranging bats. We tracked nine straw-coloured fruit bats (Eidolon helvum) that flew 42.5 ± 17.5 km (mean ± s.d.) to and from their roost near Accra, Ghana. Following detailed atmospheric simulations, we found that bats compensated for wind drift, as predicted under constant winds, and decreased their airspeed in response to tailwind assistance such that their groundspeed remained nearly constant. In addition, bats increased their airspeed with increasing crosswind speed. Overall, bats modulated their airspeed in relation to wind speed at different wind directions in a manner predicted by a two-dimensional optimal movement model. We conclude that sophisticated behavioural mechanisms to minimize the cost of transport under various wind conditions have evolved in bats. The bats' response to the wind is similar to that reported for migratory birds and insects, suggesting convergent evolution of flight behaviours in volant organisms.

Urban-rural difference in satisfaction with primary healthcare services in Ghana.

PubMed

Yaya, Sanni; Bishwajit, Ghose; Ekholuenetale, Michael; Shah, Vaibhav; Kadio, Bernard; Udenigwe, Ogochukwu

2017-11-25

Understanding regional variation in patient satisfaction about healthcare systems (PHCs) on the quality of services provided is instrumental to improving quality and developing a patient-centered healthcare system by making it more responsive especially to the cultural aspects of health demands of a population. Reaching to the innovative National Health Insurance Scheme (NHIS) in Ghana, surpassing several reforms in healthcare financing has been a milestone. However, the focus of NHIS is on the demand side of healthcare delivery. Studies focusing on the supply side of healthcare delivery, particularly the quality of service as perceived by the consumers are required. A growing number of studies have focused on regional differences of patient satisfaction in developed countries, however little research has been conducted concerning patient satisfaction in resource-poor settings like in Ghana. This study was therefore dedicated to examining the variation in satisfaction across rural and urban women in Ghana. Data for the present study were obtained from the latest demographic and health survey in Ghana (GDHS 2014). Participants were 3576 women aged between 15 and 49 years living in non-institutional settings in Ghana. Summary statistics in percentages was used to present respondents' demographic, socioeconomic characteristics. Chi-square test was used to find association between urban-rural differentials with socio-economic variables. Multiple logistic regression was performed to measure the association of being satisfied with primary healthcare services with study variables. Model fitness was tested by pseudo R 2 . Statistical significance was set at p < 0.05. The findings in this study revealed that about 57.1% were satisfied with primary health care services. The urban and rural areas reported 57.6 and 56.6% respectively which showed no statistically significant difference (z = 0.64; p = 0.523; 95%CI: -0.022, 0.043). Bivariate analysis showed that region, highest level of education, wealth index and type of facility were significantly associated with location of residence (urban-rural areas). After adjusting for confounding variables using logistic regression, geographical location became a key factor of satisfaction with primary healthcare services by location of residence. In urban areas, respondents from Greater Accra had 64% increase in the level of satisfaction when compared to those in Western region (OR = 1.64; 95CI: 1.09-2.47), Upper East had 75% increase in satisfaction compared to Western region (OR = 1.75; 95%CI: 1.08-2.84), Northern had an estimated 44% reduction in satisfaction when compared to Western region (OR = 0.56; 95%CI: 0.34-0.92). However, rural areas in Central, Volta, Eastern, Ashanti, Brong Aghafo, Northern and Upper West region had 51, 81, 69, 46, 62, 75 and 61% reduction respectively in the level of satisfaction when compared to Western region. Patient satisfaction is an important indicator of health outcomes. Quality of care and measuring level of patient satisfaction has been found to be the most useful tool to predict utilization and compliance. In fact, satisfied patients are more likely than unsatisfied ones to continue using health care services. Our results suggest that policymakers need to better understand the determinants of satisfaction with the health system and how different socio-demographic groups perceive satisfaction with healthcare services so as to address health inequalities between urban and rural areas within the same country.

Design and implementation of community engagement interventions towards healthcare quality improvement in Ghana: a methodological approach.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-12-01

Nearly four decades after the Alma-Ata declaration of 1978 on the need for active client/community participation in healthcare, not much has been achieved in this regard particularly in resource constrained countries like Ghana, where over 70 % of communities in rural areas access basic healthcare from primary health facilities. Systematic Community Engagement (SCE) in healthcare quality assessment remains a grey area in many health systems in Africa, albeit the increasing importance in promoting universal access to quality basic healthcare services. Design and implement SCE interventions that involve existing community groups engaged in healthcare quality assessment in 32 intervention primary health facilities. The SCE interventions form part of a four year randomized controlled trial (RCT) in the Greater Accra and Western regions of Ghana. Community groups (n = 52) were purposively recruited and engaged to assess non-technical components of healthcare quality, recommend quality improvement plans and reward best performing facilities. The interventions comprised of five cyclical implementation steps executed for nearly a year. Wilcoxon sign rank test was used to ascertain differences in group perceptions of service quality during the first and second assessments, and ordered logistic regression analysis performed to determine factors associated with groups' perception of healthcare quality. Healthcare quality was perceived to be lowest in non-technical areas such as: information provision to clients, directional signs in clinics, drug availability, fairness in queuing, waiting times, and information provision on use of suggestion boxes and feedback on clients' complaints. Overall, services in private health facilities were perceived to be better than public facilities (p < 0.05). Community groups dominated by artisans and elderly members (60 + years) had better perspectives on healthcare quality than youthful groups (Coef. =1.78; 95 % CI = [-0.16 3.72]) and other categories of community groups (Coef. = 0.98; 95 % CI = [-0.10 2.06]). Non-technical components of healthcare quality remain critical to clients and communities served by primary healthcare providers. The SCE concept is a potential innovative and complementary quality improvement strategy that could help enhance client experiences, trust and confidence in healthcare providers. SCE interventions are more cost effective, community-focused and could easily be scaled-up and sustained by local health authorities.

Knowledge and disclosure of HIV status among adolescents and young adults attending an adolescent HIV clinic in Accra, Ghana.

PubMed

Kenu, Ernest; Obo-Akwa, Adjoa; Nuamah, Gladys B; Brefo, Anita; Sam, Miriam; Lartey, Margaret

2014-11-26

In Ghana it is estimated that 1.2% of HIV infections occur in young people aged 15-24 but the representation in our clinics is small. Adherence to treatment, appointment keeping and knowledge of HIV status remains a challenge. Disclosure has been shown to result in better adherence to therapy, good clinical outcomes, psychological adjustment and reduction in the risk of HIV transmission when the young person becomes sexually active. A baseline study was conducted to ascertain if adolescents and young adults knew their HIV status and their knowledge on HIV. Informed consent and assent were obtained from willing participants. Self-administered questionnaires on general knowledge of HIV, HIV treatment and disclosure were collected and analyzed. Thirty-four young persons participated in the study. The mean age was 16.9±SD 2.5 and 62% (21/32) were female. All of them were still in school. Eighty-five percent were aware that young people their age could fall sick, 91% had heard of HIV, 70% knew someone with HIV and 45% thought that adolescents were not at risk of HIV. On modes of HIV transmission, 66.7% knew HIV was transmitted through sex and 63.6% knew about mother to child transmission. Fifty three percent (18/34) knew their HIV status, 50% (17/34) were on antiretroviral and 35% (6/17) of them admitted to missing ARV doses. One person who said he was HIV negative and another who did not know his status were both on ARVs. Disclosure of HIV status to adolescents and young people is dependent on a complex mix of factors and most practitioners recommend an age and developmentally appropriate disclosure. Thus it is highly individualized. The knowledge and awareness of HIV was 91% compared to 97% of adults in the most recent Ghana Demographic and Health Survey however only about two thirds had acceptable in depth knowledge on HIV. Only half knew their HIV status which was not the best considering their ages. There is the need to strengthen education to young persons with HIV, support adhere to ARVs for better outcomes and assist care givers to disclose HIV status to them.

Efficiency of private and public primary health facilities accredited by the National Health Insurance Authority in Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Akazili, James; Spieker, Nicole; Arhinful, Daniel Kojo; Rinke de Wit, Tobias F

2015-01-01

Despite improvements in a number of health outcome indicators partly due to the National Health Insurance Scheme (NHIS), Ghana is unlikely to attain all its health-related millennium development goals before the end of 2015. Inefficient use of available limited resources has been cited as a contributory factor for this predicament. This study sought to explore efficiency levels of NHIS-accredited private and public health facilities; ascertain factors that account for differences in efficiency and determine the association between quality care and efficiency levels. The study is a cross-sectional survey of NHIS-accredited primary health facilities (n = 64) in two regions in southern Ghana. Data Envelopment Analysis was used to estimate technical efficiency of sampled health facilities while Tobit regression was employed to predict factors associated with efficiency levels. Spearman correlation test was performed to determine the association between quality care and efficiency. Overall, 20 out of the 64 health facilities (31 %) were optimally efficient relative to their peers. Out of the 20 efficient facilities, 10 (50 %) were Public/government owned facilities; 8 (40 %) were Private-for-profit facilities and 2 (10 %) were Private-not-for-profit/Mission facilities. Mission (Coef. = 52.1; p = 0.000) and Public (Coef. = 42.9; p = 0.002) facilities located in the Western region (predominantly rural) had higher odds of attaining the 100 % technical efficiency benchmark than those located in the Greater Accra region (largely urban). No significant association was found between technical efficiency scores of health facilities and many technical quality care proxies, except in overall quality score per the NHIS accreditation data (Coef. = -0.3158; p < 0.05) and SafeCare Essentials quality score on environmental safety for staff and patients (Coef. = -0.2764; p < 0.05) where the association was negative. The findings suggest some level of wastage of health resources in many healthcare facilities, especially those located in urban areas. The Ministry of Health and relevant stakeholders should undertake more effective need analysis to inform resource allocation, distribution and capacity building to promote efficient utilization of limited resources without compromising quality care standards.

Diversity in breeding sites and distribution of Anopheles mosquitoes in selected urban areas of southern Ghana.

PubMed

Mattah, Precious A Dzorgbe; Futagbi, Godfred; Amekudzi, Leonard K; Mattah, Memuna M; de Souza, Dziedzorm K; Kartey-Attipoe, Worlasi D; Bimi, Langbong; Wilson, Michael D

2017-01-13

Anopheles vectors of malaria are supposedly less common in urban areas as a result of pollution, but there is increasing evidence of their adaptation to organically polluted water bodies. This study characterized the breeding habitats of Anopheles mosquitoes in the two major urban areas in southern Ghana; Accra (AMA) and Sekondi-Takoradi (STMA) Metropolitan Areas, during dry and wet seasons. Anopheles mosquito larvae were sampled using standard dipping methods to determine larval densities. The origin, nature and stability of 21 randomly selected sites were observed and recorded. Mosquito larvae were reared to adults and Anopheles species identified by both morphological and molecular means. Sixty-six percent of Anopheles habitats were permanent and 34% temporal, and 74.5% man-made while 25.5% were natural. Puddles and urban farm sites accounted for over 51% of all Anopheles mosquitoes sampled. The mean larval densities among the habitat types was highest of 13.7/dip for puddles and lowest of 2.3/dip for stream/river, and the variation between densities were significant (P = 0.002). The mean larval densities were significantly higher in the wet season than in the dry season for the two study areas combined (P = 0.0191) and AMA (P = 0.0228). Over 99% of the 5,802 morphologically identified Anopheles species were An. gambiae (s.l.) of which more than 99% of the studied 898 were An. coluzzii (62%) and An. gambiae (s.s.) (34%). Urban farms, puddles, swamps and ditches/ dugouts accounted for approximately 70% of all An. coluzzii identified. Conversely, drains, construction sites, streams/rivers and "others" contributed 80% of all An. gambiae (s.s.) sampled. The wet season had significantly higher proportion of Anopheles larvae compared to the dry season (Z = 8.3683, P < 0.0001). Also, the proportion of Anopheles mosquitoes produced by permanent breeding sites was 61.3% and that of temporary sites was 38.7%. Taken together, the data suggest that man-made and/ or permanent habitats were the main contributors to Anopheles larval populations in the cities and that regulation of the anthropogenic processes that lead to development of breeding places and proper environmental management can drastically reduce mosquito breeding sites in urban areas of Ghana.

Asking, Giving, Receiving: Friendship as Survival Strategy among Accra's Street Children

ERIC Educational Resources Information Center

Mizen, Phillip; Ofosu-Kusi, Yaw

2010-01-01

This article considers friendship among street children in Accra. Drawing upon the findings of a three-year qualitative research project, the article argues that friendship is a neglected element of research yet cooperation, mutuality and exchange between friends are essential to street children's survival. Living within the extremities of the…

Perspectives of urban Ghanaian women on vasectomy.

PubMed

Asare, Ofeibea; Otupiri, Easmon; Apenkwa, Joana; Odotei-Adjei, Rose

2017-02-08

Advocacy for male involvement in family planning has been championed over the years after the 1994 International Conference on Population and Development (ICPD). There are a few contraceptive methods for men, and vasectomy uptake has been identified as one of the indicators of male involvement in family planning. Vasectomy also known as male sterilization is a permanent form of contraception. It is a generally safe, quick, easy, effective surgical operation with rare complications to prevent release of sperm. The study explored the vasectomy perspectives of urban Ghanaian women. A qualitative approach was used and five focus group discussions were held with women in urban Accra. The study was conducted in the five sub-metropolitan areas of the Accra Metropolitan Health Directorate from September-October 2013. Participants were adult and young adult women who are members of organized groups and unions. Data were analyzed manually after transcribing and coding and themes were sorted using thematic version 0.9. Both adult and young adult participants regarded vasectomy as an easy way for male partners to become promiscuous and cheat on them (women) because the operation renders males incapable of having a child; promiscuity could lead to the women contracting sexually transmitted infections including HIV/AIDS. They were also skeptical about vasectomy and the possibility that it could damage the sexual organs of their partners and affect their sexual relationships. The uptake of vasectomy will not benefit a new wife in case of divorce or death of a previous wife. Some women would allow their partners to undergo the procedure only if both of them will benefit health-wise and also if it would reduce the financial burden on the family. The women held mixed perceptions; both negative and positive views were shared on vasectomy uptake. The views were predominantly negative, and they regarded vasectomy as an unacceptable method of contraception. The women virtually had no reasons to encourage their partners to undergo a vasectomy. In order to increase vasectomy uptake in Ghana, innovative efforts to address the misconceptions and superstitions surrounding vasectomy should take centre stage; appropriate and targeted messaging during integrated health services delivery and social/health campaigns would be a good starting point.

Structured identification of response options to address environmental health risks at the Agbogbloshie electronic waste site.

PubMed

Cazabon, Danielle; Fobil, Julius N; Essegbey, George; Basu, Niladri

2017-11-01

Electronic waste (e-waste) is a growing problem across low- and middle-income countries. Agbogbloshie (Accra, Ghana) is among the world's largest and most notorious e-waste sites, with an increasing number of studies documenting a range of environmental health risks. The present study aimed to provide national, regional, and international stakeholders with a summary of expert opinion on the most pressing problems arising from e-waste activities at Agbogbloshie, as well as suggested solutions to address these problems. Structured interviews were performed between April and September 2015 that used a Logical Framework Approach as a scoping exercise to gauge problems and benefits of e-waste recycling, and the Delphi methodology to identify response options. Stakeholders (n = 19) from 15 institutions were interviewed with 2 rounds of a Delphi Poll: open-ended interviews followed by an electronic questionnaire in which experts ranked various proposed response options based on health, environmental, social, and economic benefit and feasibility. The goal was to prioritize potential interventions that would address identified problems at Agbogbloshie. Experts identified the most beneficial and feasible options in decreasing rank order as follows and prefaced by the statement "it is recommended that": 1) there be further research on the health effects; 2) e-waste workers be given appropriate personal protective equipment; 3) the Ministry of the Environment, Science, Technology and Innovation re-visit Ghana's Hazardous Waste Bill; 4) e-waste workers be involved in the planning process of interventions and are be kept informed of any results; and 5) there be increased education and sensitization on hazards related to e-waste for both workers and the general public. These solutions are discussed in relation to ongoing dialogue at the international level concerning e-waste recycling interventions, with strengths and weaknesses examined for the Ghanaian context. Integr Environ Assess Manag 2017;13:980-991. ©2017 SETAC. © 2017 SETAC.

An investigation of users' attitudes, requirements and willingness to use mobile phone-based interactive voice response systems for seeking healthcare in Ghana: a qualitative study.

PubMed

Brinkel, J; Dako-Gyeke, P; Krämer, A; May, J; Fobil, J N

2017-03-01

In implementing mobile health interventions, user requirements and willingness to use are among the most crucial concerns for success of the investigation and have only rarely been examined in sub-Saharan Africa. This study aimed to specify the requirements of caregivers of children in order to use a symptom-based interactive voice response (IVR) system for seeking healthcare. This included (i) the investigation of attitudes towards mobile phone use and user experiences and (ii) the assessment of facilitators and challenges to use the IVR system. This is a population-based cross-sectional study. Four qualitative focus group discussions were conducted in peri-urban and rural towns in Shai Osudoku and Ga West district, as well as in Tema- and Accra Metropolitan Assembly. Participants included male and female caregivers of at least one child between 0 and 10 years of age. A qualitative content analysis was conducted for data analysis. Participants showed a positive attitude towards the use of mobile phones for seeking healthcare. While no previous experience in using IVR for health information was reported, the majority of participants stated that it offers a huge advantage for improvement in health performance. Barriers to IVR use included concerns about costs, lack of familiarly with the technology, social barriers such as lack of human interaction and infrastructural challenges. The establishment of a toll-free number as well as training prior to IVR system was discussed for recommendation. This study suggests that caregivers in the socio-economic environment of Ghana are interested and willing to use mobile phone-based IVR to receive health information for child healthcare. Important identified users' needs should be considered by health programme implementers and policy makers to help facilitate the development and implementation of IVR systems in the field of seeking healthcare. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Medicinal plants used to treat TB in Ghana.

PubMed

Nguta, Joseph Mwanzia; Appiah-Opong, Regina; Nyarko, Alexander K; Yeboah-Manu, Dorothy; Addo, Phyllis G A

2015-06-01

The current study was designed to document medicinal plant species that are traditionally used to treat tuberculosis (TB) by Ghanaian communities. The medicinal plants used against TB or its signs and symptoms were selected using library and online published data searches. A guided questionnaire interview was also conducted with a botanist involved in plant collection at the Centre for Scientific Research into Plant Medicine (CSRPM) at Mampong. Data obtained were entered in Excel and summarized into means and frequencies using SPSS 12.0.1 for windows, and expressed as tables and bar graphs. A total of 15 medicinal plant species distributed between 13 genera and 13 families were documented. The following medicinal plant species were found to be used against TB in Greater Accra and Eastern parts of Ghana: Azadirachta indica A. Juss. Stem bark (Meliaceae), Hygrophila auriculata Heine, whole plant (Acanthaceae), Chenopodium ambrosioides L. leaves (Amaranthaceae), Coix lacryma-jobi L. glumes (Poaceae), Solanum torvum Sw. unripe fruits (Solanaceae), Solanum torvum Sw. leaves (Solanaceae), Bidens pilosa L. whole plant (Asteraceae), Phyllanthus fraternus G.L. Webster leaves (Phyllanthaceae), Dissotis rotundifolia (Sm.) Triana, leaves (Melastomataceae), Cymbopogon giganteus Chiov. Leaves (Poaceae), Cyperus articulatus L. roots (Cyperaceae), Allium sativum L. bulb (Amaryllidaceae), Zingiber officinale Roscoe, rhizomes (Zingiberaceae), Allium cepa L. bulbs (Amaryllidaceae), Allium cepa L. leaves (Amaryllidaceae), Aloe vera var. barbadensis aqueous extract from leaves (Xanthorrhoeaceae), Aloe vera var. barbadensis organic extract from leaves (Xanthorrhoeaceae), Cocos nucifera Linn, water (Arecaceae) and Cocos nucifera Linn. Husk (Arecaceae). The collected plant species could be a source of a new class of drugs against TB. Bioactivity guided fractionation is recommended to identify lead compounds for antimycobacterial activity. The current paper documents for the first time medicinal plant species used by Ghanaian communities to treat TB. These results are a basis for selection of plants for further pharmacological, toxicological and phytochemical studies in developing new plant-based antimycobacterial drugs. Copyright © 2015 Asian African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Self-reported functional, communicative, and critical health literacy on foodborne diseases in Accra, Ghana.

PubMed

Gupta, Sangeeta; Tutu, Raymond Asare; Boateng, John; Busingye, Janice Desire; Elavarthi, Sathya

2018-01-01

Although substantial progress has been made in reducing total mortality resulting from foodborne diseases, diarrheal illness are still the second most common illnesses among children. In Ghana, foodborne diseases have consistently been among the top 20 causes of outpatient illness over the last couple of decades. This study, therefore, examines health literacy on foodborne diseases and the relative effects of health literacy on self-rated health. Foodborne diseases are major causes of morbidity and mortality globally. A mixed-method approach was used for this study. A survey questionnaire and an in-depth interview guideline were administered to samples of 401 and 30 individuals, respectively. We undertook reliability and validity analyses. ANOVA and chi-square tests were undertaken to assess bivariate association between health literacy and demographic variables as well as health status. Ordinal logistic regression models were used to examine the relative effects of health literacy on self-rated health status controlling for individual characteristics. The instrument was internally consistent (Cronbach alpha = 0.744) and valid. On health literacy, 40% of the respondents reported not to require help when they are given information on foodborne diseases to read by a doctor, nurse, or pharmacist. Approximately 60% of respondents need help with completing or filling out hospital documents. Educational level was found to be positively related to functional health literacy. Ordinal logit regression models showed that health literacy is a predictor of self-rated health after controlling for demographic variables. Functional literacy is relatively low in the community. There is a positive association between educational level and functional health literacy. The study has also demonstrated the direct positive relationship between health literacy and health status controlling for covariates. Subsequent studies will need to examine multiple level dimensions of health literacy with direct link between specific foodborne diseases and health literacy.

Myths and misconceptions about tuberculosis transmission in Ghana

PubMed Central

2013-01-01

Background Myths and misconceptions about TB can serve as a barrier to efforts at reducing stigmatisation of people infected and affected by the disease. Understanding such drivers of myths and misconceptions is important for improving information, education and communication (IEC) efforts of national control and preventive interventions. This study therefore assesses the influence of interaction of spatial, socioeconomic and demographic characteristics on myths and misconceptions. Methods Data was drawn from male (N = 4,546) and female (N = 4,916) files of the 2008 Ghana Demographic and Health Survey. A myth and misconception variable was created from five-related constructs with internal consistency score of r = 0. 8802 for males (inter-item correlation: 0.5951) and for females, r = 0. 0.9312 (inter-item correlation: 0.7303). The Pearson Chi-square was used to test the bivariate relationship between the independent variables and the dependent variable. Logistic regression was subsequently used to explore the factors determining myths and misconceptions of TB transmission. Results Majority of Ghanaians (males: 66.75%; females: 66.13%) did not hold myths and misconceptions about TB transmission. Females resident in the Upper East (aOR = 0.31, CI = 0.17-0.55) and Upper West (aOR = 0.41, CI = 0.24-0.69) and males resident in the Northern (aOR = 0.23, CI = 0.13-0.39) and the Greater Accra (aOR = 0.25, CI = 0.16-0.39) regions were independently associated with no misconceptions about TB transmission. Significant differences were also found in education, ethnicity and age. Conclusion That spatial and other socioeconomic difference exists in myths and misconceptions suggest the need for spatial, socioeconomic and demographic segmentations in IEC on TB. This holds potentials for reaching out to those who are in critical need of information and education on the transmission processes of TB. PMID:24028419

Commuting fruit bats beneficially modulate their flight in relation to wind

PubMed Central

Sapir, Nir; Horvitz, Nir; Dechmann, Dina K. N.; Fahr, Jakob; Wikelski, Martin

2014-01-01

When animals move, their tracks may be strongly influenced by the motion of air or water, and this may affect the speed, energetics and prospects of the journey. Flying organisms, such as bats, may thus benefit from modifying their flight in response to the wind vector. Yet, practical difficulties have so far limited the understanding of this response for free-ranging bats. We tracked nine straw-coloured fruit bats (Eidolon helvum) that flew 42.5 ± 17.5 km (mean ± s.d.) to and from their roost near Accra, Ghana. Following detailed atmospheric simulations, we found that bats compensated for wind drift, as predicted under constant winds, and decreased their airspeed in response to tailwind assistance such that their groundspeed remained nearly constant. In addition, bats increased their airspeed with increasing crosswind speed. Overall, bats modulated their airspeed in relation to wind speed at different wind directions in a manner predicted by a two-dimensional optimal movement model. We conclude that sophisticated behavioural mechanisms to minimize the cost of transport under various wind conditions have evolved in bats. The bats’ response to the wind is similar to that reported for migratory birds and insects, suggesting convergent evolution of flight behaviours in volant organisms. PMID:24648227

Cranioplasty using polymethyl methacrylate implant constructed from an alginate impression and wax elimination technique.

PubMed

Abdulai, Ae; Iddrissu, Mi; Dakurah, Tk

2006-03-01

Summary This is a retrospective review of the record charts. A joint study by maxillofacial and neurosurgical units, department of surgery, Korle Bu Teaching Hospital, Accra, Ghana, a tertiary and premier health care centre. Seventeen consecutive patients with various cranial defects treated using prefabricated acrylic methyl methacrylate implants. The cranioplasty on all the patients took place at an average of about 12 months after the initial surgery. These included complications during and after surgery. X-ray views of the skull, ranging from true lateral to anterior-posterior, were taken at follow-up and examined to ascertain the stability of the graft by looking out for any adverse bony changes around it or loosening of any of the steel sutures securing it to the skull. A total of 17 patients (5 males and 12 females) with a mean age of 30.4 years were treated. Follow-up period ranged from 9 months to two years. In all cases the surgical procedure was uneventful and the cosmetic results were good. There was no significant change in the size and shape of the preformed methyl methacrylate implant after autoclaving. Cranioplasty using prefabricated acrylic methyl methacrylate implants apart from being affordable also ensure shorter operative time and good aesthetic result.

Associations of aquatic invertebrates and water quality in the ecology of an emerging tropical disease

NASA Astrophysics Data System (ADS)

Benbow, M.; Merritt, R. W.; Kimbirauskas, R.; Kolar, R.

2005-05-01

Mycobacterium ulcerans Infection is commonly called Buruli ulcer, a rapidly emerging skin disease that is often disfiguring and causes severe and lasting morbidity in developing nations of the tropics and sub-tropics. Outbreaks of BU are nearly always associated with slow-flowing aquatic habitats affected by human-mediated landscape changes, and biting aquatic insects are thought to play a role in transmission. As a part of a World Health Organization initiative, we are determining landscape factors that determine water quality conditions conducive for enhanced M. ulcerans growth and abundance in the aquatic environment. In June 2004 we collected water quality and invertebrate data from 12 water bodies near Accra, Ghana, Africa. Preliminary analyses found predator-dominated communities (from 47% - 64%) with Hemiptera (e.g., Belostomatidae and Naucoridae) most often collected. Using exploratory canonical correspondence analysis, sites separated out by functional feeding groups and water quality variables. Higher water hardness and total suspended solids was most associated with scrapers (i.e., snails) and shrimp, respectively. PCR evidence suggests that M. ulcerans is found among snails, fish and invertebrates. Future studies are proposed that take a multi-scale, multidisciplinary approach for identifying disturbance metrics that can be used to predict human Buruli ulcer incidence near monitored water bodies.

Stress of home life and gender role socializations, family cohesion, and symptoms of anxiety and depression.

PubMed

Anyan, Frederick; Hjemdal, Odin

2017-04-05

This cross-sectional study investigated the relation of sociocultural prescriptions of gender role socializations to differences in stress at home and to anxiety and depressive symptoms for adolescent girls and boys, with family cohesion as a mediator. A total of 244 boys and 285 girls aged 13-17 years recruited from Accra, Ghana completed the Short Mood Feeling Questionnaire, Spielberger State Anxiety Inventory, Stress of Home Life and Family Cohesion self-report scales in April 2015. In each sample, two mediation analyses were conducted using Structural Equation Modelling. Exposure to stress at home that was perceived to result from sociocultural prescriptions of gender role norms largely accounted for anxiety and depressive symptoms among girls, whereas this relation was non-significant among boys. Significant indirect relations through low family cohesion to anxiety symptoms were observed for girls and boys but not to depressive symptoms for boys. These findings suggest that differences in gender role socializations at home may account for individual differences in associations between exposure to stress at home and anxiety and depressive symptoms as well as explain the differential indirect relations through low family cohesion. Improving family cohesion while reducing stress at home may contribute to reducing stress and thus anxiety and depressive symptoms.

The health of the poor: women living in informal settlements.

PubMed

Fink, G; Arku, R; Montana, L

2012-06-01

A large share of the urban population in developing countries lives in informal settlements or "slums" today. This study investigates the association between slum residence and health among adult Ghanaian women residing in the Accra Metropolitan Area. Health data collected as part of the Women's Health Study of Accra round II (WHSA-II) was combined with data from the Household and Welfare Study of Accra (HAWS) to compare the health of female slum dwellers to the health of female non-slum dwellers living in the Accra Metropolitan Area. Group means were calculated and multivariate linear regression models were estimated to compare eight domains of health as measured by the short-form 36 (SF-36) questionnaire. Women living in informal settlements were found to display consistently better health. Conditional on all observable characteristics, women living in informal settlements scored higher on all self-reported health outcomes than women living in non-slum areas. The differences appear largest for general health as well as for the physical role functioning domains, and appear smallest for the social role functioning and bodily pain domains. The results presented suggest that slum residence does not have a negative effect on self-reported health among women in Accra. Three factors may contribute to the generally positive association between slum residence and observed outcomes: i) self-selection of individuals with strong health into informal settlements and an accordingly small impact of environmental factors on health ii) self-selection of more driven and ambitious individuals into slum neighborhoods who may have a generally more positive view of their health and iii) the geographic placement of slum neighborhoods in central neighborhoods with relatively easy access to health facilities.

Intermittent preventive treatment of malaria in pregnancy: a cross-sectional survey to assess uptake of the new sulfadoxine-pyrimethamine five dose policy in Ghana.

