Attitudes toward Psychiatry among Final-Year Medical Students in Kumasi, Ghana

ERIC Educational Resources Information Center

Laugharne, Richard; Appiah-Poku, John; Laugharne, Jon; Shankar, Rohit

2009-01-01

Objective: Most sub-Saharan African countries have fewer psychiatrists than one per one million people. One possible reason could be that medical students have a negative attitude toward the specialty. The authors evaluated the attitudes toward a career in psychiatry of final-year medical students in Kumasi, Ghana, and compare these with attitudes…

TIMSS 2011 Science Assessment Results: A Review of Ghana's Performance

ERIC Educational Resources Information Center

Buabeng, Isaac; Owusu, Kofi Acheaw; Ntow, Forster Danso

2014-01-01

This paper reviews Ghana's performance in the TIMSS 2011 survey in comparison with other African and some high performing countries which participated in the TIMSS assessment. Students' achievement in the science content areas assessed were summarized and teacher preparation constructs of teachers of the students who took part in the assessment…

Removing user fees in the health sector: a review of policy processes in six sub-Saharan African countries.

PubMed

Meessen, Bruno; Hercot, David; Noirhomme, Mathieu; Ridde, Valéry; Tibouti, Abdelmajid; Tashobya, Christine Kirunga; Gilson, Lucy

2011-11-01

In recent years, governments of several low-income countries have taken decisive action by removing fully or partially user fees in the health sector. In this study, we review recent reforms in six sub-Saharan African countries: Burkina Faso, Burundi, Ghana, Liberia, Senegal and Uganda. The review describes the processes and strategies through which user fee removal reforms have been implemented and tries to assess them by referring to a good practice hypotheses framework. The analysis shows that African leaders are willing to take strong action to remove financial barriers met by vulnerable groups, especially pregnant women and children. However, due to a lack of consultation and the often unexpected timing of the decision taken by the political authorities, there was insufficient preparation for user fee removal in several countries. This lack of preparation resulted in poor design of the reform and weaknesses in the processes of policy formulation and implementation. Our assessment is that there is now a window of opportunity in many African countries for policy action to address barriers to accessing health care. Mobilizing sufficient financial resources and obtaining long-term commitment are obviously crucial requirements, but design details, the formulation process and implementation plan also need careful thought. We contend that national policy-makers and international agencies could better collaborate in this respect.

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…

Treatment-seeking patterns for malaria in pharmacies in five sub-Saharan African countries.

PubMed

Ladner, Joël; Davis, Ben; Audureau, Etienne; Saba, Joseph

2017-08-29

Artemisinin-based combination therapy (ACT) is recommended as the first-line anti-malarial treatment strategy in sub-Saharan African countries. WHO policy recommends parasitological confirmation by microscopy or rapid diagnostic test (RDT) in all cases of suspected malaria prior to treatment. Gaps remain in understanding the factors that influence patient treatment-seeking behaviour and anti-malarial drug purchase decisions in the private sector. The objective of this study was to identify patient treatment-seeking behaviour in Ghana, Kenya, Nigeria, Tanzania, and Uganda. Face-to-face patient interviews were conducted at a total of 208 randomly selected retail outlets in five countries. At each outlet, exit interviews were conducted with five patients who indicated they had come seeking anti-malarial treatment. The questionnaire was anonymous and standardized in the five countries and collected data on different factors, including socio-demographic characteristics, history of illness, diagnostic practices (i.e. microscopy or RDT), prescription practices and treatment purchase. The price paid for the treatment was also collected from the outlet vendor. A total of 994 patients were included from the five countries. Location of malaria diagnosis was significantly different in the five countries. A total of 484 blood diagnostic tests were performed, (72.3% with microscopy and 27.7% with RDT). ACTs were purchased by 72.5% of patients who had undergone blood testing and 86.5% of patients without a blood test, regardless of whether the test result was positive or negative (p < 10 -4 ). A total of 531 patients (53.4%) had an anti-malarial drug prescription, of which 82.9% were prescriptions for an ACT. There were significant differences in prescriptions by country. A total of 923 patients (92.9%) purchased anti-malarial drugs in an outlet, including 79.1% of patients purchasing an ACT drug: 98.0% in Ghana, 90.5% in Kenya, 80.4% in Nigeria, 69.2% in Tanzania, and 57.7% in

Triacylglycerol and triterpene ester composition of shea nuts from seven African countries.

PubMed

Akihisa, Toshihiro; Kojima, Nobuo; Katoh, Naoko; Kikuchi, Takashi; Fukatsu, Makoto; Shimizu, Naoto; Masters, Eliot T

2011-01-01

The compositions of the triacylglycerol (TAG) and triterpene ester (TE) fractions of the kernel fats (n-hexane extracts; shea butter) of the shea tree (Vitellaria paradoxa; Sapotaceae) were determined for 36 samples from seven sub-Saharan countries, i.e., Cote d' Ivoire, Ghana, Nigeria, Cameroun, Chad, Sudan, and Uganda. The principal TAGs are stearic-oleic-stearic (SOS; mean 31.2%), SOO (27.7%), and OOO (10.8%). The TE fractions contents are in the range of 0.5-6.5%, and contain α-amyrin cinnamate (1c; mean 29.3%) as the predominant TE followed by butyrospermol cinnamate (4c; 14.8%), α-amyrin acetate (1a; 14.1%), lupeol cinnamate (3c; 9.0%), β-amyrin cinnamate (2c; 7.6%), lupeol acetate (3a; 7.2%), butyrospermol acetate (4a; 5.8%), and β-amyrin acetate (2a; 4.9%). Shea kernel fats from West African provenances contained, in general, higher levels of high-melting TAGs such as SOS, and higher amount of TEs than those from East African provenances. No striking regional difference in the composition of the TE fractions was observed. Copyright © 2011 by Japan Oil Chemists' Society

African and classical swine fever situation in Ivory-Coast and neighboring countries, 2008-2013.

PubMed

Kouakou, K V; Michaud, V; Biego, H G; Gnabro, H P G; Kouakou, A V; Mossoun, A M; Awuni, J A; Minoungou, G L; Aplogan, G L; Awoumé, F K; Albina, E; Lancelot, R; Couacy-Hymann, E

2017-02-01

This study was conducted from 2008 to 2013 to determine the animal health status of Ivory Coast and neighboring countries (Burkina Faso, Ghana, Togo and Benin) for African swine fever (ASF) and classical swine fever (CSF), and to assess the risk factors for ASF introduction in Ivory Coast. Ivory Coast had probably been free from ASF from 1998 to 2014 when it was re-introduced in this country. However, the ASF virus was found in all neighboring countries. In contrast, no evidence of CSF infection was found so far in Ivory Coast and neighboring countries. To assess the risk of ASF reintroduction in Ivory Coast, we surveyed 59 modern pig farms, and 169 pig owners in 19 villages and in two towns. For the village livestock, the major risk factor was the high frequency of pig exchanges with Burkinabe villages. In the commercial sector, many inadequate management practices were observed with respect to ASF. Their identification should enable farmers and other stakeholders to implement a training and prevention program to reduce the introduction risk of ASF in their farms. Copyright © 2016 Elsevier B.V. All rights reserved.

Homicide-suicide in Ghana: perpetrators, victims, and incidence characteristics.

PubMed

Adinkrah, Mensah

2014-03-01

Homicide-suicide in the industrialized West has been studied for many years. Yet, only limited scholarly research currently exists on the subject in Africa and other non-Western societies. The aim of the present descriptive study was to investigate homicide-suicides in contemporary Ghana. A content analysis of homicide-suicide reports in a major Ghanaian daily newspaper during 1990 to 2009 was conducted. The results overwhelmingly support findings in the literature, suggesting that homicide-suicides are extremely rare events in Ghana. The overwhelming majority of reported homicide-suicides were committed by males, with females substantially more likely to be the homicide victims. The offenders and victims were generally of low socioeconomic status. Most homicide-suicides involved victims and offenders who were intimately acquainted as family members. The majority of cases involved men who killed their wives on suspicion of infidelity; the next largest category involved men who murdered wives who threatened divorce or separation. The principal homicide and suicide methods were shooting with firearms, hacking with machetes, and stabbing with knives. The findings of the study are discussed in relation to Ghana's patriarchal family system and ideology and present socioeconomic issues in the country. This study recommends further research on this subject in Ghana and other African countries. This is necessary to further an understanding of homicide-suicide as a phenomenon, as well as a necessary prelude to the development and implementation of effective preventive programs.

Challenges to the reproductive-health needs of African women: on religion and maternal health utilization in Ghana.

PubMed

Gyimah, Stephen Obeng; Takyi, Baffour K; Addai, Isaac

2006-06-01

How relevant is religion to our understanding of maternal health (MH) service utilization in sub-Saharan Africa? We ask this question mainly because while the effect of religion on some aspects of reproductive behavior (e.g., fertility, contraception) has not gone unnoticed in the region, very few studies have examined the possible link with MH service utilization. Understanding this link in the context of sub-Saharan Africa is particularly relevant given the overriding influence of religion on the social fabric of Africans and the unacceptably high levels of maternal mortality in the region. As African countries struggle to achieve their stipulated reductions in maternal and child mortality levels by two-thirds by 2015 as part of the Millennium Development Goals, the need to examine the complex set of macro- and micro-factors that affect maternal and child health in the region cannot be underestimated. Using data from the 2003 Ghana Demographic Survey, we found religion (measured by denominational affiliation) to be a significant factor in MH use. This is true even after we had controlled for socio-economic variables. In general, Moslem and traditional women were less likely to use such services compared with Christians. The findings are discussed with reference to our theoretical framework and some policy issues are highlighted.

International trends in health science librarianship part 15: West Africa (Ghana, Nigeria, Senegal).

PubMed

Sulemani, Solomon Bayugo; Afarikumah, Ebenezer; Aggrey, Samuel Bentil; Ajuwon, Grace A; Diallo, Ousmane

2015-09-01

This is the 15th in a series of articles exploring international trends in health science librarianship in the 21st century. It is the third of four articles pertaining to different regions in the African continent. The present issue focuses on countries in West Africa (Ghana, Nigeria and Senegal). The next feature column will investigate trends in North Africa. JM. © 2015 Health Libraries Group.

Stakeholders Perspectives on the Success Drivers in Ghana's National Health Insurance Scheme - Identifying Policy Translation Issues.

PubMed

Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie

2016-10-01

Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Based on an empirical qualitative case study of stakeholders' views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. In the study, interviewees referred to both 'hard and soft' elements as driving the "success" of the Ghana scheme. The main 'hard elements' include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The 'soft' elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years, amounting to a process best conceived as germination as opposed

Breast Cancer and African Ancestry: Lessons Learned at the 10-Year Anniversary of the Ghana-Michigan Research Partnership and International Breast Registry

PubMed Central

Jiagge, Evelyn; Oppong, Joseph Kwaku; Bensenhaver, Jessica; Aitpillah, Francis; Gyan, Kofi; Kyei, Ishmael; Osei-Bonsu, Ernest; Adjei, Ernest; Ohene-Yeboah, Michael; Toy, Kathy; Jackson, Karen Eubanks; Akpaloo, Marian; Acheampong, Dorcas; Antwi, Beatrice; Agyeman, Faustina Obeng; Alhassan, Zainab; Fondjo, Linda Ahenkorah; Owusu-Afriyie, Osei; Brewer, Robert Newman; Gyamfuah, Amma; Salem, Barbara; Johnson, Timothy; Wicha, Max; Merajver, Sofia; Kleer, Celina; Pang, Judy; Amankwaa-Frempong, Emmanuel; Stark, Azadeh; Abantanga, Francis; Awuah, Baffour

2016-01-01

Women with African ancestry in western, sub-Saharan Africa and in the United States represent a population subset facing an increased risk of being diagnosed with biologically aggressive phenotypes of breast cancer that are negative for the estrogen receptor, the progesterone receptor, and the HER2/neu marker. These tumors are commonly referred to as triple-negative breast cancer. Disparities in breast cancer incidence and outcome related to racial or ethnic identity motivated the establishment of the International Breast Registry, on the basis of partnerships between the Komfo Anokye Teaching Hospital in Kumasi, Ghana, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, and the Henry Ford Health System in Detroit, Michigan. This research collaborative has featured educational training programs as well as scientific investigations related to the comparative biology of breast cancer in Ghanaian African, African American, and white/European American patients. Currently, the International Breast Registry has expanded to include African American patients throughout the United States by partnering with the Sisters Network (a national African American breast cancer survivors’ organization) and additional sites in Ghana (representing West Africa) as well as Ethiopia (representing East Africa). Its activities are now coordinated through the Henry Ford Health System International Center for the Study of Breast Cancer Subtypes. Herein, we review the history and results of this international program at its 10-year anniversary. PMID:28717716

NEWS for Africa: adaptation and reliability of a built environment questionnaire for physical activity in seven African countries.

PubMed

Oyeyemi, Adewale L; Kasoma, Sandra S; Onywera, Vincent O; Assah, Felix; Adedoyin, Rufus A; Conway, Terry L; Moss, Sarah J; Ocansey, Reginald; Kolbe-Alexander, Tracy L; Akinroye, Kingsley K; Prista, Antonio; Larouche, Richard; Gavand, Kavita A; Cain, Kelli L; Lambert, Estelle V; Aryeetey, Richmond; Bartels, Clare; Tremblay, Mark S; Sallis, James F

2016-03-08

Built environment and policy interventions are effective strategies for controlling the growing worldwide deaths from physical inactivity-related non-communicable diseases. To improve built environment research and develop African specific evidence, it is important to first tailor built environment measures to African contexts and assess their psychometric properties across African countries. This study reports on the adaptation and test-retest reliability of the Neighborhood Environment Walkability Scale in seven sub-Saharan African countries (NEWS-Africa). The original NEWS comprising 8 subscales measuring reported physical and social attributes of neighborhood environments was systematically adapted for Africa through extensive input from physical activity and public health researchers, built environment professionals, and residents in seven African countries: Cameroon, Ghana, Kenya, Mozambique, Nigeria, South Africa and Uganda. Cognitive testing of NEWS-Africa was conducted among diverse residents (N = 109, 50 youth [12 - 17 years] and 59 adults [22 - 67 years], 69 % from low socioeconomic status [SES] neighborhoods). NEWS-Africa was translated into local languages and evaluated for 2-week test-retest reliability in adult participants (N = 301; female = 50.2 %; age = 32.3 ± 12.9 years) purposively recruited from neighborhoods varying in walkability (high and low walkable) and SES (high and low income) and from villages in six of seven participating countries. The original 67 NEWS items was expanded to 89 scores (76 individual NEWS items and 13 computed scales). Several modifications were made to individual items, and some new items were added to capture important attributes in the African environment. A new scale on personal safety was created, and the aesthetics scale was enlarged to reflect African specific characteristics. Over 95 % of all NEWS-Africa scores (items plus computed scales) demonstrated evidence of "excellent" (ICCs�

Development of an emergency nursing training curriculum in Ghana.

PubMed

Bell, Sue Anne; Oteng, Rockefeller; Redman, Richard; Lapham, Jeremy; Bam, Victoria; Dzomecku, Veronica; Yakubu, Jamila; Tagoe, Nadia; Donkor, Peter

2014-10-01

The formal provision of emergency health care is a developing specialty in many sub-Saharan African countries, including Ghana. While emergency medicine training programs for physicians are on the rise, there are few established training programs for emergency nurses. The results of a unique collaboration are described between a university in the United States, a Ghanaian university and a Ghanaian teaching hospital that has developed an emergency nursing diploma program. The expected outcomes of this training program include: (a) an innovative, interdisciplinary, team-based clinical training model, (b) a unique and low-resource emergency nursing curriculum and (c) a comprehensive and sustainable training program to increase in-country retention of nurses. Copyright © 2014 Elsevier Ltd. All rights reserved.

DEVELOPMENT OF AN EMERGENCY NURSING TRAINING CURRICULUM IN GHANA

PubMed Central

Bell, Sue Anne; Oteng, Rockefeller; Redman, Richard; Lapham, Jeremy; Bam, Victoria; Dzomecku, Veronica; Yakubu, Jamila; Tagoe, Nadia; Donkor, Peter

2014-01-01

The formal provision of emergency health care is a developing specialty in many sub-Saharan African countries, including Ghana. While emergency medicine training programs for physicians are on the rise, there are few established training programs for emergency nurses. The results of a unique collaboration are described between a university in the United States, a Ghanaian university and a Ghanaian teaching hospital that has developed an emergency nursing diploma program. The expected outcomes of this training program include: a) an innovative, interdisciplinary, team-based clinical training model b) a unique and low-resource emergency nursing curriculum and c) a comprehensive and sustainable training program to increase in-country retention of nurses. PMID:24631161

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.

Contraceptive Use in Ghana: The Role of Service Availability, Quality, and Price. Living Standards Measurement Study Working Papers No. 111.

ERIC Educational Resources Information Center

Oliver, Raylynn

Ghana was among the first sub-Saharan African countries to adopt a population policy, in 1969. In this paper, individual women are linked to the characteristics of the nearest pharmacy, health facility and source of family planning to assess the relative importance of socioeconomic background and the availability, price and quality of family…

Women's empowerment and choice of contraceptive methods in selected African countries.

PubMed

Do, Mai; Kurimoto, Nami

2012-03-01

It is generally believed that women's lack of decision-making power may restrict their use of modern contraceptives. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in African countries. Data came from the latest round of Demographic and Health Surveys conducted between 2006 and 2008 in Namibia, Zambia, Ghana and Uganda. Responses from married or cohabiting women aged 15-49 were analyzed for six dimensions of empowerment and the current use of female-only methods or couple methods. Bivariate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use. Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision making was associated with the use of either female-only or couple methods (1.1 for all), as was agreement on fertility preferences (1.3-1.6) and the ability to negotiate sexual activity (1.1-1.2). In Namibia, women's negative attitudes toward domestic violence were correlated with the use of couple methods (1.1). Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence.

Ghana: Country Status Report (Revision).

ERIC Educational Resources Information Center

McFerren, Margaret

A survey of the status of language usage in Ghana begins with an overview of the distribution and usage of English, as the sole official language, and of the local languages Akan, Ewe, Adangme, Dagbani, Nzema, Ga, Dagaari, and Hausa. A matrix follows that rates these languages on: (1) their usage rating using State Department classifications; (2)…

International parental migration and the psychological well-being of children in Ghana, Nigeria, and Angola.

PubMed

Mazzucato, Valentina; Cebotari, Victor; Veale, Angela; White, Allen; Grassi, Marzia; Vivet, Jeanne

2015-05-01

When parents migrate, leaving their children in the origin country, transnational families are formed. Transnational family studies on children who are "left behind" indicate that children suffer psychologically from parental migration. Many of the factors identified as affecting children's responses to parental migration however are not considered in child psychology and family sociology studies. This study aims to bridge these areas of knowledge by quantitatively investigating the association between transnational families and children's psychological well-being. It analyzes a survey conducted in three African countries in 2010-11 (Ghana N = 2760; Angola N = 2243; Nigeria N = 2168) amongst pupils of secondary schools. The study compares children in transnational families to those living with their parents in their country of origin. Children's psychological well-being is measured through the Strengths and Difficulties Questionnaire. Multiple regression analyses reveal that children in transnational families fare worse than their counterparts living with both parents but not in Ghana where living conditions mediate this relationship. This paper also looks at four characteristics of transnational families and finds that specific characteristics of transnational families and country contexts matter: (1) changing caregivers is associated with poorer well-being in all countries; (2) which parent migrates does not make a difference in Ghana, when mothers migrate and fathers are caregivers results in poorer well-being in Nigeria, and both mother's and father's migration result in worse outcomes in Angola; (3) the kin relationship of the caregiver is not associated with poorer well-being in Ghana and Nigeria but is in Angola; (4) children with parents who migrate internationally do not show different results than children whose parents migrate nationally in Ghana and Nigeria but in Angola international parental migration is associated with poorer psychological well

Water footprint as an indicator of agricultural productivity in African countries

NASA Astrophysics Data System (ADS)

Chico Zamanillo, Daniel; Zhang, Guoping; Mathews, Ruth

2017-04-01

Sub-Saharan Africa is one of the regions with the largest scope for improved agricultural development that would contribute to global food security while respecting environmental boundaries. More importantly, undernourishment is a challenge for many African countries and needs to be addressed to achieve the 2030 Agenda for Sustainable Development. This study was conducted to support the Netherlands Ministry of Foreign Affair's Inclusive Green Growth aim of increasing water use efficiency by 25% in Dutch financed projects. A water footprint profile was developed for 7 Sub-Saharan countries; Benin, Ethiopia, Ghana, Kenya, Mali, Mozambique and Rwanda. The profiles provide an overview of water use from the perspective of the goods produced within the country, the consumption of goods, in particular agricultural crops, whether these goods are produced domestically or imported from other countries and the level of blue water scarcity experienced in the country. Across all countries, key food crops such as maize, and sorghum have low water productivity relative to the global water footprint benchmark. Export crops such as tea in Kenya or cocoa in Ghana show a good performance over global production. Furthermore, the water footprint of crops over the period 2006-2013 was compared to data from the period 1996-2005. Changes in yield and the resulting changes in the water footprint were assessed for both food and export crops. Yields in food crops improved in some countries, and in some years, but not consistently across all countries and years. The greatest gains in water productivity were in key export crops. The results provide insights into whether improvements have been made in water productivity in recent years and through comparison with the global water footprint benchmark, remaining opportunities for further gains in water productivity were identified. Going forward, policies that will enhance further improvement in water productivity and support greater food and

Birth registration and access to health care: an assessment of Ghana's campaign success.