PubMed

Owusu-Boateng, Ivy; Anto, Francis

2017-08-10

Malaria in pregnancy poses a great risk to both mother and fetus. In Ghana, malaria accounts for 3.4% of deaths and 16.8% of all hospital admissions in pregnant women. In 2014, Ghana updated her policy on intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) to reflect the updated policy of the WHO. This study determined the level of uptake of sulfadoxine pyrimethamine (SP) to serve as baseline for monitoring progress and also reviewed stock levels of SP, a key factor in the programme implementation. A cross-sectional hospital-based study was carried out among nursing mothers who had delivered within 12 weeks and were seeking postnatal care at Osu Government Maternity Home in Accra. Antenatal record books of the mothers were reviewed and data collected on number of visits and receipt of IPTp-SP. Mothers were interviewed and data collected on their background characteristics and obstetric history. Data on SP stock levels for the past 6 months were also reviewed. Logistic regression analysis was carried out to determine antenatal indicators on uptake of IPTp-SP using Stata version 12. The proportion of uptake of three-five doses of SP were: IPT3 (87.5%), IPT4 (55.7%) and IPT5 (14.5%). The proportion of women who received the first dose of SP at 16 weeks of gestation was 21.3%. Women who made ≥4 visits were more likely to receive ≥3 doses of SP than those who made <4 visits (AOR = 4.57, 95% CI 1.15-18.16, p < 0.05). Women receiving the first dose of SP in the third trimester were less likely to receive ≥3 doses of SP than those who received the drug in the second trimester (AOR = 0.04, 95% CI 0.01-0.16, p < 0.05). Stock levels of SP were adequate to meet the demands by the pregnant women at the Maternity Home for the period under review. The uptake of ≥3 doses of SP was high in the study area. Frequent visits to the antenatal clinic and early uptake of the first dose of SP by pregnant women are necessary to achieve the new target of five or more doses of SP.

Activity of medicinal plants from Ghana against the parasitic gut protist Blastocystis.

PubMed

Bremer Christensen, Charlotte; Soelberg, Jens; Stensvold, Christen R; Jäger, Anna K

2015-11-04

The plants tested in this study were examples of plants historically used to treat or alleviate several types of stomach disorders manifested by e.g. stomachache, diarrhoea or dysentery. These plants have been consumed typically as a decoction, sometimes mixed with other flavourings. The aim of this study was to evaluate the anti-Blastocystis activity of 24 plant parts from 21 medicinal plants from Ghana. The medicinal plants were collected in the Greater Accra region of Ghana. Every plant part was tested in three different extracts; an ethanolic, a warm, and a cold water extract, at a final concentration of 1 mg/mL for the initial screening, and in a range from 0.0156 to 1mg/mL for determination of inhibitory concentrations. The obligate anaerobic parasitic gut protist Blastocystis (subtype 4) was used as a 48 h old subcultivated isolate in the final concentration of 10(6) cells/mL. Plant extracts inoculated with Blastocystis were incubated at 37 °C for 24 h and 48 h. Both MIC minimum inhibitory concentration (MIC90) assays and minimal lethal concentration (MLC) assays were performed after 24 h and 48 h. The half maximal inhibitory concentration (IC50) was derived after 24 h and 48 h. Antimicrobial activity was tested against two Gram-positive and two Gram-negative bacteria for all 24 plant parts at a final concentration of 1mg/mL. Screening of the 24 different plant parts showed significant anti-Blastocystis activity of six of the ethanolic extracts: Mallotus oppositifolius, IC50, 24 h 27.8 µg/mL; Vemonia colorata, IC50, 24 h 117.9 µg/mL; Zanthoxylum zanthoxyloides, cortex IC50, 24 h 255.6 µg/mL; Clausena anisata, IC50, 24 h 314.0 µg/mL; Z. zanthoxyloides, radix IC50, 24 h 335.7 µg/mL and Eythrina senegalensis, IC50, 24 h 527.6 µg/mL. The reference anti-protozoal agent metronidazole (MTZ) had an IC50, 24 h of 7.6 µg/mL. Only C. anisata showed antimicrobial activity at a concentration of 800 µg/mL. Six ethanolic plant extracts showed significant anti-parasitic activity against Blastocystis. M. oppositifolius showed nearly as good activity as the reference anti-protozoal drug MTZ. Historically, the active plants found in this study have been used against dysentery, diarrhoea or other stomach disorders. Nowadays they are not used specifically for dysentery, but they are being used as medicinal plants against various stomach disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Groundwater Exploration for Rural Communities in Ghana, West Africa

NASA Astrophysics Data System (ADS)

McKay, W. A.

2001-05-01

Exploration for potable water in developing countries continues to be a major activity, as there are more than one billion people without access to safe drinking water. Exploration for groundwater becomes more critical in regions where groundwater movement and occurrence is controlled by secondary features such as fractures and faults. Drilling success rates in such geological settings are generally very low, but can be improved by integrating geological, hydrogeological, aerial photo interpretation with land-based geophysical technology in the selection of drilling sites. To help alleviate water supply problems in West Africa, the Conrad N. Hilton Foundation and other donors, since 1990, have funded the World Vision Ghana Rural Water Project (GRWP) to drill wells for potable water supplies in the Greater Afram Plains (GAP) of Ghana. During the first two years of the program, drilling success rates using traditional methods ranged from 35 to 80 percent, depending on the area. The average drilling success rate for the program was approximately 50 percent. In an effort to increase the efficiency of drilling operations, the Desert Research Institute evaluated and developed techniques for application to well-siting strategies in the GAP area of Ghana. A critical project element was developing technical capabilities of in-country staff to independently implement the new strategies. Simple cost-benefit relationships were then used to evaluate the economic advantages of developing water resources using advanced siting methods. The application of advanced methods in the GAP area reveal an increase of 10 to 15 percent in the success rate over traditional methods. Aerial photography has been found to be the most useful of the imagery products covering the GAP area. An effective approach to geophysical exploration for groundwater has been the combined use of EM and resistivity methods. Economic analyses showed that the use of advanced methods is cost-effective when success rates with traditional methods are less than 70 to 90 percent. Finally, with the focus of GRWP activities shifting to Ghana's northern regions, new challenges in drilling success rates are being encountered. In certain districts, success rates as low as 35 percent are observed, raising questions about the efficacy of existing well-siting strategies in the current physical setting, and the validity of traditional cost-benefit analyses for assessing the economic aspects of water exploration in drought-stricken areas.

Shaping the Security Environment Newport paper no. 29

DTIC Science & Technology

2006-11-29

interest in and set the stage for a ministerial conference. That ministerial conference, held in November 2006 in Cotonou , Benin, brought together...awareness has been at least partially met. The Accra workshop and Cotonou Ministerial Conference were both considered suc- cessful in that the outputs...Organization and the Maritime Organization for West and Central Africa in the Accra workshop and Cotonou S H A P I N G T H E S E C U R I T Y E N V I R

Performance of Clinical Criteria for Screening of Possible Antiretroviral Related Mitochondrial Toxicity in HIV-Infected Children in Accra.

PubMed

Langs-Barlow, Allison; Renner, Lorna; Katz, Karol; Northrup, Veronika; Paintsil, Elijah

2013-01-01

Mitochondrial damage is implicated in highly active antiretroviral therapy (HAART) toxicity. HIV infection also causes mitochondrial toxicity (MT). Differentiating between the two is critical for HIV management. Our objective was to test the utility of the Mitochondrial Disease Criteria (MDC) and the Enquête Périnatale Française (EPF) to screen for possible HAART related MT in HIV-infected children in Ghana. The EPF and MDC are compilations of clinical symptoms, or criteria, of MT: a (+) score indicates possible MT. We applied these criteria retrospectively to 403 charts of HIV-infected children. Of those studied, 331/403 received HAART. Comparing HAART exposed and HAART naïve children, the difference in EPF score, but not MDC, approached significance (P = 0.1). Young age at HIV diagnosis or at HAART initiation was associated with (+) EPF (P ≤ 0.01). Adherence to HAART trended toward an association with (+) EPF (P = 0.09). Exposure to nevirapine, abacavir, or didanosine increased risk of (+) EPF (OR = 3.55 (CI = 1.99-6.33), 4.76 (2.39-9.43), 4.93 (1.29-18.87)). Neither EPF nor MDC identified a significant difference between HAART exposed or naïve children regarding possible MT. However, as indicators of HAART exposure are associated with (+) EPF, it may be a candidate for prospective study of possible HAART related MT in resource-poor settings.

Use of a spatial scan statistic to identify clusters of births occurring outside Ghanaian health facilities for targeted intervention.

PubMed

Bosomprah, Samuel; Dotse-Gborgbortsi, Winfred; Aboagye, Patrick; Matthews, Zoe

2016-11-01

To identify and evaluate clusters of births that occurred outside health facilities in Ghana for targeted intervention. A retrospective study was conducted using a convenience sample of live births registered in Ghanaian health facilities from January 1 to December 31, 2014. Data were extracted from the district health information system. A spatial scan statistic was used to investigate clusters of home births through a discrete Poisson probability model. Scanning with a circular spatial window was conducted only for clusters with high rates of such deliveries. The district was used as the geographic unit of analysis. The likelihood P value was estimated using Monte Carlo simulations. Ten statistically significant clusters with a high rate of home birth were identified. The relative risks ranged from 1.43 ("least likely" cluster; P=0.001) to 1.95 ("most likely" cluster; P=0.001). The relative risks of the top five "most likely" clusters ranged from 1.68 to 1.95; these clusters were located in Ashanti, Brong Ahafo, and the Western, Eastern, and Greater regions of Accra. Health facility records, geospatial techniques, and geographic information systems provided locally relevant information to assist policy makers in delivering targeted interventions to small geographic areas. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Determinants of sexual dysfunction among clinically diagnosed diabetic patients

PubMed Central

2011-01-01

Background Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Method Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years) visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS) and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Results Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%), non-sensuality (74.5%), dissatisfaction with sexual acts (71.9%), non-communication (70.8%) and impotence (67.9%). Other areas of sexual function, including premature ejaculation (56.6%) and avoidance (42.7%) were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT) are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c), FBS, perceived desirable, too short IELT, and weight as well as waist circumference. Conclusion SD rate from this study is high but similar to that reported among self-reported diabetic patients in Kumasi, Ghana and vary according to the condition and age. The determinants of SD from this study are income level, exercise, obesity, higher perception of "desirable" and "too short" IELT. PMID:21612653

Assessment of PCBs and exposure risk to infants in breast milk of primiparae and multiparae mothers in an electronic waste hot spot and non-hot spot areas in Ghana.

PubMed

Asamoah, Anita; Essumang, David Kofi; Muff, Jens; Kucheryavskiy, Sergey V; Søgaard, Erik Gydesen

2018-01-15

The aim of the study was to assess the levels of PCBs in the breast milk of some Ghanaian women at suspected hotspot and relatively non-hotspot areas and to find out if the levels of these PCBs pose any risk to the breastfed infants. A total of 128 individual human breast milk were sampled from both primiparae and multiparae mothers. The levels of PCBs in the milk samples were compared. Some of these mothers (105 individuals) work or reside in and around Agbogbloshie (hot-spot), the largest electric and electronic waste dump and recycling site in Accra, Ghana. Others (23 donor mothers) also reside in and around Kwabenya (non-hotspot) which is a mainly residential area without any industrial activities. Samples were analyzed using GC-MS/MS. The total mean levels and range of Σ 7 PCBs were 3.64ng/glipidwt and ˂LOD-29.20ng/glipidwt, respectively. Mean concentrations from Agbogbloshie (hot-spot area) and Kwabenya (non-hotspot areas) were 4.43ng/glipidwt and 0.03ng/glipidwt, respectively. PCB-28 contributed the highest of 29.5% of the total PCBs in the milk samples, and PCB-101 contributed the lowest of 1.74%. The estimated daily intake of PCBs and total PCBs concentrations in this work were found to be lower as compared to similar studies across the world. The estimated hazard quotient using Health Canada's guidelines threshold limit of 1μg/kgbw/day showed no potential health risk to babies. However, considering minimum tolerable value of 0.03μg/kgbw/day defined by the Agency for Toxic Substances and Disease Registry (ATSDR), the values of some mothers were found to be at the threshold limit. This may indicate a potential health risk to their babies. Mothers with values at the threshold levels of the minimum tolerable limits are those who work or reside in and around the Agbogbloshie e-waste site. Copyright © 2017 Elsevier B.V. All rights reserved.

Uterine Tonus Assessment by Midwives versus Patient self-assessment in the active management of the third stage of labor (UTAMP): study protocol for a randomized controlled trial.

PubMed

Browne, Joyce L; Damale, Nelson K R; Raams, Tessa M; Van der Linden, Eva L; Maya, Ernest T; Doe, Roseline; Rijken, Marcus J; Adanu, Richard; Grobbee, Diederick E; Franx, Arie; Klipstein-Grobusch, Kerstin

2015-12-18

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide and accounts for one third of maternal deaths in low-income and middle-income countries. PPH can be prevented by active management of the third stage of labor (AMTSL), a series of steps recommended by the World Health Organization to be performed by skilled birth attendants (SBAs). Task shifting in the AMTSL step of uterotonic drugs administration to community health workers, traditional birth attendants and self-administration has been investigated as a strategy to increase access to quality obstetric care considering persistent SBA and facility-based delivery shortages. The aim of this study is to assess task shifting in the final step of AMTSL and compare uterine tonus assessment by a SBA to self-assessment. The study is an individual-level two-arm non-inferiority randomized controlled trial (RCT). A total of 800 women will be recruited in Korle Bu Teaching Hospital in Accra, Ghana. Adult women in labor at term with an expected vaginal delivery who received antenatal instructions for self-assessment of uterine tonus will be eligible for inclusion. Women with an increased risk for PPH will be excluded. Women will be randomized to uterine tone assessment by a skilled birth attendant (midwife) or uterine tone self-assessment (with the safety back-up of a midwife present in case of PPH or uterine atony). Postpartum blood loss will be measured through weighing of disposable mats. The main study endpoints are PPH (≥500 ml blood loss), severe PPH (≥1000 ml blood loss), mean blood loss, and routine maternal and neonatal outcomes. Participants and caregivers will not be blinded given the nature of the intervention. A reduction of PPH-related maternal mortality requires full implementation of AMTSL. Task shifting of uterine tone assessment may contribute to increased AMTSL implementation in (clinical) settings where SBAs capacity is constrained. Clinicaltrials.gov: NCT02223806 , registration August 2014. PACTR201402000736158 , registration July 2014. University of Ghana, Medical School Ethical and Protocol Review Committee: MS-Et/M.8-P4.1/2014-2015.

Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana.

PubMed

Bello, Ajediran I; Ofori, Eric K; Alabi, Oluwasegun J; Adjei, David N

2014-03-29

Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists' PFR interpretation with radiologists are not common in Ghana. Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0-24, interpreted as follow: 0-8 points (low), 9-16 points (moderate) and 17-24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher's exact test at α = 0.05. The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist's interpretation of 24 points (assessment guide). The physiotherapists' levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). The physiotherapists' skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist's interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus, routine PFR viewing techniques should be made a priority in physiotherapists' continuing professional education.

Priority: Africa Programme for Action Proposed by the Director-General (1990-1995). Development of Higher Education in Africa--The African University: Into the New Millennium. Results of a Series of Seminars on Higher Education in Africa (Accra: November 1991, Dakar: November 1992 and Alexandria: April 1993).

ERIC Educational Resources Information Center

Association of African Universities, Accra-North (Ghana).

This document brings into focus the main ideas and action-oriented decisions emanating from the seminars of heads of African universities which took place on the themes of: the mission of the African university (Accra, 1991); restructuring the African university (Dakar, 1992); and the resources and management of the African university (Alexandria,…

A simulation/optimization model for groundwater resources management in the Afram Plains area, Ghana

USGS Publications Warehouse

Yidana, S.M.

2008-01-01

A groundwater flow simulation model was developed using available hydrogeo logical data to A groundwater flow simulation model was developed using available hydrogeological data to describe groundwater flow in the Afram Plains area. A nonlinear optimization model was then developed and solved for the management of groundwater resources to meet irrigation and household needs. The objective was to maximize groundwater extraction for irrigation activities from the shallow aquifers of the southern Voltaian Sedimentary Basin that underly the area This would improve food security, raise the standard of living and ultimately alleviate poverty in the Afram Plains. The calibrated flow model is in tandem with the general hydrochemical evolution of groundwater in the area and fits the observed data with about a 98% degree of confidence. Groundwater resources may not be the limiting factor in the development of irrigated agriculture. Groundwater has tremendous potential to meet current and future irrigation needs. It was determined from this study that profit from maize irrigation in the Afram Plains area could rise from US$301, 000 in 2007 to over US$3.5 million by the end of the last management period (2013) as irrigation practice is improved, and the economic strength to increase the acreage for irrigation improves. Even with these margins of profit, the drawdown constraint was not reached in any of the management periods. It is expected that rechargefrom the irrigation water would reclaim the lost hydraulic head. The single significant constraint was the amount of land area that could be developed for irrigation in the area. The profit obtained per unit cubic meter of water used also improved over the same management period.

Prevalence of BPH and lower urinary tract symptoms in West Africans.

PubMed

Chokkalingam, A P; Yeboah, E D; Demarzo, A; Netto, G; Yu, K; Biritwum, R B; Tettey, Y; Adjei, A; Jadallah, S; Li, Y; Chu, L W; Chia, D; Niwa, S; Partin, A; Thompson, I M; Roehrborn, C; Hoover, R N; Hsing, A W

2012-06-01

BPH and lower urinary tract symptoms (LUTS) are very common among older men in Western countries. However, the prevalence of these two conditions in the developing countries is less clear. We assessed the age-standardized prevalence of BPH and/or LUTS among West Africans in a probability sample of 950 men aged 50-74 in Accra, Ghana, with no evidence of biopsy-confirmed prostate cancer after screening with PSA and digital rectal examination (DRE). Information on LUTS was based on self-reports of the International Prostate Symptom Score (IPSS). BPH was estimated using DRE, PSA levels and imputed prostate volume. The prevalence of DRE-detected enlarged prostate was 62.3%, while that of PSA≥1.5 ng ml(-1) (an estimate of prostate volume ≥ 30 cm(3)) was 35.3%. The prevalence of moderate-to-severe LUTS (IPSS≥8) was 19.9%. The prevalence of IPSS≥8 and an enlarged prostate on DRE was 13.3%. Although there is no universally agreed-upon definition of BPH/LUTS, making comparisons across populations difficult, BPH and/or LUTS appear to be quite common among older Ghanaian men. We found that after age standardization, the prevalence of DRE-detected enlarged prostate in Ghanaian men is higher than previously reported for American men, but the prevalence of LUTS was lower than previously reported for African Americans. Further studies are needed to confirm these findings and identify the risk factors for BPH in both Africans and African Americans.

Performance of Clinical Criteria for Screening of Possible Antiretroviral Related Mitochondrial Toxicity in HIV-Infected Children in Accra

PubMed Central

Katz, Karol; Northrup, Veronika

2013-01-01

Mitochondrial damage is implicated in highly active antiretroviral therapy (HAART) toxicity. HIV infection also causes mitochondrial toxicity (MT). Differentiating between the two is critical for HIV management. Our objective was to test the utility of the Mitochondrial Disease Criteria (MDC) and the Enquête Périnatale Française (EPF) to screen for possible HAART related MT in HIV-infected children in Ghana. The EPF and MDC are compilations of clinical symptoms, or criteria, of MT: a (+) score indicates possible MT. We applied these criteria retrospectively to 403 charts of HIV-infected children. Of those studied, 331/403 received HAART. Comparing HAART exposed and HAART naïve children, the difference in EPF score, but not MDC, approached significance (P = 0.1). Young age at HIV diagnosis or at HAART initiation was associated with (+) EPF (P ≤ 0.01). Adherence to HAART trended toward an association with (+) EPF (P = 0.09). Exposure to nevirapine, abacavir, or didanosine increased risk of (+) EPF (OR = 3.55 (CI = 1.99–6.33), 4.76 (2.39–9.43), 4.93 (1.29–18.87)). Neither EPF nor MDC identified a significant difference between HAART exposed or naïve children regarding possible MT. However, as indicators of HAART exposure are associated with (+) EPF, it may be a candidate for prospective study of possible HAART related MT in resource-poor settings. PMID:23533730

Anaemia in pregnant adolescent girls with malaria and practicing pica.

PubMed

Intiful, Freda Dzifa; Wiredu, Edwin Kwame; Asare, George Awuku; Asante, Matilda; Adjei, David Nana

2016-01-01

Pregnancy during the adolescent period is challenging mainly because of the nutritional demands of both the adolescent and pregnancy period. The risk for anaemia increases especially in developing countries such as Ghana where malaria is endemic and the practice of pica is common. In this study, we sought to determine the prevalence of anaemia, pica practice and malaria infection among pregnant adolescent girls and assess the extent to which these factors are associated. Two hundred and sixty five (265) pregnant adolescent girls were recruited from three hospitals in Accra. Haemoglobin levels, malaria infection and the practice of pica were assessed. Pearson's Chi squared tests were used to determine associations and logistic regression analysis was used to determine the odds of being anaemic. Significance was set at p≤0.05. Anaemia prevalence was 76% with severity ranging from mild (47.8%) to severe (0.8%). About 27.5% were moderately anaemic. Pica was practiced in only 9.1% of the girls. Malaria infection was prevalent in 17.7% of the girls. The logistic regression analysis indicated that pregnant girls with malaria infection were 3.56 times more likely to be anaemic when compared to those without malaria. Also, those who practiced pica were 1.23 times more likely to be anaemic when compared to those who did not practice pica. Anaemia is very prevalent in pregnant adolescent girls and is a public health problem. Drastic measures should be taken to reduce the high prevalence.

Coastal erosion management in Accra: Combining local knowledge and empirical research

PubMed Central

2016-01-01

Coastal erosion along the Accra coast has become a chronic phenomenon that threatens both life and property. The issue has assumed a centre stage of national debate in recent times because of its impact on the coastal communities. Lack of reliable geospatial data hinders effective scientific investigations into the changing trends in the shoreline position. However, knowledge about coastal erosion, by the local people, and how far the shoreline has migrated inland over time is high in the coastal communities in Accra. This opens a new chapter in coastal erosion research to include local knowledge of the local settlers in developing sustainable coastal management. This article adopted a scientific approach to estimate rate of erosion and tested the results against perceived erosion trend by the local settlers. The study used a 1974 digital topographic map and 1996 aerial photographs. The end point rate statistical method in DSAS was used to compute the rates of change. The short-term rate of change for the 22-year period under study was estimated as -0.91 m/annum ± 0.49 m/annum. It was revealed that about 79% of the shoreline is eroding, while the remaining 21% is either stabilised or accreting. It emerged, from semi-structured interviews with inhabitants in the Accra coastal communities, that an average of about 30 m of coastal lands are perceived to have been lost to erosion for a period of about 20 years. This translates to a historic rate of change of about 1.5 m/year, which corroborates the results of the scientific study. Again this study has established that the local knowledge of the inhabitants, about coastal erosion, can serve as reliable information under scarcity of scientific data for coastal erosion analyses in developing countries.

Immunization delivery in the second year of life in Ghana: the need for a multi-faceted approach.

PubMed

Nyaku, Mawuli; Wardle, Melissa; Eng, Jodi Vanden; Ametewee, Lynnette; Bonsu, George; Larbi Opare, Joseph Kwadwo; Conklin, Laura

2017-01-01

in 2012, pneumococcal conjugate vaccine (PCV), rotavirus vaccine and a second dose of measles-containing vaccine (MCV2) were introduced into the Expanded Program on Immunization (EPI) in Ghana. According to Ghana's EPI schedule, PCV and rotavirus vaccine are given in the first year of life and MCV2 in the second year of life (2YL) at 18 months. Although coverage with the last doses of PCV and rotavirus vaccine reached almost 90% coverage within four years of introduction, MCV2 coverage did not rise above 70%. The World Health Organization Global Measles and Rubella Strategic Plan established a 2020 milestone to achieve at least 95% coverage with the first and second doses of measles-containing vaccine in each district and nationally. We developed a project to address challenges to delivery of immunizations and other child health services at the 18-month visit and throughout the 2YL. from March to April 2016, we conducted a cluster survey of households (HHs) with children 24-35 months of age in three regions in Ghana to assess knowledge, attitudes and beliefs among caregivers about immunization during the 2YL and to collect childhood vaccination history data using vaccination cards. Three independent samples were selected from the Northern (NR), Volta (VR), and Greater Accra (GAR) regions. A survey and direct observations were performed a ta representative sample of health facilities (HFs) providing immunization services in the same regions to further characterize barriers to immunization access, utilization and delivery in the 2YL. data on a total of 464 children ages 24-35 months were collected in the HH survey: 211 in NR, 153 in VR, and 100 in GAR (response rate > 99%). First dose of measles-containing vaccine (MCV1) coverage was (NR: 87%, VR: 96%, GAR: 99%); however, MCV2 coverage was lower (NR: 60%, VR: 83%, GAR: 70%). MCV1 to MCV2 dropout was 32% in NR, 14% in VR, and 31% in GAR. Caregiver awareness of immunization against measles was 69% in NR, 75% in VR, and 68% in GAR yet less than half knew the recommended ages for receiving the vaccine, (NR: 4%, VR: 9%, GAR: 44%). Among 160 HFs participating in the survey (>50 in each region), most lacked a defaulter tracing system (NR: 94%,VR: 76%,GAR: 85%). A varying proportion of HCWs correctly indicated how to record a catch-up first dose of MCV administered to an 18-month-old child in the 12-23 month immunization register (NR: 38%, VR: 55%, GAR: 67%) and on the vaccination card (NR: 54%, VR: 53%, GAR: 76%). Although more than half of caregivers would accept text messages, (NR: 57%, VR: 78%, GAR: 96%) including reminders, related to their child's immunizations, < 10% HFs were utilizing this practice. challenges encountered with the establishment of an immunization visit beyond the first year of life included knowledge gaps among caregivers, high dropout rates between MCV1 and MCV2 in all study regions, and a lack of defaulter tracing systems in most healthcare facilities providing childhood immunizations. Targeted strategies that promote behavioral, cultural, and policy changes are needed to strengthen 2YL child health service delivery and improve vaccination coverage.

Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana.

PubMed

Ackumey, Mercy M; Gyapong, Margaret; Pappoe, Matilda; Kwakye-Maclean, Cynthia; Weiss, Mitchell G

2012-05-11

Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra. Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD) and perceived causes (PC) among respondents with pre-ulcer and ulcer conditions. The Fisher's exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents' narratives clarified illness experiences and meanings with reference to PC and PD variables. Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%). Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5%) and respondents who claimed they had no water contact, questioned the credibility of health messages Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and prolonged healing is perceived to make ideas of witchcraft as a PC more credible, among respondents with ulcers. Health messages should address issues of locally perceived risk and vulnerability. Guided by study findings, further research on the role of environmental, socio-cultural and genetic factors in BU contagion, is also needed to clarify and formulate health messages and strengthen public health initiatives.

Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana

PubMed Central

2012-01-01

Background Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra. Methods Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD) and perceived causes (PC) among respondents with pre-ulcer and ulcer conditions. The Fisher’s exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents’ narratives clarified illness experiences and meanings with reference to PC and PD variables. Results Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%). Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5%) and respondents who claimed they had no water contact, questioned the credibility of health messages Conclusions Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and prolonged healing is perceived to make ideas of witchcraft as a PC more credible, among respondents with ulcers. Health messages should address issues of locally perceived risk and vulnerability. Guided by study findings, further research on the role of environmental, socio-cultural and genetic factors in BU contagion, is also needed to clarify and formulate health messages and strengthen public health initiatives. PMID:22471884

The DACCIWA 2016 radiosonde campaign in southern West Africa

NASA Astrophysics Data System (ADS)

Fink, Andreas H.; Maranan, Marlon; Knippertz, Peter; Ngamini, Jean-Blaise; Francis, Sabastine

2017-04-01

Operational upper-air stations are very sparsely distributed over West Africa, resulting in the necessity to enhance radiosonde observations for the DACCIWA (Dynamics-Aerosol-Chemistry-Cloud Interactions in West Africa) experimental period during June-July 2016. Building on the AMMA (African Monsoon - Multidisciplinary Analyses) experience, existing infrastructures, as well as human networks, the upper air network was successfully augmented to a spatial density that is unprecedented for southern West Africa. Altogether, more than 750 experimental radiosondes were launched at seven stations in three countries along the Guinea Coast. From its outset, the DACCIWA radiosonde campaign had three pillars: (a) enhancing soundings at operational or quiescent AMMA radiosonde stations; (b) launching sondes at DACCIWA supersites and two additional DACCIWA field sites; and (c) collecting standard and - if possible - high-resolution data from other operational RS stations. In terms of (a), it was found during preparing recce visits to West Africa, that the AMMA-activated stations of Cotonou (Benin) and Abuja (Nigeria) were operational though almost "invisible" on the World Meteorological Organisation's Global Teleconnection System (GTS). These and other AMMA legacies facilitated the implementation of enhanced, four-times daily soundings at Abidjan (Ivory Coast), Cotonou and Parakou (both Benin). Two well-instrumented DACCIWA ground sites at Kumasi (Ghana) and Savé (Benin) performed 06 UTC soundings, being enhanced to four-times daily ascents during fifteen Intensive Observing Periods (IOPs). In addition, research staff and students from the Karlsruhe Institute of Technology (KIT) and African partners conducted up to five-times daily soundings at Lamto (Ivory Coast) and Accra (Ghana). Almost all of the experimental DACCIWA ascents were submitted to the GTS in real time and assimilated at least at three European numerical weather prediction centres that helped to improve their operational analysis over southern West Africa during June-July 2016. In addition, upper-air data from the Nigerian stations Lagos, Abuja and Kano, not available in international archives, were collected and fed into the DACCIWA database. Instrumental to the success of the DACCIWA radiosonde campaign under challenging logistical constraints was the excellent collaboration and commitment of various African partners. In addition, European and African students worked together in the field to ensure an uninterrupted sounding frequency. The present contribution will describe the network, aspects of the Africa-European team working, the available data and their accessibility for research, as well as some first applications and highlights.

The effect of small solar powered 'Bͻkͻͻ' net fans on mosquito net use: results from a randomized controlled cross-over trial in southern Ghana.

PubMed

Briët, Olivier J T; Yukich, Joshua O; Pfeiffer, Constanze; Miller, William; Jaeger, Mulako S; Khanna, Nitin; Oppong, Samuel; Nardini, Peter; Ahorlu, Collins K; Keating, Joseph

2017-01-03

Long-lasting insecticidal nets (LLINs) are ineffective malaria transmission prevention tools if they are unused. Discomfort due to heat is the most commonly reported reason for not using nets, but this problem is largely unaddressed. With increasing rural electrification and the dropping price of solar power, fans could improve comfort inside nets and be affordable to populations in malaria endemic areas. Here, results are presented from a pilot randomized controlled cross-over study testing the effect of fans on LLIN use. Eighty-three households from two rural communities in Greater Accra, Ghana, randomized into three groups, participated in a 10-month cross-over trial. After a screening survey to identify eligible households, all households received new LLINs. Bͻkͻͻ net fan systems (one fan per member) were given to households in Group 1 and water filters were given to households in Group 2. At mid-point, Group 1 and 2 crossed over interventions. Households in Group 1 and 2 participated in fortnightly surveys on households' practices related to nets, fans and water filters, while households in Group 3 were surveyed only at screening, mid-point and study end. Entomological and weather data were collected throughout the study. Analysis took both 'per protocol' (PP) and 'intention to treat' (ITT) approaches. The mid- and end-point survey data from Group 1 and 2 were analysed using Firth logistic regressions. Fortnightly survey data from all groups were analysed using logistic regressions with random effects. Provision of fans to households appeared to increase net use in this study. Although the increase in net use explained by fans was not significant in the primary analyses (ITT odds ratio 3.24, p > 0.01; PP odds ratio = 1.17, p > 0.01), it was significant in secondary PP analysis (odds ratio = 1.95, p < 0.01). Net use was high at screening and even higher after provision of new LLINs and with follow up. Fan use was 90-100% depending on the fortnightly visit. This pilot study could not provide definitive evidence that fans increase net use. A larger study with additional statistical power is needed to assess this association across communities with diverse environmental and socio-demographic characteristics.

Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana

PubMed Central

2014-01-01

Background Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists’ PFR interpretation with radiologists are not common in Ghana. Method Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0–24, interpreted as follow: 0–8 points (low), 9–16 points (moderate) and 17–24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher’s exact test at α = 0.05. Results The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist’s interpretation of 24 points (assessment guide). The physiotherapists’ levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). Conclusions The physiotherapists’ skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist’s interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus, routine PFR viewing techniques should be made a priority in physiotherapists’ continuing professional education. PMID:24678695

Determinants of Intention to Use Mobile Phone Caller Tunes to Promote Voluntary Blood Donation: Cross-Sectional Study

PubMed Central

Burdine, James N; Aftab, Ammar; Asamoah-Akuoko, Lucy; Anum, David A; Kretchy, Irene A; Samman, Elfreda W; Appiah, Patience B; Bates, Imelda

2018-01-01

Background Voluntary blood donation rates are low in sub-Saharan Africa. Sociobehavioral factors such as a belief that donated blood would be used for performing rituals deter people from donating blood. There is a need for culturally appropriate communication interventions to encourage individuals to donate blood. Health care interventions that use mobile phones have increased in developing countries, although many of them focus on SMS text messaging (short message service, SMS). A unique feature of mobile phones that has so far not been used for aiding blood donation is caller tunes. Caller tunes replace the ringing sound heard by a caller to a mobile phone before the called party answers the call. In African countries such as Ghana, instead of the typical ringing sound, a caller may hear a message or song. Despite the popularity of such caller tunes, there is a lack of empirical studies on their potential use for promoting blood donation. Objective The aim of this study was to use the technology acceptance model to explore the influence of the factors—perceived ease of use, perceived usefulness, attitude, and free of cost—on intentions of blood or nonblood donors to download blood donation-themed caller tunes to promote blood donation, if available. Methods A total of 478 blood donors and 477 nonblood donors were purposively sampled for an interviewer-administered questionnaire survey at blood donation sites in Accra, Ghana. Data were analyzed using descriptive statistics, exploratory factor analysis, and confirmatory factory analysis or structural equation modeling, leading to hypothesis testing to examine factors that determine intention to use caller tunes for blood donation among blood or nonblood donors who use or do not use mobile phone caller tunes. Results Perceived usefulness had a significant effect on intention to use caller tunes among blood donors with caller tunes (beta=.293, P<.001), blood donors without caller tunes (beta=.165, P=.02, nonblood donors with caller tunes (beta=.278, P<.001), and nonblood donors without caller tunes (beta=.164, P=.01). Attitudes had significant effect on intention to use caller tunes among blood donors without caller tunes (beta=.351, P<.001), nonblood donors with caller tunes (beta=.384, P<.001), nonblood donors without caller tunes (beta=.539, P<.001) but not among blood donors with caller tunes (beta=.056, P=.44). The effect of free-of-cost caller tunes on the intention to use for blood donation was statistically significant (beta=.169, P<.001) only in the case of nonblood donors without caller tunes, whereas this path was statistically not significant in other models. Conclusions Our results provide empirical evidence for designing caller tunes to promote blood donation in Ghana. The study found that making caller tunes free is particularly relevant for nonblood donors with no caller tunes. PMID:29728343

Heart Rate, Stress, and Occupational Noise Exposure among Electronic Waste Recycling Workers

PubMed Central

Burns, Katrina N.; Sun, Kan; Fobil, Julius N.; Neitzel, Richard L.

2016-01-01

Electronic waste (e-waste) is a growing occupational and environmental health issue around the globe. E-waste recycling is a green industry of emerging importance, especially in low-and middle-income countries where much of this recycling work is performed, and where many people’s livelihoods depend on this work. The occupational health hazards of e-waste recycling have not been adequately explored. We performed a cross-sectional study of noise exposures, heart rate, and perceived stress among e-waste recycling workers at a large e-waste site in Accra, Ghana. We interviewed 57 workers and continuously monitored their individual noise exposures and heart rates for up to 24 h. More than 40% of workers had noise exposures that exceeded recommended occupational (85 dBA) and community (70 dBA) noise exposure limits, and self-reported hearing difficulties were common. Workers also had moderate to high levels of perceived stress as measured via Cohen’s Perceived Stress Scale, and reported a variety of symptoms that could indicate cardiovascular disease. Noise exposures were moderately and significantly correlated with heart rate (Spearman’s ρ 0.46, p < 0.001). A mixed effects linear regression model indicated that a 1 dB increase in noise exposure was associated with a 0.17 increase in heart rate (p-value = 0.01) even after controlling for work activities, age, smoking, perceived stress, and unfavorable physical working conditions. These findings suggest that occupational and non-occupational noise exposure is associated with elevations in average heart rate, which may in turn predict potential cardiovascular damage. PMID:26797626

Risk Perceptions of Wastewater Use for Urban Agriculture in Accra, Ghana.

PubMed

Antwi-Agyei, Prince; Peasey, Anne; Biran, Adam; Bruce, Jane; Ensink, Jeroen

2016-01-01

Poor food hygiene is a significant risk to public health globally, but especially in low and middle-income countries where access to sanitation, and general hygiene remain poor. Food hygiene becomes even more pertinent when untreated, or poorly treated wastewater is used in agriculture. In such circumstances the WHO recommends the adoption of a multiple-barrier approach that prescribes health protective measures at different entry points along the food chain. This study sought to assess the knowledge and awareness of wastewater use for crop production, its related health risks, and adoption of health protective measures by farmers, market salespersons and consumers using questionnaires and focus group discussions. In the period from September 2012 to August 2013, 490 respondents were interviewed during two cropping seasons. The study found that awareness of the source of irrigation water was low among consumers and street food vendors, though higher among market vendors. In contrast, health risk awareness was generally high among salespersons and consumers, but low among farmers. The study found that consumers did not prioritize health indicators when buying produce from vendors but were motivated to buy produce, or prepared food based on taste, friendship, cost, convenience and freshness of produce. Similarly, farmers' awareness of health risk did not influence their adoption of safer farm practices. The study recommends the promotion of interventions that would result in more direct benefits to both producers and vendors, together with hygiene education and enforcement of food safety byelaws in order to influence behaviour change, and increase the uptake of the multiple-barrier approach.

Dried blood spot measurement of pregnancy-associated plasma protein A (PAPP-A) and free β-subunit of human chorionic gonadotropin (β-hCG) from a low-resource setting.

PubMed

Browne, J L; Schielen, P C J I; Belmouden, I; Pennings, J L A; Klipstein-Grobusch, K

2015-06-01

The objectives of the article is to compare pregnancy-associated plasma protein A (PAPP-A) and free β-subunit of human chorionic gonadotropin (β-hCG) concentrations in dried blood spots (DBSs) with serum of samples obtained from a public hospital in a low-resource setting and to evaluate their stability. Serum and DBS samples were obtained by venipuncture and finger prick from 50 pregnant participants in a cohort study in a public hospital in Accra, Ghana. PAPP-A and β-hCG concentrations from serum and DBS were measured with an AutoDELFIA® (PerkinElmer, PerkinElmer, Turku, Finland) automatic immunoassay. Correlation and Passing-Bablok regression analyses were performed to compare marker levels. High correlation (>0.9) was observed for PAPP-A and β-hCG levels between various sampling techniques. The β-hCG concentration was stable between DBS and serum, PAPP-A concentration consistently lower in DBS. Our findings suggest that β-hCG can be reliably collected from DBS in low-resource tropical settings. The exact conditions of the clinical workflow necessary for reliable PAPP-A measurement in these settings need to be further developed in the future. These findings could have implications for prenatal screening programs feasibility in low-income and middle-income countries, as DBS provides an alternative minimally invasive sampling method, with advantages in sampling technique, stability, logistics, and potential application in low-resource settings. © 2015 John Wiley & Sons, Ltd.

Heart Rate, Stress, and Occupational Noise Exposure among Electronic Waste Recycling Workers.

PubMed

Burns, Katrina N; Sun, Kan; Fobil, Julius N; Neitzel, Richard L

2016-01-19

Electronic waste (e-waste) is a growing occupational and environmental health issue around the globe. E-waste recycling is a green industry of emerging importance, especially in low-and middle-income countries where much of this recycling work is performed, and where many people's livelihoods depend on this work. The occupational health hazards of e-waste recycling have not been adequately explored. We performed a cross-sectional study of noise exposures, heart rate, and perceived stress among e-waste recycling workers at a large e-waste site in Accra, Ghana. We interviewed 57 workers and continuously monitored their individual noise exposures and heart rates for up to 24 h. More than 40% of workers had noise exposures that exceeded recommended occupational (85 dBA) and community (70 dBA) noise exposure limits, and self-reported hearing difficulties were common. Workers also had moderate to high levels of perceived stress as measured via Cohen's Perceived Stress Scale, and reported a variety of symptoms that could indicate cardiovascular disease. Noise exposures were moderately and significantly correlated with heart rate (Spearman's ρ 0.46, p < 0.001). A mixed effects linear regression model indicated that a 1 dB increase in noise exposure was associated with a 0.17 increase in heart rate (p-value = 0.01) even after controlling for work activities, age, smoking, perceived stress, and unfavorable physical working conditions. These findings suggest that occupational and non-occupational noise exposure is associated with elevations in average heart rate, which may in turn predict potential cardiovascular damage.

Risk Perceptions of Wastewater Use for Urban Agriculture in Accra, Ghana

PubMed Central

Antwi-Agyei, Prince; Peasey, Anne; Biran, Adam; Bruce, Jane; Ensink, Jeroen

2016-01-01

Poor food hygiene is a significant risk to public health globally, but especially in low and middle-income countries where access to sanitation, and general hygiene remain poor. Food hygiene becomes even more pertinent when untreated, or poorly treated wastewater is used in agriculture. In such circumstances the WHO recommends the adoption of a multiple-barrier approach that prescribes health protective measures at different entry points along the food chain. This study sought to assess the knowledge and awareness of wastewater use for crop production, its related health risks, and adoption of health protective measures by farmers, market salespersons and consumers using questionnaires and focus group discussions. In the period from September 2012 to August 2013, 490 respondents were interviewed during two cropping seasons. The study found that awareness of the source of irrigation water was low among consumers and street food vendors, though higher among market vendors. In contrast, health risk awareness was generally high among salespersons and consumers, but low among farmers. The study found that consumers did not prioritize health indicators when buying produce from vendors but were motivated to buy produce, or prepared food based on taste, friendship, cost, convenience and freshness of produce. Similarly, farmers’ awareness of health risk did not influence their adoption of safer farm practices. The study recommends the promotion of interventions that would result in more direct benefits to both producers and vendors, together with hygiene education and enforcement of food safety byelaws in order to influence behaviour change, and increase the uptake of the multiple-barrier approach. PMID:26978778

Understanding tobacco use and socioeconomic inequalities among men in Ghana, and Lesotho.

PubMed

Dickson, Kwamena Sekyi; Ahinkorah, Bright Opoku

2017-01-01

Tobacco use is one of the leading causes of preventable deaths and has become a significant public health issue. Previous studies have paid less attention to tobacco use and socio-economic equalities among men in developing countries. This study examines the relationship between tobacco use and socio-economic inequalities among men in Ghana and Lesotho. The study made use of data from the 2014 Demographic and Health Survey (DHS) from Ghana, and Lesotho. Binary logistic regression was employed to examine the associations between socio-economic inequality characteristics of respondents and tobacco use. The results showed that the prevalence of tobacco use was high in Lesotho (47.9%) as compared to that of Ghana (6.3%). Tobacco use was generally high across all age groups in Lesotho and in contrast, it was relatively low across all ages in Ghana. A statistically significant association was found between all the socio-economic variables and tobacco use in both countries. The prevalence of tobacco use was smaller in age group 15-24 years compared to the age groups 25-34 years and 35-59 years in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR's in Ghana are respectively 5.3 (95% CI: 3.29-8.59) and 9.7 (95% CI: 6.20-15.06), compared to respectively 1.7 (95% CI: 1.32-2.11) and 1.7 (95% CI: 1.36-2.12). Smoking prevalence was smaller in men with higher level of education compared to men with no education in both Ghana and Lesotho, although the association was weaker in Ghana. The AOR in Ghana is 0.1 (95% CI: (0.02-0.11), compared to 0.2 (95% Cl: (0.17-0.30). The prevalence of tobacco use was smaller among men in urban areas compared to rural areas in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 2.1 (95% CI: 1.67-2.73), compared to 1.6 (95% CI: (1.31-1.95). In both countries, prevalence of tobacco use was higher in men who are traditionalist/spiritualists or who had no religion compared to Christians, although the association was stronger in Ghana. The AOR in Ghana is 6.2 (95% CI: (4.42-4.09) compared to 1.7 (95% CI: (1.21-2.47). The prevalence of tobacco use was low among men with richest wealth status compared to men with poorest wealth status in both Ghana and Lesotho, although the association is weaker in Ghana. The AOR in Ghana is 0.1 (95% Cl: (0.06-0.17) compared to 0.4 (95% CI: (0.51-1.12). In relation to occupation, prevalence of tobacco use was smaller among professional workers compared to men in the Agricultural sector in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 9.3 (95% Cl: (4.54-18.99), compared to 3.5 (95% CI: (2.27-5.52). Formerly married men in both countries were more likely to use tobacco compared to currently not married men, although the prevalence was higher in Ghana. The AOR in Ghana is 1.6 (95% CI: (0.99-2.28)], compared to 1.4 (95% CI: (0.89-2.28) in Lesotho. Although similar socio-economic inequality factors provided an understanding of tobacco use among men in Ghana and Lesotho, there were variations in relation to how each factor influences tobacco use.

Culture and the environment in Ghana

NASA Astrophysics Data System (ADS)

Dyasi, Hubert M.

1985-03-01

The traditional culture of Ghana stressed a strong relationship with the environment, and a culturally acceptable environmental management resulted from strictures and taboos related to the land. Following its independence in 1957, Ghana has enacted laws that reflect an enlightened environmental policy. These are especially important because of the difficulties Ghana has had in its economic development using Western technology that has damaged the fragile tropical ecosystem. A key aspect of Ghana's policy is the attempt to marry scientific knowledge and traditional beliefs for environmentally sound management of Ghana's resources.

Determinants of Intention to Use Mobile Phone Caller Tunes to Promote Voluntary Blood Donation: Cross-Sectional Study.

PubMed

Appiah, Bernard; Burdine, James N; Aftab, Ammar; Asamoah-Akuoko, Lucy; Anum, David A; Kretchy, Irene A; Samman, Elfreda W; Appiah, Patience B; Bates, Imelda

2018-05-04

Voluntary blood donation rates are low in sub-Saharan Africa. Sociobehavioral factors such as a belief that donated blood would be used for performing rituals deter people from donating blood. There is a need for culturally appropriate communication interventions to encourage individuals to donate blood. Health care interventions that use mobile phones have increased in developing countries, although many of them focus on SMS text messaging (short message service, SMS). A unique feature of mobile phones that has so far not been used for aiding blood donation is caller tunes. Caller tunes replace the ringing sound heard by a caller to a mobile phone before the called party answers the call. In African countries such as Ghana, instead of the typical ringing sound, a caller may hear a message or song. Despite the popularity of such caller tunes, there is a lack of empirical studies on their potential use for promoting blood donation. The aim of this study was to use the technology acceptance model to explore the influence of the factors-perceived ease of use, perceived usefulness, attitude, and free of cost-on intentions of blood or nonblood donors to download blood donation-themed caller tunes to promote blood donation, if available. A total of 478 blood donors and 477 nonblood donors were purposively sampled for an interviewer-administered questionnaire survey at blood donation sites in Accra, Ghana. Data were analyzed using descriptive statistics, exploratory factor analysis, and confirmatory factory analysis or structural equation modeling, leading to hypothesis testing to examine factors that determine intention to use caller tunes for blood donation among blood or nonblood donors who use or do not use mobile phone caller tunes. Perceived usefulness had a significant effect on intention to use caller tunes among blood donors with caller tunes (beta=.293, P<.001), blood donors without caller tunes (beta=.165, P=.02, nonblood donors with caller tunes (beta=.278, P<.001), and nonblood donors without caller tunes (beta=.164, P=.01). Attitudes had significant effect on intention to use caller tunes among blood donors without caller tunes (beta=.351, P<.001), nonblood donors with caller tunes (beta=.384, P<.001), nonblood donors without caller tunes (beta=.539, P<.001) but not among blood donors with caller tunes (beta=.056, P=.44). The effect of free-of-cost caller tunes on the intention to use for blood donation was statistically significant (beta=.169, P<.001) only in the case of nonblood donors without caller tunes, whereas this path was statistically not significant in other models. Our results provide empirical evidence for designing caller tunes to promote blood donation in Ghana. The study found that making caller tunes free is particularly relevant for nonblood donors with no caller tunes. ©Bernard Appiah, James N Burdine, Ammar Aftab, Lucy Asamoah-Akuoko, David A Anum, Irene A Kretchy, Elfreda W Samman, Patience B Appiah, Imelda Bates. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 04.05.2018.

Pronounced Seasonal Changes in the Movement Ecology of a Highly Gregarious Central-Place Forager, the African Straw-Coloured Fruit Bat (Eidolon helvum)

PubMed Central

Fahr, Jakob; Abedi-Lartey, Michael; Esch, Thomas; Machwitz, Miriam; Suu-Ire, Richard; Wikelski, Martin; Dechmann, Dina K. N.

2015-01-01

Background Straw-coloured fruit bats (Eidolon helvum) migrate over vast distances across the African continent, probably following seasonal bursts of resource availability. This causes enormous fluctuations in population size, which in turn may influence the bats’ impact on local ecosystems. We studied the movement ecology of this central-place forager with state-of-the-art GPS/acceleration loggers and concurrently monitored the seasonal fluctuation of the colony in Accra, Ghana. Habitat use on the landscape scale was assessed with remote sensing data as well as ground-truthing of foraging areas. Principal Findings During the wet season population low (~ 4000 individuals), bats foraged locally (3.5–36.7 km) in urban areas with low tree cover. Major food sources during this period were fruits of introduced trees. Foraging distances almost tripled (24.1–87.9 km) during the dry season population peak (~ 150,000 individuals), but this was not compensated for by reduced resting periods. Dry season foraging areas were random with regard to urban footprint and tree cover, and food consisted almost exclusively of nectar and pollen of native trees. Conclusions and Significance Our study suggests that straw-coloured fruit bats disperse seeds in the range of hundreds of meters up to dozens of kilometres, and pollinate trees for up to 88 km. Straw-coloured fruit bats forage over much larger distances compared to most other Old World fruit bats, thus providing vital ecosystem services across extensive landscapes. We recommend increased efforts aimed at maintaining E. helvum populations throughout Africa since their keystone role in various ecosystems is likely to increase due to the escalating loss of other seed dispersers as well as continued urbanization and habitat fragmentation. PMID:26465139

Towards improved uptake of malaria chemoprophylaxis among West African travellers: identification of behavioural determinants

PubMed Central

2013-01-01

Background Malaria is a potentially lethal illness for which preventive measures are not optimally used among all travellers. Travellers visiting friends and relatives in their country of origin (VFRs) are known to use chemoprophylaxis less consistently compared to tourist travellers. In this study, factors explaining the low use of chemoprophylaxis were pursued to contribute to improving uptake of preventive measures among VFRs. Methods Following in-depth interviews with Ghanaians living in Amsterdam, a questionnaire was developed to assess which behavioural determinants were related to taking preventive measures. The questionnaire was administered at gates of departing flights from Schiphol International Airport, Amsterdam (the Netherlands) to Kotoka International Airport, Accra (Ghana). Results In total, 154 questionnaires were eligible for analysis. Chemoprophylaxis had been started by 83 (53.9%) and bought by 93 (60.4%) travellers. Pre-travel advice had been obtained by 104 (67.5%) travellers. Those who attended the pre-travel clinic and those who incorrectly thought they had been vaccinated against malaria were more likely to use preventive measures. Young-, business- and long-term travellers, those who had experienced malaria, and those who thought curing malaria was easier than taking preventive tablets were less likely to use preventive measures. Conclusion Almost half of the VFRs travelling to West Africa had not started chemoprophylaxis; therefore, there is room for improvement. Risk reduction strategies could aim at improving attendance to travel clinics and focus on young-, business and long term travellers and VFRs who have experienced malaria during consultation. Risk reduction strategies should focus on improving self-efficacy and conceptions of response efficacy, including social environment to aim at creating the positive social context needed. PMID:24107150

Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities: a Ghanaian cohort study.

PubMed

Amoakoh-Coleman, Mary; Klipstein-Grobusch, Kerstin; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Ansah, Evelyn K

2016-11-24

Guideline utilization aims at improvement in quality of care and better health outcomes. The objective of the current study was to determine the effect of provider complete adherence to the first antenatal care guidelines on the risk of maternal and neonatal complications in a low resource setting. Women delivering in 11 health facilities in the Greater Accra region of Ghana were recruited into a cohort study. Their first antenatal visit records were reviewed to assess providers' adherence to the guidelines, using a thirteen-point checklist. Information on their socio-demographic characteristics and previous pregnancy history was collected. Participants were followed up for 6 weeks post-partum to complete data collection on outcomes. The incidence of maternal and neonatal complications was estimated. The effects of complete adherence on risk of maternal and neonatal complications were estimated and expressed as relative risks (RRs) with their 95% confidence intervals (CI) adjusted for a potential clustering effect of health facilities. Overall, 926 women were followed up to 6 weeks post-partum. Mean age (SD) of participants was 28.2 (5.4) years. Complete adherence to guidelines pertained to the care of 48.5% of women. Incidence of preterm deliveries, low birth weight, stillbirths and neonatal mortality were 5.3, 6.1, 0.4 and 1.4% respectively. Complete adherence to the guidelines decreased risk of any neonatal complication [0.72 (0.65-0.93); p = 0.01] and delivery complication [0.66 (0.44-0.99), p = 0.04]. Complete provider adherence to antenatal care guidelines at first antenatal visit influences delivery and neonatal outcomes. While there is the need to explore and understand explanatory mechanisms for these observations, programs that promote complete adherence to guidelines will improve the pregnancy outcomes.

Pronounced Seasonal Changes in the Movement Ecology of a Highly Gregarious Central-Place Forager, the African Straw-Coloured Fruit Bat (Eidolon helvum).

PubMed

Fahr, Jakob; Abedi-Lartey, Michael; Esch, Thomas; Machwitz, Miriam; Suu-Ire, Richard; Wikelski, Martin; Dechmann, Dina K N

2015-01-01

Straw-coloured fruit bats (Eidolon helvum) migrate over vast distances across the African continent, probably following seasonal bursts of resource availability. This causes enormous fluctuations in population size, which in turn may influence the bats' impact on local ecosystems. We studied the movement ecology of this central-place forager with state-of-the-art GPS/acceleration loggers and concurrently monitored the seasonal fluctuation of the colony in Accra, Ghana. Habitat use on the landscape scale was assessed with remote sensing data as well as ground-truthing of foraging areas. During the wet season population low (~ 4000 individuals), bats foraged locally (3.5-36.7 km) in urban areas with low tree cover. Major food sources during this period were fruits of introduced trees. Foraging distances almost tripled (24.1-87.9 km) during the dry season population peak (~ 150,000 individuals), but this was not compensated for by reduced resting periods. Dry season foraging areas were random with regard to urban footprint and tree cover, and food consisted almost exclusively of nectar and pollen of native trees. Our study suggests that straw-coloured fruit bats disperse seeds in the range of hundreds of meters up to dozens of kilometres, and pollinate trees for up to 88 km. Straw-coloured fruit bats forage over much larger distances compared to most other Old World fruit bats, thus providing vital ecosystem services across extensive landscapes. We recommend increased efforts aimed at maintaining E. helvum populations throughout Africa since their keystone role in various ecosystems is likely to increase due to the escalating loss of other seed dispersers as well as continued urbanization and habitat fragmentation.

Performance Assessment of Ga District Mutual Health Insurance Scheme, Greater Accra Region, Ghana.

PubMed

Nsiah-Boateng, Eric; Aikins, Moses

This study assessed performance of the Ga District Mutual Health Insurance Scheme over the period 2007-2009. The desk review method was used to collect secondary data on membership coverage, revenue, expenditure, and claims settlement patterns of the scheme. A household survey was also conducted in the Madina Township by using a self-administered semi-structured questionnaire to determine community coverage of the scheme. The study showed membership coverage of 21.8% and community coverage of 22.2%. The main reasons why respondents had not registered with the scheme are that contributions are high and it does not offer the services needed. Financially, the scheme depended largely on subsidies and reinsurance from the National Health Insurance Authority for 89.8% of its revenue. Approximately 92% of the total revenue was spent on medical claims, and 99% of provider claims were settled beyond the stipulated 4-week period. There is an increasing trend in medical claims expenditure and lengthy delay in claims settlements, with most of them being paid beyond the mandatory 4-week period. Introduction of cost-containment measures including co-payment and capitation payment mechanism would be necessary to reduce the escalating cost of medical claims. Adherence to the 4-week stipulated period for payment of medical claims would be important to ensure that health care providers are financially resourced to deliver continuous health services to insured members. Furthermore, resourcing the scheme would be useful for speedy vetting of claims and also, community education on the National Health Insurance Scheme to improve membership coverage and revenue from the informal sector. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

Towards improved uptake of malaria chemoprophylaxis among West African travellers: identification of behavioural determinants.

PubMed

Wieten, Rosanne W; Harting, Janneke; Biemond, Pieter M; Grobusch, Martin P; van Vugt, Michèle

2013-10-10

Malaria is a potentially lethal illness for which preventive measures are not optimally used among all travellers. Travellers visiting friends and relatives in their country of origin (VFRs) are known to use chemoprophylaxis less consistently compared to tourist travellers. In this study, factors explaining the low use of chemoprophylaxis were pursued to contribute to improving uptake of preventive measures among VFRs. Following in-depth interviews with Ghanaians living in Amsterdam, a questionnaire was developed to assess which behavioural determinants were related to taking preventive measures. The questionnaire was administered at gates of departing flights from Schiphol International Airport, Amsterdam (the Netherlands) to Kotoka International Airport, Accra (Ghana). In total, 154 questionnaires were eligible for analysis. Chemoprophylaxis had been started by 83 (53.9%) and bought by 93 (60.4%) travellers. Pre-travel advice had been obtained by 104 (67.5%) travellers. Those who attended the pre-travel clinic and those who incorrectly thought they had been vaccinated against malaria were more likely to use preventive measures. Young-, business- and long-term travellers, those who had experienced malaria, and those who thought curing malaria was easier than taking preventive tablets were less likely to use preventive measures. Almost half of the VFRs travelling to West Africa had not started chemoprophylaxis; therefore, there is room for improvement. Risk reduction strategies could aim at improving attendance to travel clinics and focus on young-, business and long term travellers and VFRs who have experienced malaria during consultation. Risk reduction strategies should focus on improving self-efficacy and conceptions of response efficacy, including social environment to aim at creating the positive social context needed.

Sachet drinking water in Ghana’s Accra-Tema metropolitan area: past, present, and future

PubMed Central

Weeks, John R.; Fink, Günther

2013-01-01

Population growth in West Africa has outpaced local efforts to expand potable water services, and private sector sale of packaged drinking water has filled an important gap in household water security. Consumption of drinking water packaged in plastic sachets has soared in West Africa over the last decade, but the long-term implications of these changing consumption patterns remain unclear and unstudied. This paper reviews recent shifts in drinking water, drawing upon data from the 2003 and 2008 Demographic and Health Surveys, and provides an overview of the history, economics, quality, and regulation of sachet water in Ghana’s Accra-Tema Metropolitan Area. Given the pros and cons of sachet water, we suggest that a more holistic understanding of the drinking water landscape is necessary for municipal planning and sustainable drinking water provision. PMID:24294481

Human Resource Local Content in Ghana's Upstream Petroleum Industry

NASA Astrophysics Data System (ADS)

Benin, Papa

Enactment of Ghana's Petroleum (Local Content and Local Participation) Regulations, 2013 (L.I. 2204) was intended to regulate the percentage of local products, personnel, financing, and goods and services rendered within Ghana's upstream petroleum industry value chain. Five years after the inception of Ghana's upstream oil and gas industry, a gap is evident between the requirements of L.I. 2204 and professional practice. Drawing on Lewin's change theory, a cross-sectional study was conducted to examine the extent of differences between the prevailing human resource local content and the requirements of L.I. 2204 in Ghana's upstream petroleum industry. The extent to which training acquired by indigenous Ghanaians seeking jobs in Ghana's oil fields affects the prevalent local content in its upstream petroleum industry was also examined. Survey data were collected from 97 management, technical, and other staff in 2 multinational petroleum companies whose oil and gas development plans have been approved by the Petroleum Commission of Ghana. To answer the research questions and test their hypotheses, one-way ANOVA was performed with staff category (management, technical, and other) as the independent variable and prevalent local content as the dependent variable. Results indicated that prevailing local content in Ghana's upstream petroleum industry meets the requirements of L.I. 2204. Further, training acquired by indigenous Ghanaians seeking jobs in Ghana's oil fields affects the prevalent local content in its offshore petroleum industry. Findings may encourage leaders within multinational oil companies and the Petroleum Commission of Ghana to organize educational seminars that equip indigenous Ghanaians with specialized skills for working in Ghana's upstream petroleum industry.

Improving Skilled Birth Attendance in Ghana: An Evidence-Based Policy Brief.

PubMed

Apanga, Paschal Awingura; Awoonor-Williams, John Koku

2017-01-01

This commentary has the objective of improving skilled birth attendance in Ghana to reduce maternal and neonatal mortality and morbidity. We have provided evidence of causes of low-skilled birth attendance in Ghana. Physical accessibility of health care, sociocultural factors, economic factors and health care system delivery problems were found as the main underlying causes of low levels of skilled birth attendance in Ghana. The paper provides potential strategies in addressing maternal and child health issues in Ghana.