PubMed

Fagernäs, Sonja; Odame, Joyce

2013-06-01

Birth registration remains far from complete in many developing countries. This was true of Ghana before a major registration campaign was undertaken. This study, based on survey data, assesses the results of a registration campaign initiated in 2004-2005 in Ghana. Key strategies included: extending the legal period for free registration of infants; incorporating registration in child health promotion weeks; training community health workers to register births; using community registration volunteers; registering children during celebrations, and piloting community population registers. This paper discusses the contribution of these strategies to the increase in registration rates and shows the degree of association between birth registration and various health-care access indicators and family characteristics. The Ghana Births and Deaths Registry worked together with international organizations, mainly Plan International and the United Nations Children's Fund, to implement the birth registration campaign. Unlike many other sub-Saharan African countries, Ghana saw a substantial rise in registration rates over the campaign period. Campaign strategies improved accessibility and shortened distance to registration centres. Survey data show that the registration rate for children younger than 5 years rose from 44% in 2003 to 71% in 2008. Incorporation of birth registration into community health care, health campaigns and mobile registration activities can reduce the indirect costs of birth registration, especially in poorer communities, and yield substantial increases in registration rates. The link between the health sector and registration activities should be strengthened further and the use of community population registers expanded.

Clinical nursing and midwifery research: grey literature in African countries.

PubMed

Sun, C; Dohrn, J; Omoni, G; Malata, A; Klopper, H; Larson, E

2016-03-01

This study reviewed grey literature to assess clinical nursing and midwifery research conducted in southern and eastern African countries over the past decade. The shortage of published nursing research from African countries severely limits the ability of practicing nurses and midwives to base clinical decisions on solid evidence. However, little is known regarding unpublished or unindexed clinical research ('grey literature'), a potentially rich source of information. Identifying these sources may reveal resources to assist nurses in providing evidence-based care. This scoping review of grey literature on clinical nursing and midwifery research in southern and eastern African countries helped to identify gaps in research and assess whether these gaps differ from published research. Systematic searches of grey literature were performed. Research was included if it was conducted by nurses in 1 of 25 southern or eastern African countries, between 2004 and 2014 and included patient outcomes. Data were extracted on location, institution, research topic, institutional connections and author information. Chi-square tests were performed to compare differences between indexed and non-indexed literature. We found 262 studies by 287 authors from 17 southern and eastern African countries covering 13 topics. Although all topics were also found in indexed literature and there were statistically significant differences between the number of times, fewer topics were covered in grey literature vs. indexed. Patient satisfaction and experience and traditional health practices were more likely to be published, whereas chronic disease, assault and paediatric-related research were less often published. Generally, there is a paucity of clinical nursing research in this region. This could reflect the shortage of nurses prepared to conduct research in this region. Nurses may find additional resources for evidence in the grey literature. A complete understanding of the state of nursing

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.

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,…

Clinical nursing and midwifery research in African countries: a scoping review.

PubMed

Sun, Carolyn; Larson, Elaine

2015-05-01

Globally, the nursing shortage has been deemed a crisis, but African countries have been hit hardest. Therefore, it is of utmost importance nurses use the best available evidence and that nursing research is targeted to address gaps in the evidence. To achieve this, an understanding of what is currently available and identification of gaps in clinical nursing research is critical. We performed a scoping review of existing literature to assess clinical nursing research conducted in all African countries over the past decade, identify gaps in clinical nursing and midwifery research, determine whether they match with health priorities for countries, and define priorities for regional clinical nursing research agendas to improve health outcomes. This is a scoping review of published clinical nursing research conducted in African countries. Systematic searches of literature published between January 01, 2004 and September 15, 2014 were performed in PubMed, Medline, CINHAL, and Embase. Research was included if it was conducted by nurses, included data obtained in African countries or regions within the African continent, published in a peer-reviewed journal with an abstract, and included patient outcomes. Abstracts were independently reviewed for inclusion by two authors. The following data were extracted: countries of publication and study, study type and design, journal, language, and topics of research. Gaps in the literature were identified. Initially, 1091 papers were identified with a final sample of 73 articles meeting inclusion criteria. Studies used 12 designs, were published in 35 journals published in five countries (including two African countries); 29% of the research was published in a single journal (Curatonis). Research was mostly qualitative (57%) and included twenty countries in Africa (38%). There were 12 major topics of study, most often midwifery/maternal/child health (43%), patient experiences (38%), and human immunodeficiency virus (HIV

Building local human resources to implement SLMTA with limited donor funding: The Ghana experience.

PubMed

Nkrumah, Bernard; van der Puije, Beatrice; Bekoe, Veronica; Adukpo, Rowland; Kotey, Nii A; Yao, Katy; Fonjungo, Peter N; Luman, Elizabeth T; Duh, Samuel; Njukeng, Patrick A; Addo, Nii A; Khan, Fazle N; Woodfill, Celia J I

2014-11-03

In 2009, Ghana adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme in order to improve laboratory quality. The programme was implemented successfully with limited donor funding and local human resources. To demonstrate how Ghana, which received very limited PEPFAR funding, was able to achieve marked quality improvement using local human resources. Local partners led the SLMTA implementation and local mentors were embedded in each laboratory. An in-country training-of-trainers workshop was conducted in order to increase the pool of local SLMTA implementers. Three laboratory cohorts were enrolled in SLMTA in 2011, 2012 and 2013. Participants from each cohort attended in a series of three workshops interspersed with improvement projects and mentorship. Supplemental training on internal audit was provided. Baseline, exit and follow-up audits were conducted using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. In November 2013, four laboratories underwent official SLIPTA audits by the African Society for Laboratory Medicine (ASLM). The local SLMTA team successfully implemented three cohorts of SLMTA in 15 laboratories. Seven out of the nine laboratories that underwent follow-up audits have reached at least one star. Three out of the four laboratories that underwent official ASLM audits were awarded four stars. Patient satisfaction increased from 25% to 70% and sample rejection rates decreased from 32% to 10%. On average, $40 000 was spent per laboratory to cover mentors' salaries, SLMTA training and improvement project support. Building in-country capacity through local partners is a sustainable model for improving service quality in resource-constrained countries such as Ghana. Such models promote country ownership, capacity building and the use of local human resources for the expansion of SLMTA.

Evolutionary history of rabies in Ghana.

PubMed

Hayman, David T S; Johnson, Nicholas; Horton, Daniel L; Hedge, Jessica; Wakeley, Philip R; Banyard, Ashley C; Zhang, Shoufeng; Alhassan, Andy; Fooks, Anthony R

2011-04-05

Rabies virus (RABV) is enzootic throughout Africa, with the domestic dog (Canis familiaris) being the principal vector. Dog rabies is estimated to cause 24,000 human deaths per year in Africa, however, this estimate is still considered to be conservative. Two sub-Saharan African RABV lineages have been detected in West Africa. Lineage 2 is present throughout West Africa, whereas Africa 1a dominates in northern and eastern Africa, but has been detected in Nigeria and Gabon, and Africa 1b was previously absent from West Africa. We confirmed the presence of RABV in a cohort of 76 brain samples obtained from rabid animals in Ghana collected over an eighteen-month period (2007-2009). Phylogenetic analysis of the sequences obtained confirmed all viruses to be RABV, belonging to lineages previously detected in sub-Saharan Africa. However, unlike earlier reported studies that suggested a single lineage (Africa 2) circulates in West Africa, we identified viruses belonging to the Africa 2 lineage and both Africa 1 (a and b) sub-lineages. Phylogeographic Bayesian Markov chain Monte Carlo analysis of a 405 bp fragment of the RABV nucleoprotein gene from the 76 new sequences derived from Ghanaian animals suggest that within the Africa 2 lineage three clades co-circulate with their origins in other West African countries. Africa 1a is probably a western extension of a clade circulating in central Africa and the Africa 1b virus a probable recent introduction from eastern Africa. We also developed and tested a novel reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assay for the detection of RABV in African laboratories. This RT-LAMP was shown to detect both Africa 1 and 2 viruses, including its adaptation to a lateral flow device format for product visualization. These data suggest that RABV epidemiology is more complex than previously thought in West Africa and that there have been repeated introductions of RABV into Ghana. This analysis highlights the

Community-Level Gender Equity and Extramarital Sexual Risk-Taking Among Married Men in Eight African Countries

PubMed Central

Stephenson, Rob

2014-01-01

CONTEXT In many parts of Africa, women are most likely to become infected with HIV by having unprotected sex with their husbands, who may have acquired the virus through extramarital sex. However, the ways in which aspects of community environments—particularly those related to gender equity—shape men’s extramarital sexual risk-taking are not well understood. METHODS Demographic and Health Survey data from eight African countries (Chad, Ghana, Malawi, Nigeria, Tanzania, Uganda, Zambia and Zimbabwe) were used to examine associations between married men’s engaging in risky extramarital sex (i.e., having had both unprotected sex and extramarital sex) and indicators of gender equity and other community characteristics. Separate multilevel logistic regression models that incorporated individual, household and community measures were created for each country. RESULTS In five countries, men who lived in communities with more equal ratios of women to men with at least a primary education were less likely to report risky extramarital sexual activity (odds ratios, 0.4–0.6). A similar relationship was found in four countries for the ratio of women to men who were employed (0.4–0.5). In three countries, men who lived in communities with more conservative attitudes toward wife-beating or male decision making had elevated odds of extramarital sexual risk-taking (1.1–1.5). CONCLUSIONS While HIV prevention programs should focus on reducing gender inequities, they also need to recognize the conservative cultural factors that influence the formation of men’s masculine identities and, in turn, affect their sexual behavior. PMID:21245024

The UCAR Africa Initiative: Enabling African Solutions to African Needs

NASA Astrophysics Data System (ADS)

Pandya, R.; Bruintjes, R.; Foote, B.; Heck, S.; Hermann, S.; Hoswell, L.; Konate, M.; Kucera, P.; Laing, A.; Lamptey, B.; Moncrieff, M.; Ramamurthy, M.; Roberts, R.; Spangler, T.; Traoré, A.; Yoksas, T.; Warner, T.

2007-12-01

The University Corporation for Atmospheric Research (UCAR) Africa Initiative (AI) is a coordinated effort aimed at building sustainable partnerships between UCAR and African institutions in order to pursue research and applications for the benefit of the African people. The initiative is based on four fundamental operating principles, concisely summarized by the overall philosophy of enabling African solutions to African needs. The four principles are: • Collaborate with African institutions • Focus on institutional capacity building and research support • Explore science research themes critical to Africa and important for the world • Leverage the research infrastructure in UCAR to add value These principles are realized in a set of pilot activities, chosen for their high probability of short-term results and ability to set the stage for longer-term collaboration. The three pilot activities are listed below. 1. A modest radar network and data-distribution system in Mali and Burkina Faso, including a data-sharing MOU between the Mail and Burkina Faso Weather Services. 2. A partnership among UCAR, the Ghana Meteorological Agency, and the Ghana university community to develop an operational Weather Research and Forecasting (WRF) model for West Africa. The output is used by researchers and operational forecasters in Africa. Model output is also part of a demonstration project that aims to allow humanitarian agencies to share geo-referenced information in Africa via a web portal. 3. A workshop in Ouagadougou, Burkina Faso from April 2-6, 2007, with the theme Improving Lives by Understanding Weather. The workshop, co-organized with Programme SAAGA and the Commité Permanent Inter-Etats de Lutte Contre la Sécheresse dans le Sahel (CILSS), included over 80 participants from 18 countries, and produced a set of recommendations for continued collaboration. Our presentation will provide an update of these pilot activities and point to future directions. Recognizing

Alcohol Control Policies in 46 African Countries: Opportunities for Improvement.

PubMed

Ferreira-Borges, Carina; Esser, Marissa B; Dias, Sónia; Babor, Thomas; Parry, Charles D H

2015-07-01

There is little information on the extent to which African countries are addressing alcohol consumption and alcohol-related harm, which suggests that evaluations of national alcohol policies are needed in this region. The aim of this article is to examine the strength of a mix of national alcohol control policies in African countries, as well as the relationship between alcohol policy restrictiveness scores and adult alcohol per capita consumption (APC) among drinkers at the national level. We examined national alcohol policies of 46 African countries, as of 2012, in four regulatory categories (price, availability, marketing and drink-driving), and analyzed the restrictiveness of national alcohol policies using an adapted Alcohol Policy Index (API). To assess the validity of the policy restrictiveness scores, we conducted correlational analyses between policy restrictiveness scores and APC among drinkers in 40 countries. Countries attained a mean score of 44.1 of 100 points possible, ranging from 9.1 (Sao Tomé and Principe) to 75.0 (Algeria), with low scores indicating low policy restrictiveness. Policy restrictiveness scores were negatively correlated with and APC among drinkers (rs = -0.353, P = 0.005). There is great variation in the strength of alcohol control policies in countries throughout the African region. Tools for comparing the restrictiveness of alcohol policies across countries are available and are an important instrument to monitor alcohol policy developments. The negative correlation between policy restrictiveness and alcohol consumption among drinkers suggests the need for stronger alcohol policies as well as increased training and capacity building at the country level. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Spatio-Temporal Distribution of Mycobacterium tuberculosis Complex Strains in Ghana.

PubMed

Yeboah-Manu, Dorothy; Asare, P; Asante-Poku, A; Otchere, I D; Osei-Wusu, S; Danso, E; Forson, A; Koram, K A; Gagneux, Sebastien

2016-01-01

There is a perception that genomic differences in the species/lineages of the nine species making the Mycobacterium tuberculosis complex (MTBC) may affect the efficacy of distinct control tools in certain geographical areas. We therefore analyzed the prevalence and spatial distribution of MTBC species and lineages among isolates from pulmonary TB cases over an 8-year period, 2007-2014. Mycobacterial species isolated by culture from consecutively recruited pulmonary tuberculosis patients presenting at selected district/sub-district health facilities were confirmed as MTBC by IS6110 and rpoß PCR and further assigned lineages and sub lineages by spoligotyping and large sequence polymorphism PCR (RDs 4, 9, 12, 702, 711) assays. Patient characteristics, residency, and risks were obtained with a structured questionnaire. We used SaTScan and ArcMap analyses to identify significantly clustered MTBC lineages within selected districts and spatial display, respectively. Among 2,551 isolates, 2,019 (79.1%), 516 (20.2%) and 16 (0.6%) were identified as M. tuberculosis sensu stricto (MTBss), M. africanum (Maf), 15 M. bovis and 1 M. caprae, respectively. The proportions of MTBss and Maf were fairly constant within the study period. Maf spoligotypes were dominated by Spoligotype International Type (SIT) 331 (25.42%), SIT 326 (15.25%) and SIT 181 (14.12%). We found M. bovis to be significantly higher in Northern Ghana (1.9% of 212) than Southern Ghana (0.5% of 2339) (p = 0.020). Using the purely spatial and space-time analysis, seven significant MTBC lineage clusters (p< 0.05) were identified. Notable among the clusters were Ghana and Cameroon sub-lineages found to be associated with north and south, respectively. This study demonstrated that overall, 79.1% of TB in Ghana is caused by MTBss and 20% by M. africanum. Unlike some West African Countries, we did not observe a decline of Maf prevalence in Ghana.

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

Prevalence of foodborne pathogens in food from selected African countries - A meta-analysis.

PubMed

Paudyal, Narayan; Anihouvi, Victor; Hounhouigan, Joseph; Matsheka, Maitshwarelo Ignatius; Sekwati-Monang, Bonno; Amoa-Awua, Wisdom; Atter, Amy; Ackah, Nina Bernice; Mbugua, Samuel; Asagbra, Agnes; Abdelgadir, Warda; Nakavuma, Jesca; Jakobsen, Mogens; Fang, Weihuan

2017-05-16

Food safety information in the African region is insufficient and fragmented due to lack of surveillance, documentation and reporting, thereby resulting in inefficient utilization of resources, duplication of activities, and lack of synergy among the countries of the region. This paper reviews the prevalence of foodborne pathogens in seven African countries (Benin, Botswana, Ghana, Kenya, Nigeria, Sudan and Uganda) from papers in regional or international journals published between January 2000 and December 2015. One hundred and sixteen publications that dealt with food microbiology were reviewed for general analysis, while 66 papers on contamination of pathogenic bacteria were used for meta-analysis of prevalence. The food items were split into two categories: raw foods and ready-to-eat (RTE) foods (including street food and beverages) for meta-analysis. Majority of the reviewed studies (67.2%, 78/116) dealt with food of animal origin: 38.8% for meat and eggs, 17.2% for dairy products and 11.2% for aquatic products. Only 8.6% examined foods of plant origin (fruits and vegetables). The remaining 24.1% was the composite RTE food and beverages. Enterobacteriaceae, Escherichia coli, Salmonella, Staphylococcus aureus and Listeria monocytogenes were the most frequently reported organisms in those studies. Although the data were highly heterogeneous, a striking feature is high prevalence of the major pathogens in RTE foods, almost as high as in raw foods. E. coli averaged at 37.6% in raw foods and 31.6% in RTE foods. The corresponding prevalence for Salmonella was 19.9% vs 21.7%; S. aureus, 27.8% vs 25.1% and L. monocytogenes, 19.5% vs 6.7%. The average prevalence of foodborne pathogens in these countries was 34.2% (29.0-39.3%). Differences in food types as well as non-uniform protocols for sampling and identification might have contributed to high heterogeneity (I 2 >97%) although some high prevalence data could be factual with extensive varieties of raw and RTE foods

Aetiology of stillbirths and neonatal deaths in rural Ghana: implications for health programming in developing countries.

PubMed

Edmond, Karen M; Quigley, Maria A; Zandoh, Charles; Danso, Samuel; Hurt, Chris; Owusu Agyei, Seth; Kirkwood, Betty R

2008-09-01

In developing countries many stillbirths and neonatal deaths occur at home and cause of death is not recorded by national health information systems. A community-level verbal autopsy tool was used to obtain data on the aetiology of stillbirths and neonatal deaths in rural Ghana. Objectives were to describe the timing and distribution of causes of stillbirths and neonatal deaths according to site of death (health facility or home). Data were collected from 1 January 2003 to 30 June 2004; 20,317 deliveries, 696 stillbirths and 623 neonatal deaths occurred over that time. Most deaths occurred in the antepartum period (28 weeks gestation to the onset of labour) (33.0%). However, the highest risk periods were during labour and delivery (intrapartum period) and the first day of life. Infections were a major cause of death in the antepartum (10.1%) and neonatal (40.3%) periods. The most important cause of intrapartum death was obstetric complications (59.3%). There were significantly fewer neonatal deaths resulting from birth asphyxia in the home than in the health facilities and more deaths from infection. Only 59 (20.7%) mothers of neonates who died at home reported that they sought care from an appropriate health care provider (doctor, nurse or health facility) during their baby's illness. The results from this study highlight the importance of studying community-level data in developing countries and the high risk of intrapartum stillbirths and infectious diseases in the rural African mother and neonate. Community-level interventions are urgently needed, especially interventions that reduce intrapartum deaths and infection rates in the mother and infant.

The impact of HIV/AIDS on human development in African countries.

PubMed

Boutayeb, Abdesslam

2009-11-18

In the present paper, we consider the impact of HIV/AIDS on human development in African countries, showing that, beyond health issues, this disease should and must be seen as a global development concern, affecting all components of human development. Consequently, we stress the necessity of multidisciplinary approaches that model, estimate and predict the real impact of HIV/AIDS on human development of African countries in order to optimise the strategies proposed by national countries, international institutions and their partners. In our search strategy, we relied on secondary information, mainly through National Human Development Reports of some African countries and regular publications released by the United Nations (UN), United Nations Development Programme (UNDP), World Health Organization (WHO) and the World Bank. We restricted ourselves to reports dealing explicitly with the impact of HIV/AIDS on human development in African countries. HIV/AIDS is affecting the global human development of African countries through its devastating impact on health and demographic indicators such as life expectancy at birth, healthcare assistance, age and sex distribution, economic indicators like income, work force, and economic growth, education and knowledge acquisition and other indicators like governance, gender inequality and human rights. On the basis of the national reports reviewed, it appears clearly that HIV/AIDS is no longer a crisis only for the healthcare sector, but presents a challenge to all sectors. Consequently, HIV/AIDS is a development question and should be viewed as such. The disease is impeding development by imposing a steady decline in the key indicators of human development and hence reversing the social and economic gains that African countries are striving to attain. Being at the same time a cause and consequence of poverty and underdevelopment, it constitutes a challenge to human security and human development by diminishing the chances of

Building local human resources to implement SLMTA with limited donor funding: The Ghana experience

PubMed Central

van der Puije, Beatrice; Bekoe, Veronica; Adukpo, Rowland; Kotey, Nii A.; Yao, Katy; Fonjungo, Peter N.; Luman, Elizabeth T.; Duh, Samuel; Njukeng, Patrick A.; Addo, Nii A.; Khan, Fazle N.; Woodfill, Celia J.I.

2014-01-01

Background In 2009, Ghana adopted the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme in order to improve laboratory quality. The programme was implemented successfully with limited donor funding and local human resources. Objectives To demonstrate how Ghana, which received very limited PEPFAR funding, was able to achieve marked quality improvement using local human resources. Method Local partners led the SLMTA implementation and local mentors were embedded in each laboratory. An in-country training-of-trainers workshop was conducted in order to increase the pool of local SLMTA implementers. Three laboratory cohorts were enrolled in SLMTA in 2011, 2012 and 2013. Participants from each cohort attended in a series of three workshops interspersed with improvement projects and mentorship. Supplemental training on internal audit was provided. Baseline, exit and follow-up audits were conducted using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. In November 2013, four laboratories underwent official SLIPTA audits by the African Society for Laboratory Medicine (ASLM). Results The local SLMTA team successfully implemented three cohorts of SLMTA in 15 laboratories. Seven out of the nine laboratories that underwent follow-up audits have reached at least one star. Three out of the four laboratories that underwent official ASLM audits were awarded four stars. Patient satisfaction increased from 25% to 70% and sample rejection rates decreased from 32% to 10%. On average, $40 000 was spent per laboratory to cover mentors’ salaries, SLMTA training and improvement project support. Conclusion Building in-country capacity through local partners is a sustainable model for improving service quality in resource-constrained countries such as Ghana. Such models promote country ownership, capacity building and the use of local human resources for the expansion of SLMTA. PMID:26937417

Occupational Respiratory Diseases of Miners from Two Gold Mines in Ghana

PubMed Central

Ayaaba, Esther; Li, Yan; Yuan, Jiali; Ni, Chunhui

2017-01-01

Objective: This study investigated respiratory disorders among gold miners in Ghana, a sub-Saharan African country. Material and Methods: A cross-sectional exploratory design that employed quantitative methods was conducted among 1001 male workers from the Obuasi and Tarkwa mines from December 2015 to April 2016. A total of 1001 workers, consisting of 505 and 496 underground and surface miners, respectively, were involved. The cross-sectional descriptive design was used because data was collected from participants of different experiences by selected participants at a time. Results: The study found significant association between age, educational background, marital status and drinking alcohol on respiratory disorders. The prevalence of asthma, pneumonia, bronchitis and emphysema were respectively 47.55%, 14.29%, 9.69% and 5.10%. Coughing was the most cited respiratory symptom (35.4%). Conclusions: The study documents important evidence on the level of respiratory disorders among miners in Ghana. Instituting appropriate health education interventions and improving the working environment is critical to improving the overall health and preventing respiratory disorders among miners. PMID:28327542

Do unsafe tetanus toxoid injections play a significant role in the transmission of HIV/AIDS? Evidence from seven African countries.

PubMed

de Walque, D

2008-04-01

Although sexual transmission is generally considered to be the main factor driving the HIV/AIDS epidemic in Africa, recent studies have claimed that iatrogenic transmission should be considered as an important source of HIV infection. In particular, receipt of tetanus toxoid injections during pregnancy has been reported to be associated with HIV infection in Kenya. The objective of this paper is to assess the robustness of this association among women in nationally representative HIV surveys in seven African countries. The association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was analysed, using individual-level data from women who gave birth in the past five years. These data are from the nationally representative Demographic and Health Surveys, which included HIV testing in seven African countries: Burkina Faso 2003 (N = 2424), Cameroon 2004 (N = 2600), Ethiopia 2005 (N = 2886), Ghana 2003 (N = 2560), Kenya 2003 (N = 1617), Lesotho 2004 (N = 1278) and Senegal 2005 (N = 2126). Once the odds ratios (OR) were adjusted for five-year age groups and for ethnic, urban and regional indicators, the association between prophylactic tetanus toxoid injections during pregnancy and HIV infection was never statistically significant in any of the seven countries. Only in Cameroon was there an association between previous tetanus toxoid injection and HIV positivity but it became weaker (OR 1.53, 95% CI 0.91 to 2.57) once urban location and ethnic group were adjusted for. Although the risk of HIV infection through unsafe injections and healthcare should not be ignored and should be reduced, it does not seem that there is, at present and in the seven countries studied, strong evidence supporting the claim that unsafe tetanus toxoid injections are a major factor driving the HIV epidemic.

Status of health sector strategic plans in five countries of the WHO African Region.

PubMed

Barry, S P; Sambo, L G; Bakeera, S; Kirigia, J M; Diarra-Nama, A J

2009-01-01

To assess the adequacy of the existing strategic plans and compare the format and content of health sector strategic plans with the guidelines in selected countries of the African region. The health strategic plans for Gambia, Liberia, Malawi, Tanzania and Uganda, which are kept at the WHO/AFRO, were reviewed. All health strategic plans among the Anglophone countries (Gambia, Ghana, Kenya, Liberia, Malawi, Mauritius, Tanzania, Uganda, Zambia and Zimbabwe) that were developed after the year 2000 were eligible for inclusion. Fifty percent of these countries that fitted this criterion were randomly selected. They included Gambia, Liberia, Malawi, Tanzania and Uganda. The analysis framework used in the review included situation analysis; an assessment of appropriateness of strategies that are selected; well developed indicators for each strategy; the match between the service and outcomes targets with available resources; and existence of a clear framework for partnership engagement for implementation. Most of the strategic plans identify key ill health conditions and their contributing factors. Health service and resource gaps are described but not quantified in the Botswana, Gambia, Malawi, Tanzania strategic documents. Most of the plans selected strategies that related to the situational analysis. Generally, countries' plans had clear indicators. Matching service and outcome targets to available resources was the least addressed area in majority of the plans. Most of the strategic plans identified stakeholders and acknowledged their participation in the implementation, providing different levels of comprehensiveness. Some of the areas that are well addressed according to the analysis framework included: addressing the strategic concerns of the health policies; identifying key partners for implementation; and selection of appropriate strategies. The following areas needed more emphasis: quantification of health system gaps; setting targets that are cognisant of the

Salt Use Behaviours of Ghanaians and South Africans: A Comparative Study of Knowledge, Attitudes and Practices

PubMed Central

Menyanu, Elias; Russell, Joanna; Biritwum, Richard; Kowal, Paul

2017-01-01

Salt consumption is high in Africa and the continent also shares the greatest burden of hypertension. This study examines salt-related knowledge, attitude and self-reported behaviours (KAB) amongst adults from two African countries—Ghana and South Africa—which have distributed different public health messages related to salt. KAB was assessed in the multinational longitudinal World Health Organisation (WHO) study on global AGEing and adult health (WHO-SAGE) Wave 2 (2014–2015). Respondents were randomly selected across both countries—Ghana (n = 6746; mean age 58 years old; SD 17; 41% men; 31% hypertensive) and South Africa (n = 3776, mean age 54 years old; SD 17; 32% men; 45% hypertensive). South Africans were more likely than Ghanaians to add salt to food at the table (OR 4.80, CI 4.071–5.611, p < 0.001) but less likely to add salt to food during cooking (OR 0.16, CI 0.130–0.197, p < 0.001). South Africans were also less likely to take action to control their salt intake (OR 0.436, CI 0.379–0.488, p < 0.001). Considering the various salt reduction initiatives of South Africa that have been largely absent in Ghana, this study supports additional efforts to raise consumer awareness on discretionary salt use and behaviour change in both countries. PMID:28846641

Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Mansingh; Sin, Shwe

2014-12-18

Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants. We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for 'current smoking' (cigarettes, pipe, cigars, etc.) and 'current SLT use' (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country. Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers). Prevalence of smoking among women was much

How dietary intake has been assessed in African countries? A systematic review.

PubMed

Vila-Real, Catarina; Pimenta-Martins, Ana; Gomes, Ana Maria; Pinto, Elisabete; Maina, Ndegwa Henry

2018-04-13

Dietary patterns are often considered as one of the main causes of non-communicable diseases worldwide. It is of utmost importance to study dietary habits in developing countries since this work is scarce. To summarize the most recent research conducted in this field in African countries, namely the most used methodologies and tools. A systematic review was conducted on MEDLINE®/PubMed, aiming to identify scientific publications focused on studies of dietary intake of different African populations, in a ten-year period. Papers not written in English/Portuguese/Spanish, studies developed among African people but not developed in African countries, studies aiming to assess a particular nutrient/specific food/food toxin and studies that assessed dietary intake among children were excluded. Out of 99 included studies, the 24-hour recall and the food-frequency questionnaire were the most used dietary intake assessment tools, used to assess diet at an individual level. It was also observed that often country-unspecific food composition databases are used, and the methodologies employed are poorly validated and standardized. There is an emergent need to improve the existing food databases by updating food data and to develop suitable country-specific databases for those that do not have their own food composition table.

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

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

Enhancing research capacity of African institutions through social networking.

PubMed

Jimenez-Castellanos, Ana; Ramirez-Robles, Maximo; Shousha, Amany; Bagayoko, Cheick Oumar; Perrin, Caroline; Zolfo, Maria; Cuzin, Asa; Roland, Alima; Aryeetey, Richmond; Maojo, Victor

2013-01-01

Traditionally, participation of African researchers in top Biomedical Informatics (BMI) scientific journals and conferences has been scarce. Looking beyond these numbers, an educational goal should be to improve overall research and, therefore, to increase the number of scientists/authors able to produce and publish high quality research. In such scenario, we are carrying out various efforts to expand the capacities of various institutions located at four African countries - Egypt, Ghana, Cameroon and Mali - in the framework of a European Commission-funded project, AFRICA BUILD. This project is currently carrying out activities such as e-learning, collaborative development of informatics tools, mobility of researchers, various pilot projects, and others. Our main objective is to create a self-sustained South-South network of BMI developers.

E-waste interventions in Ghana.

PubMed

Asante, Kwadwo Ansong; Pwamang, John A; Amoyaw-Osei, Yaw; Ampofo, Joseph Addo

2016-03-01

Electrical and electronic waste (e-waste) has become an emerging environmental and human health problem in the world in the 21st century. Recently, the developing nations of West Africa (e.g. Ghana and Nigeria) have become a major destination for e-waste worldwide. In Ghana, the e-waste recyclers use primitive methods (mechanical shredding and open burning) to remove plastic insulation from copper cables. This technique can release highly toxic chemicals and severely affect the environment and human health if improperly managed. It is as a result of the adverse impact on human health that some interventions are being made in Ghana to reduce exposure. The present mode of recycling/dismantling, which happens at Agbogbloshie must be replaced by official receiving/recycling centers to be established. Currently, equipment to strip both large and small cables are available in the country via the Blacksmith Institute (USA) and it is expected that the e-waste workers will embrace the use of these machines. This technology will go a long way to help prevent the burning of e-waste and will be replicated in other smaller e-waste centers in the country.

Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? The RODAM study.

PubMed

Agyemang, Charles; Meeks, Karlijn; Beune, Erik; Owusu-Dabo, Ellis; Mockenhaupt, Frank P; Addo, Juliet; de Graft Aikins, Ama; Bahendeka, Silver; Danquah, Ina; Schulze, Matthias B; Spranger, Joachim; Burr, Tom; Agyei-Baffour, Peter; Amoah, Stephen K; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Nicolaou, Mary; Adeyemo, Adebowale; van Straalen, Jan; Smeeth, Liam; Stronks, Karien

2016-10-21

Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries. A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education. In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana. Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.

Health system strengthening: a qualitative evaluation of implementation experience and lessons learned across five African countries.

PubMed

Rwabukwisi, Felix Cyamatare; Bawah, Ayaga A; Gimbel, Sarah; Phillips, James F; Mutale, Wilbroad; Drobac, Peter

2017-12-21

Achieving the United Nations Sustainable Development Goals in sub-Saharan Africa will require substantial improvements in the coverage and performance of primary health care delivery systems. Projects supported by the Doris Duke Charitable Foundation's (DDCF) African Health Initiative (AHI) created public-private-academic and community partnerships in five African countries to implement and evaluate district-level health system strengthening interventions. In this study, we captured common implementation experiences and lessons learned to understand core elements of successful health systems interventions. We used qualitative data from key informant interviews and annual progress reports from the five Population Health Implementation and Training (PHIT) partnership projects funded through AHI in Ghana, Mozambique, Rwanda, Tanzania, and Zambia. Four major overarching lessons were highlighted. First, variety and inclusiveness of concerned key players (public, academic and private) are necessary to address complex health system issues at all levels. Second, a learning culture that promotes evidence creation and ability to efficiently adapt were key in order to meet changing contextual needs. Third, inclusion of strong implementation science tools and strategies allowed informed and measured learning processes and efficient dissemination of best practices. Fourth, five to seven years was the minimum time frame necessary to effectively implement complex health system strengthening interventions and generate the evidence base needed to advocate for sustainable change for the PHIT partnership projects. The AHI experience has raised remaining, if not overlooked, challenges and potential solutions to address complex health systems strengthening intervention designs and implementation issues, while aiming to measurably accomplish sustainable positive change in dynamic, learning, and varied contexts.

A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

PubMed

Brathwaite, Rachel; Addo, Juliet; Smeeth, Liam; Lock, Karen

2015-01-01

To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

Association between health worker motivation and healthcare quality efforts in Ghana

PubMed Central

2013-01-01

Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. Methods The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. Results The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic’s effort towards quality improvement and patient safety (P <0.05). Conclusion As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially

Association between health worker motivation and healthcare quality efforts in Ghana.

PubMed

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

2013-08-14

Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic's effort towards quality improvement and patient safety (P <0.05). As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where

Key influences in the design and implementation of mental health information systems in Ghana and South Africa.

PubMed

Ahuja, S; Mirzoev, T; Lund, C; Ofori-Atta, A; Skeen, S; Kufuor, A

2016-01-01

Strengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa. We report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews with key stakeholders and reviews of key documents and secondary data from the improved MHIS. We analyzed the qualitative data using a framework approach. Key components of the MHIS intervention involved the introduction of a redesigned patient registration form, entry into computers for analysis every 2 months by clinical managerial staff, and utilization of data in hospital management meetings in three psychiatric hospitals in Ghana; and the introduction of a new set of mental health indicators and related forms and tally sheets at primary care clinics and district hospitals in five districts in the KwaZulu-Natal and Northern Cape provinces in South Africa. Overall, the key stakeholders perceived the MHIS strengthening as an effective intervention in both countries with an enhanced set of indicators in South Africa and introduction of a computerized system in Ghana. Influences on the design and implementation of MHIS interventions in Ghana and South Africa relate to resources, working approaches

An assessment of mental health policy in Ghana, South Africa, Uganda and Zambia

PubMed Central

2011-01-01

Background Approximately half of the countries in the African Region had a mental health policy by 2005, but little is known about quality of mental health policies in Africa and globally. This paper reports the results of an assessment of the mental health policies of Ghana, South Africa, Uganda and Zambia. Methods The WHO Mental Health Policy Checklist was used to evaluate the most current mental health policy in each country. Assessments were completed and reviewed by a specially constituted national committee as well as an independent WHO team. Results of each country evaluation were discussed until consensus was reached. Results All four policies received a high level mandate. Each policy addressed community-based services, the integration of mental health into general health care, promotion of mental health and rehabilitation. Prevention was addressed in the South African and Ugandan policies only. Use of evidence for policy development varied considerably. Consultations were mainly held with the mental health sector. Only the Zambian policy presented a clear vision, while three of four countries spelt out values and principles, the need to establish a coordinating body for mental health, and to protect the human rights of people with mental health problems. None included all the basic elements of a policy, nor specified sources and levels of funding for implementation. Deinstitutionalisation and the provision of essential psychotropic medicines were insufficiently addressed. Advocacy, empowerment of users and families and intersectoral collaboration were inadequately addressed. Only Uganda sufficiently outlined a mental health information system, research and evaluation, while only Ghana comprehensively addressed human resources and training requirements. No country had an accompanying strategic mental health plan to allow the development and implementation of concrete strategies and activities. Conclusions Six gaps which could impact on the policies' effect

The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

PubMed Central

2013-01-01

Background Malaria causes significant mortality and morbidity in sub-Saharan Africa (SSA), especially among children less than five years of age (U5 children). Although the economic burden of malaria in this region has been assessed previously, the extent and variation of this burden remains unclear. This study aimed to estimate the economic costs of malaria in U5 children in three countries (Ghana, Tanzania and Kenya). Methods Health system and household costs previously estimated were integrated with costs associated with co-morbidities, complications and productivity losses due to death. Several models were developed to estimate the expected treatment cost per episode per child, across different age groups, by level of severity and with or without controlling for treatment-seeking behaviour. Total annual costs (2009) were calculated by multiplying the treatment cost per episode according to severity by the number of episodes. Annual health system prevention costs were added to this estimate. Results Household and health system costs per malaria episode ranged from approximately US$ 5 for non-complicated malaria in Tanzania to US$ 288 for cerebral malaria with neurological sequelae in Kenya. On average, up to 55% of these costs in Ghana and Tanzania and 70% in Kenya were assumed by the household, and of these costs 46% in Ghana and 85% in Tanzania and Kenya were indirect costs. Expected values of potential future earnings (in thousands) lost due to premature death of children aged 0–1 and 1–4 years were US$ 11.8 and US$ 13.8 in Ghana, US$ 6.9 and US$ 8.1 in Tanzania, and US$ 7.6 and US$ 8.9 in Kenya, respectively. The expected treatment costs per episode per child ranged from a minimum of US$ 1.29 for children aged 2–11 months in Tanzania to a maximum of US$ 22.9 for children aged 0–24 months in Kenya. The total annual costs (in millions) were estimated at US$ 37.8, US$ 131.9 and US$ 109.0 nationwide in Ghana, Tanzania and Kenya and included average

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.

Natural history of chronic hepatitis B in Euro-Mediterranean and African countries.

PubMed

Hadziyannis, Stephanos J

2011-07-01

Data derived from population, case-control, and cohort studies conducted in several Euro-Mediterranean and African countries disclose impressive similarities in the age and modes of hepatitis B virus (HBV) transmission and in the prevalence, duration, and outcome of the four phases of the natural history of chronic infection. Perinatal HBV infection is rare while the vast majority of chronic infections originate from horizontal HBV transmission to infants and children. HBeAg loss and seroconversion to anti-HBe occur in a few years time, usually during the second decade of life. HBeAg-negative/anti-HBe-positive chronic hepatitis B (CHB), predominates in these countries being 7-9 times more frequent than HBeAg-positive CHB. The predominance of HBeAg-negative CHB is largely linked to the molecular characteristics of HBV genotype D prevailing in European and African countries of the Mediterranean basin and of genotype E and subgenotype A1 that prevail in the other parts of Africa. The molecular characteristics of the African subgenotype A1 differ from those of European subgenotype A2 explaining the fact that patients infected subgenotype A1 demonstrate an earlier loss of HBeAg and seroconversion to anti-HBe during the natural course of HBV infection compared to those infected with subgenotype A2. It is proposed that the molecular characteristics of HBV genotypes and subgenotypes prevailing in Euro-Mediterranean and African countries acting in concert with host and environmental factors largely determine the natural history of chronic HBV infection and its significant differences from countries of HBV genotype C and B and of subgenotype Ae predominance. The knowledge of the natural history of chronic HBV infection in Euro-Mediterranean and African countries combined with wide screening programs for prompt recognition and treatment of chronic HBV infection both in its HBeAg-positive and -negative immune reactive phases can be expected to increase the efficacy of current

Diaspora engagement of African migrant health workers - examples from five destination countries.

PubMed

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals.

Heterogeneity of Rotavirus Vaccine Efficacy Among Infants in Developing Countries.

PubMed

Gruber, Joann F; Hille, Darcy A; Liu, G Frank; Kaplan, Susan S; Nelson, Micki; Goveia, Michelle G; Mast, T Christopher

2017-01-01

Rotavirus is the leading cause of severe diarrhea worldwide in young children. Although rotavirus vaccine efficacy is high in developed countries, efficacy is lower in developing countries. Here, we investigated heterogeneity of rotavirus vaccine efficacy by infant characteristics in developing countries. An exploratory, post hoc analysis was conducted using randomized controlled trial data of the pentavalent rotavirus vaccine (RV5) conducted in Africa and Asia (NCT00362648). Infants received either 3 doses of vaccine/placebo and were followed for up to 2 years. Within subgroups, vaccine efficacies and 95% confidence intervals (CIs) against rotavirus gastroenteritis (RVGE) were estimated using Poisson regression. We assessed heterogeneity of efficacy by age at first dose, gender, breastfeeding status and nutrition status. African children receiving the first dose at <8 weeks had lower efficacy (23.7%; 95% CI: -8.2%-46.3%) than those vaccinated at ≥8 weeks (59.1%; 95% CI: 34.0%-74.6%). Marginally statistically significant differences were observed by age at first dose, gender and underweight status in Ghana and gender in Asian countries. Heterogeneity of efficacy was observed for age at first dose in African countries. This was an exploratory analysis; additional studies are needed to validate these results.

Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative.