Understanding handpump sustainability: Determinants of rural water source functionality in the Greater Afram Plains region of Ghana†

PubMed Central

Shields, Katherine F.; Chan, Terence U.; Christenson, Elizabeth; Cronk, Ryan D.; Leker, Hannah; Samani, Destina; Apoya, Patrick; Lutz, Alexandra

2015-01-01

Abstract Safe drinking water is critical to human health and development. In rural sub‐Saharan Africa, most improved water sources are boreholes with handpumps; studies suggest that up to one third of these handpumps are nonfunctional at any given time. This work presents findings from a secondary analysis of cross‐sectional data from 1509 water sources in 570 communities in the rural Greater Afram Plains (GAP) region of Ghana; one of the largest studies of its kind. 79.4% of enumerated water sources were functional when visited; in multivariable regressions, functionality depended on source age, management, tariff collection, the number of other sources in the community, and the district. A Bayesian network (BN) model developed using the same data set found strong dependencies of functionality on implementer, pump type, management, and the availability of tools, with synergistic effects from management determinants on functionality, increasing the likelihood of a source being functional from a baseline of 72% to more than 97% with optimal management and available tools. We suggest that functionality may be a dynamic equilibrium between regular breakdowns and repairs, with management a key determinant of repair rate. Management variables may interact synergistically in ways better captured by BN analysis than by logistic regressions. These qualitative findings may prove generalizable beyond the study area, and may offer new approaches to understanding and increasing handpump functionality and safe water access. PMID:27667863

Impact of Electronic Resources and Usage in Academic Libraries in Ghana: Evidence from Koforidua Polytechnic & All Nations University College, Ghana

ERIC Educational Resources Information Center

Akussah, Maxwell; Asante, Edward; Adu-Sarkodee, Rosemary

2015-01-01

The study investigates the relationship between impact of electronic resources and its usage in academic libraries in Ghana: evidence from Koforidua Polytechnic & All Nations University College, Ghana. The study was a quantitative approach using questionnaire to gather data and information. A valid response rate of 58.5% was assumed. SPSS…

Unfettering the Ball and Chain of Gender Discrimination: Gendered Experiences of Senior STEM Women in Ghana

ERIC Educational Resources Information Center

Boateng, Fred Kofi

2017-01-01

Gender disparities are rife in Ghana and its educational sector. Despite the plethora of research on gender disparities in Ghana's education system, there is no coverage on gender disparities in the Science, Technology, Engineering, and Mathematics (STEM) fields in Ghana. The paper's purpose of the article was to examine the experiences of…

Sociodemographic Determinants of Malaria among Under-Five Children in Ghana.

PubMed

Nyarko, Samuel Harrenson; Cobblah, Anastasia

2014-01-01

Background. Malaria is an entrenched global health challenge particularly in the sub-Saharan African countries. However, in Ghana, little is known about the determinants of malaria prevalence among under-five children. As such, this study sought to examine the sociodemographic factors that determine malaria among under-five children in Ghana. Methods. This paper used secondary data drawn from the 2008 Ghana Demographic and Health Survey. Bivariate analysis and complementary log-log regression models were used to examine the determinants of malaria prevalence among under-five children in Ghana for the study period. Results. The results therefore revealed that region of residence, age of child, and ownership of mosquito net were the key predictors of malaria cases among under-five children in Ghana for the five-year period preceding the survey. Conclusion. It is therefore imperative that special education on prevention of malaria should be intensified by the National Malaria Control Programme in all the regions in order to reduce malaria prevalence particularly among under-five children in Ghana.

Immunization delivery in the second year of life in Ghana: the need for a multi-faceted approach

PubMed Central

Nyaku, Mawuli; Wardle, Melissa; Eng, Jodi Vanden; Ametewee, Lynnette; Bonsu, George; Larbi Opare, Joseph Kwadwo; Conklin, Laura

2017-01-01

Introduction in 2012, pneumococcal conjugate vaccine (PCV), rotavirus vaccine and a second dose of measles-containing vaccine (MCV2) were introduced into the Expanded Program on Immunization (EPI) in Ghana. According to Ghana’s EPI schedule, PCV and rotavirus vaccine are given in the first year of life and MCV2 in the second year of life (2YL) at 18 months. Although coverage with the last doses of PCV and rotavirus vaccine reached almost 90% coverage within four years of introduction, MCV2 coverage did not rise above 70%. The World Health Organization Global Measles and Rubella Strategic Plan established a 2020 milestone to achieve at least 95% coverage with the first and second doses of measles-containing vaccine in each district and nationally. We developed a project to address challenges to delivery of immunizations and other child health services at the 18-month visit and throughout the 2YL. Methods from March to April 2016, we conducted a cluster survey of households (HHs) with children 24-35 months of age in three regions in Ghana to assess knowledge, attitudes and beliefs among caregivers about immunization during the 2YL and to collect childhood vaccination history data using vaccination cards. Three independent samples were selected from the Northern (NR), Volta (VR), and Greater Accra (GAR) regions. A survey and direct observations were performed a ta representative sample of health facilities (HFs) providing immunization services in the same regions to further characterize barriers to immunization access, utilization and delivery in the 2YL. Results data on a total of 464 children ages 24-35 months were collected in the HH survey: 211 in NR, 153 in VR, and 100 in GAR (response rate > 99%). First dose of measles-containing vaccine (MCV1) coverage was (NR: 87%, VR: 96%, GAR: 99%); however, MCV2 coverage was lower (NR: 60%, VR: 83%, GAR: 70%). MCV1 to MCV2 dropout was 32% in NR, 14% in VR, and 31% in GAR. Caregiver awareness of immunization against measles was 69% in NR, 75% in VR, and 68% in GAR yet less than half knew the recommended ages for receiving the vaccine, (NR: 4%, VR: 9%, GAR: 44%). Among 160 HFs participating in the survey (>50 in each region), most lacked a defaulter tracing system (NR: 94%,VR: 76%,GAR: 85%). A varying proportion of HCWs correctly indicated how to record a catch-up first dose of MCV administered to an 18-month-old child in the 12-23 month immunization register (NR: 38%, VR: 55%, GAR: 67%) and on the vaccination card (NR: 54%, VR: 53%, GAR: 76%). Although more than half of caregivers would accept text messages, (NR: 57%, VR: 78%, GAR: 96%) including reminders, related to their child’s immunizations, < 10% HFs were utilizing this practice. Conclusion challenges encountered with the establishment of an immunization visit beyond the first year of life included knowledge gaps among caregivers, high dropout rates between MCV1 and MCV2 in all study regions, and a lack of defaulter tracing systems in most healthcare facilities providing childhood immunizations. Targeted strategies that promote behavioral, cultural, and policy changes are needed to strengthen 2YL child health service delivery and improve vaccination coverage. PMID:29296139

The first cases of Lassa fever in Ghana.

PubMed

Dzotsi, E K; Ohene, S-A; Asiedu-Bekoe, F; Amankwa, J; Sarkodie, B; Adjabeng, M; Thouphique, A M; Ofei, A; Oduro, J; Atitogo, D; Bonney, J H K; Paintsil, S C N; Ampofo, W

2012-09-01

Lassa fever is a zoonotic disease endemic in West Africa but with no previous case reported in Ghana. We describe the first two laboratory confirmed cases of Lassa fever from the Ashanti Region of Ghana detected in October and December, 2011.

Cardiovascular diseases in Ghana within the context of globalization.

PubMed

Ofori-Asenso, Richard; Garcia, Daireen

2016-02-01

This paper discusses how globalization and its elements are influencing health dynamics and in particular Cardiovascular diseases (CVDs) in Ghana. It assesses the growing burden of CVDs and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on CVDs in Ghana. It also set out the dimensions of the relationship between CVD risk factors and globalization. The paper concludes with a discussion on strategies for tackling the growing burden of CVDs in Ghana.

Cardiovascular diseases in Ghana within the context of globalization

PubMed Central

Garcia, Daireen

2016-01-01

This paper discusses how globalization and its elements are influencing health dynamics and in particular Cardiovascular diseases (CVDs) in Ghana. It assesses the growing burden of CVDs and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on CVDs in Ghana. It also set out the dimensions of the relationship between CVD risk factors and globalization. The paper concludes with a discussion on strategies for tackling the growing burden of CVDs in Ghana. PMID:26885494

Some Epidemiological Characteristics of Perpetrators and Victims of Incest in Contemporary Ghana: Analysis of Media Reports.

PubMed

Quarshie, Emmanuel N-B; Osafo, Joseph; Akotia, Charity S; Peprah, Jennifer; Andoh-Arthur, Johnny

2017-01-01

In Ghana, incest is considered sinful, taboo, and illegal. However, recent media reports show that incest has become a daily reality in Ghana. This study is a situational analysis of the pattern of incest in Ghana as reported in the media from January 2008 through July 2015. Qualitative content analysis was conducted on 48 incest news reports in Ghana. The findings showed that father-daughter incest was most frequent across the study period. Forty-seven females aged 3 to 25 years and a male aged 3 years were identified as victims. Generally, the incest lasted between 1 day and 13 years before disclosure. Perpetrators employed psychological and/or physical methods to coerce their victims. Marital difficulties, diabolical control, and seduction by victim featured prominently as alleged motives behind the abuse. The study observes that the recent increase in father-daughter incest warrants an immediate shift of research attention onto men's mental health in Ghana.

Ghana. Country Demographic Profiles, No. 5.

ERIC Educational Resources Information Center

Bureau of the Census (DOC), Suitland, MD. Population Div.

Tables of demographic information about Ghana are presented, including size of population and estimates of fertility and mortality. The data were obtained primarily from population censuses in 1960 and 1970, a 1960 post-enumeration survey, and a 1971 supplementary enquiry. Because Ghana's vital registration system is incomplete, the data are not…

Student Loans in Ghana.

ERIC Educational Resources Information Center

Kotey, N.

1992-01-01

This article summarizes the current pattern of finance of higher education in Ghana, gives a brief history of student loans in Ghana, and describes a new program, which is administered by the Social Security and National Insurance Trust and is expected to result in a higher rate of loan repayment. (Author/DB)

The Determinants of Girls' Educational Enrollment in Ghana. Working Paper.

ERIC Educational Resources Information Center

Johnson, Rebecca; Kyle, Steven

This study examined the determinants of school enrollment in Ghana, considering historical and social information to formulate an econometric model of school enrollment patterns for households. Data came from a 1989 survey of households in Ghana. The survey collected basic information about community characteristics, health and school facilities,…

Making a Difference in Ghana's Classrooms: Educators and Communities as Partners.

ERIC Educational Resources Information Center

O'Grady, Barbara

This report describes how partnerships between educators and the community are helping improve education in Ghana. Though the basic education program, Improving Learning through Partnerships (ILP), Ghana is strengthening its educational foundation by using master teachers to help improve basic skills instruction and by involving parents and other…

Children with Intellectual Disabilities and Special School Education in Ghana

ERIC Educational Resources Information Center

Kassah, Bente Lilljan Lind; Kassah, Alexander Kwesi; Phillips, Deborah

2018-01-01

Even though Ghana has embraced international calls for mainstream education, many children with intellectual disabilities still receive education in segregated special schools. This article discusses the views of seven informants on the importance of special schools in Ghana. After securing the consent of our informants, we conducted in-depth…

Ghana Open Data Initiative | Ghana Open Data Initiative

Science.gov Websites

Information Technology Agency (NITA) 2012-2016 government of Ghana. All right reserved. Agencies Search  Get Involved Finance Health Agriculture Energy Education Environment Local Government City Data Extractive Statistics Business Elections About Us Open Government FAQ Aid Data Sites Data

Progressivity of health care financing and incidence of service benefits in Ghana.

PubMed

Akazili, James; Garshong, Bertha; Aikins, Moses; Gyapong, John; McIntyre, Di

2012-03-01

The National Health Insurance (NHI) scheme was introduced in Ghana in 2004 as a pro-poor financing strategy aimed at removing financial barriers to health care and protecting all citizens from catastrophic health expenditures, which currently arise due to user fees and other direct payments. A comprehensive assessment of the financing and benefit incidence of health services in Ghana was undertaken. These analyses drew on secondary data from the Ghana Living Standards Survey (2005/2006) and from an additional household survey which collected data in 2008 in six districts covering the three main ecological zones of Ghana. Findings show that Ghana's health care financing system is progressive, driven largely by the progressivity of taxes. The national health insurance levy (which is part of VAT) is mildly progressive while NHI contributions by the informal sector are regressive. The distribution of total benefits from both public and private health services is pro-rich. However, public sector district-level hospital inpatient care is pro-poor and benefits of primary-level health care services are relatively evenly distributed. For Ghana to attain an equitable health system and fully achieve universal coverage, it must ensure that the poor, most of whom are not currently covered by the NHI, are financially protected, and it must address the many access barriers to health care.

Community engagement to inform the development of a sickle cell counselor training and certification program in Ghana.

PubMed

Anie, Kofi A; Treadwell, Marsha J; Grant, Althea M; Dennis-Antwi, Jemima A; Asafo, Mabel K; Lamptey, Mary E; Ojodu, Jelili; Yusuf, Careema; Otaigbe, Ayo; Ohene-Frempong, Kwaku

2016-07-01

Sickle cell disease (SCD) and sickle cell trait (SCT) are highly prevalent in Africa. Despite public health implications, there is limited understanding of community issues for implementing newborn screening and appropriate family counseling. We conducted a 3-day workshop in Kumasi, Ghana, with community leaders as lay program development advisors to assist the development and implementation of a Sickle Cell Counselor Training and Certification Program. We employed qualitative methods to understand cultural, religious, and psychosocial dimensions of SCD and SCT, including the advisors' attitudes and beliefs in relation to developing a culturally sensitive approach to family education and counseling that is maximally suited to diverse communities in Ghana. We collated advisors' discussions and observations in order to understand community issues and potential challenges and guide strategies for advocacy in SCD family education and counseling. Results from the workshop revealed that community leaders representing diverse communities in Ghana were engaged constructively in discussions about developing a culturally sensitive counselor training program. Key findings included the importance of improved knowledge about SCD among the public and youth in particular, the value of stakeholders such as elders and religious and traditional leaders, and government expectations of reduced SCD births. We submitted a report to the Ministry of Health in Ghana with recommendations for the next steps in developing a national sickle cell counselor training program. We named the program "Genetic Education and Counseling for Sickle Cell Conditions in Ghana" (GENECIS-Ghana). The first GENECIS-Ghana Training and Certification Program Workshop was conducted from June 8 to 12, 2015.

Smoking in Ghana: a review of tobacco industry activity.

PubMed

Owusu-Dabo, E; Lewis, S; McNeill, A; Anderson, S; Gilmore, A; Britton, J

2009-06-01

African countries are a major potential market for the tobacco industry, and the smoking epidemic is at various stages of evolution across the continent. Ghana is an African country with a low prevalence of smoking despite an active tobacco industry presence for over 50 years. This study explores potential reasons for this apparent lack of industry success. To explore the history of tobacco industry activity in Ghana and to identify potential reasons for the current low prevalence of smoking. A search was made of tobacco industry archives and other local sources to obtain data relevant to marketing and consumption of tobacco in Ghana. British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954. After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006. The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions, which may have restricted industry growth, are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date.

Student Activism and Democratic Quality in Ghana's Fourth Republic

ERIC Educational Resources Information Center

Van Gyampo, Ransford Edward

2013-01-01

Student activism has been pivotal in Ghana's political and democratic history. Prior to Ghana's Fourth Republic, student activism was highly confrontational and entailed student support or opposition to the various regimes depending on the extent to which the regimes were accepted by all as being rightful or legitimate. After 23 years of…

Education Reform for the Expansion of Mother-Tongue Education in Ghana

ERIC Educational Resources Information Center

Rosekrans, Kristin; Sherris, Arieh; Chatry-Komarek, Marie

2012-01-01

In 1957 Ghana was the first sub-Saharan colonial nation-state to achieve independence from British rule. The language of literacy instruction, however, remained English throughout most of Ghana's independence, effectively thwarting reading and writing in 11 major and 67 minor indigenous languages in use today. After years of policy shifts,…

Basic School Leaders in Ghana: How Equipped Are They?

ERIC Educational Resources Information Center

Donkor, Anthony Kudjo

2015-01-01

This paper examines the leadership preparedness of institutional-level practice with focus on basic schools in Ghana. The analysis of documents on teacher training curriculum and, one-on-one and focus group interviews with teachers and school leaders revealed that in all the 38 teacher training institutions in Ghana where teachers are prepared for…

Rosmarinic acid content in antidiabetic aqueous extract of Ocimum canum Sims grown in Ghana

USDA-ARS?s Scientific Manuscript database

Rosmarinic acid (RA) is an important polyphenol that is found in a variety of herbs including Ocimum canum sims (locally called eme or akokobesa in Ghana). Aqueous extracts from the leaves of O.canum are used as an antidiabetic herbal medicine in Ghana. Interestingly, rosmarinic acid content and p...

Ghana. Part One-Class Materials. Development Studies No. 1, Third Impression.

ERIC Educational Resources Information Center

Jones, Paula; Bourne, Fay

Background readings and classroom materials dealing with Ghana for use with secondary and college students are provided in this publication. The major historical, social, geographical, and political aspects which have contributed to the present day development of Ghana are examined. The background readings for teachers which comprise section one…

The Northeast Ghana Savannah Project--A Case Study in Project Design.

ERIC Educational Resources Information Center

Matlock, W. Gerald; Johnson, Jack D.

This report examines a project design for land degradation problems in the northern and upper regions of Ghana. The project was jointly sponsored by the Ghana Council for Scientific and Industrial Research and the Agency for International Development. The council is responsible for coordinating the activities of 10 independent research institutes.…

Ghana Country Analysis Brief

EIA Publications

2016-01-01

Ghana is a small oil and natural gas producer in West Africa. Oil and natural gas production are both expected to increase within the next five years with the start of new offshore projects. Ghana exports its crude oil production to international markets, while the country’s natural gas production is used to fuel its domestic power plants.

An Analytical Review of the Changing Facets of Ghana's Education Policy Discourse(s)

ERIC Educational Resources Information Center

Nuzdor, Hope Pius; Ansah, Francis

2017-01-01

An analytical appraisal of key documents on Ghana's education suggests that her post-independence education policy has evolved from predominantly socialist and social democratic ideals towards neo-liberal and capitalist ideological policy direction over time. This article traces and documents this discursive shift in Ghana's education policy…

The Internationalisation Agenda: A Critical Examination of Internationalisation Strategies in Public Universities in Ghana

ERIC Educational Resources Information Center

Gyamera, Gifty Oforiwaa

2015-01-01

Recently, various strategies have been adopted and adapted by universities in Ghana to re/position themselves in the international arena. Utilising postcolonial and neoliberal theories, this paper critically examines the internationalisation strategies of three public universities in Ghana. Although all the universities have adopted strategies to…

Pregnancy Associated Plasma Protein-A and Placental Growth Factor in a Sub-Saharan African Population: A Nested Cross-Sectional Study

PubMed Central

Klipstein-Grobusch, Kerstin; Koster, Maria P. H.; Ramamoorthy, Dhivya; Antwi, Edward; Belmouden, Idder; Franx, Arie; Grobbee, Diederick E.; Schielen, Peter C. J. I.

2016-01-01

Background Baseline distributions of pregnancy disorders’ biomarkers PlGF and PAPP-A levels are primarily based on Western European populations of Caucasian ethnicity. Differences in PAPP-A and PlGF concentrations by ethnicity have been observed, with increased levels in Afro-Caribbean, East Asian, and South Asian women. Baseline concentrations of sub-Saharan African women have not been evaluated. Objectives To investigate PlGF and PAPP-A in a sub-Saharan African population and assess the performance of existing reference values of PAPP-A and PlGF. Methods A nested cross-sectional study was conducted in two public hospitals in Accra, Ghana. Out of the original 1010 women enrolled in the cohort, 398 participants were eligible for inclusion with a normotensive singleton gestation and serum samples taken between 56–97 days of pregnancy. PAPP-A and PlGF concentrations were measured with an automated immunoassay. Multiple of the median (MoM) values corrected for gestation and maternal weight for PAPP-A and PlGF were calculated using reference values of a Dutch perinatal screening laboratory based on over 10.000 samples, and PlGF manufacturer reference values, respectively. Results The PAPP-A median MoM was 2.34 (interquartile range (IQR) 1.24–3.97). Median PlGF MoM was 1.25 (IQR 0.95–1.80). Median MoM values for PAPP-A and PlGF tended to be slightly different for various Ghanaian ethnic subgroups. Conclusions PAPP-A and PlGF MoM values appear to be substantially higher in a sub-Saharan African population compared to the Caucasian or Afro-Caribbean MoM values previously reported. The difference suggests the need for a specific correction factor for this population to avoid underestimation of risk for fetal aneuploidies or placental disorders when using PAPP-A and PlGF MoM for screening purposes. PMID:27532602

For money or service?: a cross-sectional survey of preference for financial versus non-financial rural practice characteristics among Ghanaian medical students.

PubMed

Johnson, Jennifer C; Nakua, Emmanuel; Dzodzomenyo, Mawuli; Agyei-Baffour, Peter; Gyakobo, Mawuli; Asabir, Kwesi; Kwansah, Janet; Kotha, S Rani; Snow, Rachel C; Kruk, Margaret E

2011-11-03

Health worker shortage and maldistribution are among the biggest threats to health systems in Africa. New medical graduates are prime targets for recruitment to deprived rural areas. However, little research has been done to determine the influence of workers' background and future plans on their preference for rural practice incentives and characteristics. The purpose of this study was to identify determinants of preference for rural job characteristics among fourth year medical students in Ghana. We asked fourth-year Ghanaian medical students to rank the importance of rural practice attributes including salary, infrastructure, management style, and contract length in considering future jobs. We used bivariate and multivariate ordinal logistic regression to estimate the association between attribute valuation and students' socio-demographic background, educational experience, and future career plans. Of 310 eligible fourth year medical students, complete data was available for 302 students (97%). Students considering emigration ranked salary as more important than students not considering emigration, while students with rural living experience ranked salary as less important than those with no rural experience. Students willing to work in a rural area ranked infrastructure as more important than students who were unwilling, while female students ranked infrastructure as less important than male students. Students who were willing to work in a rural area ranked management style as a more important rural practice attribute than those who were unwilling to work in a rural area. Students studying in Kumasi ranked contract length as more important than those in Accra, while international students ranked contract length as less important than Ghanaian students. Interventions to improve rural practice conditions are likely to be more persuasive than salary incentives to Ghanaian medical students who are willing to work in rural environments a priori. Policy experiments should test the impact of these interventions on actual uptake by students upon graduation.

Sex differences in perceived risk and testing experience of HIV in an urban fishing setting in Ghana.

PubMed

Yawson, Alfred E; Appiah, Labi K; Yawson, Anita O; Bonsu, George; Aluze-Ele, Simon; Amanhyia, Nana A K Owusu; Lartey, Margaret; Adjei, Andrew A; Lawson, Aaron L; Beckwith, Curt; Kwara, Awewura; Flanigan, Timothy

2014-11-15

Understanding sex differences in willingness to test and testing experience could aid the design of focus interventions to enhance uptake and engagement with care, treatment and support services. This study determined differences in perceived risk of acquiring HIV, willingness to test and HIV testing experience in an urban fishing community. A cross-sectional community survey was conducted in 2013 among men and women in two fishing communities (Chorkor and James Town) in Accra. In all, 554 subjects (≥ 18 years) were involved, 264 in Chorkor and 290 in James Town. Data on demographic characteristics, perceived risk for HIV and willingness to test for HIV and testing experience were collected with a structured questionnaire. Descriptive statistics and Chi square test were used for the analysis at 95% significant level, using SPSS version 21. Of 554 subjects, 329 (59.4%) were females, and median age was 32 years. Overall, only 91(40.4%) men and 118(35.9%) women perceived themselves to be at risk of acquiring HIV. A significant proportion of women were willing to test for HIV compared to men (86.3% vs. 80.0%, P = 0.048). Women were more likely to have ever tested for HIV compared to men (42.2% vs. 28.6%, P = 0.001) and more women had tested within 12 months prior to survey than men (49.6% vs. 40.6%, P = 0.230). Of the number who had tested for HIV infection, a higher proportion of men tested voluntarily 42(65.6%), while a higher proportion of women tested as part of healthcare service received 96(69.1%); (P = 0.001; indicating women vs. men). Sex differences in risk perception and willingness to test need more focused public education and behaviour change communication strategies to achieve high coverage. Community-based strategies could improve HIV testing among men whilst more access to testing in health settings should be available to women in these communities.

For money or service? a cross-sectional survey of preference for financial versus non-financial rural practice characteristics among ghanaian medical students

PubMed Central

2011-01-01

Background Health worker shortage and maldistribution are among the biggest threats to health systems in Africa. New medical graduates are prime targets for recruitment to deprived rural areas. However, little research has been done to determine the influence of workers' background and future plans on their preference for rural practice incentives and characteristics. The purpose of this study was to identify determinants of preference for rural job characteristics among fourth year medical students in Ghana. Methods We asked fourth-year Ghanaian medical students to rank the importance of rural practice attributes including salary, infrastructure, management style, and contract length in considering future jobs. We used bivariate and multivariate ordinal logistic regression to estimate the association between attribute valuation and students' socio-demographic background, educational experience, and future career plans. Results Of 310 eligible fourth year medical students, complete data was available for 302 students (97%). Students considering emigration ranked salary as more important than students not considering emigration, while students with rural living experience ranked salary as less important than those with no rural experience. Students willing to work in a rural area ranked infrastructure as more important than students who were unwilling, while female students ranked infrastructure as less important than male students. Students who were willing to work in a rural area ranked management style as a more important rural practice attribute than those who were unwilling to work in a rural area. Students studying in Kumasi ranked contract length as more important than those in Accra, while international students ranked contract length as less important than Ghanaian students. Conclusions Interventions to improve rural practice conditions are likely to be more persuasive than salary incentives to Ghanaian medical students who are willing to work in rural environments a priori. Policy experiments should test the impact of these interventions on actual uptake by students upon graduation. PMID:22050704

Entrapment of Victims of Spousal Abuse in Ghana: A Discursive Analysis of Family Identity and Agency of Battered Women.

PubMed

Adjei, Stephen Baffour

2015-06-02

Drawing on discursive psychology and positioning theory, this study explores the influence of cultural and familial value orientations on battered women's identity, agency, and decision to leave or stay in abusive conjugal relationship in Ghana. Two semi-structured focus group discussions and four in-depth personal interviews were conducted with 16 victims of husband-to-wife abuse from rural and urban Ghana. The findings indicate that entrapment of victims of spousal abuse in Ghana reflects their social embeddedness and that battered women's identities and agency are expressed in the context of familial and cultural value orientations. The primacy of family identity and victims' apparent implicit moral obligation to preserve the social image of their extended family influence their entrapment. Participants' discursive accounts further suggest that stay or leave decisions of battered women in Ghana reflect a joint product of negotiated agency between victims and their extended family. It is thus argued that the agency of battered women in Ghana is not constituted by individual psychological states or motives, but instead, viewed as a property of victims who exercise it in a given relational context, and partly constituted by familial relationships and identities. The study suggests that intervention initiatives in Ghana should focus on the phenomenon of conjugal violence beyond immediate victims to include families and the larger communities in which victims are embedded. © The Author(s) 2015.

Medical physics practice and training in Ghana.

PubMed

Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw

2016-06-01

Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Rosmarinic acid content in antidiabetic aqueous extract from ocimum canum sims in Ghana

USDA-ARS?s Scientific Manuscript database

Rosmarinic acid (RA) is an important polyphenol that is found in a variety of herbs including Ocimum canum sims (locally called eme or akokobesa in Ghana). Aqueous extracts from the leaves of O. canum are used as an antidiabetic herbal medicine in Ghana. Analytical TLC was used to examine the compos...

Religious Differences in Modernization of the Family: Family Demographics Trends in Ghana

ERIC Educational Resources Information Center

Heaton, Tim B.; Darkwah, Akosua

2011-01-01

This research examines trends in a broad set of reproductive and marital behaviors in Ghana, focusing on religious group differences. These comparisons provide evidence of how family trends are constrained by religious identity in a less developed country. Three waves of the Ghana Demographic and Health Surveys are used to track trends in the age…

Expectations and Integration of Early Career Academics into the Teaching Career: Empirical Evidence from Ghana

ERIC Educational Resources Information Center

Alabi, Goski; Abdulai, Munkaila

2016-01-01

The preparation and induction of Early Career Academics (ECAs) in Ghana has been investigated using a qualitative study that employed an enumerative-ethnographic approach. The study combined reviews of policy documents, interviews of 50 Deans and Heads of Departments and surveys of ECAs in five purposively selected universities in Ghana to capture…

Risk Factors for Road Transport-Related Injury among Pedestrians in Rural Ghana: Implications for Road Safety Education

ERIC Educational Resources Information Center

Teye-Kwadjo, Enoch

2017-01-01

Objectives: Injuries and mortality resulting from pedestrian road traffic crashes are a major public health problem in Ghana. This study investigated risk factors for road transport-related injury among pedestrians in rural Ghana. Design: Case study design using qualitative data. Method: In-depth interviews were conducted with pedestrians.…

Tertiary Education Policy in Ghana. An Assessment: 1988-1998.

ERIC Educational Resources Information Center

Girdwood, Alison

This study was one of several activities conducted at the end of a 5-year World Bank/Government of Ghana project, the Tertiary Education Project (TEP). This project was designed to assist the government of Ghana with the restructuring and quality enhancement of its tertiary education sector. Although the government had prepared an ambitious reform…

Educational Access in Ghana. Country Policy Brief

ERIC Educational Resources Information Center

Akyeampong, K.; Djangmah, J.; Oduro, A.; Seidu, A.; Hunt, F.

2008-01-01

This Policy Brief describes and explains patterns of access to schools in Ghana. It outlines policy and legislation on access to education and provides an analysis of access, vulnerability and exclusion. It is based on findings from the Country Analytic Report on Access to Basic Education in Ghana (Akyeampong et al, 2007) [ED508809] which can be…

Causes of childhood blindness in Ghana: results from a blind school survey in Upper West Region, Ghana, and review of the literature.

PubMed

Huh, Grace J; Simon, Judith; Grace Prakalapakorn, S

2017-06-13

Data on childhood blindness in Ghana are limited. The objectives of this study were to determine the major causes of childhood blindness and severe visual impairment (SVI) at Wa Methodist School for the Blind in Northern Ghana, and to compare our results to those published from other studies conducted in Ghana. In this retrospective study, data from an eye screening at Wa Methodist School in November 2014 were coded according to the World Health Organization/Prevention of Blindness standardized reporting methodology. Causes of blindness/SVI were categorized anatomically and etiologically, and were compared to previously published studies. Of 190 students screened, the major anatomical causes of blindness/SVI were corneal scar/phthisis bulbi (CS/PB) (n = 28, 15%) and optic atrophy (n = 23, 12%). The major etiological causes of blindness/SVI were unknown (n = 114, 60%). Eighty-three (44%) students became blind before age one year. Of four published blind school surveys conducted in Ghana, CS/PB was the most common anatomical cause of childhood blindness. Over time, the prevalence of CS/PB within blind schools decreased in the north and increased in the south. Measles-associated visual loss decreased from 52% in 1987 to 10% in 2014 at Wa Methodist School. In a blind school in northern Ghana, CS/PB was the major anatomical cause of childhood blindness/SVI. While CS/PB has been the most common anatomical cause of childhood blindness reported in Ghana, there may be regional changes in its prevalence over time. Being able to identify regional differences may guide future public health strategies to target specific causes.