PubMed

Mutale, Wilbroad; Chintu, Namwinga; Amoroso, Cheryl; Awoonor-Williams, Koku; Phillips, James; Baynes, Colin; Michel, Cathy; Taylor, Angela; Sherr, Kenneth

2013-01-01

Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication dependent, with challenges due to poor feedback

Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative

PubMed Central

2013-01-01

Background Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. Comparisons across strategies All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). Discussion Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication

Unmet/met need for contraception and self-reported abortion in Ghana.

PubMed

Amo-Adjei, Joshua; Darteh, Eugene K M

2017-10-01

Unmet need for contraception in several sub-Saharan African countries, including Ghana, remains high, with implications for unintended pregnancies and unsafe abortion, associated maternal morbidity and mortality. In this paper, we analysed for any associations between unmet/met need for contraception and the prevalence of abortion. The paper utilizes the 2014 Ghana Demographic Health Survey dataset. Applying descriptive statistics initially, and later, a binary logistic regression, we estimate two different models, taking into account, unmet/met need for contraception (Model 1) and a multivariable one comprising socioeconomic, spatial, cultural and demographic behaviour variables (Model 2) to test the associations between unmet/met need for contraception in Ghana. One-fourth (25%) of sampled women in 2014 had ever had an abortion. The bivariate results showed that women who reported "no unmet" considerably tended to report abortion more than the reference category - not married and no sex in the last 30days. The elevated odds among respondents who indicated "no unmet need" persisted even after controlling for all the relevant confounders. Relatedly, unlike women with an unmet need for spacing, women who desired to limit childbearing had a slightly higher tendency to report an abortion. The linkage between unmet need for contraception appears more complex, particularly when the connections are explored post-abortion. Thus, while an abortion episode is most likely due to unintended pregnancy, contraception may still not be used, after an abortion, probably because of failure, side effects or simply, a dislike for any method. Copyright © 2017 Elsevier B.V. All rights reserved.

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.

Social inequalities, regional disparities and health inequity in North African countries.

PubMed

Boutayeb, Abdesslam; Helmert, Uwe

2011-05-31

During the last decades, North African countries have substantially improved economic, social and health conditions of their populations in average. In all countries, human development in general and life expectancy, literacy and per capita income in particular have increased. However, improvement was not equally shared between groups of different milieu, regions or level of income. Social inequalities and health inequity have persisted or even worsened. Data are generally scarce and few studies were devoted to this topic in North Africa as a region. In this paper, we carry out a comparative study on the achievements of these countries, not only in terms of human development and its components but also in terms of inequalities' reduction and health equity. This study is based on data available for comparison between North African countries. The main data sources are provided by reports released by the World Health Organisation (WHO), United Nations Development Programme (UNDP), United Nations Children's Fund (UNICEF), the World Bank, surveys such as Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) and finally recent papers published on equity in different countries of the region. There is no doubt that education, health and human development in general have improved in North Africa during the last decades. Improvement was, however, uneven and unequally enjoyed by different socioeconomic groups. Indeed, each country included in this study shows large urban-rural disparities, discrepancies between advantaged and disadvantaged regions and cities; and unacceptable differences between rich and poor. Health inequity is particularly seen through access to health services and infant mortality. During the last decades, North African decision makers have endeavoured to improve social and economic conditions of their populations. Globally, health, education and living standard in general have substantially improved in average. However, North

"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

Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme.

PubMed

Hofman, Karen; Blomstedt, Yulia; Addei, Sheila; Kalage, Rose; Maredza, Mandy; Sankoh, Osman; Bangha, Martin; Kahn, Kathleen; Becher, Heiko; Haafkens, Joke; Kinsman, John

2013-04-03

The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training. SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services

Situation Report--Ghana, India, and South Africa.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in three foreign countries are presented in these situation reports. Countries included are Ghana, India, and South Africa. Information is provided under two topics: general background and family planning situation, where appropriate and if it is available. General background covers ethnic groups,…

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

Science-based health innovation in Ghana: health entrepreneurs point the way to a new development path

PubMed Central

2010-01-01

Background 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. Methods 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. Results 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. Conclusions 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

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

Impact of regulatory requirements on medicine registration in African countries – perceptions and experiences of pharmaceutical companies in South Africa

PubMed Central

Narsai, Kirti; Williams, Abeda; Mantel-Teeuwisse, Aukje Kaija

2012-01-01

Objective: Access to medicines has long been and remains a challenge in African countries. The impact of medicines registration policies in these countries poses a challenge for pharmaceutical companies wanting to register medicines in these countries. The recent AMRHI (African Medicines Registration Harmonisation Initiative) has increased the focus on the need for harmonisation. Medicines registration regulations differ across African countries. Anecdotal evidence, based on the experience of pharmaceutical companies on progress towards harmonisation is somewhat different, i.e. that country specific requirements were a barrier to the registration of medicines. The objective of this study was therefore to determine the nature and extent of regulatory hurdles experienced by pharmaceutical companies who wish to register and supply medicines to African countries. Methods: This cross-sectional descriptive pilot study was conducted across pharmaceutical companies, both local and multinational. These companies were based in South Africa and were also members of Pharmaceutical Industry Association of South Africa (PIASA). The pharmaceutical companies supply both the private and public sectors. An online survey was developed using Survey Monkey. Survey questions focused on the following strands: nature and level of current supply of medicines to African countries by companies, general regulatory requirements, region specific questions and country specific questions across four regional economic communities in Africa, namely; Southern African Development Community (SADC), East African Community (EAC), Economic Community of the West African States (ECOWAS) and Economic Community of Central African States (ECCAS). Results: A total of 33 responses were received to the questionnaire of which 26 respondents were from the PIASA Regulatory working group and 7 were from the PIASA Export working group.It was noted that since most of the regulatory authorities in Africa are resource

Enhancing collaboration between China and African countries for schistosomiasis control.

PubMed

Xu, Jing; Yu, Qing; Tchuenté, Louis-Albert Tchuem; Bergquist, Robert; Sacko, Moussa; Utzinger, Jürg; Lin, Dan-Dan; Yang, Kun; Zhang, Li-Juan; Wang, Qiang; Li, Shi-Zhu; Guo, Jia-Gang; Zhou, Xiao-Nong

2016-03-01

Schistosomiasis remains an important public health issue, with a large number of cases reported across sub-Saharan Africa, and parts of Asia and Latin America. China was once highly endemic, but has made substantial progress and is moving towards elimination of schistosomiasis. Meanwhile, despite long-term, repeated, school-based chemotherapy in many African countries, more than 90% of all schistosomiasis cases are concentrated in Africa, and hence, this continent constitutes the key challenge for schistosomiasis control. Opportunities and issues for international collaboration in the fight against schistosomiasis are outlined with a focus on China's experiences, including the role of public health authorities and intersectoral collaboration, use of new and effective snail control approaches and diagnostic tools adapted to the specific stage of control, as well as the strengthening of risk mapping and surveillance-response mechanisms. Training courses targeting African governmental officials and professionals, coupled with field visits of African scientists and control programme managers to China, and vice versa, are considered important for improved schistosomiasis control and elimination. The crucial question remains whether the Chinese experience can be translated and applied in African countries to improve the effectiveness of health interventions and scale-up. Copyright © 2016 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Opportunities for Distance Education in the Commonwealth African Countries.

ERIC Educational Resources Information Center

INTELECON Research & Consultancy Ltd., Vancouver (British Columbia).

The geo-demographic, economic, and infrastructural makeup of 12 African countries (Botswana. Gambia, Kenya, Lesotho, Malawi, Nigeria, Sierra Leone, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe) were compared to determine the potential benefits to them of a Commonwealth of Learning (COL) distance education initiative. Data were collected on…

Diaspora engagement of African migrant health workers – examples from five destination countries

PubMed Central

Wojczewski, Silvia; Poppe, Annelien; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Pentz, Stephen; Kutalek, Ruth

2015-01-01

Background Migrant health workers fill care gaps in their destination countries, but they also actively engage in improving living conditions for people of their countries of origin through expatriate professional networks. This paper aims to explore the professional links that migrant health workers from sub-Saharan African countries living in five African and European destinations (Botswana, South Africa, Belgium, Austria, and the United Kingdom) have to their countries of origin. Design Qualitative interviews were conducted with migrant doctors, nurses, and midwives from sub-Saharan Africa (N=66). A qualitative content analysis of the material was performed using the software ATLAS.ti. Results Almost all migrant health workers have professional ties with their countries of origin supporting health, education, and social structures. They work with non-governmental organizations, universities, or hospitals and travel back and forth between their destination country and country of origin. For a few respondents, professional engagement or even maintaining private contacts in their country of origin is difficult due to the political situation at home. Conclusions The results show that African migrant health workers are actively engaged in improving living conditions not only for their family members but also for the population in general in their countries of origin. Our respondents are mediators and active networkers in a globalized and transnationally connected world. The research suggests that the governments of these countries of origin could strategically use their migrant health workforce for improving education and population health in sub-Saharan Africa. Destination countries should be reminded of their need to comply with the WHO Global Code of Practice for the international recruitment of health professionals. PMID:26652910

Poor mental health in Ghana: who is at risk?

PubMed Central

2013-01-01

Background Poor mental health is a leading cause of disability worldwide with considerable negative impacts, particularly in low-income countries. Nevertheless, empirical evidence on its national prevalence in low-income countries, particularly in Africa, is limited. Additionally, researchers and policy makers are now calling for empirical investigations of the association between empowerment and poor mental health among women. We therefore sought to estimate the national prevalence of poor mental health in Ghana, explore its correlates on a national level, and examine associations between empowerment and poor mental health among women. Methods We conducted a cross-sectional analysis using data from a nationally representative survey conducted in Ghana in 2009–2010. Interviews were conducted face-to-face with participants (N = 9,524 for overall sample; n = 3,007 for women in relationships). We used the Kessler Psychological Distress Scale (K10) to measure psychological distress and assessed women’s attitudes about their roles in decision-making, attitudes towards intimate partner violence, partner control, and partner abuse. We used weighted multivariable multinomial regression models to determine the factors independently associated with experiencing psychological distress for our overall sample and for women in relationships. Results Overall, 18.7% of the sample reported either moderate (11.7%) or severe (7.0%) psychological distress. The prevalence of psychological distress was higher among women than men. Overall, the prevalence of psychological distress differed by gender, marital status, education, wealth, region, health and religion, but not by age or urban/rural location. Women who reported having experienced physical abuse, increased partner control, and who were more accepting of women’s disempowerment had greater likelihoods of psychological distress (P-values < 0.05). Conclusions Psychological distress is substantial among both men and

Cannabis and Amphetamine Use and Associated Factors among School-Going Adolescents in Nine African Countries

ERIC Educational Resources Information Center

Peltzer, Karl; Pengpid, Supa

2018-01-01

The aim of this study was to assess the prevalence of cannabis and amphetamine use and associated factors among adolescents in nine African countries. We analyzed cross-sectional data from 25,372 adolescents (mean age 14.3 years, SD = 1.6) from nine African countries that participated in the Global School-Based Student Health Survey (GSHS) in…

Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis

PubMed Central

Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

2016-01-01

Objectives Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Setting Women's experience of user fees in 5 African countries. Primary and secondary outcome measures Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities’ births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries’ choice. Participants We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). Results User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Conclusions Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. PMID:26823178

Health expenditure and economic growth - a review of the literature and an analysis between the economic community for central African states (CEMAC) and selected African countries.

PubMed

Piabuo, Serge Mandiefe; Tieguhong, Julius Chupezi

2017-12-01

African leaders accepted in the year 2001 through the Abuja Declaration to allocate 15% of their government expenditure on health but by 2013 only five (5) African countries achieved this target. In this paper, a comparative analysis on the impact of health expenditure between countries in the CEMAC sub-region and five other African countries that achieved the Abuja declaration is provided. Data for this study was extracted from the World Development Indicators (2016) database, panel ordinary least square (OLS), fully modified ordinary least square (FMOLS) and dynamic ordinary least square (DOLS) were used as econometric technic of analysis. Results showed that health expenditure has a positive and significant effect on economic growth in both samples. A unit change in health expenditure can potentially increase GDP per capita by 0.38 and 0.3 units for the five other African countries that achieve the Abuja target and for CEMAC countries respectively, a significant difference of 0.08 units among the two samples. In addition, a long-run relationship also exist between health expenditure and economic growth for both groups of countries. Thus African Economies are strongly advised to achieve the Abuja target especially when other socio-economic and political factors are efficient.

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.

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.

Skin diseases among schoolchildren in Ghana, Gabon, and Rwanda.

PubMed

Hogewoning, Arjan; Amoah, Abena; Bavinck, Jan Nico Bouwes; Boakye, Daniel; Yazdanbakhsh, Maria; Adegnika, Akim; De Smedt, Stefan; Fonteyne, Yannick; Willemze, Rein; Lavrijsen, Adriana

2013-05-01

Skin diseases, especially skin infections, among schoolchildren in Africa can be a major health problem. The objective of this study was to determine the prevalences of skin diseases among children in rural and urban schools in three different African countries and to study the influence of socioeconomic level. Cross-sectional, population-based studies were performed in Ghana, Gabon, and Rwanda. Point prevalences of skin diseases were estimated on the basis of physical examination by at least one dermatologist. A total of 4839 schoolchildren were seen. The overall prevalence of schoolchildren with any skin disease was high and amounted to 34.6% and 42.0% in two Ghanaian studies, 45.8% in Gabon, and 26.7% in Rwanda. In children with skin diseases, skin infections represented the greatest proportion of disease, accounting for 14.7% and 17.6% of skin disease in the Ghanaian studies, and 27.7% and 22.7% in Gabon and Rwanda, respectively. Diseases with the highest prevalence were tinea capitis and bacterial skin infections, especially in rural areas and in schools serving children living at lower socioeconomic levels. The prevalences of skin diseases among African schoolchildren were high. Skin infections such as tinea capitis and pyoderma predominated. © 2013 The International Society of Dermatology.

Infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality

PubMed Central

Ogbo, Felix A.; Agho, Kingsley; Ogeleka, Pascal; Woolfenden, Sue; Page, Andrew; Eastwood, John

2017-01-01

Background The impacts of optimal infant feeding practices on diarrhoea have been documented in some developing countries, but not in countries with high diarrhoea mortality as reported by the World Health Organisation/United Nations Children’s Fund. We aimed to investigate the association between infant feeding practices and diarrhoea in sub-Saharan African countries with high diarrhoea mortality. Method The study used the most recent Demographic and Health Survey datasets collected in nine sub-Saharan African countries with high diarrhoea mortality, namely: Burkina Faso (2010, N = 9,733); Demographic Republic of Congo (2013; N = 10,458); Ethiopia (2013, N = 7,251); Kenya (2014, N = 14,034); Mali (2013, N = 6,365); Niger (2013, N = 7,235); Nigeria (2013, N = 18,539); Tanzania (2010, N = 5,013); and Uganda (2010, N = 4,472). Multilevel logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between infant feeding practices and diarrhoea in these nine African countries. Results Diarrhoea prevalence was lower among children whose mothers practiced early initiation of breastfeeding, exclusive and predominant breastfeeding. Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with lower risk of diarrhoea (OR = 0.81; 95% confidence interval (CI): 0.77–0.85, P<0.001 and OR = 0.50; 95%CI: 0.43–0.57, respectively). In contrast, introduction of complementary foods (OR = 1.31; 95%CI: 1.14–1.50) and continued breastfeeding at one year (OR = 1.27; 95%CI: 1.05–1.55) were significantly associated with a higher risk of diarrhoea. Conclusion Early initiation of breastfeeding and exclusive breastfeeding are protective of diarrhoea in sub-Saharan African countries with high diarrhoea mortality. To reduce diarrhoea mortality and also achieve the health-related sustainable development goals in sub-Saharan African, an integrated, multi-agency strategic partnership within each

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.

Next-Generation Sequencing Reveals Frequent Opportunities for Exposure to Hepatitis C Virus in Ghana

PubMed Central

Phillips, Richard O.; Mora, Nallely; Xia, Guo-liang; Campo, David S.; Purdy, Michael A.; Dimitrova, Zoya E.; Owusu, Dorcas O.; Punkova, Lili T.; Skums, Pavel; Owusu-Ofori, Shirley; Sarfo, Fred Stephen; Vaughan, Gilberto; Roh, Hajung; Opare-Sem, Ohene K.; Cooper, Richard S.; Khudyakov, Yury E.

2015-01-01

Globally, hepatitis C Virus (HCV) infection is responsible for a large proportion of persons with liver disease, including cancer. The infection is highly prevalent in sub-Saharan Africa. West Africa was identified as a geographic origin of two HCV genotypes. However, little is known about the genetic composition of HCV populations in many countries of the region. Using conventional and next-generation sequencing (NGS), we identified and genetically characterized 65 HCV strains circulating among HCV-positive blood donors in Kumasi, Ghana. Phylogenetic analysis using consensus sequences derived from 3 genomic regions of the HCV genome, 5'-untranslated region, hypervariable region 1 (HVR1) and NS5B gene, consistently classified the HCV variants (n = 65) into genotypes 1 (HCV-1, 15%) and genotype 2 (HCV-2, 85%). The Ghanaian and West African HCV-2 NS5B sequences were found completely intermixed in the phylogenetic tree, indicating a substantial genetic heterogeneity of HCV-2 in Ghana. Analysis of HVR1 sequences from intra-host HCV variants obtained by NGS showed that three donors were infected with >1 HCV strain, including infections with 2 genotypes. Two other donors share an HCV strain, indicating HCV transmission between them. The HCV-2 strain sampled from one donor was replaced with another HCV-2 strain after only 2 months of observation, indicating rapid strain switching. Bayesian analysis estimated that the HCV-2 strains in Ghana were expanding since the 16th century. The blood donors in Kumasi, Ghana, are infected with a very heterogeneous HCV population of HCV-1 and HCV-2, with HCV-2 being prevalent. The detection of three cases of co- or super-infections and transmission linkage between 2 cases suggests frequent opportunities for HCV exposure among the blood donors and is consistent with the reported high HCV prevalence. The conditions for effective HCV-2 transmission existed for ~ 3–4 centuries, indicating a long epidemic history of HCV-2 in Ghana. PMID

Child witch hunts in contemporary Ghana.

PubMed

Adinkrah, Mensah

2011-09-01

The persecution of children as witches has received widespread reportage in the international mass media. In recent years, hundreds of children have been killed, maimed and abandoned across Africa based on individual and village-level accusations of witchcraft. Despite the media focus, to date, very little systematic study has investigated the phenomenon. In this case study, the persecution of child witches in Ghana is studied to explore the nature and patterns of witch hunts against children in the West African nation. There are no reliable national data on child abuse related to witchcraft accusations in Ghana. For this study, 13 cases of child witch hunts appearing in the local media during 1994-2009 were analyzed. Case summaries were constructed for each incident to help identify the socio-demographic characteristics of assailants and victims, victim-offender relationships, the methods of attacks, the spatial characteristics, as well as the motivations for the attacks. Children branded as witches ranged in age from 1-month-old to 17-years-old, were primarily from poor backgrounds, and lived in rural areas of the country. Accusations of witchcraft and witch assaults were lodged by close family members often through the encouragement of, or in concert with Christian clergymen and fetish priests. Accused witches were physically brutalized, tortured, neglected, and in two cases, murdered. For school-aged children, imputations of witchcraft contributed to stigmatization in both the community and at school, resulting in dropping out. The most frequently expressed reason for persecution of the child was suspicion that the child had used witchcraft to cause the death or illness of family relations or someone in the community. Another reason was suspicion that the child was responsible for the business failure or financial difficulties of a perceived victim. The results of this research are consistent with findings in the witchcraft literature suggesting that seemingly

Health insurance subscription among women in reproductive age in Ghana: do socio-demographics matter?

PubMed

Amu, Hubert; Dickson, Kwamena Sekyi

2016-12-01

Premised that health insurance schemes in Africa have only been introduced recently and continue evolving, various concerns have been raised regarding their effectiveness in improving utilisation of orthodox health care and the reduction of out-of-pocket expenditures for their population, particularly women. To examine the effects of socio-demographics on health insurance subscription among women in Ghana. The study draws on the 2014 Ghana Demographic and Health Survey. Bivariate descriptive analysis and binary logistic regression were used to analyse the data. Wealth status, age, religion, birth parity, marriage and ecological zone were found to have significantly predicted health insurance subscription among women in reproductive age in Ghana. Urban dwellers, women who are nulliparous, those with no or low levels of education, African traditionalists and the poor were those who largely did not subscribe to the scheme. The findings underscore the need for the National Health Insurance Authority to carry out more education in association with the National Commission for Civic Education and the Information Services Department to recruit more urban dwellers, nulliparous women, those with no or low levels of education, African traditionalists and the poor unto the scheme.

Burden and epidemiology of rotavirus diarrhea in selected African countries: preliminary results from the African Rotavirus Surveillance Network.

PubMed

Mwenda, Jason M; Ntoto, Kinkela Mina; Abebe, Almaz; Enweronu-Laryea, Christabel; Amina, Ismail; Mchomvu, Jackson; Kisakye, Annet; Mpabalwani, Evans M; Pazvakavambwa, Isoro; Armah, George E; Seheri, L M; Kiulia, Nicholas M; Page, N; Widdowson, Marc-Alain; Steele, A Duncan

2010-09-01

Severe rotavirus diarrhea in children <5 years of age is a major public health problem; however, limited regional and country specific data on rotavirus disease burden are available from sub-Saharan Africa. In June 2006, the World Health Organization Regional Office for Africa initiated rotavirus surveillance in selected African countries. With use of standardized methodology developed by the World Health Organization, children <5 years of age who were hospitalized with severe diarrhea were enrolled, and stool specimens were collected for detection of rotavirus strains with use of a commercial enzyme immunoassay. Rotavirus strains were further characterized for G and P types with use of a reverse-transcriptase polymerase chain reaction. From June 2006 through December 2008, rotavirus surveillance was established at 14 sites in 11 African countries. Of 5461 stool samples collected from children enrolled in 8 countries with 1 or 2 complete years of data, 2200 (40%) were positive for rotavirus. Ninety percent of all rotavirus hospitalizations occurred among children aged 3-12 months. Predominant types included G1P[8] (21%), G2P[4] (7%), and P [8] (29%); however, unusual types were also detected, including G8P[6] (5%), G8P[8] (1%), G12P[6] (1%), and G12P[6] (1%). A high percentage of mixed rotavirus infections was also detected. These preliminary results indicate that rotavirus is a major cause of severe diarrheal disease in African children.

"The Older Women Are Men:" Navigating the Academic Terrain, Perspectives from Ghana

ERIC Educational Resources Information Center

Mabokela, Reitumetse Obakeng; Mlambo, Yeukai Angela

2015-01-01

This qualitative study investigates how the intersection of gender, socio-cultural factors, and organizational culture impact professional experiences of women academics at a selected public university in Ghana. Given the glaring absence of women in academic positions across many African universities, particularly at academic ranks beyond the…

Appropriateness of no-fault compensation for research-related injuries from an African perspective: an appeal for action by African countries.

PubMed

Kamalo, Patrick Dongosolo; Manda-Taylor, Lucinda; Rennie, Stuart

2016-08-01

Compensation for research-related injuries (RRIs) remains a challenge in the current environment of global collaborative biomedical research as exemplified by the continued reluctance of the US government, a major player in international biomedical research, to enact regulation for mandatory compensation for RRIs. This stance is in stark contrast to the mandatory compensation policies adopted by other democracies like the European Union (EU) countries. These positions taken by the USA and the EU create a nexus of confusion when research is exported to low-income and middle-income countries which have no laws guiding compensation for RRIs. In this paper, we begin by exploring the background to policies concerning RRIs, how they reflect on the traditional dispute resolution mechanisms in African societies, and how this compares with the no-fault compensation model. We then explore the underlying African ethical framework of Ubuntu in the sub-Saharan region, guiding traditional practices of dispute resolution and compensation, and how this framework can help to form the moral justification for no-fault compensation as the preferred compensation model for RRIs for African countries. Finally, we call upon countries in the African Union (AU), to adopt a no-fault policy for compensation of RRIs, and enact it into a regulatory requirement for insurance-based no-fault compensation for biomedical research, which will then be enforced by member states of the AU. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Can Student Populations in Developing Countries Be Reached by Online Surveys? The Case of the National Service Scheme Survey (N3S) in Ghana

ERIC Educational Resources Information Center

Langer, Arnim; Meuleman, Bart; Oshodi, Abdul-Gafar Tobi; Schroyens, Maarten

2017-01-01

This article tackles the question whether it is a viable strategy to conduct online surveys among university students in developing countries. By documenting the methodology of the National Service Scheme Survey conducted in Ghana, we set out to answer three questions: (1) How can a sample of university students be obtained? (2) How can students…

An oceanography summer school in Ghana, West Africa

NASA Astrophysics Data System (ADS)

Arbic, B. K.; Ansong, J. K.; Johnson, W.; Nyadjro, E. S.; Nyarko, E.

2016-02-01

Because oceanography is a global science, it clearly benefits from the existence of a world-wide network of oceanographers. As with most STEM disciplines, sub-Saharan Africa is not as well represented in the field of oceanography as it should be, given its large population. The need for oceanographers in sub-Saharan Africa is great, due to a long list of ocean-related issues affecting African development, including but not limited to fishing, oil drilling, sea level rise, coastal erosion, shipping, and piracy. We view this as an opportunity as well as a challenge. Many of the world's fastest growing economies are in sub-Saharan Africa, and STEM capacity building could further fuel this growth. With support from the US National Science Foundation, we ran an oceanography summer school from August 24-27, 2015, at the Regional Maritime University (RMU) in Ghana, West Africa. This first summer school was lecture-based, with a focus on basic chemical oceanography, basic physical oceanography, ocean modeling, and satellite oceanography. About 35 participants came to almost every lecture, and about 20 other participants came to some of the lectures as their time permitted. The participants included RMU faculty, 12 students from the Kwame Nkrumah University of Science and Technology, one Associate Oceanographer from the University of Ghana, and some participants from private sector companies and Ghanaian governmental agencies. There were long and lively discussions at the end of each lecture, and there was a lengthy discussion at the conclusion of the school on how to improve future summer schools. In 2016 and 2017, we plan to divide into smaller groups so that participants can pursue their particular interests in greater depth, and to allow time for student presentations. We also plan to begin exploring the potential for research partnerships, and to utilize distance learning to involve more faculty and students from locations throughout Ghana and perhaps from even other

Socioeconomic implications of tobacco use in Ghana.

PubMed

John, Rijo M; Mamudu, Hadii M; Liber, Alex C

2012-10-01

Country-level evidence from Africa on the prevalence of tobacco use and the role played by both demographic and socioeconomic factors, as influences on the use of tobacco products, is sparse. This paper analyzes the determinants of tobacco use in Ghana and explores the association between tobacco use and poverty in the country. Data from the 2008 Ghana Demographic and Health Survey, a nationally representative survey of households (n = 12,323), were used to generate descriptive statistics and characterize tobacco use in the country. A logistic regression model was used to evaluate the relationships between tobacco use and age, place of residence, region, education status, wealth, marital status, alcohol use, and whether the person has children. Unadjusted and adjusted odds ratios were calculated for tobacco users and nonusers on the likelihood of their purchase of selected commodities indicative of living standards. Tobacco use was significantly higher among those living in poverty stricken regions, those with less education, lower levels of wealth, parents, and alcohol users. Tobacco use was significantly higher among men (7%) than women (0.4%), and it increased to a peak age of 41.4 years before it declined. Using tobacco was also associated with a lower likelihood of purchasing health insurance. Tobacco use is inextricably related to poverty in Ghana. Policies should be formulated to target populations and regions with higher tobacco prevalence to combat both poverty and tobacco use simultaneously.

Tobacco Control and Tobacco Farming in African Countries

PubMed Central

Hu, Teh-wei; Lee, Anita H.

2015-01-01

During the past decade, tobacco leaf production has shifted from high-income countries to developing countries, particularly those in Africa. Most African governments promote tobacco farming as a way to alleviate poverty. The economic benefit of tobacco farming has been used by the tobacco industry to block tobacco control policies. The tobacco industry is active in promoting the alleged positive aspects of tobacco farming and in “protecting” farmers from what they portray as unfair tobacco control regulations that reduce demand. Tobacco farming has many negative consequences for the health and wellbeing of farmers, as well as for the environment and the long-term wellbeing of the country concerned.1-3 We provide an overview of tobacco farming issues in Africa. Encompassing multi-dimensional issues of economic development, there is far more to it than tobacco control questions. PMID:25428192

Temperament Styles of Children in Three Sub-Saharan African Countries

ERIC Educational Resources Information Center

Oakland, Thomas; Callueng, Carmelo

2015-01-01

This cross-national research examined temperament style preferences among children in three sub-Saharan African countries (i.e., Nigeria, South Africa, and Zimbabwe) and possible differences between them on four bipolar temperament styles: extroverted-introverted, practical-imaginative, thinking-feeling, and organized-flexible. Children in these…

The prevalence of underweight, overweight, obesity and associated risk factors among school-going adolescents in seven African countries.

PubMed

Manyanga, Taru; El-Sayed, Hesham; Doku, David Teye; Randall, Jason R

2014-08-28

The burden caused by the coexistence of obesity and underweight in Low and Middle Income Countries is a challenge to public health. While prevalence of underweight among youth has been well documented in these countries, overweight, obesity and their associated risk factors are not well understood unlike in high income countries. Cross-sectional data from the Global School-based Student Health Survey (GSHS) conducted in seven African countries were used for this study. The survey used a clustered design to obtain a representative sample (n = 23496) from randomly selected schools. 53.6% of the sample was male, and participants ranged in age from 11-17 years old. Body Mass Index (BMI) was calculated using age and sex adjusted self-reported heights and weights. Classification of weight status was based on the 2007 World Health Organization growth charts (BMI-for-age and sex). Multivariable Logistic Regression reporting Odds Ratios was used to assess potential risk factors on BMI, adjusting for age, sex, and country. Statistical analyses were performed with Stata with an alpha of 0.05 and reporting 95% confidence intervals. Unadjusted rates of being underweight varied from 12.6% (Egypt) to 31.9% (Djibouti), while being overweight ranged from 8.7% (Ghana) to 31.4% (Egypt). Obesity rates ranged from 0.6% (Benin) to 9.3% (Egypt). Females had a higher overweight prevalence for every age group in five of the countries, exceptions being Egypt and Malawi. Overall, being overweight was more prevalent among younger (≤12) adolescents and decreased with age. Males had a higher prevalence of being underweight than females for every country. There was a tendency for the prevalence of being underweight to increase starting in the early teens and decrease between ages 15 and 16. Most of the potential risk factors captured by the GSHS were not significantly associated with weight status. The prevalence of both overweight and underweight was relatively high, demonstrating the

Language policy and science: Could some African countries learn from some Asian countries?

NASA Astrophysics Data System (ADS)

Brock-Utne, Birgit

2012-08-01

This article deals with the fact that most children in Africa are taught in a language neither they nor their teachers master, resulting in poor education outcomes. While there are also donor interests and donor competition involved in retaining ex-colonial languages, as well as an African elite that may profit from this system, one of the main reasons why teaching in ex-colonial languages persists lies in the fact that a large proportion of the general public still believes that the best way to learn a foreign language is to have it as a language of instruction. By contrast, research studies conducted in Africa, as well as examples from Asian countries such as Sri Lanka and Malaysia, have shown that children actually learn mathematics and science much better in local and familiar languages. Though the recent World Bank Education Strategy policy paper is entitled Learning for All, it does not specify which language learning should take place in. A claim one often hears in countries of so-called Anglophone Africa is that English is the language of science and technology, and that teaching these subjects through English (instead of teaching English as a subject in its own right as a foreign language) is best. The monolingual island of Zanzibar is in fact about to reintroduce English as the language of instruction in maths and science from grade 5 onwards in primary school. The author of this paper suggests that when it comes to language policy, some African and some Asian countries could learn from each other.

Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis.

PubMed

Leone, Tiziana; Cetorelli, Valeria; Neal, Sarah; Matthews, Zoë

2016-01-28

Evidence on whether removing fees benefits the poorest is patchy and weak. The aim of this paper is to measure the impact of user fee reforms on the probability of giving birth in an institution or undergoing a caesarean section (CS) in Ghana, Burkina Faso, Zambia, Cameroon and Nigeria for the poorest strata of the population. Women's experience of user fees in 5 African countries. Using quasi-experimental regression analysis we tested the impact of user fee reforms on facilities' births and CS differentiated by wealth, education and residence in Burkina Faso and Ghana. Mapping of the literature followed by key informant interviews are used to verify details of reform implementation and to confirm and support our countries' choice. We analysed data from consecutive surveys in 5 countries: 2 case countries that experienced reforms (Ghana and Burkina Faso) by contrast with 3 that did not experience reforms (Zambia, Cameroon, Nigeria). User fee reforms are associated with a significant percentage of the increase in access to facility births (27 percentage points) and to a much lesser extent to CS (0.7 percentage points). Poor (but not the poorest), and non-educated women, and those in rural areas benefitted the most from the reforms. User fees reforms have had a higher impact in Burkina Faso compared with Ghana. Findings show a clear positive impact on access when user fees are removed, but limited evidence for improved availability of CS for those most in need. More women from rural areas and from lower socioeconomic backgrounds give birth in health facilities after fee reform. Speed and quality of implementation might be the key reason behind the differences between the 2 case countries. This calls for more research into the impact of reforms on quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

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

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…

Key Copyright Issues in African Distance Education: A South African Case Study

ERIC Educational Resources Information Center

Ncube, Caroline B.

2011-01-01

This report draws primarily on the results of the recently concluded African Copyright and Access to Knowledge (ACA2K) Project, which investigated copyright and access to learning materials in face-to-face, distance education (DE), and dual-mode tertiary educational institutions in Egypt, Ghana, Kenya, Morocco, Mozambique, Senegal, South Africa,…

IDSR as a Platform for Implementing IHR in African Countries

PubMed Central

Kasolo, Francis; Yoti, Zabulon; Bakyaita, Nathan; Gaturuku, Peter; Katz, Rebecca; Fischer, Julie E.

2013-01-01

Of the 46 countries in the World Health Organization (WHO) African region (AFRO), 43 are implementing Integrated Disease Surveillance and Response (IDSR) guidelines to improve their abilities to detect, confirm, and respond to high-priority communicable and noncommunicable diseases. IDSR provides a framework for strengthening the surveillance, response, and laboratory core capacities required by the revised International Health Regulations [IHR (2005)]. In turn, IHR obligations can serve as a driving force to sustain national commitments to IDSR strategies. The ability to report potential public health events of international concern according to IHR (2005) relies on early warning systems founded in national surveillance capacities. Public health events reported through IDSR to the WHO Emergency Management System in Africa illustrate the growing capacities in African countries to detect, assess, and report infectious and noninfectious threats to public health. The IHR (2005) provide an opportunity to continue strengthening national IDSR systems so they can characterize outbreaks and respond to public health events in the region. PMID:24041192

Scientific equity: experiments in laboratory education in Ghana.

PubMed

Osseo-Asare, Abena Dove

2013-12-01

During the 1960s the Ministry of Education in Ghana created a network of school laboratories to increase scientific literacy among young citizens. The ministry stocked these "Science Centres" with imported beakers, Bunsen burners, and books. Education officials and university scientists worked with teachers to create lesson plans on water, air, plants, and other topics. The government hoped that scientifically minded schoolchildren would be better prepared to staff the industries of the future. The adoption of laboratory norms represented a desire for scientific equity, rather than a condition of cultural mimicry. Interviews with ministry officials and science educators, alongside letters and reports, indicate how students and teachers appropriated the laboratories in the small West African nation. Their experiences in mobilizing resources from across Ghana and around the world provide a metaphor for ongoing efforts to establish access to scientific goods in Africa.

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.

How can psychological theory help to promote condom use in sub-Saharan African developing countries?

PubMed

Campbell, T

1997-06-01

Condom use for HIV prevention has been very inconsistent in most sub-Saharan African countries. Studies from around the continent report that knowledge about HIV transmission is variable and seems to be related to gender, socioeconomic and educational status. There is a large body of psychological knowledge about HIV prevention which has been applied to condom promotion campaigns in developed countries. These approaches to condom promotion, based on formal theory, have not been used on a wide scale in African countries and this paper explores ways in which psychological theory might be appropriately applied in a situation of high HIV prevalence.

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

HIV/AIDS-related social anxieties in adolescents in three African countries.

PubMed

Venier, J L; Ross, M W; Akande, A

1998-02-01

This study examines the social anxieties associated with HIV prevention in adolescents in three African countries (Nigeria, Kenya, and Zimbabwe). The subjects used in this study were black Africans in form 2 or grade 10 in public high schools (Nigeria, n = 387; Kenya, n = 274; Zimbabwe n = 313). Subjects responded to the 33 item AIDS Social Assertiveness Scale (ASAS). Data indicated similar factor structures for each of the three countries and included five factors. The combined sample factor intercorrelations were modestly but significantly correlated. The mean scores for each factor were compared, and ANOVA of the factors by country, by gender, and by interaction between country and gender were performed. The factor structures were very similar between countries, each including five factors that had similar themes: condom interactions, refusal of risk, confiding in significant others, contact with people with HIV/AIDS, and general assertiveness. These factor structures were also very similar to one found in previous studies of Australian adolescents on the ASAS. The Kenyan means for four of the five factors were significantly lower than those for Nigeria, and were also significantly lower than the Zimbabwean means for two of the five factors, suggesting that Kenyan students are less anxious about social situations related to HIV/AIDS than others. Significant variance was found for several factors due to gender, country, and the interaction between gender and country. These results have important implications for designing education programs. The similarities of anxieties regarding HIV/AIDS social situations suggest that these clusters of social barriers to reduction of HIV infection risk might form the basis of educational interventions, and that dimensions of HIV social anxieties are similar across countries.

Nursing in Ghana: A Search for Florence Nightingale in an African City.

PubMed

Adu-Gyamfi, Samuel; Brenya, Edward

2016-01-01

Nursing in Ghana is a crucial subject that permeates almost every issue in the society especially the field of hospital care. To a large extent, the frontiers of nursing have expanded since the time of Florence Nightingale. Globally some studies have been done to study nursing icons like her. The values in nursing practice however continue to preoccupy our minds. The need to accentuate the gains made by historical figures in nursing in present times as well as the nature of interactions between practitioners and patients continues to be of paramount concern to many across the globe and Ghana in particular. This study does an analysis of existing literature on Florence Nightingale and the nature of nursing in Ghana from the colonial times. Additionally, it analyzes responses concerning the activities of nurses and their interactions with patients in Kumasi. The varied information has been thematically pieced together to make inferences that are of great interest to nursing practitioners, policy makers, administrators, and educators among others. The findings to the study suggest among other things that the challenges faced by the nursing institution in modern times are similar to those of the earlier period. The study calls for the emulation of the positive ideas of Florence Nightingale to promote the interest of patients, a core objective championed by a revered nurse.

Nursing in Ghana: A Search for Florence Nightingale in an African City

PubMed Central

Adu-Gyamfi, Samuel; Brenya, Edward

2016-01-01

Nursing in Ghana is a crucial subject that permeates almost every issue in the society especially the field of hospital care. To a large extent, the frontiers of nursing have expanded since the time of Florence Nightingale. Globally some studies have been done to study nursing icons like her. The values in nursing practice however continue to preoccupy our minds. The need to accentuate the gains made by historical figures in nursing in present times as well as the nature of interactions between practitioners and patients continues to be of paramount concern to many across the globe and Ghana in particular. This study does an analysis of existing literature on Florence Nightingale and the nature of nursing in Ghana from the colonial times. Additionally, it analyzes responses concerning the activities of nurses and their interactions with patients in Kumasi. The varied information has been thematically pieced together to make inferences that are of great interest to nursing practitioners, policy makers, administrators, and educators among others. The findings to the study suggest among other things that the challenges faced by the nursing institution in modern times are similar to those of the earlier period. The study calls for the emulation of the positive ideas of Florence Nightingale to promote the interest of patients, a core objective championed by a revered nurse. PMID:27382644

Transfusion-transmitted malaria in Ghana.

PubMed

Owusu-Ofori, Alex K; Betson, Martha; Parry, Christopher M; Stothard, J Russell; Bates, Imelda

2013-06-01

In sub-Saharan Africa, the prevalence of malaria parasitemia in blood donors varies from 0.6% to 50%. Although the burden of TTM in malaria-endemic countries is unknown, it is recommended that all donated blood is screened for malaria parasites. This study aimed to establish the incidence of TTM and identify a suitable screening test. Pregnant women, children, and immunocompromised malaria-negative transfusion recipients in a teaching hospital in Ghana were recruited over the course of 1 year. Parasites detected in recipients within 14 days of the transfusion were genotyped and compared to parasites in the transfused blood. The presence of genotypically identical parasites in the recipient and the transfused blood confirmed transfusion-transmitted malaria. Four malaria screening tests were compared to assess their usefulness in the context of African blood banks. Of the 50 patients who received transfusions that were positive for Plasmodium falciparum by polymerase chain reaction (PCR), 7 recipients developed PCR-detectable parasitemia. In only 1 of the 50 recipients (2%) was the parasite identical to that in the transfused blood. The prevalence of P. falciparum malaria in transfused blood was 4.7% (21/445) by microscopy, 13.7% (60/440) by rapid diagnostic test, 18% (78/436) by PCR, and 22.2% (98/442) by enzyme immunoassay. Although malaria parasites are commonly detected in blood donors in malaria-endemic areas, transfusion-transmitted malaria occurs infrequently. Policies recommend screening blood donors for malaria, but none of the commonly used methods is sufficiently sensitive to be used by blood banks in malaria-endemic countries.

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

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.

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.

JOICFP included in GII mission to Ghana. Global Issues Initiative.