Smoking in Ghana: a review of tobacco industry activity

PubMed Central

Owusu-Dabo, E; Lewis, S; McNeill, A; Anderson, S; Gilmore, A; Britton, J

2009-01-01

Background: African countries are a major potential market for the tobacco industry, and the smoking epidemic is at various stages of evolution across the continent. Ghana is an African country with a low prevalence of smoking despite an active tobacco industry presence for over 50 years. This study explores potential reasons for this apparent lack of industry success. Objective: To explore the history of tobacco industry activity in Ghana and to identify potential reasons for the current low prevalence of smoking. Methods: A search was made of tobacco industry archives and other local sources to obtain data relevant to marketing and consumption of tobacco in Ghana. Findings: British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954. After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006. Conclusion: The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions, which may have restricted industry growth, are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date. PMID:19359263

Career destinations of University of Ghana Medical School graduates of various year groups.

PubMed

Lassey, A T; Lassey, P D; Boamah, M

2013-06-01

To report on the current career destination of the University of Ghana Medical School (UGMS) qualified doctors in the year groups, 1998, 2000, 2003, 2005 and 2008. Interview of doctors from each year group currently working at the Korle-Bu Teaching Hospital corroborated by phone calls to the doctors. All Ghanaian doctors from each graduating year group. 1. Current location of employment in Ghana or abroad, 2. Gender ratios of the doctors retained in Ghana. Three hundred and seventy-two (372) UGMS doctors consisting of 353 Ghanaians and 19 foreign students graduated over the five year groups. Of the 353 Ghanaians, 113 emigrated, while all but one of the 240 living in Ghana, practice medicine. The retention rate improved from 54.2% in 1998 to 86.3% in 2008. The overall retention rate however is 68.0% while the retention rates for the male and female doctors were 69.3% and 64.6% respectively. Of the 177 doctors practicing in Ghana from the first 4 year-groups (i.e. 1998, 2000, 2003 and 2005,) 139 (i.e. 31, 31, 34 and 43 from the respective year groups) have either completed postgraduate training or are in the residency training programme. Thus 78.5% of these doctors working in Ghana have opted for postgraduate training. The establishment of the GCPS and to a lesser extent the introduction of the ADHA before it appear to have slowed down the medical brain drain as more and more doctors avail themselves of the local opportunities. The GCPS therefore needs supporting effectively in order to continue to be a strong incentive for the retention of doctors in Ghana, apart from helping to staff district general hospitals with specialists.

Review: Abortion care in Ghana: A critical review of the literature

PubMed Central

Rominski, Sarah D; Lori, Jody R

2015-01-01

The Government of Ghana has taken important steps to mitigate the impact of unsafe abortion. However, the expected decline in maternal deaths is yet to be realized. This literature review aims to present findings from empirical research directly related to abortion provision in Ghana and identify gaps for future research. A total of four (4) databases were searched with the keywords “Ghana and abortion” and hand review of reference lists was conducted. All abstracts were reviewed. The final include sample was 39 articles. Abortion-related complications represent a large component of admissions to gynecological wards in hospitals in Ghana as well as a large contributor to maternal mortality. Almost half of the included studies were hospital-based, mainly chart reviews. This review has identified gaps in the literature including: interviewing women who have sought unsafe abortions and with healthcare providers who may act as gatekeepers to women wishing to access safe abortion services. PMID:25438507

A comparative analysis of fertility differentials in Ghana and Nigeria.

PubMed

Olatoregun, Oluwaseun; Fagbamigbe, Adeniyi Francis; Akinyemi, Odunayo Joshua; Yusuf, Oyindamola Bidemi; Bamgboye, Elijah Afolabi

2014-09-01

Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries' fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn't significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels.

Radiation Protection, Safety and Security Issues in Ghana.

PubMed

Boadu, Mary; Emi-Reynolds, Geoffrey; Amoako, Joseph Kwabena; Akrobortu, Emmanuel; Hasford, Francis

2016-11-01

Although the use of radioisotopes in Ghana began in 1952, the Radiation Protection Board of Ghana was established in 1993 and served as the national competent authority for authorization and inspection of practices and activities involving radiation sources until 2015. The law has been superseded by an Act of Parliament, Act 895 of 2015, mandating the Nuclear Regulatory Authority of Ghana to take charge of the regulation of radiation sources and their applications. The Radiation Protection Institute in Ghana provided technical support to the regulatory authority. Regulatory and service activities that were undertaken by the Institute include issuance of permits for handling of a radiation sources, authorization and inspection of radiation sources, radiation safety assessment, safety assessment of cellular signal towers, and calibration of radiation-emitting equipment. Practices and activities involving application of radiation are brought under regulatory control in the country through supervision by the national competent authority.

Alcohol consumption, beverage prices and measurement error.

PubMed

Young, Douglas J; Bielinska-Kwapisz, Agnieszka

2003-03-01

Alcohol price data collected by the American Chamber of Commerce Researchers Association (ACCRA) have been widely used in studies of alcohol consumption and related behaviors. A number of problems with these data suggest that they contain substantial measurement error, which biases conventional statistical estimators toward a finding of little or no effect of prices on behavior. We test for measurement error, assess the magnitude of the bias and provide an alternative estimator that is likely to be superior. The study utilizes data on per capita alcohol consumption across U.S. states and the years 1982-1997. State and federal alcohol taxes are used as instrumental variables for prices. Formal tests strongly confim the hypothesis of measurement error. Instrumental variable estimates of the price elasticity of demand range from -0.53 to -1.24. These estimates are substantially larger in absolute value than ordinary least squares estimates, which sometimes are not significantly different from zero or even positive. The ACCRA price data are substantially contaminated with measurement error, but using state and federal taxes as instrumental variables mitigates the problem.

African Regional Seminar for Advanced Training In Systematic Curriculum Development and Evaluation. (Achimota, Ghana, 14 July--15 August 1975). Report.

ERIC Educational Resources Information Center

Swedish International Development Authority (SIDA).

This report summarizes the African Regional Seminar for Advanced Training in Systematic Curriculum Development and Evaluation that was held at Achimota, Ghana, July 14-August 15 1975. Attending the seminar were 67 participants from 12 African countries, including Cameroon, Gambia, Ghana, Kenya, Liberia, Malawi, Nigeria, Sierra Leone, Swaziland,…

Access to English Language Acquisition in Ghana Schools for the Deaf: Are the Deaf Students Handicapped?

ERIC Educational Resources Information Center

Obosu, Gideon Kwesi; Opoku-Asare, Nana Afia; Deku, Prosper

2016-01-01

This paper primarily discusses the challenges deaf students in Ghana are likely to grapple with as they access education provided for them in English language. The arguments discussed in this paper are supported by findings from a multiple site case study of five Schools for the Deaf purposively sampled from four regions of Ghana. Observations…

School Feeding and Educational Access in Rural Ghana: Is Poor Targeting and Delivery Limiting Impact?

ERIC Educational Resources Information Center

Essuman, Ato; Bosumtwi-Sam, Cynthia

2013-01-01

In an effort to address social imbalances and equity in Ghana's education delivery and to achieve her Education for All (EFA) agenda, some pro-poor programmes have been introduced. Among these is the Ghana School Feeding Programme (GSFP) that aims among others, at providing safety nets for the poor, increasing school enrolment in addition to…

A National Vision for Girls' Education in Ghana and a Framework for Action: Charting the Way Forward.

ERIC Educational Resources Information Center

Academy for Educational Development, Washington, DC.

This document presents a national vision for girls' education in Ghana and a strategic framework for achieving that vision. The vision statement is: "All Ghana's girl-children and their brothers are healthy, attend safe, welcoming schools, are well-taught by qualified teachers who understand their needs, achieve according to their potential,…

Rethinking Christian Religious Education in Ghana: History, Challenges and Prospects

ERIC Educational Resources Information Center

Addai-Mununkum, Richardson

2014-01-01

This scholarly essay employs an African philosophical and symbolic construct--Sank?fa--to examine religious education in Ghana. Sank?fa implores the need to examine the past in order to understand the present and to plan for the future. In line with this frame, I recount the history of religious education in Ghana, examine the present challenges,…

Child Labor and Schooling in Ghana. Ghana: Labor Markets and Poverty. Policy Research Working Papers.

ERIC Educational Resources Information Center

Canagarajah, Sudharshan; Coulombe, Harold

This report examines the determinants of child labor in conjunction with school participation trends for children ages 7-14 in Ghana. The report is based on data from national household surveys conducted 1987-92. Specifically, the study examined the influence of variables such as child age and sex; parent's education, religion, and employment; and…

Achieving Quality Education in Ghana: The Spotlight on Primary Education within the Kumasi Metropolis

ERIC Educational Resources Information Center

Boakye-Amponsah, Abraham; Enninful, Ebenezer Kofi; Anin, Emmanuel Kwabena; Vanderpuye, Patience

2015-01-01

Background: Ghana being a member of the United Nations, committed to the Universal Primary Education initiative in 2000 and has since implemented series of educational reforms to meet the target for the Millennium Development Goal (MDG) 2. Despite the numerous government interventions to achieve the MDG 2, many children in Ghana have been denied…

Organizational Justice and Job Satisfaction as Predictors of Turnover Intentions among Teachers in the Offinso South District of Ghana

ERIC Educational Resources Information Center

Addai, Prince; Kyeremeh, Evans; Abdulai, Wahab; Sarfo, Jacob Owusu

2018-01-01

There is high incidence of teachers' agitation for a better pay and other conditions of service in Ghana. This study assessed the influence of job satisfaction and organizational justice on turnover intentions among teachers. One hundred and fourteen teachers at the Offinso South District of Ghana were conveniently selected to complete the…

What Is the Effect of Child Labour on Learning Achievement? Evidence from Ghana. Innocenti Working Papers.

ERIC Educational Resources Information Center

Heady, Christopher

This paper reports on a study that analyzed the links between child labor and poor school performance. Using data gathered in Ghana in recent years through the administration of tests, the study measured reading achievement and mathematics achievement to about half of the individuals surveyed as part of the Ghana Living Standards Survey. The paper…

Ghana watershed prototype products

USGS Publications Warehouse

,

2007-01-01

A number of satellite data sets are available through the U.S. Geological Survey (USGS) for monitoring land surface features. Representative data sets include Landsat, Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), and Shuttle Radar Topography Mission (SRTM). The Ghana Watershed Prototype Products cover an area within southern Ghana, Africa, and include examples of the aforementioned data sets along with sample SRTM derivative data sets.

The State of Information and Communication Technology and Health Informatics in Ghana

PubMed Central

Achampong, Emmanuel Kusi

2012-01-01

Information and Communication Technology (ICT) has become a major tool in delivery of health services and has had an innovative impact on quality of life. ICT is affecting the way healthcare is delivered to clients. In this paper, we discuss the state of ICT and health informatics in Ghana. We also discuss the state of various relevant infrastructures for the successful implementation of ehealth projects. We analyse the past and present state of health informatics in Ghana, in comparison to other African countries. We also review the challenges facing successful implementation of health informatics projects in Ghana and suggest possible solutions. PMID:23569633

What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana.

PubMed

Dickson, Kwamena Sekyi; Adde, Kenneth Setorwu; Amu, Hubert

2016-01-01

Background . There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods . The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results . Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner's education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35-26.4) more likely to deliver at a health facility than the poorest women. Conclusions . It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner's education, parity, and distance in their planning regarding delivery care in rural Ghana.

Microbial food safety in Ghana: a meta-analysis.

PubMed

Saba, Courage K S; Gonzalez-Zorn, Bruno

2012-12-16

Food safety is a crucial factor in the growth of developing countries worldwide. In this study, we present a meta-analysis of microbiological food safety publications from Ghana. The search words "Ghana food safety", "Ghana food research", and "Ghana food bacteria" were used to search for microbiological food safety publications with related abstracts or titles in PubMed, published between 1997 and 2009. We obtained 183 research articles, from which we excluded articles concerning ready-to-eat microbial fermented foods and waterborne microorganisms as well as articles without abstracts. The criteria used for analysis of these publications were based on an assessment of methodological soundness previously developed for use in the medical field, with some modifications incorporated. The most predominant bacteria in Ghanain foods are Enterobacter spp., Citrobacter spp., Klebsiella spp. and Escherichia spp., which were found to be present in 65%, 50%, 46% and 38% respectively, of the food samples considered in the studies analysed. The most contaminated food samples were macaroni, salad, and milk. Although the methodological quality of the articles was generally sound, most of them did not give directions for future research. Several did not state possible reasons for differences between studies. The microbiological food contamination in Ghana is alarming. However, we found that the downward trend in publications of microbial food safety articles is appalling. Hence a concerted effort in research on food safety is needed in Ghana to help curb the incidence of preventable food-borne disease.

Dropping Out of School in Southern Ghana: The Push-Out and Pull-Out Factors. CREATE Pathways to Access. Research Monograph No. 55

ERIC Educational Resources Information Center

Ananga, Eric

2011-01-01

Addressing school dropout has been one of the most controversial elements of policy since the introduction of free compulsory universal basic education (FCUBE) in Ghana. However, research that utilises qualitative biographical detail surrounding irregular attendance and the critical events in the process that lead to dropout in Ghana is limited. I…

The Impact of Sex Education on Teenage Pregnancy in Basic Schools of Bawku Municipal District in Ghana

ERIC Educational Resources Information Center

Donkor, Anthony Kudjo; Lariba, Azure Love

2017-01-01

The incidence of teenage pregnancy has been on the rise in Ghana, especially in the Bawku-East Municipality. In Ghana adults rarely discussed sexual matters with the youth. Thus, the youth have little or no information about the biological changes that take place in their bodies during the transitional period from youth to adulthood. This has…

Promoting Socio-Economic Development: How Mobile Telephony Is an Agent for Creating High-Paying Jobs in Ghana from the Service Providers' Perspective

ERIC Educational Resources Information Center

Boateng, Ofori

2011-01-01

This exploration study examined solely, mobile telephony (which is an important aspect of ICTs) and how it promotes the creation of high-paying jobs that positively impact socio-economic development in Ghana from the service providers. perspective. This academic study focusing solely on Ghana mobile telephony service providers is the first of its…

No Pending National Elections, Who Cares? What Newspaper Publications Reveal about Local Efforts Towards Millennium Development Goal 3

ERIC Educational Resources Information Center

Arku, Frank S.; Arku, Cynthia

2013-01-01

The Millennium Development Goals (MDGs) has become a catch phrase in development discourse. This study is an assessment of the MDG 3: to promote gender equality at all levels of education in Ghana. The Daily Graphic (a newspaper in Ghana) which is Ghana's prominent newspaper was reviewed from 2000 to 2011 to determine the frequency of articles…

Influence and Challenges of the Capitation Grant on Education Delivery in Basic Schools in Ghana

ERIC Educational Resources Information Center

Pajibo, Edison; Tamanja, Emmanuel M. J.

2017-01-01

In Ghana, some children do not attend school, because their parents are unable to afford levies and fees charged by schools. This led to the introduction of the Capitation Grant Scheme in 2005. This study investigates the influence of the Capitation Grant Scheme on education delivery in basic schools in Ghana, through a close study of the Ga West…

Assessment of the Policy Guidelines for the Teaching and Learning of Geography at the Senior High School Level in Ghana

ERIC Educational Resources Information Center

Ababio, Bethel T.; Dumba, Hillary

2014-01-01

This article empirically assessed the extent to which geography teachers adhered to the Ghana Education Service policy guidelines on the teaching of geography at the Senior High School Level in Ghana. Census survey was used to collect data from seven geography teachers because of the researchers' objective of gaining a quick insight into the…

Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path.

PubMed

Al-Bader, Sara; Daar, Abdallah S; Singer, Peter A

2010-12-13

Science, technology and innovation have long played a role in Ghana's vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana's capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana's health innovation system. Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently. Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development. While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system.

Assessing the impoverishment effects of out-of-pocket healthcare payments prior to the uptake of the national health insurance scheme in Ghana.

PubMed

Akazili, James; Ataguba, John Ele-Ojo; Kanmiki, Edmund Wedam; Gyapong, John; Sankoh, Osman; Oduro, Abraham; McIntyre, Di

2017-05-22

There is a global concern regarding how households could be protected from relatively large healthcare payments which are a major limitation to accessing healthcare. Such payments also endanger the welfare of households with the potential of moving households into extreme impoverishment. This paper examines the impoverishing effects of out-of-pocket (OOP) healthcare payments in Ghana prior to the introduction of Ghana's national health insurance scheme. Data come from the Ghana Living Standard Survey 5 (2005/2006). Two poverty lines ($1.25 and $2.50 per capita per day at the 2005 purchasing power parity) are used in assessing the impoverishing effects of OOP healthcare payments. We computed the poverty headcount, poverty gap, normalized poverty gap and normalized mean poverty gap indices using both poverty lines. We examine these indicators at a national level and disaggregated by urban/rural locations, across the three geographical zones, and across the ten administrative regions in Ghana. Also the Pen's parade of "dwarfs and a few giants" is used to illustrate the decreasing welfare effects of OOP healthcare payments in Ghana. There was a high incidence and intensity of impoverishment due to OOP healthcare payments in Ghana. These payments contributed to a relative increase in poverty headcount by 9.4 and 3.8% using the $1.25/day and $2.5/day poverty lines, respectively. The relative poverty gap index was estimated at 42.7 and 10.5% respectively for the lower and upper poverty lines. Relative normalized mean poverty gap was estimated at 30.5 and 6.4%, respectively, for the lower and upper poverty lines. The percentage increase in poverty associated with OOP healthcare payments in Ghana is highest among households in the middle zone with an absolute increase estimated at 2.3% compared to the coastal and northern zones. It is clear from the findings that without financial risk protection, households can be pushed into poverty due to OOP healthcare payments. Even relatively richer households are impoverished by OOP healthcare payments. This paper presents baseline indicators for evaluating the impact of Ghana's national health insurance scheme on impoverishment due to OOP healthcare payments.

Health psychology in Ghana: A review of the multidisciplinary origins of a young sub-field and its future prospects.

PubMed

de-Graft Aikins, Ama

2018-03-01

This article presents a historical overview of psychology applied to health and health psychology in Ghana. A brief history of health, illness and healthcare in Ghana is introduced. Then, the history of psychology in Ghana is presented, with signposts of the major turns in the field in relation to psychology and other disciplines applied to health and the emergence of health psychology as a sub-field. Selected health psychology studies are reviewed to highlight ideological trends in the field. Finally, future prospects are considered in terms of how the sub-field can transition into an established critical field with unique contributions to make to global health psychology.

The changing face of women in physics in Ghana

NASA Astrophysics Data System (ADS)

Andam, Aba Bentil; Amponsah, Paulina Ekua; Nsiah-Akoto, Irene; Gyamfi, Kwame; Hood, Christiana Odumah

2013-03-01

Ghana is said to be the first independent sub-Saharan African country outside South Africa to promote science education and the application of science in industrial and social development. It has long been recognized that many schools' science curricula extend the extracurricular activities of boys more than those of girls. In order to bridge this gap, efforts have been made to give girls extra assistance in the learning of science by exposing them to science activities through specific camps, road shows, exhibitions, and so on. The best known of such efforts is the Science, Technology, and Mathematics Education (STME) camps and clinics for girls, which started in Ghana 23 years ago. Since our attendance at the Third International Conference on Women in Physics in Seoul, Korea, a lot has been achieved to further improve female science education, and this credit goes to STME. The first female nuclear engineer from Ghana graduated from the University of Ghana in March 2010.

Prevalence and correlates of contraceptive use among female adolescents in Ghana.

PubMed

Nyarko, Samuel H

2015-08-19

Adolescence is a critical stage in the life course and evidence suggests that even though contraceptive use has been steadily increasing among women in Ghana over the past years, contraceptive prevalence and determinants among female adolescents is quite lacking. This paper examines the prevalence and correlates of contraceptive use among female adolescents in Ghana. The paper used data from the 2008 Ghana Demographic and Health survey. Bivariate analysis was carried out to determine the contraceptive prevalence among female adolescents while logistic regression analysis was applied to examine the correlates of female adolescent contraceptive use. The study founded that female adolescent contraceptive use was significantly determined by age of adolescent, education, work status, knowledge of ovulatory cycle, visit of health facility and marital status. This has implications for adolescent sexual and reproductive health programmes in Ghana. It is therefore essential to intensify girl child education and strengthen the provision of family planning information and services for female adolescents in the country.

Debated agronomy: public discourse and the future of biotechnology policy in Ghana.

PubMed

Braimah, Joseph A; Atuoye, Kilian N; Vercillo, Siera; Warring, Carrie; Luginaah, Isaac

2017-01-01

This paper examines the highly contested and ongoing biotechnology (Bt) policy-making process in Ghana. We analyse media content on how Bt is viewed in the context of Ghana's parliamentary debate on the Plant Breeders Bill and within the broader public policy-making literature. This paper does not seek to take a position on Bt or the Bill, but to understand how policy actors influence the debate with political and scientific rhetoric in Ghana. The study reveals that in the midst of scientific uncertainties of Bt's potential for sustainable agriculture production and food security, policy decisions that encourage its future adoption are heavily influenced by health, scientific, economic, environmental and political factors dictated by different ideologies, values and norms. While locally pioneered plant breeding is visible and common in the Ghanaian food chain, plant breeding/GMOs/Bt from international corporations is strongly resisted by anti-GMO coalitions. Understanding the complex and messy nature of Bt policy-making is critical for future development of agricultural technology in Ghana and elsewhere.

An Analysis of Factors Influencing Urbanite Woman Learner-Participation in Functional Literacy Programs in Selected Christian Churches, Accra

ERIC Educational Resources Information Center

Saah, Albert Amoah

2013-01-01

The promotion of adult functional literacy programs per se, neither creates the necessary motivation for learning, nor enhances the participation of adult learners in work-oriented or socio-cultural functional literacy programs. The task in learning-teaching transaction is to create the enabling environment for harnessing and enhancing…

Introduction of Core Based Subjects in the Curriculum of Technical and Vocational Institutions in Ghana: Assessment of Its Effect on Practical Training Sessions

ERIC Educational Resources Information Center

William, Otu

2015-01-01

Technical education among other things focuses on training the skill manpower needs of the youth in most countries of which Ghana is no exception. This study looks at Ghana Education Service technical and vocational sector reform programme introduced in 2010 with emphasis on the introduction of compulsory core based subjects and its effect on…

Approaches for Advancing Girls' Education in Ghana: A Symposium To Examine Current Practices and Identify Future Directions (1st, Ajumako, Central Region, Ghana, June 25-26, 2001).

ERIC Educational Resources Information Center

Academy for Educational Development, Washington, DC.

The Girls' Education Unit (GEU) of the Basic Education Division of Ghana Education Service (GES) organized this Approaches for Advancing Girls' Education (AAGE) symposium to address the issues of girls' education, to construct a comprehensive picture of what interventions related to girls' education are currently being implemented, and identify…

The Challenge of Financing Higher Education and the Role of Student Loans Scheme: An Analysis of the Student Loan Trust Fund (SLTF) in Ghana

ERIC Educational Resources Information Center

Atuahene, Francis

2008-01-01

Student loans program is one of the most controversial phenomena in financing higher education in Ghana, but its importance as a cost sharing mechanism is incontestable. This paper describes the challenge of financing higher education in Ghana. It provides a critique of the Social Security and National Insurance Trust (SSNIT) Student Loans Scheme,…

The Effect of Performance Assessment-Driven Instruction on the Attitude and Achievement of Senior High School Students in Mathematics in Cape Coast Metropolis, Ghana

ERIC Educational Resources Information Center

Arhin, Ato Kwamina

2015-01-01

The study was a quasi-experimental research project conducted to investigate the effect of performance assessment-driven instructions on the attitude and achievement in mathematics of senior high school students in Ghana at Ghana National College in Cape Coast. Two Form 1 science classes were used for the study and were assigned as experimental…

An examination of environmental correlates with childhood height-for-age in Ghana.

PubMed

Nikoi, Ebenezer; Anthamatten, Peter

2013-01-01

The relationship between a child's environment and nutritional status is difficult to examine yet could offer an important guide to policy. The objective of the present work was to examine individual and environmental correlates with childhood height-for-age in Ghana. Data were derived from the 2008 MEASURE Demographic and Health Survey in Ghana, the 2000 Ghana Population and Housing Census, and the World Wide Fund for Nature's eco-regions database. A generalized linear mixed regression model was used to estimate the effects of individual and environmental correlates on height-for-age. The study examined 2225 Ghanaian children aged 0-59 months. The setting was all districts in Ghana for the year 2008. After accounting for individual characteristics of children, mothers and households, height-for-age was significantly associated with population density. Other significantly associated variables in the final model were the age of the child, vaccination status, the size of the child at birth, months of breast-feeding, mother's BMI, whether the child's mother had health insurance and wealth quintile. In addition to a number of characteristics of the children and their households, the social milieu is important to understanding differences in height-for-age among children in Ghana. The biophysical environment was not associated with height-for-age.

Exploring the linkage between exposure to mass media and HIV testing among married women and men in Ghana.

PubMed

Sano, Yujiro; Sedziafa, Alice P; Amoyaw, Jonathan A; Boateng, Godfred O; Kuuire, Vincent Z; Boamah, Sheila; Kwon, Eugena

2016-01-01

Although HIV testing is critical to the treatment and prevention of HIV/AIDS, utilization rate of HIV testing services among married women and men remains low in Ghana. Mass media, as a tool to increase overall HIV testing turnouts, has been considered one of the important strategies in promoting and enhancing behavioural changes related to HIV/AIDS prevention. Using the 2014 Ghana Demographic and Health Survey, the current study examines the relationship between levels of exposure to print media, radio, and television and the uptake of HIV testing among married women and men in Ghana. Results show that HIV testing is more prevalent among married women than their male counterparts. We also find that higher levels of exposure to radio is associated with HIV testing among women, while higher levels of exposure to print media and television are associated with HIV testing among men. Implications of these findings are discussed for Ghana's HIV/AIDS strategic framework, which aims to expanding efforts at dealing with the HIV/AIDS epidemic. Specifically, it is important for health educators and programme planners to deliver HIV-related messages through television, radio, and print media to increase the uptake of HIV testing particularly among married women and men in Ghana.

Effect of timely initiation of breastfeeding on child health in Ghana.

PubMed

Fosu-Brefo, Rita; Arthur, Eric

2015-01-01

Early initiation of breastfeeding and exclusive breastfeeding practices have been argued to be one of the important ways of ensuring child health. Unfortunately, owing to modernization, most nursing mothers fail to adhere to such practices. This is believed to be a factor contributory to poor child health in Ghana. Thus, this study investigated the effect of timely initiation of breastfeeding on child health in Ghana. Cross sectional data using secondary data based on the positivism approach to research was employed. The Ordinary least squares and the Instrumental variables approach were used in estimating the effect of breastfeeding and other socio demographic indicators on the health of the child. Data for the study was sourced from the 2008 round of the Ghana Demographic and Health Survey. The results indicate that timely initiation of breastfeeding, both immediately and hours after birth are important factors that influence the child's health. Additionally, factors such as the wealth of the household, mother's education, age and size of the child at birth and age of the mother are important factors that also influence the health of the child in Ghana. The findings imply that efforts should be made on encouraging appropriate breastfeeding practices among nursing mothers to ensure proper child development and growth in Ghana.

Reproductive health laws and fertility decline in Ghana.

PubMed

Finlay, Jocelyn E; Fox, Ashley M

2013-11-01

An unresolved debate in demography concerns the causal sequence between the supply of contraception and the demand for smaller families in fertility decline. Through a mixed-methods approach, we explored the effect of a sudden increase in access to legal abortion on subsequent fertility decline when Ghana's criminal code was amended in 1985. Using Ghana Demographic and Health Surveys, we constructed a panel of women aged 15-34 years and undertook a spline regression analysis to examine the effect of legal changes in 1985 and fertility decline controlling for social determinants of fertility. In addition, we conducted 17 key informant interviews (KIIs) to understand the reasons for the legal change and competing explanations for fertility decline. Multivariate results indicated that the timing of the liberalization of the abortion law coincided with the onset of Ghana's fertility decline. The KIIs indicated that the reasons for the liberalization of reproductive health laws were in response to famine and physician advocacy. While the timing of the abortion law liberalization coincided with the fertility decline in Ghana, we are unable to decouple the effect of the legal change from the effects of a severe famine that affected the region at the same time. Further research on documented and undocumented abortion in Ghana should be conducted to validate the contribution of legal abortion to fertility decline. © 2013.

Destigmatising abortion: expanding community awareness of abortion as a reproductive health issue in Ghana.

PubMed

Lithur, Nana Oye

2004-04-01

Traditional and cultural values, social perceptions, religious teachings and criminalisation have facilitated stigmatisation of abortion in Ghana. Abortion is illegal in Ghana except in three instances. Though the law allows for performance of abortion in three circumstances, the Ghana reproductive health service policy did not have any induced legal abortion services component to cover the three exceptions until it was revised in 2003. The policy only had 'unsafe and post-abortion' care components, and abortions performed in health facilities operated by the Ghana Health Service were performed under this component. Though the policy has been revised, women and girls who need abortion services in Ghana more often resort to the backstreet dangerous methods and procedures. Criminalisation of abortion and those who perform abortions has contributed to unsafe abortion, the second leading cause of maternal deaths in Ghana. Most of these are performed outside the formal health service structures. Traditionally, abortion is perceived as a shameful act and the community may shun and give a woman who has caused anabortion derogatory names. Would provision of legal abortion services be culturally acceptable within a Ghanaian community? Yes, if they are made aware of the reproductive health benefits of providing safe abortion services. Three major strategies that would help to destigmatise abortion in the community are (1) the liberal interpretation of the three exceptions to the law on abortion; (2) expanding community awareness of its reproductive health benefits; and (3) improving and increasing access to legal abortion services within the formal health facilities.