PubMed

1996-03-01

Among countries in West Africa, Ghana is the main focus of the Global Issues Initiative (GII) on Population and AIDS and one of twelve priority countries selected for official development assistance (ODA) under the program. A ten-member project formulation mission sent to Ghana by the Ministry of Foreign Affairs (MOFA) of Japan was in the country during January 10-18. This mission was the first of its kind to be sent to Africa. It was led by the director of the Third Project Formulation Study Division, Project Formulation Study Department, Japan International Cooperation Agency (JICA), and included representatives of MOFA, JICA, and the Ministry of Health and Welfare, and an observer from UNAIDS. The mission's chief objective was to explore possibilities for Japanese cooperation in the areas of population, child health, and HIV/AIDS in line with the Mid-Term Health Strategy (MTHS) formulated in 1995 by the government of Ghana. The mission also explored the possibility of collaboration with major donors, international organizations, international agencies, and NGOs. The mission met with representatives of NGOs from population, women, AIDS, and health-related areas on January 13, who were then briefed upon Japan's Grant Assistance for Grassroots Project for local NGOs. Views were exchanged upon NGO activities.

Hunger influenced life expectancy in war-torn Sub-Saharan African countries.

PubMed

Uchendu, Florence N

2018-04-27

Malnutrition is a global public health problem especially in developing countries experiencing war/conflicts. War might be one of the socio-political factors influencing malnutrition in Sub-Saharan African (SSA) countries. This study aims at determining the influence of war on corruption, population (POP), number of population malnourished (NPU), food security and life expectancy (LE) in war-torn SSA countries (WTSSA) by comparing their malnutrition indicators. Fourteen countries in WTSSA were stratified into zones according to war incidences. Countries' secondary data on population (POP), NPU, Food Security Index (FSI), corruption perceptions index (CPI), Global Hunger Index (GHI) and LE were obtained from global published data. T test, multivariate and Pearson correlation analyses were performed to determine the relationship between CPI, POP, GHI, FSI, NPU, male LE (MLE) and female LE (FLE) in WTSSA at p < .05. Data were presented in tables, means, standard deviation and percentages. Mean NPU, CPI, GHI, POP, FSI, MLE and FLE in WTSSA were 5.0 million, 28.3%, 18.2%, 33.8 million, 30.8%, 54.7 years and 57.1 years, respectively. GHI significantly influenced LE in both male and female POP in WTSSA. NPU, CPI, FSI, GHI and FLE were not significantly different according to zones except in MLE. Malnutrition indicators were similarly affected in WTSSA. Hunger influenced life expectancy. Policies promoting good governance, equity, peaceful co-existence, respect for human right and adequate food supply will aid malnutrition eradication and prevent war occurrences in Sub-Saharan African countries.

Ethnopharmacological reports on anti-Buruli ulcer medicinal plants in three West African countries.

PubMed

Tsouh Fokou, Patrick Valere; Nyarko, Alexander Kwadwo; Appiah-Opong, Regina; Tchokouaha Yamthe, Lauve Rachel; Addo, Phyllis; Asante, Isaac K; Boyom, Fabrice Fekam

2015-08-22

Buruli ulcer (BU) is the third most common mycobacterial infection in the world, after tuberculosis and leprosy and has recently been recognized as an important emerging disease. This disease is common in West Africa where more than 99% of the burden is felt and where most affected people live in remote areas with traditional medicine as primary or only option. Reports indicate that the ethnopharmacological control approach of the disease in such settings has shown promise. However, no or very few compilations of traditional knowledge in using medicinal plants to treat BU have been attempted so far. This review aimed to record medicinal plants used traditionally against BU in three countries in West Africa: Ivory Coast, Ghana and Benin and for which ethnopharmacological knowledge supported by pharmacological investigations has been reported. The information recorded in this review will support further pharmacological research to develop appropriate drugs for a better BU control. A systematic review of the literature on ethnobotanical use and anti-BU activity of plants reported for BU treatment was performed. The approach consisted to search several resources, including Technical Reports, Books, Theses, Conference proceedings, web-based scientific databases such as publications on PubMed, Science direct, Springer, ACS, Scielo, PROTA, Google and Google scholar reporting ethnobotanical surveys and screening of natural products against Mycobacterium ulcerans. This study was limited to papers and documents published either in English or French reporting ethnopharmacological knowledge in BU treatment or pharmacological potency in vitro. This review covered the available literature up to December 2014. The majority of reports originated from the three most affected West African countries (Cote d'Ivoire, Ghana and Benin). Though, 98 plant species belonging to 48 families have been identified as having anti-BU use, many have received no or little attention. Most of the

Training needs for research in health inequities among health and demographic researchers from eight African and Asian countries.

PubMed

Haafkens, Joke; Blomstedt, Yulia; Eriksson, Malin; Becher, Heiko; Ramroth, Heribert; Kinsman, John

2014-12-10

To support equity focussed public health policy in low and middle income countries, more evidence and analysis of the social determinants of health inequalities is needed. This requires specific know how among researchers. The INDEPTH Training and Research Centres of Excellence (INTREC) collaboration will develop and provide training on the social determinants of health approach for health researchers from the International Network for the Demographic Evaluation of Populations and Their Health in Low- and Middle-Income Countries (INDEPTH) in Africa and Asia. To identify learning needs among the potential target group, this qualitative study explored what INDEPTH researchers from Ghana, Tanzania, South Africa, Kenya, Indonesia, India, Vietnam, and Bangladesh feel that they want to learn to be able to conduct research on the causes of health inequalities in their country. Using an inductive method, online concept-mapping, participants were asked to generate statements in response to the question what background knowledge they would need to conduct research on the causes of health inequalities in their country, to sort those statements into thematic groups, and to rate them in terms of how important it would be for the INTREC program to offer instruction on each of the statements. Statistical techniques were used to structure statements into a thematic cluster map and average importance ratings of statements/clusters were calculated. Of the 150 invited researchers, 82 participated in the study: 54 from Africa; 28 from Asia. Participants generated 59 statements and sorted them into 6 broader thematic clusters: "assessing health inequalities"; "research design and methods"; "research and policy"; "demography and health inequalities"; "social determinants of health" and "interventions". African participants assigned the highest importance to further training on methods for assessing health inequalities. Asian participants assigned the highest importance to training on

Addressing the workforce crisis: the professional aspirations of pharmacy students in Ghana.

PubMed

Owusu-Daaku, Frances; Smith, Felicity; Shah, Rita

2008-10-01

A lack of skilled health professionals, and net migration from developing to more developed countries, are widely recognised as barriers to the delivery of effective health care. However, few studies have investigated this issue from the perspective of pharmacists, although they are increasingly viewed as a potentially valuable and underexploited health care resource. The objectives of this study were to examine the professional aspirations and perceived opportunities of final year pharmacy students in a developing country; and consider what developments may encourage them to remain in, and contribute to, health care in their home country. Final year pharmacy students from the Faculty of Pharmacy, KNUST, Kumasi, Ghana, were randomly selected and invited to participate in in-depth interviews. These were audio-recorded (with permission of respondents) and transcribed verbatim to enable a qualitative analysis. professional aspirations, and perceived opportunities and barriers to their achievement in Ghana and abroad. Results Participants viewed themselves, and wished to be viewed by others, as health professionals. They described a commitment to applying their clinical knowledge and to education beyond their first degree. However, they identified significant barriers to the achievement of professional aspirations in Ghana, which would diminish their opportunities to contribute to health care. Whilst most students expressed the expectation or desire to travel at some point, usually early, in their career, they all demonstrated a commitment to their country and stated a wish to return. Overall the study highlighted prospective pharmacists in Ghana as ambitious, committed potential health professionals. The study indicates that a lack of attention by policy makers and professional bodies to ways of exploiting the contribution of pharmacists to public health, may represent a lost potential human resource for health in developing countries.

Hygiene behaviour and associated factors among in-school adolescents in nine African countries.

PubMed

Pengpid, Supa; Peltzer, Karl

2011-06-01

This report examines hygiene behaviour and associated factors among 13-15 year old in-school adolescents in nine African countries. The total sample included 25,760 school children aged 13-15 years from nationally representative samples from nine African countries. We examined the prevalence of and relationship between tooth brushing, hand washing before eating, hand washing after toileting, hand washing with soap and a range of psychosocial factors such as socio-demographic characteristics, health behaviour, mental health or well-being and protective factors. Overall, sub-optimal hygiene behaviour was reported, the proportions of school children reporting optimal (>once a day) tooth brushing (77.3%) was higher than the proportions reported for washing their hands regularly before meals (62.2%), after toileting (58.4%) and washing their hands with soap (35.0%). In multivariate analysis higher education, health-enhancing behaviours such as daily fruits or vegetable consumption, and protective factors such as caregiver supervision were associated with tooth brushing, hand washing before meals, hand washing after toileting and washing of hands with soap. The cross-national data on hygiene behaviour from nine African countries found sub-optimal hygiene behaviour. Various determinants of optimal hygiene behaviour were identified that can guide programmes to improve hygiene behaviour of this adolescent population.

The public health effects of water and sanitation in selected West African countries.

PubMed

Alagidede, P; Alagidede, A N

2016-01-01

This paper examines access to water and improved sanitation target under the Millennium Development Goal 7c (MDG 7c) for six West African countries: Chad, Niger, Nigeria, Mauritania, Sierra Leone and Togo. The article outlines some possible causes for the slow progress in achieving the MDG 7c, examines the public health effects of missing the targets, and charts paths for policy makers to consider in bringing these targets to acceptable levels. The study is based on secondary data analysis of trends in water and sanitation indicators for the six countries from 2000 to 2014. The data are drawn from the World Development Indicators (WDI) of the World Bank, and the World Health Organisation Joint Monitoring Programme (WHO JMP) and WaterAid Africa Wash Map. The performance of each country in the two indicators is presented and judged against the target set under MDG 7c. Forecasts based on the expiry of the MDG's in 2015 and the time required to achieve the targets are carried out. The study showes that while some progress has been made in improved water, sanitation showed slow progress for all the countries between 2000 and 2014. The goal of attaining acceptable sanitation shows that the six West African countries have lagged behind the MDG 7c target and the progress is equally slow. At the current rate of progress if strong public and private sector intervention mechanisms are not instituted across the board, the six West African countries under study would continue to lag behind the rest of the world in terms of access to improved water and sanitation. This has consequences for poverty alleviation and the risk of the re-emergence of neglected tropical diseases. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

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

Abuse of Disabled Children in Ghana

ERIC Educational Resources Information Center

Kassah, Alexander Kwesi; Kassah, Bente Lilljan Lind; Agbota, Tete Kobla

2012-01-01

Even though disabled children are targets of various forms of abuse, such issues remain mostly undocumented open secrets in many countries including Ghana. The article is based on a qualitative data provided by three key informants. Six stories emerged from the data and are discussed in terms of four main forms of abuse. Labelling theories are…

The Cost of Annual versus Biannual Community-Directed Treatment of Onchocerciasis with Ivermectin: Ghana as a Case Study

PubMed Central

Turner, Hugo C.; Osei-Atweneboana, Mike Y.; Walker, Martin; Tettevi, Edward J.; Churcher, Thomas S.; Asiedu, Odame; Biritwum, Nana-Kwadwo; Basáñez, María-Gloria

2013-01-01

Background It has been proposed that switching from annual to biannual (twice yearly) mass community-directed treatment with ivermectin (CDTI) might improve the chances of onchocerciasis elimination in some African foci. However, historically, relatively few communities have received biannual treatments in Africa, and there are no cost data associated with increasing ivermectin treatment frequency at a large scale. Collecting cost data is essential for conducting economic evaluations of control programmes. Some countries, such as Ghana, have adopted a biannual treatment strategy in selected districts. We undertook a study to estimate the costs associated with annual and biannual CDTI in Ghana. Methodology The study was conducted in the Brong-Ahafo and Northern regions of Ghana. Data collection was organized at the national, regional, district, sub-district and community levels, and involved interviewing key personnel and scrutinizing national records. Data were collected in four districts; one in which treatment is delivered annually, two in which it is delivered biannually, and one where treatment takes place biannually in some communities and annually in others. Both financial and economic costs were collected from the health care provider's perspective. Principal Findings The estimated cost of treating annually was US Dollars (USD) 0.45 per person including the value of time donated by the community drug distributors (which was estimated at USD 0.05 per person per treatment round). The cost of CDTI was approximately 50–60% higher in those districts where treatment was biannual than in those where it was annual. Large-scale mass biannual treatment was reported as being well received and considered sustainable. Conclusions/Significance This study provides rigorous evidence of the different costs associated with annual and biannual CDTI in Ghana which can be used to inform an economic evaluation of the debate on the optimal treatment frequency required to control

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.

Fostering repeat donations in Ghana.

PubMed

Owusu-Ofori, S; Asenso-Mensah, K; Boateng, P; Sarkodie, F; Allain, J-P

2010-01-01

Most African countries are challenged in recruiting and retaining voluntary blood donors by cost and other complexities and in establishing and implementing national blood policies. The availability of replacement donors who are a cheaper source of blood has not enhanced repeat voluntary donor initiatives. An overview of activities for recruiting and retaining voluntary blood donors was carried out. Donor records from mobile sessions were reviewed from 2002 to 2008. A total of 71,701 blood donations; 45,515 (63.5%) being voluntary donations with 11,680 (25%) repeat donations were collected during the study period. Donations from schools and colleges contributed a steady 60% of total voluntary whilst radio station blood drives increased contribution from 10 to 27%. Though Muslim population is less than 20%, blood collection was above the 30-donation cost-effectiveness threshold with a repeat donation trend reaching 60%. In contrast Christian worshippers provided <25 unit/session and 30% repeat donations. Repeat donation trends amongst school donors and radio blood drives were 20% and 70% respectively. Repeat donations rates have been variable amongst different blood donor groups in Kumasi, Ghana. The impact of community leaders in propagating altruism cannot be overemphasized. Programs aiming at motivating replacement donors to be repeat donors should be developed and assessed. Copyright 2009 The International Association for Biologicals. All rights reserved.

Impact of MenAfriVac in nine countries of the African meningitis belt, 2010-15: an analysis of surveillance data.

PubMed

Trotter, Caroline L; Lingani, Clément; Fernandez, Katya; Cooper, Laura V; Bita, André; Tevi-Benissan, Carol; Ronveaux, Olivier; Préziosi, Marie-Pierre; Stuart, James M

2017-08-01

In preparation for the introduction of MenAfriVac, a meningococcal group A conjugate vaccine developed for the African meningitis belt, an enhanced meningitis surveillance network was established. We analysed surveillance data on suspected and confirmed cases of meningitis to quantify vaccine impact. We compiled and analysed surveillance data for nine countries in the meningitis belt (Benin, Burkina Faso, Chad, Côte d'Ivoire, Ghana, Mali, Niger, Nigeria, and Togo) collected and curated by the WHO Inter-country Support Team between 2005 and 2015. The incidence rate ratios (IRRs) of suspected and confirmed cases in vaccinated and unvaccinated populations were estimated with negative binomial regression models. The relative risk of districts reaching the epidemic threshold of ten per 100 000 per week was estimated according to district vaccination status. The incidence of suspected meningitis cases declined by 57% (95% CI 55-59) in vaccinated compared with unvaccinated populations, with some heterogeneity observed by country. We observed a similar 59% decline in the risk of a district reaching the epidemic threshold. In fully vaccinated populations, the incidence of confirmed group A disease was reduced by more than 99%. The IRR for non-A serogroups was higher after completion of MenAfriVac campaigns (IRR 2·76, 95% CI 1·21-6·30). MenAfriVac introduction has led to substantial reductions in the incidence of suspected meningitis and epidemic risk, and a substantial effect on confirmed group A meningococcal meningitis. It is important to continue strengthening surveillance to monitor vaccine performance and remain vigilant against threats from other meningococcal serogroups and other pathogens. World Health Organization. Copyright © 2017 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Establishing sustainable performance-based incentive schemes: views of rural health workers from qualitative research in three sub-Saharan African countries.

PubMed

Yé, M; Aninanya, G A; Sié, A; Kakoko, D C V; Chatio, S; Kagoné, M; Prytherch, H; Loukanova, S; Williams, J E; Sauerborn, R

2014-01-01

Performance-based incentives (PBIs) are currently receiving attention as a strategy for improving the quality of care that health providers deliver. Experiences from several African countries have shown that PBIs can trigger improvements, particularly in the area of maternal and neonatal health. The involvement of health workers in deciding how their performance should be measured is recommended. Only limited information is available about how such schemes can be made sustainable. This study explored the types of PBIs that rural health workers suggested, their ideas regarding the management and sustainability of such schemes, and their views on which indicators best lend themselves to the monitoring of performance. In this article the authors reported the findings from a cross-country survey conducted in Burkina Faso, Ghana and Tanzania. The study was exploratory with qualitative methodology. In-depth interviews were conducted with 29 maternal and neonatal healthcare providers, four district health managers and two policy makers (total 35 respondents) from one district in each of the three countries. The respondents were purposively selected from six peripheral health facilities. Care was taken to include providers who had a management role. By also including respondents from district and policy level a comparison of perspectives from different levels of the health system was facilitated. The data that was collected was coded and analysed with support of NVivo v8 software. The most frequently suggested PBIs amongst the respondents in Burkina Faso were training with per-diems, bonuses and recognition of work done. The respondents in Tanzania favoured training with per-diems, as well as payment of overtime, and timely promotion. The respondents in Ghana also called for training, including paid study leave, payment of overtime and recognition schemes for health workers or facilities. Respondents in the three countries supported the mobilisation of local resources to

Psychological distress in Ghana: associations with employment and lost productivity.

PubMed

Canavan, Maureen E; Sipsma, Heather L; Adhvaryu, Achyuta; Ofori-Atta, Angela; Jack, Helen; Udry, Christopher; Osei-Akoto, Isaac; Bradley, Elizabeth H

2013-03-07

Mental health disorders account for 13% of the global burden of disease, a burden that low-income countries are generally ill-equipped to handle. Research evaluating the association between mental health and employment in low-income countries, particularly in sub-Saharan Africa, is limited. We address this gap by examining the association between employment and psychological distress. We analyzed data from the Ghana Socioeconomic Panel Survey using logistic regression (N = 5,391 adults). In multivariable analysis, we estimated the association between employment status and psychological distress, adjusted for covariates. We calculated lost productivity from unemployment and from excess absence from work that respondents reported was because of their feelings of psychological distress. Approximately 21% of adults surveyed had moderate or severe psychological distress. Increased psychological distress was associated with increased odds of being unemployed. Men and women with moderate versus mild or no psychological distress had more than twice the odds of being unemployed. The association of severe versus mild or no distress with unemployment differed significantly by sex (P-value for interaction 0.004). Among men, the adjusted OR was 12.4 (95% CI: 7.2, 21.3), whereas the association was much smaller for women (adjusted OR = 3.8, 95% CI: 2.5, 6.0). Extrapolating these figures to the country, the lost productivity associated with moderate or severe distress translates to approximately 7% of the gross domestic product of Ghana. Psychological distress is strongly associated with unemployment in Ghana. The findings underscore the importance of addressing mental health issues, particularly in low-income countries.

Strengthening care for injured persons in less developed countries: a case study of Ghana and Mexico.

PubMed

Mock, Charles; Arreola-Risa, Carlos; Quansah, Robert

2003-01-01

In all countries, the priority for reducing road traffic injuries should be prevention. Nonetheless, there are low-cost ways to strengthen the care of injured persons, that will help to lower the toll from road traffic. The purpose of this review was to elucidate ways to accomplish this goal in the context of less developed countries. Studies selected for this review were obtained by Medline review, selecting on key words such as trauma, injury, trauma care, essential health services, and developing country. Articles pertaining to any country and all available years were considered. In addition, the authors utilized articles from the gray literature and journals from Mexico and Ghana that are not Medline referenced. Studies surveyed point to road safety and other forms of injury prevention, as well as prehospital care, as likely priorities for developing countries. Nonetheless, hospital-based improvements can contribute to decreases in mortality and, especially, decreases in disability. For both prehospital and hospital based care, studies revealed several critical weak points to address in: (1) human resources (staffing and training); (2) physical resources (equipment, supplies, and infrastructure); and (3) administration and organization. The 'essential services' approach, which has contributed to progress in a variety of fields of international health, needs to be developed for the care of the injured. This would define the trauma treatment services that could realistically be made available to virtually every injured person. It would then address the inputs of human resources, physical resources, and administration necessary to assure these services optimally in the different geographic and socioeconomic environments worldwide. Finally, it would identify and target deficiencies in these inputs that need to be strengthened.

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.

Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

2016-08-30

In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from participants for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS, inadequate coordination among

Does the operations of the National Health Insurance Scheme (NHIS) in Ghana align with the goals of Primary Health Care? Perspectives of key stakeholders in northern Ghana.