Who is utilizing anti-retroviral therapy in Ghana: An analysis of ART service utilization

PubMed Central

2012-01-01

Introduction The global scale-up of antiretroviral therapy (ART) for HIV patients has led to concerns regarding inequities in utilization of ART services in resource-limited contexts. In this paper, we describe regional and sex differentials in the distribution of ART among adult HIV patients in Ghana. We highlight the need for interventions to address the gender-based and geographic inequities related to the utilization of ART services in Ghana. Methods We reviewed National AIDS/STIs Control Program’s ART service provision records from January 2003 through December 2010, extracting data on adults aged 15+ who initiated ART in Ghana over a period of eight years. Data on the number of patients on treatment, year of enrollment, sex, and region were obtained and compared. Results The number of HIV patients receiving ART in Ghana increased more than 200-fold from 197 in 2003, to over 45,000 in 2010. However, for each of six continuous years (2005-2010) males comprised approximately one-third of adults newly enrolled on ART. As ART coverage has expanded in Ghana, the proportion of males receiving ART declined from 41.7% in 2004 to 30.1% in 2008 and to 27.6% in 2010. Also, there is disproportionate regional ART utilization across the country. Some regions report ART enrollment lower than their percent share of number of HIV infected persons in the country. Conclusions Attention to the comparatively fewer males initiating ART, as well as disproportionate regional ART utilization is urgently needed. All forms of gender-based inequities in relation to HIV care must be addressed in order for Ghana to realize successful outcomes at the population level. Policy makers in Ghana and elsewhere need to understand how gender-based health inequities in relation to HIV care affect both men and women and begin to design appropriate interventions. PMID:23072340

Distribution of causes of maternal mortality among different socio-demographic groups in Ghana; a descriptive study.

PubMed

Asamoah, Benedict O; Moussa, Kontie M; Stafström, Martin; Musinguzi, Geofrey

2011-03-10

Ghana's maternal mortality ratio remains high despite efforts made to meet Millennium Development Goal 5. A number of studies have been conducted on maternal mortality in Ghana; however, little is known about how the causes of maternal mortality are distributed in different socio-demographic subgroups. Therefore the aim of this study was to assess and analyse the causes of maternal mortality according to socio-demographic factors in Ghana. The causes of maternal deaths were assessed with respect to age, educational level, rural/urban residence status and marital status. Data from a five year retrospective survey was used. The data was obtained from Ghana Maternal Health Survey 2007 acquired from the database of Ghana Statistical Service. A total of 605 maternal deaths within the age group 12-49 years were analysed using frequency tables, cross-tabulations and logistic regression. Haemorrhage was the highest cause of maternal mortality (22.8%). Married women had a significantly higher risk of dying from haemorrhage, compared with single women (adjusted OR = 2.7, 95%CI = 1.2-5.7). On the contrary, married women showed a significantly reduced risk of dying from abortion compared to single women (adjusted OR = 0.2, 95%CI = 0.1-0.4). Women aged 35-39 years had a significantly higher risk of dying from haemorrhage (aOR 2.6, 95%CI = 1.4-4.9), whereas they were at a lower risk of dying from abortion (aOR 0.3, 95% CI = 0.1-0.7) compared to their younger counterparts. The risk of maternal death from infectious diseases decreased with increasing maternal age, whereas the risk of dying from miscellaneous causes increased with increasing age. The study shows evidence of variations in the causes of maternal mortality among different socio-demographic subgroups in Ghana that should not be overlooked. It is therefore recommended that interventions aimed at combating the high maternal mortality in Ghana should be both cause-specific as well as target-specific.

Comparative Review of Selected Educational Policies of 1st and 2nd Cycle Institutions in Ghana and Burkina Faso, and That of United Kingdom and United States

ERIC Educational Resources Information Center

Kumi, Asamoah Moses; Seidu, Abarichie Adamu

2017-01-01

This article examines some selected Educational Policies of First and Second Cycle Institutions in Ghana and Burkina Faso, in comparison with that of the UK and US. The purpose of the study is to itemise the commonalities and differences in Educational Policies of both developed (UK and US) and developing countries (Ghana and Burkina Faso) in…

A Comparison of the Six Principles of the Individuals with Disabilities Education Improvement Act of the United States and the Persons with Disability Act of Ghana

ERIC Educational Resources Information Center

Mumuni, Samad Dimbie

2010-01-01

This study compared the six principles of IDEIA of the United States and the Persons with Disability Act of Ghana with the view to determining their similarities and differences. Recommendations were made with the ultimate aim of exploring the need for change in the special education delivery systems in the United States and Ghana. The comparative…

Women, microcredit and family planning practices: a case study from rural Ghana.

PubMed

Norwood, Carolette

2011-01-01

This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis.

PubMed

Odeyemi, Isaac A O; Nixon, John

2013-01-22

Nigeria and Ghana have recently introduced a National Health Insurance Scheme (NHIS) with the aim of moving towards universal health care using more equitable financing mechanisms. This study compares health and economic indicators, describes the structure of each country's NHIS within the wider healthcare system, and analyses impacts on equity in financing and access to health care. The World Bank and other sources were used to provide comparative health and economic data. Pubmed, Embase and EconLit were searched to locate studies providing descriptions of each NHIS and empirical evidence regarding equity in financing and access to health care. A diagrammatical representation of revenue-raising, pooling, purchasing and provision was produced in order to analyse the two countries' systems. Over the period 2000-2010, Ghana maintained a marked advantage in life expectancy, infant mortality, under-5 year mortality, and has a lower burden of major diseases. Health care expenditure is about 5% of GDP in both countries but public expenditure in 2010 was 38% of total expenditure in Nigeria and 60% in Ghana. Financing and access are less equitable in Nigeria as, inter alia, private out-of-pocket expenditure has fallen from 80% to 66% of total spending in Ghana since the introduction of its NHIS but has remained at over 90% in Nigeria; NHIS membership in Nigeria and Ghana is approximately 3.5% and 65%, respectively; Nigeria offers a variable benefits package depending on membership category while Ghana has uniform benefits across all beneficiaries. Both countries exhibit improvements in equity but there is a pro-rich and pro-urban bias in membership. Major health indicators are more favourable in Ghana and overall equity in financing and access are weaker in Nigeria. Nigeria is taking steps to expand NHIS membership and has potential to expand its public spending to achieve greater equity. However, heavy burdens of poverty, disease and remote settings make this a substantial challenge. Ghana's relative success has to be tempered by the high number of exemptions through taxation and the threat of moral hazard. The results and methods are anticipated to be informative for policy makers and researchers in both countries and other developing countries more widely.

Public Health Burden of Hearing Impairment and the Promise of Genomics and Environmental Research: A Case Study in Ghana, Africa.

PubMed

Adadey, Samuel Mawuli; Awandare, Gordon; Amedofu, Goffrey Kwabla; Wonkam, Ambroise

2017-11-01

Hearing impairment (HI) is one of the most disabling conditions of major global health burden that contributes adversely to the social and economic development of a country, if not managed properly. A proper assessment of the nationwide burden and etiology of HI is instrumental in the prevention, treatment, and management of the condition. This article sought to perform an expert review of HI in Ghana to determine the present knowledge of its burden and possible causes of the condition. A literature search was conducted in PubMed using the following keywords: "hearing loss" OR "hearing impairment" OR "deafness" AND "Ghana." The literature was scanned until July 20, 2017, with specific inclusion of targeted landmark and background articles on HI. From the search, 18 of out 5869 articles were selected and considered for the review. The results of the search indicated that there were no extensive studies to determine the national burden of HI in Ghana. However, the few studies assessed suggested that the disease is either acquired or inherited. The burden of acquired HI was higher in adults than children, women than men, and people working in a noisy environment. Regarding the genetic cause, specific founder mutations in GJB2 gene (R143W, L79P, V178A, R184Q, A197S, I203K, and L214P) was the only identified genetic cause of HI in Ghana, but the other HI genes were not investigated. There has been some modest effort to study HI in Ghana, but comprehensive studies on the genetic and environmental etiologies (using the "multi-OMICS" approaches), classification, and burden of HI on Ghana are needed.

Prevalence of HIV and hepatitis B coinfection in Ghana: a systematic review and meta-analysis.

PubMed

Agyeman, Akosua Adom; Ofori-Asenso, Richard

2016-01-01

Human immunodeficiency virus (HIV) and hepatitis B virus (HBV) coinfection has been associated with higher morbidity and mortality and may impact significantly on healthcare resource utilization. However, in Ghana, accurate estimates of the prevalence of HIV/HBV coinfection needed to inform policy decisions and the design of public health interventions are currently lacking. In this study, our aim was to determine the HIV/HBV coinfection prevalence rate in Ghana. Primary studies reporting prevalence of HIV/HBV coinfection in Ghana were retrieved through searches conducted in PubMed, science direct, Google scholar and Africa journals online (AJOL) databases. The websites of the Ministry of Health and Ghana Health Service were also searched for related reports or reviews. Additionally, the online repository of two leading Ghanaian universities were searched to identify unpublished thesis related to the subject. All online searches were conducted between 01/03/2016 and 12/03/2016. Further searches were conducted through reference screening of retrieved papers. Twelve (12) studies published between 1999 and 2016 and conducted across seven (7) regions of Ghana were included in this review. The three (3) regions with no studies' representation were Upper East, Upper West and Central regions. The 12 included studies involved a total of 8162 HIV patients. The reported HIV/HBV coinfection prevalence rates ranged from 2.4 to 41.7 %. The pooled HIV/HBV coinfection prevalence rate was determined as 13.6 % (95 % CI 10.2-16.8 %; P < 0.001). In Ghana, about one in seven HIV patients may be also be chronically infected with HBV. Preventive interventions and strategic policy directions including systematic screening of all newly diagnosed HIV cases for coinfection will be needed, so as to improve management strategies for HBV infection and antiretroviral therapy (ART) implementation.

"Ghana faces ecological disaster".

PubMed

Asmah, G F

1990-05-01

The rate of deforestation in Ghana is alarming and urgent steps need to be taken to reverse the trend, Robert D. Mann, a British tropical agriculturist, has warned. He says, "There will be further disintegration of the local climate, deterioration of soil fertility and reduced food-crop production, if the present trend of denudation by felling trees and uncontrolled bush fires is not halted and reversed." Mann, who has conducted research on "deforestation, drought and famine in Africa" was in Ghana recently to speak on the "role of the Church in West Africa in stimulating action to combat desertification". Representatives of protestant churches in Ghana, Togo, Liberia, Gambia, Nigeria, Cote d'Ivoire and Sierra Leone attended the 3-day conference which was organized by the Overseas Department of the British Methodist Church. It was to enable participants to share perspectives on the nature, scale and seriousness of the deforestation problem. Participants also exchanged experiences on village-based projects for promoting tree planting and agro-forestry, and developed strategies for the rural development programs. Robert Mann noted that Ghana was not only affected by its proximity to the Sahel, but also by its own deforestation. The situation in Ghana, once renowned for her extensive forests and woodland, has now drastically changed. By 1980/81 the area of closed forest had been reduced to 17,000 sq km from 47,9000 sq km in 1937/38. He said in 1939 the volume of wood exported from Ghana was 42,450 cubic meters but it rose to 1,471,600 cubic meters by 1987. Such activities, Mann said, put severe strain on the environment and affected both the economy and sociocultural basis of the country. full text

Medicinal plants and finished marketed herbal products used in the treatment of malaria in the Ashanti region, Ghana.

PubMed

Komlaga, Gustav; Agyare, Christian; Dickson, Rita Akosua; Mensah, Merlin Lincoln Kwao; Annan, Kofi; Loiseau, Philippe M; Champy, Pierre

2015-08-22

Ethnobotanical survey was performed to document medicinal plants employed in the management of malaria in the Bosomtwe and Sekyere East Districts of the Ashanti Region (Ghana), in comparison with the plant ingredients in herbal antimalarial remedies registered by the Ghana Food and Drug Administration. Two hundred and three (203) herbalists from 33 communities within the two districts were interviewed on medicinal plants they use to manage malaria. A literature search was made to determine already documented plants. In addition, 23 finished marketed herbal products indicated for the management of malaria were identified and their labels examined to find out which of the plants mentioned in our survey were listed as ingredients and whether these products are in anyway regulated. Ninety-eight (98) species of plants were cited for the management of malaria. In comparison with literature citations, 12 (12.2%) species were reported for the management of malaria for the first time and 20 (20.4%) others for the first time in Ghana. Twenty-three (23) finished marketed herbal antimalarial products examined contained aerial or underground parts of 29 of the plants cited in our survey as ingredients. Twenty-two (22) of these products have been registered by the Ghana Food and Drugs Authority, four (4) of which were included in the recommended herbal medicine list for treating malaria in Ghana. This study provides new additions to the inventory of medicinal plants used for the management of malaria and reports the commercial availability and regulation of finished marketed labelled herbal products intended for the treatment of malaria in Ghana. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana.

PubMed

Ohene-Yeboah, Michael; Beard, Jessica H; Frimpong-Twumasi, Benjamin; Koranteng, Adofo; Mensah, Samuel

2016-04-01

Inguinal hernia is thought to be common in rural Ghana, though no recent data exist on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings. Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia. Men with hernia completed a survey on demographics, knowledge of the disease, and barriers to surgical treatment. A total of 803 participants were examined, while 105 participants completed the survey. The prevalence of inguinal hernia was 10.8 % (95 % CI 8.0, 13.6 %), and 2.2 % (95 % CI 0, 5.4 %) of participants had scars indicative of previous repair, making the overall prevalence of treated and untreated inguinal hernia 13.0 % (95 % CI 10.2, 15.7 %). Prevalence of inguinal hernia increased with age; 35.4 % (95 % CI 23.6, 47.2 %) of men aged 65 and older had inguinal hernia. Untreated inguinal hernia was associated with lower socio-economic status. Of those with inguinal hernia, 52.4 % did not know the cause of hernia. The most common reason cited for failing to seek medical care was cost (48.2 %). Although inguinal hernia is common among adult men living in rural Ghana, surgical repair rates are low. We propose a multi-faceted public health campaign aimed at increasing access to safe hernia repair in Ghana. This approach includes a training program of non-surgeons in inguinal hernia repair headed by the Ghana Hernia Society and could be adapted for use in other low-resource settings.

Nutrition sensitivity of the 2014 budget statement of Republic of Ghana.

PubMed

Laar, Amos; Aryeetey, Richmond N O; Akparibo, Robert; Zotor, Francis

2015-11-01

Ghana's Constitution and several international treaties she has ratified demonstrate support for fundamental human rights to nutrition and freedom from hunger. However, it is unknown how this support is being translated into investment in nutrition. National budgets are important vehicles through which governments communicate intent to address pertinent national challenges. The present paper assesses the nutrition sensitivity of Ghana's budget statement for the year ending 31 December 2014. We perused the budget in its entirety, examining allocations to various sectors with the goal of identifying support for direct nutrition interventions. We examined allocations to various sectors as per cent of gross domestic product (GDP). The review shows that the total revenue and grants for the 2014 fiscal year is Ghana Cedis (GH¢) 26 001·9 million (25 % of GDP). The total expenditure for the same period is estimated at GH¢34 956·8 million (33·1 % of GDP). The health sector is allocated GH¢3 353 707 814 (3·8 % of GDP). As of 28 October 2014, the Bank of Ghana's Official Exchange Rate was US$1 = GH¢3·20. It is one of the key sectors whose interventions directly or indirectly impact on nutrition. However, the proportion of the national budget that goes to direct nutrition interventions is not evident in the budget. Nutrition is embedded in other budget lines. Allocations to relevant nutrition-sensitive sectors are very low (<0·5 % of GDP). We conclude that Ghana's 2014 budget statement pays scant attention to nutrition. By embedding nutrition in other budget lines, Ghana runs the risk of perpetually rolling out national spending actions insensitive to nutrition.

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-01-01

The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Electronic search was done for literature published between 2003-2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients' trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors.

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

PubMed Central

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward; Arhinful, Daniel Kojo

2016-01-01

Background The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Methods Electronic search was done for literature published between 2003–2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Results Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients’ trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. Conclusions The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors. PMID:27832082

Yaws

MedlinePlus

... in 5 countries (Congo, Ghana, Papua New Guinea, Solomon Islands and Vanuatu) has provided promising results and ... in 5 countries (Congo, Ghana, Papua New Guinea, Solomon Islands and Vanuatu) has provided promising results and ...

The law criminalizing attempted suicide in Ghana: the views of clinical psychologists, emergency ward nurses, and police officers.

PubMed

Hjelmeland, Heidi; Osafo, Joseph; Akotia, Charity S; Knizek, Birthe L

2014-01-01

Attempted suicide is still considered a crime in Ghana. The purpose of this study was to investigate the attitudes toward this law held by health workers and police officers in Ghana so as to provide culture-sensitive arguments to aid in abolishing the law. Qualitative interviews were conducted with eight clinical psychologists, eight emergency ward nurses, and eight police officers. The majority of informants did not agree with the law criminalizing attempted suicide in Ghana, although five of the emergency ward nurses and two police officers did. Arguments for agreeing with the law were that people have no right to take life and that the law has a deterrent effect and thus it will help reduce the suicide rate. The main argument for not agreeing with the law was that suicidal behavior is a mental health issue. Those who argued in favor of the law did not seem to reflect much on the reasons for suicidal behavior. Education on how to understand suicidal behavior and suicidal people may aid the work toward decriminalizing attempted suicide in Ghana.

Women in science in Ghana: The Ghana science clinics for girls

NASA Astrophysics Data System (ADS)

Andam, Aba Bentil; Amponsah, Paulina; Nsiah-Akoto, Irene; Anderson, Christina Oduma; Ababio, Baaba Andam; Asenso, Yaa Akomah; Nyarko, Savanna

2015-12-01

The Ghana Science Clinics for Girls, started in 1987, gave rise to a paradigm shift in the inclusion of girls in science education. One generation later, we review the impact. Our study indicates that progress has been made in the effort to mainstream women into science studies and careers, mainly as a result of the changes that took place through this intervention strategy. The retention rate for girls in science from primary to university has risen considerably and performance is higher.

Assessing the role of anthropogenic and biogenic sources on PM1 over southern West Africa using aircraft measurements

NASA Astrophysics Data System (ADS)

Brito, Joel; Freney, Evelyn; Dominutti, Pamela; Borbon, Agnes; Haslett, Sophie L.; Batenburg, Anneke M.; Colomb, Aurelie; Dupuy, Regis; Denjean, Cyrielle; Burnet, Frederic; Bourriane, Thierry; Deroubaix, Adrien; Sellegri, Karine; Borrmann, Stephan; Coe, Hugh; Flamant, Cyrille; Knippertz, Peter; Schwarzenboeck, Alfons

2018-01-01

As part of the Dynamics-Aerosol-Chemistry-Cloud Interactions in West Africa (DACCIWA) project, an airborne campaign was designed to measure a large range of atmospheric constituents, focusing on the effect of anthropogenic emissions on regional climate. The presented study details results of the French ATR42 research aircraft, which aimed to characterize gas-phase, aerosol and cloud properties in the region during the field campaign carried out in June/July 2016 in combination with the German Falcon 20 and the British Twin Otter aircraft. The aircraft flight paths covered large areas of Benin, Togo, Ghana and Côte d'Ivoire, focusing on emissions from large urban conurbations such as Abidjan, Accra and Lomé, as well as remote continental areas and the Gulf of Guinea. This paper focuses on aerosol particle measurements within the boundary layer (< 2000 m), in particular their sources and chemical composition in view of the complex mix of both biogenic and anthropogenic emissions, based on measurements from a compact time-of-flight aerosol mass spectrometer (C-ToF-AMS) and ancillary instrumentation. Background concentrations (i.e. outside urban plumes) observed from the ATR42 indicate a fairly polluted region during the time of the campaign, with average concentrations of carbon monoxide of 131 ppb, ozone of 32 ppb, and aerosol particle number concentration ( > 15 nm) of 735 cm-3 stp. Regarding submicron aerosol composition (considering non-refractory species and black carbon, BC), organic aerosol (OA) is the most abundant species contributing 53 %, followed by SO4 (27 %), NH4 (11 %), BC (6 %), NO3 (2 %) and minor contribution of Cl (< 0.5 %). Average background PM1 in the region was 5.9 µg m-3 stp. During measurements of urban pollution plumes, mainly focusing on the outflow of Abidjan, Accra and Lomé, pollutants are significantly enhanced (e.g. average concentration of CO of 176 ppb, and aerosol particle number concentration of 6500 cm-3 stp), as well as PM1 concentration (11.9 µg m-3 stp). Two classes of organic aerosols were estimated based on C-ToF-AMS: particulate organic nitrates (pONs) and isoprene epoxydiols secondary organic aerosols (IEPOX-SOA). Both classes are usually associated with the formation of particulate matter through complex interactions of anthropogenic and biogenic sources. During DACCIWA, pONs have a fairly small contribution to OA (around 5 %) and are more associated with long-range transport from central Africa than local formation. Conversely, IEPOX-SOA provides a significant contribution to OA (around 24 and 28 % under background and in-plume conditions). Furthermore, the fractional contribution of IEPOX-SOA is largely unaffected by changes in the aerosol composition (particularly the SO4 concentration), which suggests that IEPOX-SOA concentration is mainly driven by pre-existing aerosol surface, instead of aerosol chemical properties. At times of large in-plume SO4 enhancements (above 5 µg m-3), the fractional contribution of IEPOX-SOA to OA increases above 50 %, suggesting only then a change in the IEPOX-SOA-controlling mechanism. It is important to note that IEPOX-SOA constitutes a lower limit to the contribution of biogenic OA, given that other processes (e.g. non-IEPOX isoprene, monoterpene SOA) are likely in the region. Given the significant contribution to aerosol concentration, it is crucial that such complex biogenic-anthropogenic interactions are taken into account in both present-day and future scenario models of this fast-changing, highly sensitive region.

Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers.

PubMed

Gyasi, Razak Mohammed; Poku, Adjoa Afriyie; Boateng, Simon; Amoah, Padmore Adusei; Mumin, Alhassan Abdul; Obodai, Jacob; Agyemang-Duah, Williams

2017-01-01

In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana. In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana. In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.

Self-reported cataracts in older adults in Ghana: sociodemographic and health related factors.

PubMed

Yawson, Alfred E; Ackuaku-Dogbe, Edith M; Seneadza, Nana A Hagan; Mensah, George; Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul; Biritwum, Richard B

2014-09-12

Changes in function of sensory organs with increasing age have significant impact on health and wellbeing of older persons. This paper describes cataract, a chronic eye condition, self-reported among older adults in Ghana and the need for improving access to eye care services. This work was based on the World Health Organization's multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. SAGE Wave 1 in Ghana was conducted in 2007-2008 in a nationally representative sample of 4278 older adults, ≥ 50 years. Data were obtained on sociodemographic and health factors related to self-reported cataracts in older persons in Ghana. Data were analysed using descriptive measures (frequencies and proportions), chi-square test for associations in categorical outcome measures, and logistic regression for predictors of cataracts with SPSS version 21. Overall prevalence of self-reported cataracts among 4278 older adults in Ghana was 5.4%. Prevalence was proportionately higher for women (5.9%) than men (4.7%). Reported cataracts increased with age, among urban residents, in older adults living without partners and among those with the worse life satisfaction index. Older adults in lower income groups, poorly educated or living alone had difficulty seeking vision care services. Prevalence was 8.4% among persons with diabetes, 10.4% among hypertensives and 11.4% in persons with previous history of stroke. Among older persons who had ever used alcohol or tobacco, prevalence rates of reported cataracts were 5.7% and 4.9%, respectively. Logistic regression analysis indicated that increasing age, lower income status and self-reported hypertension were significantly associated with cataract among older adults in Ghana. Cataract is prevalent in older people in Ghana with approximately 1 in 20 people aged 50 years or older reporting a previous diagnosis of cataract. As cataract surgery is restorative, a public health approach on behavioural modification, well structured national outreach eye care services (for rural residents), inclusion of basic eye health services at sub-district levels, increased family support and national health insurance for older persons is indicated.

Ghana's experience in the establishment of a national digital seismic network observatory

NASA Astrophysics Data System (ADS)

Ahulu, Sylvanus; Danuor, Sylvester Kojo

2015-07-01

The Government of Ghana has established a National Digital Seismic Network Observatory in Ghana with the aim of monitoring events such as earthquakes, blasts from mining and quarrying, nuclear tests, etc. The Digital Observatory was commissioned on 19 December 2012, and was dedicated to Geosciences in Ghana. Previously Ghana did not have any operational, digital seismic network acquisition system with the capability of monitoring and analysing data for planning and research purposes. The Ghana Geological Survey has been monitoring seismic events with an analogue system which was not efficient and does not deliver real-time data. Hence, the importance of setting up the National Digital Seismic Network System which would enable the Geological Survey to constantly monitor, manage and coordinate both natural and man-made seismic activities in the country and around the globe, to some extent on real-time basis. The Network System is made up of six remote digital stations that transmit data via satellite to the central observatory. Sensors used are 3× Trillium Compact and 3× Trillium 120PA with Trident digitizers. The department has also acquired strong motion equipment: Titan accelerometers with Taurus digitizers from Nanometrics. Three of each of these instruments have been installed at the Akosombo and Kpong hydrodams, and also at the Weija water supply dam. These instruments are used to monitor dams. The peak ground acceleration (PGA) values established from the analysed data from the accelerometers will be used to retrofit or carry out maintenance work of the dam structures to avoid collapse. Apart from these, the observatory also assesses and analyses seismic waveforms relevant to its needs from the Global Seismographic Network (GSN) system operated by the US Geological Survey. The Ghana Geological Survey, through its Seismic Network Observatory makes data available to its stakeholder institutions for earthquake disaster mitigation; reports on all aspects of seismic-related disasters to the relevant government agencies that deal with disasters; makes recommendations to the government of Ghana on earthquake safety measures; and provides information to assist government institutions develop appropriate land and building policies. The Geological Survey Department, in collaboration with stakeholder agencies, periodically organises public lectures on earthquake disaster risk mitigation.

A study of autopsy procedures in Ghana: implications for the use of autopsy data in epidemiological analyses

PubMed Central

Fobil, Julius N.; Kumoji, Robert; Armah, Henry B.; Aryee, Eunice; Bilson, Francis; Carboo, Derick; Rodrigues, Frederick K.; Meyer, Christian G.; May, Juergen; Kraemer, Alexander

2011-01-01

The study of cause of death certification remains a largely neglected field in many developing countries, including Ghana. Yet, mortality information is crucial for establishing mortality patterns over time and for estimating mortality attributed to specific causes. In Ghana, autopsies remain the appropriate option for determining the cause of deaths occurring in homes and those occurring within 48 hours after admission into health facilities. Although these organ-based autopsies may generate convincing results and are considered the gold standard tools for ascertainments of causes of death, procedural and practical constraints could limit the extent to which autopsy results can be accepted and/or trusted. The objective of our study was to identify and characterise the procedural and practical constraints as well as to assess their potential effects on autopsy outcomes in Ghana. We interviewed 10 Ghanaian pathologists and collected and evaluated procedural manuals and operational procedures for the conduct of autopsies. A characterisation of the operational constraints and the Delphi analysis of their potential influence on the quality of mortality data led to a quantification of the validity threats as moderate (average expert panel score = 1) in the generality of the autopsy operations in Ghana. On the basis of the impressions of the expert panel, it was concluded that mortality data generated from autopsies in urban settings in Ghana were of sufficiently high quality to guarantee valid use in health analysis. PMID:28299049

An Integrated Assessment Approach to Address Artisanal and Small-Scale Gold Mining in Ghana.

PubMed

Basu, Niladri; Renne, Elisha P; Long, Rachel N

2015-09-17

Artisanal and small-scale gold mining (ASGM) is growing in many regions of the world including Ghana. The problems in these communities are complex and multi-faceted. To help increase understanding of such problems, and to enable consensus-building and effective translation of scientific findings to stakeholders, help inform policies, and ultimately improve decision making, we utilized an Integrated Assessment approach to study artisanal and small-scale gold mining activities in Ghana. Though Integrated Assessments have been used in the fields of environmental science and sustainable development, their use in addressing specific matter in public health, and in particular, environmental and occupational health is quite limited despite their many benefits. The aim of the current paper was to describe specific activities undertaken and how they were organized, and the outputs and outcomes of our activity. In brief, three disciplinary workgroups (Natural Sciences, Human Health, Social Sciences and Economics) were formed, with 26 researchers from a range of Ghanaian institutions plus international experts. The workgroups conducted activities in order to address the following question: What are the causes, consequences and correctives of small-scale gold mining in Ghana? More specifically: What alternatives are available in resource-limited settings in Ghana that allow for gold-mining to occur in a manner that maintains ecological health and human health without hindering near- and long-term economic prosperity? Several response options were identified and evaluated, and are currently being disseminated to various stakeholders within Ghana and internationally.

An Integrated Assessment Approach to Address Artisanal and Small-Scale Gold Mining in Ghana

PubMed Central

Basu, Niladri; Renne, Elisha P.; Long, Rachel N.

2015-01-01

Artisanal and small-scale gold mining (ASGM) is growing in many regions of the world including Ghana. The problems in these communities are complex and multi-faceted. To help increase understanding of such problems, and to enable consensus-building and effective translation of scientific findings to stakeholders, help inform policies, and ultimately improve decision making, we utilized an Integrated Assessment approach to study artisanal and small-scale gold mining activities in Ghana. Though Integrated Assessments have been used in the fields of environmental science and sustainable development, their use in addressing specific matter in public health, and in particular, environmental and occupational health is quite limited despite their many benefits. The aim of the current paper was to describe specific activities undertaken and how they were organized, and the outputs and outcomes of our activity. In brief, three disciplinary workgroups (Natural Sciences, Human Health, Social Sciences and Economics) were formed, with 26 researchers from a range of Ghanaian institutions plus international experts. The workgroups conducted activities in order to address the following question: What are the causes, consequences and correctives of small-scale gold mining in Ghana? More specifically: What alternatives are available in resource-limited settings in Ghana that allow for gold-mining to occur in a manner that maintains ecological health and human health without hindering near- and long-term economic prosperity? Several response options were identified and evaluated, and are currently being disseminated to various stakeholders within Ghana and internationally. PMID:26393627

Informing evidence-based policies for ageing and health in Ghana

PubMed Central

Byles, Julie; Aquah, Charles; Amofah, George; Biritwum, Richard; Panisset, Ulysses; Goodwin, James; Beard, John

2015-01-01

Abstract Problem Ghana’s population is ageing. In 2011, the Government of Ghana requested technical support from the World Health Organization (WHO) to help revise national policies on ageing and health. Approach We applied WHO’s knowledge translation framework on ageing and health to assist evidence based policy-making in Ghana. First, we defined priority problems and health system responses by performing a country assessment of epidemiologic data, policy review, site visits and interviews of key informants. Second, we gathered evidence on effective health systems interventions in low- middle- and high-income countries. Third, key stakeholders were engaged in a policy dialogue. Fourth, policy briefs were developed and presented to the Ghana Health Services. Local setting Ghana has a well-structured health system that can adapt to meet the health care needs of older people. Relevant changes Six problems were selected as priorities, however after the policy dialogue, only five were agreed as priorities by the stakeholders. The key stakeholders drafted evidence-based policy recommendations that were used to develop policy briefs. The briefs were presented to the Ghana Health Service in 2014. Lessons learnt The framework can be used to build local capacity on evidence-informed policy-making. However, knowledge translation tools need further development to be used in low-income countries and in the field of ageing. The terms and language of the tools need to be adapted to local contexts. Evidence for health system interventions on ageing populations is very limited, particularly for low- and middle-income settings. PMID:25558107

The impact of household wealth on child survival in Ghana.