PubMed

Awoonor-Williams, John Koku; Tindana, Paulina; Dalinjong, Philip Ayizem; Nartey, Harry; Akazili, James

2016-09-05

In 2005, the World Health Assembly (WHA) of the World Health Organization (WHO) urged member states to aim at achieving affordable universal coverage and access to key promotive, preventive, curative, rehabilitative and palliative health interventions for all their citizens on the basis of equity and solidarity. Since then, some African countries, including Ghana, have taken steps to introduce national health insurance reforms as one of the key strategies towards achieving universal health coverage (UHC). The aim of this study was to get a better understanding of how Ghana's health insurance institutions interact with stakeholders and other health sector programmes in promoting primary health care (PHC). Specifically, the study identified the key areas of misalignment between the operations of the NHIS and that of PHC. Using qualitative and survey methods, this study involved interviews with various stakeholders in six selected districts in the Upper East region of Ghana. The key stakeholders included the National Health Insurance Authority (NHIA), district coordinators of the National Health Insurance Schemes (NHIS), the Ghana Health Service (GHS) and District Health Management Teams (DHMTs) who supervise the district hospitals, health centers/clinics and the Community-based Health and Planning Services (CHPS) compounds as well as other public and private PHC providers. A stakeholders' workshop was organized to validate the preliminary results which provided a platform for stakeholders to deliberate on the key areas of misalignment especially, and to elicit additional information, ideas and responses, comments and recommendations from respondents for the achievement of the goals of UHC and PHC. The key areas of misalignments identified during this pilot study included: delays in reimbursements of claims for services provided by health care providers, which serves as a disincentive for service providers to support the NHIS; inadequate coordination among

An agricultural survey for more than 9,500 African households

PubMed Central

Waha, Katharina; Zipf, Birgit; Kurukulasuriya, Pradeep; Hassan, Rashid M.

2016-01-01

Surveys for more than 9,500 households were conducted in the growing seasons 2002/2003 or 2003/2004 in eleven African countries: Burkina Faso, Cameroon, Ghana, Niger and Senegal in western Africa; Egypt in northern Africa; Ethiopia and Kenya in eastern Africa; South Africa, Zambia and Zimbabwe in southern Africa. Households were chosen randomly in districts that are representative for key agro-climatic zones and farming systems. The data set specifies farming systems characteristics that can help inform about the importance of each system for a country’s agricultural production and its ability to cope with short- and long-term climate changes or extreme weather events. Further it informs about the location of smallholders and vulnerable systems and permits benchmarking agricultural systems characteristics. PMID:27218890

From Pentecostalism to Politics: Mass Literacy and Community Development in Late Colonial Northern Ghana

ERIC Educational Resources Information Center

Skinner, Kate

2010-01-01

This article takes as its starting point a strike among African trainee literacy workers in the Northern Territories of the Gold Coast (now Ghana) in 1952. While the existing literature tends to concentrate on the tensions and contradictions in British colonial education policy, this article uses the strike to investigate how these agendas were…

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

Status of national health research systems in ten countries of the WHO African Region.

PubMed

Kirigia, Joses M; Wambebe, Charles

2006-10-19

The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten countries reported that

Status of national health research systems in ten countries of the WHO African Region

PubMed Central

Kirigia, Joses M; Wambebe, Charles

2006-01-01

Background The World Health Organization (WHO) Regional Committee for Africa, in 1998, passed a resolution (AFR/RC48/R4) which urged its Member States in the Region to develop national research policies and strategies and to build national health research capacities, particularly through resource allocation, training of senior officials, strengthening of research institutions and establishment of coordination mechanisms. The purpose of this study was to take stock of some aspects of national resources for health research in the countries of the Region; identify current constraints facing national health research systems; and propose the way forward. Methods A questionnaire was prepared and sent by pouch to all the 46 Member States in the WHO African Region through the WHO Country Representatives for facilitation and follow up. The health research focal person in each of the countries Ministry of Health (in consultation with other relevant health research bodies in the country) bore the responsibility for completing the questionnaire. The data were entered and analysed in Excel spreadsheet. Results The key findings were as follows: the response rate was 21.7% (10/46); three countries had a health research policy; one country reported that it had a law relating to health research; two countries had a strategic health research plan; three countries reported that they had a functional national health research system (NHRS); two countries confirmed the existence of a functional national health research management forum (NHRMF); six countries had a functional ethical review committee (ERC); five countries had a scientific review committee (SRC); five countries reported the existence of health institutions with institutional review committees (IRC); two countries had a health research programme; and three countries had a national health research institute (NHRI) and a faculty of health sciences in the national university that conducted health research. Four out of the ten

Teacher Educators' Practice and Vision of Good Teaching in Teacher Education Reform Context in Ghana

ERIC Educational Resources Information Center

Akyeampong, Kwame

2017-01-01

Teacher education in sub-Sahara Africa (SSA) has been criticized for the lack of attention to learning to teach in real classrooms, which limits the opportunity for pre-service teachers to successfully introduce learner-centered pedagogy in African primary school classrooms. To address this problem, Ghana has implemented a teacher education reform…

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.

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

Tobacco use in older adults in Ghana: sociodemographic characteristics, health risks and subjective wellbeing.

PubMed

Yawson, Alfred E; Baddoo, Akosua; Hagan-Seneadza, Nana Ayegua; Calys-Tagoe, Benedict; Hewlett, Sandra; Dako-Gyeke, Phyllis; Mensah, George; Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul; Biritwum, Richard

2013-10-20

Tobacco use over the life-course threatens to increase disease burden in older adulthood, including lower income countries like Ghana. This paper describes demographic, socioeconomic, health risks and life satisfaction indices related to tobacco use among older adults in Ghana. 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. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and the University of Ghana Medical School through the Department of Community Health. A nationally representative sample of 4305 older adults aged 50 years and above were interviewed. Associations between tobacco consumption and sociodemographic, socioeconomic, health risk and life satisfaction were evaluated using chi-square and odds ratio (OR). Logistic regression analyses, adjusted for age, sex and other variables, were conducted to determine predictors of tobacco consumption in older persons. Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Tobacco use (i.e. ever used tobacco) was associated with older males, (AOR = 1.10, CI 1.05-1.15), older adults residing in rural locations (AOR = 1.37, CI 1.083-1.724), and older adults who used alcohol (AOR = 1.13, CI 0.230-2.418). Tobacco use was also associated (although not statistically significant per p-values) with increased self-reporting of angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, and stroke. Older adults who used tobacco and with increased health risks, tended to be without health insurance (AOR = 1.41, CI 1.111-1.787). Satisfaction with life and daily living was much lower for those who use tobacco. Regional differences existed in tobacco use; the three northern regions (Upper East, Northern and Upper West) had higher proportions of tobacco use among older adults in the country. Quitting tobacco use was higher

Association between Contract Teachers and Student Learning in Five Francophone African Countries

ERIC Educational Resources Information Center

Chudgar, Amita

2015-01-01

This article investigates the association between studying with a contract teacher and a student's academic outcomes, using data from five Francophone African countries for two grade levels and two subjects. Based on this analysis, the evidence for or against this form of teacher hiring is inconclusive. The results indicate that these…

A Founder Mutation in LEPRE1 Carried by 1.5% of West Africans and 0.4% of African Americans Causes Lethal Recessive Osteogenesis Imperfecta

PubMed Central

Cabral, Wayne A.; Barnes, Aileen M.; Adeyemo, Adebowale; Cushing, Kelly; Chitayat, David; Porter, Forbes D.; Panny, Susan R.; Gulamali-Majid, Fizza; Tishkoff, Sarah A.; Rebbeck, Timothy R.; Gueye, Serigne M.; Bailey-Wilson, Joan E.; Brody, Lawrence C.; Rotimi, Charles N.; Marini, Joan C.

2012-01-01

Purpose Deficiency of prolyl 3-hydroxylase 1, encoded by LEPRE1, causes recessive osteogenesis imperfecta. We previously identified a LEPRE1 mutation, exclusively in African Americans and contemporary West Africans. We hypothesized that this allele originated in West Africa and was introduced to the Americas with the Atlantic slave trade. We aimed to determine the frequency of carriers for this mutation among African Americans and West Africans, and the mutation origin and age. Methods Genomic DNA was screened for the mutation using PCR and restriction digestion, and a custom TaqMan genomic SNP assay. The mutation age was estimated using microsatellites and short tandem repeats spanning 4.2 Mb surrounding LEPRE1 in probands and carriers. Results Approximately 0.4% of Mid-Atlantic African Americans carry this mutation, estimating recessive OI in 1/260,000 births in this population. In Nigeria and Ghana, 1.48% of unrelated individuals are heterozygous carriers, predicting 1/18,260 births will be affected with recessive OI, equal to the incidence of de novo dominant OI. The mutation was not detected in Africans from surrounding countries. All carriers shared a haplotype of 63-770 Kb, consistent with a single founder for this mutation. Using linkage disequilibrium analysis, the mutation was estimated to have originated between 650 and 900 years before present (1100-1350 C.E.). Conclusions We identified a West African founder mutation for recessive OI in LEPRE1. Nearly 1.5% of Ghanians and Nigerians are carriers. The age of this allele is consistent with introduction to North America via the Atlantic slave trade (1501 – 1867 C.E). PMID:22281939

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

Addressing health system barriers to access to and use of skilled delivery services: perspectives from Ghana.

PubMed

Ganle, John Kuumuori; Fitzpatrick, Raymond; Otupiri, Easmon; Parker, Michael

2016-10-01

Poor access to and use of skilled delivery services have been identified as a major contributory factor to poor maternal and newborn health in sub-Saharan African countries, including Ghana. However, many previous studies that examine norms of childbirth and care-seeking behaviours have focused on identifying the norms of non-use of services, rather than factors, that can promote service use. Based on primary qualitative research with a total of 185 expectant and lactating mothers, and 20 healthcare providers in six communities in Ghana, this paper reports on strategies that can be used to overcome health system barriers to the use of skilled delivery services. The strategies identified include expansion and redistribution of existing maternal health resources and infrastructure, training of more skilled maternity caregivers, instituting special programmes to target women most in need, improving the quality of maternity care services provided, improving doctor-patient relationships in maternity wards, promotion of choice, protecting privacy and patient dignity in maternity wards and building partnerships with traditional birth attendants and other non-state actors. The findings suggest the need for structural changes to maternity clinics and routine nursing practices, including an emphasis on those doctor-patient relational practices that positively influence women's healthcare-seeking behaviours. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

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

Testing for purchasing power parity in 21 African countries using several unit root tests

NASA Astrophysics Data System (ADS)

Choji, Niri Martha; Sek, Siok Kun

2017-04-01

Purchasing power parity is used as a basis for international income and expenditure comparison through the exchange rate theory. However, empirical studies show disagreement on the validity of PPP. In this paper, we conduct the testing on the validity of PPP using panel data approach. We apply seven different panel unit root tests to test the validity of the purchasing power parity (PPP) hypothesis based on the quarterly data on real effective exchange rate for 21 African countries from the period 1971: Q1-2012: Q4. All the results of the seven tests rejected the hypothesis of stationarity meaning that absolute PPP does not hold in those African Countries. This result confirmed the claim from previous studies that standard panel unit tests fail to support the PPP hypothesis.

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

Report of the 7th African Rotavirus Symposium, Cape Town, South Africa, 8th November 2012.

PubMed

Seheri, L M; Mwenda, J M; Page, N

2014-11-12

The 7th African Rotavirus Symposium was held in Cape Town, South Africa, on the 8th November 2012 as a Satellite Symposium at the First International African Vaccinology Conference. Over 150 delegates participated in this symposium including scientists, clinicians, health officials, policymakers and vaccine manufacturers from across Africa. Key topics discussed included rotavirus surveillance, rotavirus vaccine introduction, post rotavirus vaccine impact analysis and intussusception data and surveillance in Africa. The symposium provided early rotavirus vaccine adopter countries in Africa (South Africa, Ghana and Botswana) an opportunity to share up-to-date information on vaccine introduction, and allowed colleagues to share experiences in establishing routine rotavirus surveillance (Tanzania, Niger and Rwanda). Overall, the symposium highlighted the high burden of rotavirus in Africa, and the need to continue to strengthen efforts in preventing rotavirus diarrhoea in Africa. Copyright © 2014. Published by Elsevier Ltd.. All rights reserved.

An adjusted bed net coverage indicator with estimations for 23 African countries

PubMed Central

2013-01-01

Background Many studies have assessed the level of bed net coverage in populations at risk of malaria infection. These revealed large variations in bed net use across countries, regions and social strata. Such studies are often aimed at identifying populations with low access to bed nets that should be prioritized in future interventions. However, often spatial differences in malaria endemicity are not taken into account. By ignoring variability in malaria endemicity, these studies prioritize populations with little access to bed nets, even if these happen to live in low endemicity areas. Conversely, populations living in regions with high malaria endemicity will receive a lower priority once a seizable proportion is protected by bed nets. Adequately assigning priorities requires accounting for both the current level of bed net coverage and the local malaria endemicity. Indeed, as shown here for 23 African countries, there is no correlation between the level of bed net coverage and the level of malaria endemicity in a region. Therefore, the need for future interventions can not be assessed based on current bed net coverage alone. This paper proposes the Adjusted Bed net Coverage (ABC) statistic as a measure taking into account both local malaria endemicity and the level of bed net coverage. The measure allows setting priorities for future interventions taking into account both local malaria endemicity and bed net coverage. Methods A mathematical formulation of the ABC as a weighted difference of bed net coverage and malaria endemicity is presented. The formulation is parameterized based on a model of malaria epidemiology (Smith et al. Trends Parasitol 25:511-516, 2009). By parameterizing the ABC based on this model, the ABC as used in this paper is proxy for the steady-state malaria burden given the current level of bed net coverage. Data on the bed net coverage in under five year olds and malaria endemicity in 23 Sub-Saharan countries is used to show that the ABC

Access to What? Creating a Composite Measure of Educational Quantity and Educational Quality for 11 African Countries

ERIC Educational Resources Information Center

Spaull, Nicholas; Taylor, Stephen

2015-01-01

The aim of the current study is to create a composite statistic of educational quantity and educational quality by combining household data (Demographic and Health Survey) on grade completion and survey data (Southern and Eastern African Consortium for Monitoring Educational Quality) on cognitive outcomes for 11 African countries: Kenya, Lesotho,…

African Braille Production: A Statistical Review and Evaluation of Countries and Costs.

ERIC Educational Resources Information Center

Mayer, Marc; Cylke, Frank Kurt

A study was conducted in 52 African countries to determine the extent of braille facilities for the blind, with the aim of choosing a location for a central braille producing facility. To make the selection, the factors of ease of communication (i.e., central location), political stability, and extent of already existing organizations for the…

A comprehensive review of available epidemiologic and HIV service data for female sex workers, men who have sex with men, and people who inject drugs in select West and Central African countries.

PubMed

MacAllister, Jack; Sherwood, Jennifer; Galjour, Joshua; Robbins, Sarah; Zhao, Jinkou; Dam, Kim; Grosso, Ashley; Baral, Stefan D

2015-03-01

To identify gaps in epidemiologic and HIV service coverage data for key populations (KP), including men who have sex with men (MSM), female sex workers (FSW), people who inject drugs (PWID), and transgender persons, in 8 West and Central Africa countries: Cameroon, Chad, Cote d'Ivoire, Democratic Republic of Congo, Ghana, Guinea-Bissau, Niger, and Nigeria. A comprehensive search of peer-reviewed literature was conducted using PubMed and MEDLINE. This search was supplemented by an additional search of relevant non-peer-reviewed, or gray, literature. Available data on HIV prevalence, KP size estimates, HIV prevention service targets, and HIV prevention service coverage, including the availability of population-specific minimum packages of services, were included in the review. No data for transgender persons were found. HIV prevalence data and size estimates were more frequently available for FSW, followed by MSM. Only 2 countries (Ghana and Nigeria) had both KP size estimates and HIV prevalence data for PWID. The degree to which HIV prevention service targets were adopted was highly variable across the selected countries, and the collection of relevant HIV prevention service coverage data for those targets that were identified was inconsistent. Population-specific minimum packages of services were identified in 3 countries (Cote d'Ivoire, Ghana, and Nigeria), although only Ghana and Nigeria included services for PWID. Epidemiologic and HIV prevention service data for FSW, MSM, PWID, and transgender persons remain sparse, and these KP are inconsistently accounted for in-service delivery and nationally endorsed minimum packages of HIV services in West and Central Africa. The strengthening of data collection and reporting to consistently include KP and the inclusion of that data in national planning is imperative for effectively addressing the HIV epidemic.

Correlation between national income, HIV/AIDS and political status and mortalities in African countries.

PubMed

Andoh, S Y; Umezaki, M; Nakamura, K; Kizuki, M; Takano, T

2006-07-01

To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education. We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants. Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR. National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

Developing effective chronic disease interventions in Africa: insights from Ghana and Cameroon

PubMed Central

2010-01-01

Background Africa faces an urgent but 'neglected epidemic' of chronic disease. In some countries stroke, hypertension, diabetes and cancers cause a greater number of adult medical admissions and deaths compared to communicable diseases such as HIV/AIDS or tuberculosis. Experts propose a three-pronged solution consisting of epidemiological surveillance, primary prevention and secondary prevention. In addition, interventions must be implemented through 'multifaceted multi-institutional' strategies that make efficient use of limited economic and human resources. Epidemiological surveillance has been prioritised over primary and secondary prevention. We discuss the challenge of developing effective primary and secondary prevention to tackle Africa's chronic disease epidemic through in-depth case studies of Ghanaian and Cameroonian responses. Methods A review of chronic disease research, interventions and policy in Ghana and Cameroon instructed by an applied psychology conceptual framework. Data included published research and grey literature, health policy initiatives and reports, and available information on lay community responses to chronic diseases. Results There are fundamental differences between Ghana and Cameroon in terms of 'multi-institutional and multi-faceted responses' to chronic diseases. Ghana does not have a chronic disease policy but has a national health insurance policy that covers drug treatment of some chronic diseases, a culture of patient advocacy for a broad range of chronic conditions and mass media involvement in chronic disease education. Cameroon has a policy on diabetes and hypertension, has established diabetes clinics across the country and provided training to health workers to improve treatment and education, but lacks community and media engagement. In both countries churches provide public education on major chronic diseases. Neither country has conducted systematic evaluation of the impact of interventions on health outcomes and cost

African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries.

PubMed

Wojczewski, Silvia; Pentz, Stephen; Blacklock, Claire; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Kutalek, Ruth

2015-01-01

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender.

Private Sector Participation in Urban Water and Sanitation Provision in Ghana: Experiences from the Tamale Metropolitan Area (TMA)

NASA Astrophysics Data System (ADS)

Osumanu, Issaka Kanton

2008-07-01

African governments, like most countries in the developing world, face daunting tasks in their attempts to provide effective and equitable water and sanitation services for their ever increasing urban populations. Consequently, the past few years have witnessed increased private sector participation in urban water and sanitation provision, as many African governments strive to improve access to water and sanitation services for their citizens in line with Millennium Development Goal 7 (MDG7). Since the early 1990s, the government of Ghana and many local authorities have entered into various forms of public-private partnerships in urban water and sanitation provision. This article examines the outcome of such partnerships using the Tamale Metropolitan Area (TMA) as a case study with the aim of providing policy guidelines for the way forward. The article argues that the public-private arrangement for water supply and sanitation infrastructure management in the Tamale Metropolis has done nothing that an invigorated public sector could not have possibly achieved. It concludes that there can be no sustainable improvement in water and sanitation provision without political commitment, stakeholder ownership, and strong support for community driven initiatives.

Private sector participation in urban water and sanitation provision in Ghana: experiences from the Tamale Metropolitan Area (TMA).

PubMed

Osumanu, Issaka Kanton

2008-07-01

African governments, like most countries in the developing world, face daunting tasks in their attempts to provide effective and equitable water and sanitation services for their ever increasing urban populations. Consequently, the past few years have witnessed increased private sector participation in urban water and sanitation provision, as many African governments strive to improve access to water and sanitation services for their citizens in line with Millennium Development Goal 7 (MDG7). Since the early 1990s, the government of Ghana and many local authorities have entered into various forms of public-private partnerships in urban water and sanitation provision. This article examines the outcome of such partnerships using the Tamale Metropolitan Area (TMA) as a case study with the aim of providing policy guidelines for the way forward. The article argues that the public-private arrangement for water supply and sanitation infrastructure management in the Tamale Metropolis has done nothing that an invigorated public sector could not have possibly achieved. It concludes that there can be no sustainable improvement in water and sanitation provision without political commitment, stakeholder ownership, and strong support for community driven initiatives.

Can countries of the WHO African Region wean themselves off donor funding for health?

PubMed

Kirigia, Joses Muthuri; Diarra-Nama, Alimata J

2008-11-01

More than 20% of total health expenditure in 48% of the 46 countries in the WHO African Region is provided by external sources. Issues surrounding aid effectiveness suggest that these countries ought to implement strategies for weaning off aid dependency. This paper broaches the following question: what are some of the strategies that countries of the region can employ to wean off donor funding for health? Five strategies are discussed: reduction in economic inefficiencies; reprioritizing public expenditures; raising additional tax revenues; increased private sector involvement in health development; and fighting corruption.

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.

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

Developing Higher Education Programs in Emergency Management: Ghana's Experience

ERIC Educational Resources Information Center

Yakubu, Mariama Bisongu

2013-01-01

Ghana is highly vulnerable and threatened by several hazards and has sought ways of minimizing impacts of hazards events over time including demonstrating an interest in developing an emergency management training and an higher education degree program. Yet, as of 2013, the country has not developed a disaster management training program or a…

Financing public healthcare institutions in Ghana.