PubMed

Lartey, Stella T; Khanam, Rasheda; Takahashi, Shingo

2016-11-22

Improving child health is one of the major policy agendas for most of the governments, especially in the developing countries. These governments have been implementing various strategies such as improving healthcare financing, improving access to health, increasing educational level, and income level of the household to improve child health. Despite all these efforts, under-five and infant mortality rates remain high in many developing nations. Some previous studies examined how economic development or household's economic condition contributes to child survival in developing countries. In Ghana, the question as to what extent does economic circumstances of households reduces infant and child mortality still remain largely unanswered. Thus, the purpose of this study is to investigate the extent to which wealth affects the survival of under-five children, using data from the Demographic and Health Survey (DHS) of Ghana. In this study, we use four waves of data from Demographic and Health Surveys (DHS) of Ghana from 1993 to 2008. The DHS is a detailed data set that provides comprehensive information on households and their demographic characteristics in Ghana. Data was obtained by distributing questionnaires to women (from 6000 households) of reproductive age between 15 and 49 years, which asked, among other things, their birth history information. The Weibull hazard model with gamma frailty was used to estimate wealth effect, as well as the trend of wealth effect on child's survival probability. We find that household wealth status has a significant effect on the child survival in Ghana. A child is more likely to survive when he/she is from a household with high wealth status. Among other factors, birth spacing and parental education were found to be highly significant to increase a child's survival probability. Our findings offer plausible mechanisms for the association of household wealth and child survival. We therefore suggest that the Government of Ghana strengthens and sustains improved livelihood programs, which reduce poverty. They should also take further initiatives that will increase adult education and improve health knowledge. To the best of our knowledge, this is the first study in Ghana that combines four cross sectional data sets from DHS to study a policy-relevant question. We extend Standard Weibull hazard model into Weibull hazard model with gamma frailty, which gives us a more accurate estimation. Finally, the findings of this study are of interest not only because they provide insights into the determinants of child health in Ghana and other developing countries, but they also suggest policies beyond the scope of health.

Oil: Lessons from Comparative Perspectives for Ghana

NASA Astrophysics Data System (ADS)

Osei-Boakye, Maame Frema

Oil as it relates to maintenance of energy consumption is becoming a very important acquired resource all around the world. This thesis focuses on Ghana as a place where recent oil discoveries have taken place, to assess the current policies being put in place to avoid the oil pitfalls of their other African counterparts and to examine oil models that could possibly work to reinforce a positive outcome for the new found oil industry in Ghana. These research aims were met through extensive research of relevant literature. The research resulted in the finding that the Ghanaian government would benefit from a combination of economic models that have been used in the past (spend all, save all and spend interest only). The main conclusion that has resulted from this research is that through strong fiscal policies towards the Ghanaian oil industry Ghana should be able to maintain a relatively stable economy which in turn will produce a stable country all around. This research argues that by creating strong policies and using a combination of the econometric oil models this will help Ghana account for the immediate need for things like infrastructure while also saving money for when/if the oil is no longer being produced in the country.

Improving the Skill Component of Clothing and Textiles among Students in Second Cycle Institutions in Ghana and Its Effect on the Polytechnic Fashion Student. A Case Study of OLA Girls, Mawuko Girls and Mawuli Senior High School in Ho, Ghana

ERIC Educational Resources Information Center

Joana, Amankwa; Selase, Gbadegbe Richard; Selorm, Gbetodeme; Emefa, Agra Florence

2015-01-01

For a nation like Ghana to develop, it is necessary to pay much attention to Vocational and Technical Education. This is so because school programmes that place emphasis on theory courses or humanities are no longer useful to the nation.Graduates who offer such programmes find it very difficult to secure employment in the Ghanaian job market…

Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

PubMed

Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

2012-01-01

Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility.

A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition.

PubMed

Ganle, John Kuumuori; Parker, Michael; Fitzpatrick, Raymond; Otupiri, Easmon

2014-12-21

To reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of Ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Although supervised delivery in Ghana has increased from 47% in 2003 to 55% in 2010, strikingly high maternal mortality ratio and low percentage of skilled attendance are still recorded in many parts of the country. To explore health system factors that inhibit women's access to and use of skilled maternal and newborn healthcare services in Ghana despite these services being provided free. We conducted qualitative research with 185 expectant and lactating mothers and 20 healthcare providers in six communities in Ghana between November 2011 and May 2012. We used Attride-Stirling's thematic network analysis framework to analyze and present our data. We found that in addition to limited and unequal distribution of skilled maternity care services, women's experiences of intimidation in healthcare facilities, unfriendly healthcare providers, cultural insensitivity, long waiting time before care is received, limited birthing choices, poor care quality, lack of privacy at healthcare facilities, and difficulties relating to arranging suitable transportation were important health system barriers to increased and equitable access and use of services in Ghana. Our findings highlight how a focus on patient-side factors can conceal the fact that many health systems and maternity healthcare facilities in low-income settings such as Ghana are still chronically under-resourced and incapable of effectively providing an acceptable minimum quality of care in the event of serious obstetric complications. Efforts to encourage continued use of maternity care services, especially skilled assistance at delivery, should focus on addressing those negative attributes of the healthcare system that discourage access and use.

Euthanasia, assisted dying and the right to die in Ghana: a socio-legal analysis.

PubMed

Owusu-Dapaa, Ernest

2013-12-01

There is unanimity among states to protect the continuation of life of the individual as a safeguard against their collective extinction. The right to life is accordingly guaranteed but its antithesis, the right to die is the subject of an unending debate. The controversy over the right to die is deepened by rapid advances in medicine, creating the capability for prolongation of life beyond the span which one's natural strength can endure. Ghana's supreme law explicitly guarantees the right to life but remains ambiguous on right to die, particularly euthanasia and assisted dying. Thus, some of the other rights, such as the right to dignity and not to be tortured, can creatively be exploited to justify some instances of euthanasia. Ghana's criminal code largely proscribes euthanasia. Notwithstanding, proscription of euthanasia and assisted dying by the law, in Ghana's empirical work undertaken in some of the communities in Ghana, suggests that euthanasia is quietly practisedin health facilities and private homes, especially in the rural areas. Contrary to the popular reasons assigned in the literature of the Western world, with respect to the practice or quest for legalization of euthanasia as being a necessity for providing relief from pain or hopeless quality of life, empirical data from social and anthropological studies conducted in Ghana reveal that poverty is the motivation for informal euthanasia practice in Ghana rather than genuine desire on part of patients to die or their relatives to see to their accelerated death. Apart from poverty, traditional cultural values of African societies consider non-natural death as a taboo and ignominy to the victim and his family. Thus, any move by the government to legalize euthanasia will need to be informed by widely held consultations and a possible referendum; otherwise the law may be just a mere transplant of Western models of legislation on euthanasia without reflecting the ethos of the African people.

Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

PubMed Central

Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

2012-01-01

Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility. PMID:22383944

Attitudes toward rape and victims of rape: a test of the feminist theory in Ghana.

PubMed

Boakye, Kofi E

2009-10-01

This study explores the usefulness of the feminist theory in explaining attitudes toward rape and victims of rape in Ghana. The feminist theory of rape posits, inter alia, that patriarchy and gender inequality are major factors in the aetiology of rape and attitudes toward rape and that underlying patriarchy and gender inequality are gender stereotypes and false beliefs (myths) about rape, rapists, and victims of rape. Thus, the theory suggests a relationship between rape myths and less favorable attitudes toward rape and victims of rape. Results from a survey conducted in Ghana show some support for the feminist theory of rape: There is evidence of rape myth acceptance in Ghana; gender is significant in predicting levels of rape myth acceptance; and finally, education or profession and age, but not religion, are associated with levels of rape myth acceptance in a predictable way.

Theoretical Framework for Plastic Waste Management in Ghana through Extended Producer Responsibility: Case of Sachet Water Waste.

PubMed

Quartey, Ebo Tawiah; Tosefa, Hero; Danquah, Kwasi Asare Baffour; Obrsalova, Ilona

2015-08-20

Currently, use and disposal of plastic by consumers through waste management activities in Ghana not only creates environmental problems, but also reinforces the notion of a wasteful society. The magnitude of this problem has led to increasing pressure from the public for efficient and practical measures to solve the waste problem. This paper analyses the impact of plastic use and disposal in Ghana. It emphasizes the need for commitment to proper management of the impacts of plastic waste and effective environmental management in the country. Sustainable Solid Waste Management (SSWM) is a critical problem for developing countries with regards to climate change and greenhouse gas emission, and also the general wellbeing of the populace. Key themes of this paper are producer responsibility and management of products at end of life. The paper proposes two theatrical recovery models that can be used to address the issue of sachet waste in Ghana.

Determinants of unprotected casual heterosexual sex in Ghana.

PubMed

Kumi-Kyereme, Akwasi; Tuoyire, Derek A; Darteh, Eugene K M

2014-05-01

Casual heterosexual sex remains a significant contributor to HIV transmissions in Ghana. The study used data from the 2008 Ghana Demographic and Health Survey (GDHS) to assess the socio-demographic, economic and spatial factors influencing unprotected casual heterosexual sex among men and women. The results of the binary logistic regression models revealed that women aged 35-44 had significantly higher odds of engaging in unprotected casual heterosexual sex than those aged 15-24, unlike the men. There were significantly lower odds of unprotected casual heterosexual sex for women and men with exposure to print media compared with those without exposure. Compared with men residing in the Western Region, unprotected casual heterosexual sex was significantly less likely among those in the Upper East Region. There is the need for behavioural change campaigns in Ghana that take into consideration the multiplicity of factors that determine unprotected casual heterosexual sex.

Ghana's education reform 2007: A realistic proposition or a crisis of vision?

NASA Astrophysics Data System (ADS)

Kuyini, Ahmed Bawa

2013-07-01

Ghana's recent "Education Reform 2007" envisions a system that strives to achieve both domestic and internationally-oriented goals emanating (1) from the Education for All (EFA) initiative, (2) from the UN Convention on the Rights of the Child and (3) from global trends in education. Emboldened by the implementation of foreign-donor-funded programmes such as EFA, the restructuring of the Ghana Education Sector Project (EdSeP) and the Science Resource Centres (SRC) project, both the education reform of 2007 and recent educational policy debates have reiterated the need to emphasise the teaching of science and information and communication technology to make Ghana's students/graduates more competitive in the global labour market. However, the bulk of Ghana's economic activity actually remains domestic or unglobalised. And given a weak economy and declining social spending due to strict adherence to the prescribed structural adjustment policies of the International Monetary Fund (IMF) and the World Bank (WB), there is concern that a focus on international competitiveness may be a crisis of vision. On the basis of the Ghanaian government's failure to meet the stated goals of previous reforms such as that of 1974, and the education system's continuing dependence on foreign donor support, this paper argues that the goals of the new reform may be unachievable on a sustainable basis. It also argues that rather than subjugate national domestic priorities to a mirage of international credibility/competitiveness, Ghana should concentrate on capacitating her students/graduates to make maximum impact at domestic and local community levels.

Smoking prevalence differs by location of residence among Ghanaians in Africa and Europe: The RODAM study

PubMed Central

Brathwaite, Rachel; Addo, Juliet; Kunst, Anton E.; Agyemang, Charles; Owusu-Dabo, Ellis; de-Graft Aikins, Ama; Beune, Erik; Meeks, Karlijn; Klipstein-Grobusch, Kerstin; Bahendeka, Silver; Mockenhaupt, Frank P.; Amoah, Stephen; Galbete, Cecilia; Schulze, Matthias B.; Danquah, Ina; Smeeth, Liam

2017-01-01

Background Although the prevalence of smoking is low in Ghana, little is known about the effect of migration on smoking. Comparing Ghanaians living in their country of origin to those living in Europe offers an opportunity to investigate smoking by location of residence and the associations between smoking behaviours and migration-related factors. Methods Data on a relatively homogenous group of Ghanaians living in London (n = 949), Amsterdam (n = 1400), Berlin (n = 543), rural Ghana (n = 973) and urban Ghana (n = 1400) from the cross-sectional RODAM (Research on Obesity & Diabetes in African Migrants) study were used. Age-standardized prevalence rates of smoking by location of residence and factors associated with smoking among Ghanaian men were estimated using prevalence ratios (PR: 95% CIs). Results Current smoking was non-existent among women in rural and urban Ghana and London but was 3.2% and 3.3% in women in Amsterdam and Berlin, respectively. Smoking prevalence was higher in men in Europe (7.8%) than in both rural and urban Ghana (4.8%): PR 1.91: 95% CI 1.27, 2.88, adjusted for age, marital status, education and employment. Factors associated with a higher prevalence of smoking among Ghanaian men included European residence, being divorced or widowed, living alone, Islam religion, infrequent attendance at religious services, assimilation (cultural orientation), and low education. Conclusion Ghanaians living in Europe are more likely to smoke than their counterparts in Ghana, suggesting convergence to European populations, although prevalence rates are still far below those in the host populations. PMID:28475620

The Project Dimension in Community Education.

ERIC Educational Resources Information Center

Thompson, J. D. Ekundaye

1994-01-01

Describes three projects sponsored by the International Community Education Association: (1) functional literacy for railway workers in Ghana; (2) youth farmers' community development project in Ghana; and (3) participatory research in a community education and development network in Sierra Leone. (SK)

Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis

PubMed Central

2013-01-01

Background Nigeria and Ghana have recently introduced a National Health Insurance Scheme (NHIS) with the aim of moving towards universal health care using more equitable financing mechanisms. This study compares health and economic indicators, describes the structure of each country’s NHIS within the wider healthcare system, and analyses impacts on equity in financing and access to health care. Methods The World Bank and other sources were used to provide comparative health and economic data. Pubmed, Embase and EconLit were searched to locate studies providing descriptions of each NHIS and empirical evidence regarding equity in financing and access to health care. A diagrammatical representation of revenue-raising, pooling, purchasing and provision was produced in order to analyse the two countries’ systems. Results Over the period 2000–2010, Ghana maintained a marked advantage in life expectancy, infant mortality, under-5 year mortality, and has a lower burden of major diseases. Health care expenditure is about 5% of GDP in both countries but public expenditure in 2010 was 38% of total expenditure in Nigeria and 60% in Ghana. Financing and access are less equitable in Nigeria as, inter alia, private out-of-pocket expenditure has fallen from 80% to 66% of total spending in Ghana since the introduction of its NHIS but has remained at over 90% in Nigeria; NHIS membership in Nigeria and Ghana is approximately 3.5% and 65%, respectively; Nigeria offers a variable benefits package depending on membership category while Ghana has uniform benefits across all beneficiaries. Both countries exhibit improvements in equity but there is a pro-rich and pro-urban bias in membership. Conclusions Major health indicators are more favourable in Ghana and overall equity in financing and access are weaker in Nigeria. Nigeria is taking steps to expand NHIS membership and has potential to expand its public spending to achieve greater equity. However, heavy burdens of poverty, disease and remote settings make this a substantial challenge. Ghana’s relative success has to be tempered by the high number of exemptions through taxation and the threat of moral hazard. The results and methods are anticipated to be informative for policy makers and researchers in both countries and other developing countries more widely. PMID:23339606

The role of institutions on the effectiveness of malaria treatment in the Ghanaian health sector.

PubMed

Amporfu, Eugenia; Nonvignon, Justice

2015-04-19

The Ghanaian health sector has undertaken several policies to help improve the quality of care received by patients. This includes the construction of several health facilities, the increase in the training of health workers, especially nurses, and the introduction of incentive packages (such as salary increase) to motivate health workers. The important question is to what extent does the institutional arrangement between the health facilities and the government as well as between health workers and public health facility administration affect the quality of care? The objective of this study is to find the effect of institutional factors on the quality of care. The institutional factors examined were mainly the extent of decentralization between government and health facilities, as well as between health workers and facility administration, the hiring procedure, and job satisfaction. The study used primary data on former patients from sixty six health facilities in three administrative regions of Ghana: the Northern, the Ashanti and the Greater Accra regions. The quality indicator used was effectiveness of treatment as determined by the patient. Ordered logit regression was run for the indicator with patient and health facility characteristics as well as institutional factors as independent variables. The sample size was 2248. The results showed that the patient's level of formal education had a strong influence on the effectiveness of treatment. In addition, effectiveness of treatment differed according to the administrative region in which the facility was located, and according to the extent of decentralization between health facility and government. The quality of instruments used for treatment, the working conditions for health workers, and job satisfaction had no effect on the effectiveness of treatment. Decentralization, the flow of information from government to health facilities and from health facility administrators to health workers are important in ensuring effectiveness. The study recommends further decentralization between health facilities as well as between health workers and administrators. In addition, the study recommends the involvement of health facilities in malaria programs to ensure the flow of information needed for effectiveness of treatment.

High levels of PAH-metabolites in urine of e-waste recycling workers from Agbogbloshie, Ghana.

PubMed

Feldt, Torsten; Fobil, Julius N; Wittsiepe, Jürgen; Wilhelm, Michael; Till, Holger; Zoufaly, Alexander; Burchard, Gerd; Göen, Thomas

2014-01-01

The informal recycling of electronic waste (e-waste) is an emerging source of environmental pollution in Africa. Among other toxins, polycyclic aromatic hydrocarbons (PAHs) are a major health concern for exposed individuals. In a cross-sectional study, the levels of PAH metabolites in the urine of individuals working on one of the largest e-waste recycling sites of Africa, and in controls from a suburb of Accra without direct exposure to e-waste recycling activities, were investigated. Socioeconomic data, basic health data and urine samples were collected from 72 exposed individuals and 40 controls. In the urine samples, concentrations of the hydroxylate PAH metabolites (OH-PAH) 1-hydroxyphenanthrene (1-OH-phenanthrene), the sum of 2- and 9-hydroxyphenanthrene (2-/9-OH-phenanthrene), 3-hydroxyphenanthrene (3-OH-phenanthrene), 4-hydroxyphenanthrene (4-OH-phenanthrene) and 1-hydroxypyrene (1-OH-pyrene), as well as cotinine and creatinine, were determined. In the exposed group, median urinary concentrations were 0.85 μg/g creatinine for 1-OH-phenanthrene, 0.54 μg/g creatinine for 2-/9-OH-phenanthrene, 0.99 μg/g creatinine for 3-OH-phenanthrene, 0.22 μg/g creatinine for 4-OH-phenanthrene, and 1.33 μg/g creatinine for 1-OH-pyrene, all being significantly higher compared to the control group (0.55, 0.37, 0.63, 0.11 and 0.54 μg/g creatinine, respectively). Using a multivariate linear regression analysis including sex, cotinine and tobacco smoking as covariates, exposure to e-waste recycling activities was the most important determinant for PAH exposure. On physical examination, pathological findings were rare, but about two thirds of exposed individuals complained about cough, and one quarter about chest pain. In conclusion, we observed significantly higher urinary PAH metabolite concentrations in individuals who were exposed to e-waste recycling compared to controls who were not exposed to e-waste recycling activities. The impact of e-waste recycling on exposure to environmental toxins and health of individuals living in the surroundings of e-waste recycling sites warrant further investigation. © 2013 Elsevier B.V. All rights reserved.

Ethnomedicinal survey and in vitro anti-plasmodial activity of the palm Borassus aethiopum Mart.

PubMed

Gruca, Marta; Yu, Wanwan; Amoateng, Patrick; Nielsen, Morten Agertoug; Poulsen, Thomas B; Balslev, Henrik

2015-12-04

Malaria remains a major global health threat, with the heaviest burden of disease in sub-Saharan Africa. Effective treatment is not available in many affected areas, and the Plasmodium falciparum parasite is becoming resistant to existing drugs. Alternative therapies are necessary to overcome these challenges. Borassus aethiopum is the third most used palm species in traditional medicines in Africa. Yet, there is only limited information substantiating medicinal properties of the palm. The objective of this study was to document medicinal uses of B. aethiopum and investigate anti-plasmodial activity of the palm extracts used in traditional medicine to treat malaria. The fieldwork and collection of samples was done in Ghana in the Greater Accra, Brong Ahafo, and Volta regions. Our ethnomedicinal survey did not specifically focus on medicinal uses against malaria; any medicinal application of B. aethiopum was of interest. Data collection employed a structured questionnaire, open-ended questions, and group discussion. The experimental extraction of samples was carried out using three common solvents: distilled water, absolute ethanol, and dichloromethane (CH2Cl2). Anti-plasmodial activity of compounds was determined against erythrocytic stages of the FCR3 strain of P. falciparum by a [3H]-hypoxanthine incorporation assay. A total of 37 use records were documented regarding the medicinal uses of B. aethiopum for the management of 24 different disorders. The highest medicinal use value was recorded for the use of B. aethiopum against malaria, and a subsequent laboratory investigation focused on evaluating anti-plasmodial activity of the palm. Several root and leaf extracts displayed anti-plasmodial activity, with the highest (78% at 50 μg/mL) elicited by one of the dichloromethane root extracts. Our results demonstrate the value of integrating ethnobotanical and pharmacological research in the study of beneficial effects of palm products on human health. While the high inhibitory activity found in dichloromethane extracts cannot validate the ethnomedicinal use, the anti-plasmodial effect observed cannot be nullified. We brought preliminary evidence that this palm is a promising source of alternative medicines that could contribute to improving health conditions in malaria endemic areas of sub-Saharan Africa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Performance evaluation of GNSS-TEC estimation techniques at the grid point in middle and low latitudes during different geomagnetic conditions

NASA Astrophysics Data System (ADS)

Abe, O. E.; Otero Villamide, X.; Paparini, C.; Radicella, S. M.; Nava, B.; Rodríguez-Bouza, M.

2017-04-01

Global Navigation Satellite Systems (GNSS) have become a powerful tool use in surveying and mapping, air and maritime navigation, ionospheric/space weather research and other applications. However, in some cases, its maximum efficiency could not be attained due to some uncorrelated errors associated with the system measurements, which is caused mainly by the dispersive nature of the ionosphere. Ionosphere has been represented using the total number of electrons along the signal path at a particular height known as Total Electron Content (TEC). However, there are many methods to estimate TEC but the outputs are not uniform, which could be due to the peculiarity in characterizing the biases inside the observables (measurements), and sometimes could be associated to the influence of mapping function. The errors in TEC estimation could lead to wrong conclusion and this could be more critical in case of safety-of-life application. This work investigated the performance of Ciraolo's and Gopi's GNSS-TEC calibration techniques, during 5 geomagnetic quiet and disturbed conditions in the month of October 2013, at the grid points located in low and middle latitudes. The data used are obtained from the GNSS ground-based receivers located at Borriana in Spain (40°N, 0°E; mid latitude) and Accra in Ghana (5.50°N, -0.20°E; low latitude). The results of the calibrated TEC are compared with the TEC obtained from European Geostationary Navigation Overlay System Processing Set (EGNOS PS) TEC algorithm, which is considered as a reference data. The TEC derived from Global Ionospheric Maps (GIM) through International GNSS service (IGS) was also examined at the same grid points. The results obtained in this work showed that Ciraolo's calibration technique (a calibration technique based on carrier-phase measurements only) estimates TEC better at middle latitude in comparison to Gopi's technique (a calibration technique based on code and carrier-phase measurements). At the same time, Gopi's calibration was also found more reliable in low latitude than Ciraolo's technique. In addition, the TEC derived from IGS GIM seems to be much reliable in middle-latitude than in low-latitude region.

Postings and transfers in the Ghanaian health system: a study of health workforce governance.

PubMed

Kwamie, Aku; Asiamah, Miriam; Schaaf, Marta; Agyepong, Irene Akua

2017-09-15

Decision-making on postings and transfers - that is, the geographic deployment of the health workforce - is a key element of health workforce governance. When poorly managed, postings and transfers result in maldistribution, absenteeism, and low morale. At stake is managing the balance between organisational (i.e., health system) and individual (i.e., staff preference) needs. The negotiation of this potential convergence or divergence of interests provides a window on practices of postings and transfers, and on the micro-practices of governance in health systems more generally. This article explores the policies and processes, and the interplay between formal and informal rules and norms which underpin postings and transfers practice in two rural districts in the Greater Accra Region of Ghana. Semi-structured interviews were conducted with eight district managers and 87 frontline staff from the district health administration, district hospital, polyclinic, health centres and community outreach compounds across two districts. Interviews sought to understand how the postings and transfers process works in practice, factors in frontline staff and district manager decision-making, personal experiences in being posted, and study leave as a common strategy for obtaining transfers. Differential negotiation-spaces at regional and district level exist and inform postings and transfers in practice. This is in contrast to the formal cascaded rules set to govern decision-making authority for postings and transfers. Many frontline staff lack policy clarity of postings and transfers processes and thus 'test' the system through informal staff lobbying, compounding staff perception of the postings and transfers process as being unfair. District managers are also challenged with limited decision-space embedded in broader policy contexts of systemic hierarchy and resource dependence. This underscores the negotiation process as ongoing, rather than static. These findings point to tensions between individual and organisational goals. This article contributes to a burgeoning literature on postings and transfers as a distinct dynamic which bridges the interactions between health systems governance and health workforce development. Importantly, this article helps to expand the notion of health systems governance beyond 'good' governance towards understanding governance as a process of negotiation.

Using Natural Materials for Educational Toys: Examples from Ghana.

ERIC Educational Resources Information Center

William, Musah; Preston, Christine

1998-01-01

Describes educational toys that are made from natural and readily available materials in Ghana. Directions and diagrams for the pawpaw-leaf horn, milk-tin helicopter, pen-top propeller, bow and arrow, spinning top, and feather helicopter are included. (DDR)

Speaking the Unspeakable: Discursive Strategies To Express Language Attitudes in Legon (Ghana) Graffiti.

ERIC Educational Resources Information Center

Obeng, Samuel Gyasi

2000-01-01

Examines how language attitudes are expressed in Legon, Ghana, a multilingual society. Focuses on the graffiti in male lavatories, which offers an interesting glimpse of some of the intergroup tensions existing within Ghanian society. (Author/VWL)

The meanings of suicidal behaviour to psychology students in Ghana: a qualitative approach.

PubMed

Osafo, Joseph; Hjelmeland, Heidi; Akotia, Charity S; Knizek, Birthe Loa

2011-11-01

The objective of this study was to examine psychology students' attitudes toward suicidal behaviour and the meanings they assign to the act. In-depth interviews were conducted with 15 final year psychology students at a university in Ghana. Interpretative Phenomenological Analysis (IPA) was used to analyze the data. The results indicated that the students had a generalized negative attitude toward suicide. Religious beliefs and family harmony are cultural contexts influencing the interpretation of suicidal behaviour as breach of divine and communal moralities. The implications of these meanings of suicidal behaviour for suicide prevention in Ghana are discussed.

Estimation of packaged water consumption and associated plastic waste production from household budget surveys

NASA Astrophysics Data System (ADS)

Wardrop, Nicola A.; Dzodzomenyo, Mawuli; Aryeetey, Genevieve; Hill, Allan G.; Bain, Robert E. S.; Wright, Jim

2017-08-01

Packaged water consumption is growing in low- and middle-income countries, but the magnitude of this phenomenon and its environmental consequences remain unclear. This study aims to quantify both the volumes of packaged water consumed relative to household water requirements and associated plastic waste generated for three West African case study countries. Data from household expenditure surveys for Ghana, Nigeria and Liberia were used to estimate the volumes of packaged water consumed and thereby quantify plastic waste generated in households with and without solid waste disposal facilities. In Ghana, Nigeria and Liberia respectively, 11.3 (95% confidence interval: 10.3-12.4), 10.1 (7.5-12.5), and 0.38 (0.31-0.45) Ml day-1 of sachet water were consumed. This generated over 28 000 tonnes yr-1 of plastic waste, of which 20%, 63% and 57% was among households lacking formal waste disposal facilities in Ghana, Nigeria and Liberia respectively. Reported packaged water consumption provided sufficient water to meet daily household drinking-water requirements for 8.4%, less than 1% and 1.6% of households in Ghana, Nigeria and Liberia respectively. These findings quantify packaged water’s contribution to household water needs in our study countries, particularly Ghana, but indicate significant subsequent environmental repercussions.

Treatment-seeking behaviour and social health insurance in Africa: the case of Ghana under the National Health Insurance Scheme.

PubMed

Fenny, Ama P; Asante, Felix A; Enemark, Ulrika; Hansen, Kristian S

2014-10-27

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah.Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries.

Treatment-Seeking Behaviour and Social Health Insurance in Africa: The Case of Ghana Under the National Health Insurance Scheme

PubMed Central

Fenny, Ama P.; Asante, Felix A.; Enemark, Ulrika; Hansen, Kristian S.

2015-01-01

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah. Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries. PMID:25560361

Maternal health-seeking behavior: the role of financing and organization of health services in Ghana.

PubMed

Aboagye, Emmanuel; Agyemang, Otuo Serebour

2013-05-30

This paper examines how organization and financing of maternal health services influence health-seeking behavior in Bosomtwe district, Ghana. It contributes in furthering the discussions on maternal health-seeking behavior and health outcomes from a health system perspective in sub-Saharan Africa. From a health system standpoint, the paper first presents the resources, organization and financing of maternal health service in Ghana, and later uses case study examples to explain how Ghana's health system has shaped maternal health-seeking behavior of women in the district. The paper employs a qualitative case study technique to build a complex and holistic picture, and report detailed views of the women in their natural setting. A purposeful sampling technique is applied to select 16 women in the district for this study. Through face-to-face interviews and group discussions with the selected women, comprehensive and in-depth information on health- seeking behavior and health outcomes are elicited for the analysis. The study highlights that characteristics embedded in decentralization and provision of free maternal health care influence health-seeking behavior. Particularly, the use of antenatal care has increased after the delivery exemption policy in Ghana. Interestingly, the study also reveals certain social structures, which influence women's attitude towards their decisions and choices of health facilities.

Spatial analysis of skilled birth attendant utilization in Ghana.

PubMed

Asamoah, Benedict Oppong; Agardh, Anette; Cromley, Ellen K

2014-04-13

Maternal mortality is a major health problem in most resource-poor settings, especially in sub-Saharan Africa. In Ghana, maternal mortality remains high and births attended by skilled health professionals are still low despite the introduction, in 2005, of free maternal health care for all women seeking care in public health facilities. This study aimed to explore geographical patterns in the risk of not utilizing a skilled birth attendant during childbirth in women of different socioeconomic backgrounds in Ghana. Global and Geographically Weighted Odds Ratios (GWORs) were used to examine the spatially varying relationships between low socioeconomic status (low education and low income) and non-utilization of skilled birth attendants based on data from the Ghana Demographic and Health Survey (GDHS) 2008. Low education and low income were associated with non-use of skilled birth attendants. The GWORs revealed a north-south spatial variation in the magnitude of the association between non-use of skilled birth attendants and low education (Log GWOR ranged from 0.75 to 9.26) or low income (Log GWOR ranged from 1.11 to 6.34) with higher values in the north. The relationship between low socioeconomic status and the non-use of skilled birth attendants in Ghana is geographically variable. Effective governmental and non-governmental interventions are needed to address these regional inequalities.

Occurrence of transmitted HIV-1 drug resistance among Drug-naïve pregnant women in selected HIV-care centres in Ghana.

PubMed

Martin-Odoom, Alexander; Adiku, Theophilus; Delgado, Elena; Lartey, Margaret; Ampofo, William K

2017-03-01

Access to antiretroviral therapy in Ghana has been scaled up across the country over the last decade. This study sought to determine the occurrence of transmitted HIV-1 drug resistance in pregnant HIV-1 positive women yet to initiate antiretroviral therapy at selected HIV Care Centres in Ghana. Plasma specimens from twenty-six (26) HIV seropositive pregnant women who were less than 28weeks pregnant with their first pregnancy and ART naïve were collected from selected HIV care centres in three (3) regions in Ghana. Genotypic testing was done for the reverse transcriptase gene and the sequences generated were analyzed for HIV-1 drug resistance mutations using the Stanford University HIV Drug Resistance Database. Resistance mutations associated with the reverse transcriptase gene were detected in 4 (15.4%) of the participants. At least one major drug resistance mutation in the reverse transcriptase gene was found in 3 (11.5%) of the women. The detection of transmitted HIV-1 drug resistance in this drug-naïve group in two regional HIV care sites is an indication of the need for renewed action in monitoring the emergence of transmitted HIV-1 drug resistance in Ghana. None declared.

A Call for Action to Improve Occupational Health and Safety in Ghana and a Critical Look at the Existing Legal Requirement and Legislation

PubMed Central

Annan, Joe-Steve; Addai, Emmanuel K.; Tulashie, Samuel K.

2015-01-01

Occupational health and safety (OHS) is a broad field of professional practice, which involves specialists from different disciplines including but not limited to engineers, occupational health physicians, physical and biological scientists, economists, and statisticians. The preventive systems required to ensure workers are protected from injuries and illnesses dwell heavily on engineers; however, the extent to which the engineer can go regarding planning and implementing preventive measures is dependent on specific legal requirements, leadership commitment from the company, organization, and nation. The objective of this paper is to identify the areas of opportunities for improvements in OHS management in Ghana with regard to the nation's legal requirements, commitment of the Ghana government, and Ghanaian leadership as well as appropriate structuring of Ghanaian institutions responsible for monitoring and managing OHS in Ghana. This paper identified Ghana's fragmented legal requirements concerning OHS, which are under different jurisdictions with unclear responsibilities and accountabilities. The paper also highlights the training needs of Ghanaian academic institutions regarding OHS. Among other recommendations made including structuring of Ghanaian institutions to manage OHS in line with the ILO-OSH 2001, this paper aligns the recommendations with the articles and elements of International Labour Organization convention number 155 and OHSAS 18001 elements. PMID:26106516

"Correcting an Erring Wife Is Normal": Moral Discourses of Spousal Violence in Ghana.

PubMed

Adjei, Stephen Baffour

2018-06-01

This study draws insights from discursive psychology to explore moral discourses of spousal violence in Ghana. In particular, it investigates how sociocultural norms and practices are invoked in talk of perpetrators and victims as moral warrants for husband-to-wife abuse in Ghana. Semi-structured focus group and personal interviews were conducted with a total of 40 participants: 16 victims, 16 perpetrators, and eight key informants from rural and urban Ghana. Participants' discursive accounts suggest that husbands have implicit moral right and obligation to punish their wives for disobedience and other infractions against male authority in marriage. Both perpetrators and victims build their talk around familiar normative discourses and practices that provide tacit support for spousal violence in Ghana. While perpetrators mobilize culturally resonant and normative repertoires to justify abuse, blame their victims, and manage their moral accountability; victims position husband-to-wife abuse as normal, legitimate, disciplinary, and corrective. These moral discourses of spousal violence apparently serve to relieve perpetrators of moral agency; prime battered women to accept abuse; and devastate their agency to leave abusive marital relationships. The findings contribute to our understanding of how cultural and social norms of spousal violence are morally constituted, reproduced, and sustained in talk of perpetrators, victims, and other key members of society.

First Detection of Leishmania tropica DNA and Trypanosoma Species in Sergentomyia Sand Flies (Diptera: Psychodidae) from an Outbreak Area of Cutaneous Leishmaniasis in Ghana

PubMed Central

Nzelu, Chukwunonso O.; Kato, Hirotomo; Puplampu, Naiki; Desewu, Kwame; Odoom, Shirley; Wilson, Michael D.; Sakurai, Tatsuya; Katakura, Ken; Boakye, Daniel A.

2014-01-01

Background Leishmania major and an uncharacterized species have been reported from human patients in a cutaneous leishmaniasis (CL) outbreak area in Ghana. Reports from the area indicate the presence of anthropophilic Sergentomyia species that were found with Leishmania DNA. Methodology/Principal Findings In this study, we analyzed the Leishmania DNA positive sand fly pools by PCR-RFLP and ITS1 gene sequencing. The trypanosome was determined using the SSU rRNA gene sequence. We observed DNA of L. major, L. tropica and Trypanosoma species to be associated with the sand fly infections. This study provides the first detection of L. tropica DNA and Trypanosoma species as well as the confirmation of L. major DNA within Sergentomyia sand flies in Ghana and suggests that S. ingrami and S. hamoni are possible vectors of CL in the study area. Conclusions/Significance The detection of L. tropica DNA in this CL focus is a novel finding in Ghana as well as West Africa. In addition, the unexpected infection of Trypanosoma DNA within S. africana africana indicates that more attention is necessary when identifying parasitic organisms by PCR within sand fly vectors in Ghana and other areas where leishmaniasis is endemic. PMID:24516676

Multivariate co-integration analysis of the Kaya factors in Ghana.

PubMed

Asumadu-Sarkodie, Samuel; Owusu, Phebe Asantewaa

2016-05-01

The fundamental goal of the Government of Ghana's development agenda as enshrined in the Growth and Poverty Reduction Strategy to grow the economy to a middle income status of US$1000 per capita by the end of 2015 could be met by increasing the labour force, increasing energy supplies and expanding the energy infrastructure in order to achieve the sustainable development targets. In this study, a multivariate co-integration analysis of the Kaya factors namely carbon dioxide, total primary energy consumption, population and GDP was investigated in Ghana using vector error correction model with data spanning from 1980 to 2012. Our research results show an existence of long-run causality running from population, GDP and total primary energy consumption to carbon dioxide emissions. However, there is evidence of short-run causality running from population to carbon dioxide emissions. There was a bi-directional causality running from carbon dioxide emissions to energy consumption and vice versa. In other words, decreasing the primary energy consumption in Ghana will directly reduce carbon dioxide emissions. In addition, a bi-directional causality running from GDP to energy consumption and vice versa exists in the multivariate model. It is plausible that access to energy has a relationship with increasing economic growth and productivity in Ghana.

Environmental Literacy of Business Students in Ghana

ERIC Educational Resources Information Center

Owusu, Godfred Matthew Yaw; Ossei Kwakye, Teddy; Welbeck, Edem Emerald; Ofori, Charles Gyamfi

2017-01-01

Purpose: This study examines the multidimensionality of the environmental literacy concept among university business students in Ghana. The study also investigates the relationship between students' interests in environmental issues and knowledge levels of environment and assesses how these two constructs influence students overall environmental…

Community-based distribution of misoprostol to prevent postpartum haemorrhage at home births: results from operations research in rural Ghana.

PubMed

Geller, S; Carnahan, L; Akosah, E; Asare, G; Agyemang, R; Dickson, R; Kapungu, C; Owusu-Ansah, L; Robinson, N; Mensah-Homiah, J

2014-02-01

To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana. Operations research. Rural Ghana. Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC). Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women. Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality. Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly. This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios. © 2013 Royal College of Obstetricians and Gynaecologists.

Assessment of formaldehyde levels in local and imported fresh fish in Ghana: a case study in the Tamale Metropolis of Ghana.

PubMed

Saba, Courage Kosi Setsoafia; Atayure, Seidu Isaac; Adzitey, Frederick

2015-03-01

Fish is an important source of protein all over the world, including in Ghana. The fishery sector plays a major role in meeting the domestic need of animal protein and also contributes greatly in foreign exchange earnings. The domestic supply of fish does not meet the demand, so Ghana imports fish and fish products from other countries. Media reports in Ghana have alleged the use of formaldehyde to preserve fish for increased shelf life and to maintain freshness. This research, therefore, sought to establish the levels of formaldehyde in imported and local fresh fish in the Tamale Metropolis by using a ChemSee formaldehyde and formalin detection test kit. Positive and negative controls were performed by using various concentrations of formalin (1, 10, 30, 50, 100, and 300 ppm) and sterile distilled water, respectively. Three times over a 6-month period, different fish species were obtained from five wholesale cold stores (where fish are sold in cartons) and some local sales points (where locally caught fish are sold). A total of 32 samples were taken during three different sampling sessions: 23 imported fish (mackerel, herring, horse mackerel, salmon, and redfish) and 9 local tilapia. The fish were cut, and 50 g was weighed and blended with an equal volume (50 ml) of sterile distilled water. Samples were transferred to test tubes and centrifuged. A test strip was dipped into the supernatant and observed for a color change. A change in color from white to pink or purple indicated the presence of formaldehyde in fish. The study showed that no formaldehyde was present in the imported and local fish obtained. The appropriate regulatory agencies should carry out this study regularly to ensure that fish consumed in Ghana is safe for consumption.

Regression Analysis to Identify Factors Associated with Urinary Iodine Concentration at the Sub-National Level in India, Ghana, and Senegal

PubMed Central

Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Touré, Ndeye Khady; Foriwa Amoaful, Esi; Gorstein, Jonathan

2018-01-01

Single and multiple variable regression analyses were conducted using data from stratified, cluster sample design, iodine surveys in India, Ghana, and Senegal to identify factors associated with urinary iodine concentration (UIC) among women of reproductive age (WRA) at the national and sub-national level. Subjects were survey household respondents, typically WRA. For all three countries, UIC was significantly different (p < 0.05) by household salt iodine category. Other significant differences were by strata and by household vulnerability to poverty in India and Ghana. In multiple variable regression analysis, UIC was significantly associated with strata and household salt iodine category in India and Ghana (p < 0.001). Estimated UIC was 1.6 (95% confidence intervals (CI) 1.3, 2.0) times higher (India) and 1.4 (95% CI 1.2, 1.6) times higher (Ghana) among WRA from households using adequately iodised salt than among WRA from households using non-iodised salt. Other significant associations with UIC were found in India, with having heard of iodine deficiency (1.2 times higher; CI 1.1, 1.3; p < 0.001) and having improved dietary diversity (1.1 times higher, CI 1.0, 1.2; p = 0.015); and in Ghana, with the level of tomato paste consumption the previous week (p = 0.029) (UIC for highest consumption level was 1.2 times lowest level; CI 1.1, 1.4). No significant associations were found in Senegal. Sub-national data on iodine status are required to assess equity of access to optimal iodine intake and to develop strategic responses as needed. PMID:29690505

Determinants of routine immunization costing in Benin and Ghana in 2011.

PubMed

Ahanhanzo, Césaire Damien; Huang, Xiao Xian; Le Gargasson, Jean-Bernard; Sossou, Justin; Nyonator, Frank; Colombini, Anais; Gessner, Bradford D

2015-05-07

Existing tools to evaluate costs do not always capture the heterogeneity of costs at the facility level. This study seeks to address this issue through an analysis of determinants of health facility immunization costs. A statistical analysis on facility routine delivery and vaccine costs was conducted using ordinary least squares regression. Explanatory variables included the number of doses administered; proportion of time spent by facility staff on immunization; average staff wage; whether the health facility had enough staff; presence of cold chain equipment; distance to a vaccine collection point; and, facility ownership. Data were drawn from representative samples of primary care facilities in Benin and Ghana (46 and 50 facilities, respectively) collected as part of the EPIC studies. Weighted average RI immunization facility cost was US$ 16,459 in Ghana and US$ 14,994 in Benin. The regression found total doses administered to be positively and significantly associated with facility cost in both countries. A 10% increase in doses resulted in a 4% increase in cost in Ghana, and a 7.5% increase in Benin. In Ghana, the proportion of immunization time, presence of cold chain, and sufficiency of staff were positively and significantly associated with total cost. In Benin, facility cost was negatively and significantly related to distance to the vaccine collection point. In the pooled sample, facilities in capital cities were associated with significantly higher costs. This study provides evidence on the importance of the level of scale in determining facility immunization cost, as well as the role of availability of health workers and time they spend on immunization in Ghana and Benin. This type of analysis can provide insights into the costs of scaling up immunization services, and can assist with development of more efficient immunization strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

The influence of socioeconomic factors on choice of infant male circumcision provider in rural Ghana; a community level population based study.

PubMed

Gyan, Thomas; McAuley, Kimberley; Strobel, Natalie; Newton, Sam; Owusu-Agyei, Seth; Edmond, Karen

2017-08-29

The influence of socio-economic determinants on choice of infant male circumcision provider is not known in areas with high population coverage such as rural Africa. The overall aim of this study was to determine the key socio-economic factors which influence the choice of infant male circumcision provider in rural Ghana. The study investigated the effect of family income, distance to health facility, and cost of the circumcision on choice of infant male circumcision provider in rural Ghana. Data from 2847 circumcised infant males aged under 12 weeks and their families were analysed in a population-based cross-sectional study conducted from May to December 2012 in rural Ghana. Multivariable logistic regression models were adjusted for income status, distance to health facility, cost of circumcision, religion, maternal education, and maternal age. Infants from the lowest income households (325, 84.0%) were more likely to receive circumcision from an informal provider compared to infants from the highest income households (260, 42.4%) even after adjusting for religious affiliation (adjusted odds ratio [aOR] 4.42, 95% CI 3.12-6.27 p = <0.001). There appeared to be a dose response with increasing risk of receiving a circumcision from an informal provider as distance to a health facility increased (aOR 1.25, 95 CI 1.30-1.38 P = <0.001). Only 9.0% (34) of families in the lowest socio-economic quintile received free circumcision services compared to 27.9% (171) of the highest income families. The Government of Ghana and Non-Government Organisations should consider additional support to poor families so they can access high quality free infant male circumcision in rural Ghana.

Cost effectiveness of option B plus for prevention of mother-to-child transmission of HIV in resource-limited countries: evidence from Kumasi, Ghana.

PubMed

VanDeusen, Adam; Paintsil, Elijah; Agyarko-Poku, Thomas; Long, Elisa F

2015-03-18

Achieving the goal of eliminating mother-to-child HIV transmission (MTCT) necessitates increased access to antiretroviral therapy (ART) for HIV-infected pregnant women. Option B provides ART through pregnancy and breastfeeding, whereas Option B+ recommends continuous ART regardless of CD4 count, thus potentially reducing MTCT during future pregnancies. Our objective was to compare maternal and pediatric health outcomes and cost-effectiveness of Option B+ versus Option B in Ghana. A decision-analytic model was developed to simulate HIV progression in mothers and transmission (in utero, during birth, or through breastfeeding) to current and all future children. Clinical parameters, including antenatal care access and fertility rates, were estimated from a retrospective review of 817 medical records at two hospitals in Ghana. Additional parameters were obtained from published literature. Modeled outcomes include HIV infections averted among newborn children, quality-adjusted life-years (QALYs), and cost-effectiveness ratios. HIV-infected women in Ghana have a lifetime average of 2.3 children (SD 1.3). Projected maternal life expectancy under Option B+ is 16.1 years, versus 16.0 years with Option B, yielding a gain of 0.1 maternal QALYs and 3.2 additional QALYs per child. Despite higher initial ART costs, Option B+ costs $785/QALY gained, a value considered very cost-effective by World Health Organization benchmarks. Widespread implementation of Option B+ in Ghana could theoretically prevent up to 668 HIV infections among children annually. Cost-effectiveness estimates remained favorable over robust sensitivity analyses. Although more expensive than Option B, Option B+ substantially reduces MTCT in future pregnancies, increases both maternal and pediatric QALYs, and is a cost-effective use of limited resources in Ghana.

Health and vulnerability to poverty in Ghana: evidence from the Ghana Living Standards Survey Round 5

PubMed Central

2012-01-01

Background An understanding of the complex relationship between health status and welfare is crucial for critical policy interventions. However, the focus of most policies in developing regions has been on current welfare to the neglect of forward-looking welfare analysis. The absence of adequate research in the area of future poverty or vulnerability to poverty has also contributed to the focus on current welfare. The objectives of this study were to estimate vulnerability to poverty among households in Ghana and examine the relationship between health status and vulnerability to poverty. Method The study used cross section data from the Fifth Round of the Ghana Living Standards Survey (GLSS 5) with a nationally representative sample of 8,687 households from all administrative regions in Ghana. A three-step Feasible Generalized Least Squares (FGLS) estimation procedure was employed to estimate vulnerability to poverty and to model the effect of health status on expected future consumption and variations in future consumption. Vulnerability to poverty estimates were also examined against various household characteristics. Results Using an upper poverty line, the estimates of vulnerability show that about 56% of households in Ghana are vulnerable to poverty in the future and this is higher than the currently observed poverty level of about 29%. Households with ill members were vulnerable to poverty. Moreover, households with poor hygiene conditions were also vulnerable to future poverty. The vulnerability to poverty estimates were, however, sensitive to the poverty line used and varied with household characteristics. Conclusion The results imply that policies directed towards poverty reduction need to take into account the vulnerability of households to future poverty. Also, hygienic conditions and health status of households need not be overlooked in poverty reduction strategies. PMID:22827954

It's the context!

USDA-ARS?s Scientific Manuscript database

This editorial was written to summarize 3 large clinical trials, one among pregnant women in Malawi, another in pregnant women in Ghana and the third in children in Cambodia. The Ghana study showed a benefit from food supplements, while the studies in Malawi and Cambodia found little benefit from ...

Kin Group Affiliation and Marital Violence Against Women in Ghana.

PubMed

Sedziafa, Alice Pearl; Tenkorang, Eric Y

2016-01-01

The socialization of men and women in Ghana often confers either patrilineal or matrilineal rights, privileges, and responsibilities. Yet, previous studies that explored domestic and marital violence in sub-Saharan Africa, and Ghana, paid less attention to kin group affiliation and how the power dynamics within such groups affect marital violence. Using the 2008 Ghana Demographic and Health Survey and applying ordinary least squares (OLS) techniques, this study examined what influences physical, sexual, and emotional violence among matrilineal and patrilineal kin groups. Results indicate significant differences among matrilineal and patrilineal kin groups regarding marital violence. Socioeconomic variables that capture feminist and power theories were significantly related to sexual and emotional violence in matrilineal societies. Also, variables that tap both cultural and life course epistemologies of domestic violence were strongly related to physical, sexual, and emotional violence among married women in patrilineal kin groups. Policymakers must pay attention to kin group affiliation in designing policies aimed at reducing marital violence among Ghanaian women.

Contamination status of arsenic in fish and shellfish from three river basins in Ghana.

PubMed

Gbogbo, Francis; Otoo, Samuel Darlynton; Asomaning, Obed; Huago, Robert Quaye

2017-08-01

Fish and shellfish are regularly consumed and sold in Ghana, yet studies on arsenic pollution in Ghana are limited largely to ground water. This study evaluated arsenic concentrations in seven species of shellfish and 10 species of fish inhabiting the mouth of Ankobra, Densu and Volta basins in Ghana and assessed the public health implications. Arsenic levels varied from 0.2 to 2.2 mg L -1 in the three rivers and were higher than WHO recommended values of 10 μg L -1 for drinking water. Except for Periophthalmus sp. and Tympanotonus fuscatus from the Ankobra in which arsenic was not detected, concentrations in the organisms ranged from 0.2 to 2.8 mg kg -1 . The maximum quantities of the organisms considered safe for consumption ranged from 375 to 5250 g per week. Caution however needs to be exercised as PTWI for arsenic needs revision, and some heavy metals such as mercury are more toxic than arsenic.

Who Cares? Pre and Post Abortion Experiences among Young Females in Cape Coast Metropolis, Ghana.

PubMed

Esia-Donkoh, Kobina; Darteh, Eugene K M; Blemano, Harriet; Asare, Hagar

2015-06-01

Issues of abortion are critical in Ghana largely due to its consequences on sexual and reproductive health. The negative perception society attaches to it makes it difficult for young females to access services and share their experiences. This paper examines the pre and post abortion experiences of young females; a subject scarcely researched in the country. Twenty-one clients of Planned Parenthood Association of Ghana (PPAG) clinic at Cape Coast were interviewed. Guided by the biopsychosocial model, the study revealed that fear of societal stigma, shame, and rejection by partners, as well as self-imposed stigma constituted some of the pre and post abortion experiences the respondents. Other experiences reported were bleeding, severe abdominal pain and psychological pain. The Ghana Health Services (GHS) and other service providers should partner the PPAG clinic to integrate psychosocial treatment in its abortion services while intensifying behaviour change communication and community-based stigma-reduction education in the Metropolis.

Bridging the gap between evidence-based innovation and national health-sector reform in Ghana.

PubMed

Awoonor-Williams, John Koku; Feinglass, Ellie S; Tobey, Rachel; Vaughan-Smith, Maya N; Nyonator, Frank K; Jones, Tanya C

2004-09-01

Although experimental trials often identify optimal strategies for improving community health, transferring operational innovation from well-funded research programs to resource-constrained settings often languishes. Because research initiatives are based in institutions equipped with unique resources and staff capabilities, results are often dismissed by decisionmakers as irrelevant to large-scale operations and national health policy. This article describes an initiative undertaken in Nkwanta District, Ghana, focusing on this problem. The Nkwanta District initiative is a critical link between the experimental study conducted in Navrongo, Ghana, and a national effort to scale up the innovations developed in that study. A 2002 Nkwanta district-level survey provides the basis for assessing the likelihood that the Navrongo model is replicable elsewhere in Ghana. The effect of community-based health planning and services exposure on family planning and safe-motherhood indicators supports the hypothesis that Navrongo effects are transferable to impoverished rural settings elsewhere, confirming the need for strategies to bridge the gap between Navrongo evidence-based innovation and national health-sector reform.

Predictors of contraceptive use among female adolescents in Ghana.

PubMed

Marrone, Gaetano; Abdul-Rahman, Lutuf; De Coninck, Zaake; Johansson, Annika

2014-03-01

Adolescent girls in Ghana still face a number of challenges accessing reproductive/sexual health services despite efforts to improve their accessibility. This paper explores the key socio-demographic factors associated with contraceptive use amongst adolescent girls in Ghana using the 2008 Ghana Demographic and Health Survey (GDHS). Data from the 2008 GDHS was analyzed. Socio-demographic variables were selected to assess their interaction with contraceptive use. Multivariable regression analyses were performed. Odds ratios and confidence intervals were computed. Place of residence and marital status were the most important predictors of contraceptive use among sexually active adolescents. Rural residents were less likely to use contraceptives compared to urban residents (OR 0.32, CI 0.12-0.84, p = 0.021) as well as married respondents compared to their unmarried peers (OR 0.27, 95% CI 0.11-0.67, p = 0.005). The accessibility of reproductive/sexual health services needs to be improved and promoted in rural areas and among married adolescent women.

Criminal prosecution of suicide attempt survivors in Ghana.

PubMed

Adinkrah, Mensah

2013-12-01

Recently, there have been calls for the decriminalization (or depenalization) of nonfatal suicidal behavior (attempted suicide) in Ghana, India, Uganda, and other societies that currently criminalize nonfatal suicidal behavior. Despite this, there is a dearth of systematic studies that examine the extent, nature, and characteristics of attempted suicide prosecutions in countries that currently criminalize nonfatal suicidal behavior. The current study, therefore, explores the phenomenon of criminal prosecution and punishment for suicide attempters in Ghana, one among several countries where nonfatal suicidal behavior is a crime. Drawing from data extracted from local Ghanaian print and electronic news media articles, the study examines the sociodemographic characteristics of suicide attempt survivors, the patterns of nonfatal suicidal behavior, as well as the criminal justice outcomes of the criminal prosecutions. The findings indicate that the majority of defendants pled guilty to or were found guilty of the charge and sentenced to penalties ranging from monetary fines to incarceration. The results are discussed with regard to their implications for reducing nonfatal suicidal behavior in Ghana.

Education and perceptions of social status and power among women in Larteh, Ghana.

PubMed

Fallon, K M

1999-01-01

In exploring the status of women in the developing world, most research emphasizes the impact of development indicators, like income or health, on women. This article goes beyond development indicators by discussing women's own perceptions of social status and power in rural Larteh, Ghana. It focuses primarily on the effects of gender and education on perception of social status and power. Section 1 offers a brief overview of the history of Ghana, reflecting the current position of women in the country. Definitions of social status and power within an African context are presented in section 2. Section 3 examines 24 interviews collected in Ghana, which asks respondents to discuss their own social status and power in relation to their community. In general, the results indicate that a woman's perception of increased social status and power is dependent on education and occupation. Other factors affecting perceptions of social status and power are wealth and culturally embedded positions held within the community, including elder, chief, and priestess.

Theoretical Framework for Plastic Waste Management in Ghana through Extended Producer Responsibility: Case of Sachet Water Waste

PubMed Central

Quartey, Ebo Tawiah; Tosefa, Hero; Danquah, Kwasi Asare Baffour; Obrsalova, Ilona

2015-01-01

Currently, use and disposal of plastic by consumers through waste management activities in Ghana not only creates environmental problems, but also reinforces the notion of a wasteful society. The magnitude of this problem has led to increasing pressure from the public for efficient and practical measures to solve the waste problem. This paper analyses the impact of plastic use and disposal in Ghana. It emphasizes the need for commitment to proper management of the impacts of plastic waste and effective environmental management in the country. Sustainable Solid Waste Management (SSWM) is a critical problem for developing countries with regards to climate change and greenhouse gas emission, and also the general wellbeing of the populace. Key themes of this paper are producer responsibility and management of products at end of life. The paper proposes two theatrical recovery models that can be used to address the issue of sachet waste in Ghana. PMID:26308016

Assessing the catastrophic effects of out-of-pocket healthcare payments prior to the uptake of a nationwide health insurance scheme in Ghana

PubMed Central

Akazili, James; McIntyre, Diane; Kanmiki, Edmund W.; Gyapong, John; Oduro, Abraham; Sankoh, Osman; Ataguba, John E.

2017-01-01

ABSTRACT Background: Financial risk protection against the cost of unforeseen healthcare has gained global attention in recent years. Although Ghana implemented a nationwide health insurance scheme with a goal of reducing financial barriers to accessing healthcare and addressing impoverishing effects of out-of-pocket (OOP) healthcare payments, there is a paucity of knowledge on the extent of financial catastrophe of such payments in Ghana. Thus, this paper assesses the catastrophic effect of OOP healthcare payments in Ghana. Methods: Ghana Living Standard Survey (GLSS 5) data collected in 2005/2006 are used in this study. Catastrophic effect of OOP healthcare payments is assessed using various thresholds of total household expenditure and non-food expenditure. Furthermore, four indices, namely the catastrophic payment headcount, catastrophic payment gap, weighted catastrophic payment headcount and weighted catastrophic payment gap, are defined and computed. Results: As at 2005/2006, it was estimated that 11.0% of households in Ghana spent over 5% of their total household expenditure on healthcare OOP. However, after adjusting for the concentration of such spending, it decreased to 10.9%. Also 10.7% of households spent more than 10% of their non-food consumption expenditure on OOP healthcare payments. Furthermore, about 2.6% of households are observed to have spent in excess of 20% of their total household income on healthcare OOP. With the exception of the 5% threshold of household expenditure, because the concentration indices of these expenditures are negative, the burden of such expenditures rests more on the poor. Conclusions: Significant levels of financial catastrophe existed in Ghana prior to the uptake of the national health insurance scheme. Poorer households were at a higher risk than the relatively well-off households. The results of this study present baseline assessment of the impact of Ghana’s health insurance policy on catastrophic healthcare payments. Thus, there is a need for continuous monitoring of financial catastrophe in the system to ensure that households are adequately protected. PMID:28485675

Prevention and management of malaria during pregnancy: findings from a comparative qualitative study in Ghana, Kenya and Malawi

PubMed Central

2013-01-01

Background In endemic regions of sub-Saharan Africa, malaria during pregnancy (MiP) is a major preventable cause of maternal and infant morbidity and mortality. Current recommended MiP prevention and control includes intermittent preventive treatment (IPTp), distribution of insecticide-treated bed nets (ITNs) and appropriate case management. This article explores the social and cultural context to the uptake of these interventions at four sites across Africa. Methods A comparative qualitative study was conducted at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. Observations, which focused on behaviours linked to MiP prevention and treatment, were also undertaken at health facilities and in local communities. Results ITNs were generally recognized as important for malaria prevention. However, their availability and use differed across the sites. In Malawi and Kenya, ITNs were sought-after items, but there were complaints about availability. In central Ghana, women saved ITNs until the birth of the child and they were used seasonally in northern Ghana. In Kenya and central Ghana, pregnant women did not associate IPTp with malaria, whereas, in Malawi and northern Ghana, IPTp was linked to malaria, but not always with prevention. Although IPTp adherence was common at all sites, whether delivered with directly observed treatment or not, a few women did not comply with IPTp often citing previous side effects. Although generally viewed as positive, experiences of malaria testing varied across the four sites: treatment was sometimes administered in spite of a negative diagnosis in Ghana (observed) and Malawi (reported). Despite generally following the advice of healthcare staff, particularly in Kenya, personal experience, and the availability and accessibility of medication – including anti-malarials – influenced MiP treatment. Conclusion Although ITNs were valued as malaria prevention, health messages could address issues that reduce their use during pregnancy in particular contexts. The impact of previous side effects on adherence to IPTp and anti-malarial treatment regimens during pregnancy also requires attention. Overtreatment of MiP highlights the need to monitor the implementation of MiP case management guidelines. PMID:24257105

Sibling rivalry and the gender gap: evidence from child health outcomes in Ghana.

PubMed

Garg, A; Morduch, J

1998-01-01

"When capital and labor markets are imperfect, choice sets narrow, and parents must choose how to ration available funds and time between their children. One consequence is that children become rivals for household resources. In economies with pro-male bias, such rivalries can yield gains to having relatively more sisters than brothers. Using a rich household survey from Ghana [the 1988-1989 Ghana Living Standards Survey], we find that on average if children had all sisters (and no brothers) they would do roughly 25-40% better on measured health indicators than if they had all brothers (and no sisters)." excerpt