PubMed

Akortsu, Mercy Akosua; Abor, Patience Aseweh

2011-01-01

The financing of healthcare services has been of a major concern to all governments in the face of increasing healthcare costs. For developing countries, where good health is considered a poverty reduction strategy, it is imperative that the hospitals used in the delivery of healthcare services are well financed to accomplish their tasks. The purpose of this paper is to examine how public hospitals in Ghana are financed, and the challenges facing the financing modes adopted. To achieve the objectives of the study, one major public healthcare institution in Ghana became the main focus. The findings of the study revealed that the main sources of financing the public healthcare institution are government subvention, internally-generated funds and donor-pooled funds. Of these sources, the internally generated fund was regarded as the most reliable, and the least reliable was the donor-pooled funds. Several challenges associated with the various financing sources were identified. These include delay in receipt of government subvention, delay in the reimbursement of services provided to subscribers of health insurance schemes, influence of government in setting user fees, and the specifications to which donor funds are put. The findings of this study have important implications for improving the financing of public healthcare institutions in Ghana. A number of recommendations are provided in this regard.

Measures for diffusion of solar PV in selected African countries

NASA Astrophysics Data System (ADS)

Nygaard, Ivan; Hansen, Ulrich Elmer; Mackenzie, Gordon; Pedersen, Mathilde Brix

2017-08-01

This paper investigates how African governments are considering supporting and promoting the diffusion of solar PV. This issue is explored by examining so-called 'technology action plans (TAPs)', which were main outputs of the Technology Needs Assessment project implemented in 10 African countries from 2010 to 2013. The paper provides a review of three distinct but characteristic trajectories for PV market development in Kenya (private-led market for solar home systems), Morocco (utility-led fee-for service model) and Rwanda (donor-led market for institutional systems). The paper finds that governments' strategies to promoting solar PV are moving from isolated projects towards frameworks for market development and that there are high expectations to upgrading in the PV value chain through local assembly of panels and local production of other system elements. Commonly identified measures include support to: local production; financing schemes; tax exemptions; establishment and reinforcement of standards; technical training; and research and development.

Ethics, culture and nursing practice in Ghana.

PubMed

Donkor, N T; Andrews, L D

2011-03-01

This paper describes how nurses in Ghana approach ethical problems. The International Council of Nurses' (ICN) Code for Nurses (2006) that serves as the model for professional code of ethics worldwide also acknowledges respect for healthy cultural values. Using the ICN's Code and universal ethical principles as a benchmark, a survey was conducted in 2009 to ascertain how nurses in Ghana respond to ethical and cultural issues in their practice. The study was qualitative with 200 participant nurses. Data were obtained through anonymous self-administered questionnaires. Descriptive statistics were used to analyze the data. Nurses' approaches to ethical problems in Ghana do not always meet expectations of the ICN Code for Nurses. They are also informed by local ethical practices related to the institutional setting and cultural environment in the country. While some cultural values complemented the ICN's Code and universal ethical principles, others conflicted with them. These data can assist nurses to provide culturally competent solutions to ethical dilemmas in their practice. Dynamic communication between nurses and patients/clients, intentional study of local cultural beliefs, and the development of ethics education will improve the conformity between universal ethical standards and local cultural values. © 2011 The Authors. International Nursing Review © 2011 International Council of Nurses.

Mapping of Mycobacterium tuberculosis Complex Genetic Diversity Profiles in Tanzania and Other African Countries

PubMed Central

Mbugi, Erasto V.; Katale, Bugwesa Z.; Streicher, Elizabeth M.; Keyyu, Julius D.; Kendall, Sharon L.; Dockrell, Hazel M.; Michel, Anita L.; Rweyemamu, Mark M.; Warren, Robin M.; Matee, Mecky I.; van Helden, Paul D.; Couvin, David; Rastogi, Nalin

2016-01-01

The aim of this study was to assess and characterize Mycobacterium tuberculosis complex (MTBC) genotypic diversity in Tanzania, as well as in neighbouring East and other several African countries. We used spoligotyping to identify a total of 293 M. tuberculosis clinical isolates (one isolate per patient) collected in the Bunda, Dar es Salaam, Ngorongoro and Serengeti areas in Tanzania. The results were compared with results in the SITVIT2 international database of the Pasteur Institute of Guadeloupe. Genotyping and phylogeographical analyses highlighted the predominance of the CAS, T, EAI, and LAM MTBC lineages in Tanzania. The three most frequent Spoligotype International Types (SITs) were: SIT21/CAS1-Kili (n = 76; 25.94%), SIT59/LAM11-ZWE (n = 22; 7.51%), and SIT126/EAI5 tentatively reclassified as EAI3-TZA (n = 18; 6.14%). Furthermore, three SITs were newly created in this study (SIT4056/EAI5 n = 2, SIT4057/T1 n = 1, and SIT4058/EAI5 n = 1). We noted that the East-African-Indian (EAI) lineage was more predominant in Bunda, the Manu lineage was more common among strains isolated in Ngorongoro, and the Central-Asian (CAS) lineage was more predominant in Dar es Salaam (p-value<0.0001). No statistically significant differences were noted when comparing HIV status of patients vs. major lineages (p-value = 0.103). However, when grouping lineages as Principal Genetic Groups (PGG), we noticed that PGG2/3 group (Haarlem, LAM, S, T, and X) was more associated with HIV-positive patients as compared to PGG1 group (Beijing, CAS, EAI, and Manu) (p-value = 0.03). This study provided mapping of MTBC genetic diversity in Tanzania (containing information on isolates from different cities) and neighbouring East African and other several African countries highlighting differences as regards to MTBC genotypic distribution between Tanzania and other African countries. This work also allowed underlining of spoligotyping patterns tentatively grouped within the newly designated EAI3-TZA

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.

Measuring Nutritional Intake of Adolescents in Ghana, West Africa

ERIC Educational Resources Information Center

Owusu, Andrew; Murdock, Peggy O'Hara; Weatherby, Norman L.

2007-01-01

With 85% of the world's adolescent populations residing in developing countries, it is important to monitor and track their nutrition status and habits. The purpose of this study, conducted in Ghana, was to provide results from a nutrition intake and eating habits questionnaire which was modified from the Youth Risk Behavior Survey. Questions were…

African Female Physicians and Nurses in the Global Care Chain: Qualitative Explorations from Five Destination Countries

PubMed Central

Wojczewski, Silvia; Pentz, Stephen; Blacklock, Claire; Hoffmann, Kathryn; Peersman, Wim; Nkomazana, Oathokwa; Kutalek, Ruth

2015-01-01

Migration of health professionals is an important policy issue for both source and destination countries around the world. The majority of migrant care workers in industrialized countries today are women. However, the dimension of mobility of highly skilled females from countries of the global south has been almost entirely neglected for many years. This paper explores the experiences of high-skilled female African migrant health-workers (MHW) utilising the framework of Global Care Chain (GCC) research. In the frame of the EU-project HURAPRIM (Human Resources for Primary Health Care in Africa), the research team conducted 88 semi-structured interviews with female and male African MHWs in five countries (Botswana, South Africa, Belgium, Austria, UK) from July 2011 until April 2012. For this paper we analysed the 34 interviews with female physicians and nurses using the qualitative framework analysis approach and the software atlas.ti. In terms of the effect of the migration on their career, almost all of the respondents experienced short-term, long-term or permanent inability to work as health-care professionals; few however also reported a positive career development post-migration. Discrimination based on a foreign nationality, race or gender was reported by many of our respondents, physicians and nurses alike, whether they worked in an African or a European country. Our study shows that in addition to the phenomenon of deskilling often reported in GCC research, many female MHW are unable to work according to their qualifications due to the fact that their diplomas are not recognized in the country of destination. Policy strategies are needed regarding integration of migrants in the labour market and working against discrimination based on race and gender. PMID:26068218

Television exposure and overweight/obesity among women in Ghana.

PubMed

Tuoyire, Derek Anamaale

2018-01-01

Although the public health importance of the association between television (TV) viewing and obesity and/or related outcomes have been demonstrated in both cross-sectional and prospective studies elsewhere, similar studies are lacking within the African region. With the view to fill this gap in the literature, the current study explored the association between TV exposure and overweight/obesity among Ghanaian women. Based on a sample of 4158 women, descriptive statistics and binary logistic regression were applied to data on TV ownership, TV viewing frequency, and body mass index (BMI) measures from the 2014 Ghana Demographic and Health Survey (GDHS) to explore the association between TV exposure and overweight/obesity among Ghanaian women. Despite controlling for other factors (age educational level, marital status, wealth quintile, occupation, type of locality, and parity), the results show that women with TV in their households, and with high TV exposure were significantly ( P  < 0.05) more likely (OR = 1.39, 95% CI = 1.002, 1.923) to be overweight/obese compared to those with no TV in their households, and no TV exposure. The study demonstrates that increased TV exposure is significantly associated with overweight/obesity among women in Ghana even after adjusting for other factors. Interventions aimed at tackling obesity in Ghana should focus on encouraging the uptake of more physically demanding pastime activities in place of TV "sit time".

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

PubMed

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity H K; Seddoh, Janet

2005-12-20

The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

PubMed Central

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity HK; Seddoh, Janet

2005-01-01

Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. Results There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income

Situation Reports--Ceylon, Costa Rica, Ghana, Haiti, Morocco, Sudan, Tunisia, and U.S.A.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in eight countries are presented in these situation reports. Countries included are Ceylon, Costa Rica, Ghana, Haiti, Morocco, Sudan, Tunisia, and the United States of America. Information is provided under two topics, general background and family planning situation, where appropriate and if it is…

The "Universal" in UHC and Ghana's National Health Insurance Scheme: policy and implementation challenges and dilemmas of a lower middle income country.

PubMed

Agyepong, Irene Akua; Abankwah, Daniel Nana Yaw; Abroso, Angela; Chun, ChangBae; Dodoo, Joseph Nii Otoe; Lee, Shinye; Mensah, Sylvester A; Musah, Mariam; Twum, Adwoa; Oh, Juwhan; Park, Jinha; Yang, DoogHoon; Yoon, Kijong; Otoo, Nathaniel; Asenso-Boadi, Francis

2016-09-21

Despite universal population coverage and equity being a stated policy goal of its NHIS, over a decade since passage of the first law in 2003, Ghana continues to struggle with how to attain it. The predominantly (about 70 %) tax funded NHIS currently has active enrolment hovering around 40 % of the population. This study explored in-depth enablers and barriers to enrolment in the NHIS to provide lessons and insights for Ghana and other low and middle income countries (LMIC) into attaining the goal of universality in Universal Health Coverage (UHC). We conducted a cross sectional mixed methods study of an urban and a rural district in one region of Southern Ghana. Data came from document review, analysis of routine data on enrolment, key informant in-depth interviews with local government, regional and district insurance scheme and provider staff and community member in-depth interviews and focus group discussions. Population coverage in the NHIS in the study districts was not growing towards near universal because of failure of many of those who had ever enrolled to regularly renew annually as required by the NHIS policy. Factors facilitating and enabling enrolment were driven by the design details of the scheme that emanate from national level policy and program formulation, frontline purchaser and provider staff implementation arrangements and contextual factors. The factors inter-related and worked together to affect client experience of the scheme, which were not always the same as the declared policy intent. This then also affected the decision to enrol and stay enrolled. UHC policy and program design needs to be such that enrolment is effectively compulsory in practice. It also requires careful attention and responsiveness to actual and potential subscriber, purchaser and provider (stakeholder) incentives and related behaviour generated at implementation levels.

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

Mean reversion in the current account of forty-eight african countries: Evidence from the Panel SURADF test

NASA Astrophysics Data System (ADS)

Chu, Hsiao-Ping; Chang, Tsangyao; Chang, Hsu-Ling; Su, Chi-Wei; Yuan, Young

2007-10-01

Here, the Panel seemingly unrelated regressions augmented Dickey-Fuller test (SURADF) test, first introduced and advanced by Breuer et al. [Misleading inferences from panel unit-root tests with an illustration from purchasing power parity, Rev. Int. Econ. 9(3) (2001) 482-493], is used to investigate the mean-reverting behavior of the current account of 48 African countries during the 1980-2004 periods. The empirical results from numerous panel-based unit root tests, conducted earlier, indicated that the current account of each of these countries is stationary; however, when Breuer et al.'s (2001) Panel SURADF test is conducted, it is found that a unit root exists in the current account of 11 of the countries studied. These results have one extremely important policy implication for the 48 African countries studied: the current account deficit of most is sustainable, and thus signifying that those nations should have no incentive to default on their international debt.

Reconceptualised life skills in secondary education in the African context: Lessons learnt from reforms in Ghana

NASA Astrophysics Data System (ADS)

Akyeampong, Kwame

2014-04-01

Early notions of life skills in Africa did not take into account the importance of a flexible and portable set of skills that would enable youth to adapt to changes in the world of work and lay the foundations for productive well-being and behaviour. Rather, life skills education in many secondary education curricula in Africa started with an emphasis on developing specific technical vocational skills considered essential for employability or self-employment. Using Ghana as an example, this paper shows how secondary education curriculum reformers recommended shifts that embraced a new interpretation of life skills focused on 21st-century skills. This gradual move also reflected the difficulty that secondary education in general has had in networking with the world of work to provide work experience that would lead to the development of work-related skills and enhance employability. The author's main argument is that although the reconceptualisation of life skills in secondary education to reflect 21st-century skills is a welcome shift in the African context, this needs to be accompanied by reforms in teacher education. Classroom teaching and learning need to be adapted in a fundamental way in order to ensure that youth fully benefit from the inclusion of 21st-century life skills in secondary education curricula. Such reforms must include pedagogical practices which nurture communication, collaboration, creativity and critical thinking skills.

Income-environment relationship in Sub-Saharan African countries: Further evidence with trade openness.

PubMed

Zerbo, Eléazar

2017-07-01

This paper examines the dynamic relationship between energy consumption, income growth, carbon emissions and trade openness in fourteen Sub-Saharan African (SSA) countries. The autoregressive distributed lag (ARDL) approach to cointegration and the Toda-Yamamoto causality test were used to investigate the long-run and short-run properties, respectively. The long-run estimations give evidence against the environmental Kuznets curve (EKC) hypothesis in SSA countries. In contrast, the results highlight the significant and monotonically contribution of income growth and energy consumption in explaining carbon emissions in the long-run and short-run in several countries. Furthermore, the results show that trade openness enhances economic growth and is not linked to causing carbon emissions in these countries. Hence, a trade incentive policy may be implemented without harmful effect on the quality of the environment.

Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

PubMed Central

2011-01-01

Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health

Measuring client satisfaction and the quality of family planning services: a comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana.

PubMed

Hutchinson, Paul L; Do, Mai; Agha, Sohail

2011-08-24

Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory

Black versus Black: The Relationship among African, African American, and African Caribbean Persons.

ERIC Educational Resources Information Center

Jackson, Jennifer V.; Cothran, Mary E.

2003-01-01

Surveyed people of African descent regarding relationships among African, African-American, and African-Caribbean persons, focusing on contact and friendship, travel to countries of the diaspora, cross-cultural communication, thoughts and stereotypes, and education. Most respondents had contacts with the other groups, but groups had preconceived…

Prevalence, awareness, treatment and control of hypertension in urban poor communities in Accra, Ghana.

PubMed

Awuah, Raphael B; Anarfi, John K; Agyemang, Charles; Ogedegbe, Gbenga; Aikins, Ama de-Graft

2014-06-01

Hypertension is a major public health problem in many sub-Saharan African countries including Ghana, but data on urban poor communities are limited. The aim of this study was therefore to assess the prevalence, awareness, management and control of hypertension among a young adult population in their reproductive ages living in urban poor communities in Accra. Cross-sectional, population-based survey of 714 young adults in their reproductive ages (women aged 15-49 years, men aged 15-59 years) living in three urban poor suburbs of Accra, Ghana. The overall prevalence of hypertension in all three communities was 28.3% (women 25.6% and men 31.0%). Among respondents who had hypertension, 7.4% were aware of their condition; 4% were on antihypertensive medication while only 3.5% of hypertensive individuals had adequate blood pressure (BP) control (BP <140/90  mmHg). The level of awareness and treatment was lower in men than in women (3.1 and 1.3% for men and 11.9 and 6.5% for women, respectively). Among individuals with hypertension, the rate of control was higher among women than among men (5.0 and 2.1%, respectively). Although about a quarter of the young adult population in these low-income communities of Accra have hypertension, the levels of awareness, treatment and control are abysmally low. We recommend community-specific primary and secondary prevention interventions that draw on existing resources, specifically implementing cardiovascular disease (CVD) interventions in faith-based organizations and task-shifting CVD care through the national Community-based Health Planning and Services (CHPS) programme.

Collective familial decision-making in times of trouble: intergenerational solidarity in Ghana.

PubMed

McGadney-Douglass, Brenda F; Douglass, Richard L

2008-06-01

In post-colonial populations the retention of the nuclear family concept of collectivism as the basis for decision-making is associated with familial and cultural survival. Collectivism within familial contexts provides intergenerational access to experience, information, resources, and sound decision making during times of conflict or dealing with the consequences of poverty. In contemporary Ghana inter-ethnic wars and conflict have marginalized minority groups, causing substantial internal displacement of people. Poverty and cultural issues have caused a persistently high level of child malnutrition and mortality in all areas of Ghana, including urban centers where appropriate food is in abundance. In each of these circumstances the senior women, particularly the grandmothers, have been found to be essential for child survival, protecting the family from dissolution, and ensuring intergenerational cultural transmission. This paper discusses the place of collective decision-making processes of older African women in two studies in Ghana that assessed the: (1) indigenous methods used for understanding and arresting violent ethnic conflict by internally displaced women who survived the 1994/95 Guinea Fowl War; and (2) parenting and grandparenting strategies from families who insured the survival of children suffering from kwashiorkor, a severe form of childhood malnutrition. In this paper, findings from qualitative interview data will include narratives and illustrative cases.

TRIPS, the Doha Declaration and increasing access to medicines: policy options for Ghana

PubMed Central

Cohen, JC; Gyansa-Lutterodt, M; Torpey, K; Esmail, LC; Kurokawa, G

2005-01-01

There are acute disparities in pharmaceutical access between developing and industrialized countries. Developing countries make up approximately 80% of the world's population but only represent approximately 20% of global pharmaceutical consumption. Among the many barriers to drug access are the potential consequences of the Trade Related Aspects of Intellectual Property Rights (TRIPS) Agreement. Many developing countries have recently modified their patent laws to conform to the TRIPS standards, given the 2005 deadline for developing countries. Safeguards to protect public health have been incorporated into the TRIPS Agreement; however, in practice governments may be reluctant to exercise such rights given concern about the international trade and political ramifications. The Doha Declaration and the recent Decision on the Implementation of Paragraph 6 of the Doha Declaration on the TRIPS Agreement and Public Health may provide more freedom for developing countries in using these safeguards. This paper focuses on Ghana, a developing country that recently changed its patent laws to conform to TRIPS standards. We examine Ghana's patent law changes in the context of the Doha Declaration and assess their meaning for access to drugs of its population. We discuss new and existing barriers, as well as possible solutions, to provide policy-makers with lessons learned from the Ghanaian experience. PMID:16336685

Social Factors Influencing Child Health in Ghana

PubMed Central

Quansah, Emmanuel; Ohene, Lilian Akorfa; Norman, Linda; Mireku, Michael Osei; Karikari, Thomas K.

2016-01-01

Objectives Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals’ target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal. Methods ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review. Results Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices. Conclusions Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother’s health knowledge is emphasised. PMID:26745277

Social Factors Influencing Child Health in Ghana.

PubMed

Quansah, Emmanuel; Ohene, Lilian Akorfa; Norman, Linda; Mireku, Michael Osei; Karikari, Thomas K

2016-01-01

Social factors have profound effects on health. Children are especially vulnerable to social influences, particularly in their early years. Adverse social exposures in childhood can lead to chronic disorders later in life. Here, we sought to identify and evaluate the impact of social factors on child health in Ghana. As Ghana is unlikely to achieve the Millennium Development Goals' target of reducing child mortality by two-thirds between 1990 and 2015, we deemed it necessary to identify social determinants that might have contributed to the non-realisation of this goal. ScienceDirect, PubMed, MEDLINE via EBSCO and Google Scholar were searched for published articles reporting on the influence of social factors on child health in Ghana. After screening the 98 articles identified, 34 of them that met our inclusion criteria were selected for qualitative review. Major social factors influencing child health in the country include maternal education, rural-urban disparities (place of residence), family income (wealth/poverty) and high dependency (multiparousity). These factors are associated with child mortality, nutritional status of children, completion of immunisation programmes, health-seeking behaviour and hygiene practices. Several social factors influence child health outcomes in Ghana. Developing more effective responses to these social determinants would require sustainable efforts from all stakeholders including the Government, healthcare providers and families. We recommend the development of interventions that would support families through direct social support initiatives aimed at alleviating poverty and inequality, and indirect approaches targeted at eliminating the dependence of poor health outcomes on social factors. Importantly, the expansion of quality free education interventions to improve would-be-mother's health knowledge is emphasised.

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

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.

A narrative synthesis of illustrative evidence on effects of capitation payment for primary care: lessons for Ghana and other low/middle-income countries.

PubMed

Andoh-Adjei, Francis-Xavier; Spaan, Ernst; Asante, Felix A; Mensah, Sylvester A; van der Velden, Koos

2016-12-01

To analyse and synthesize available international experiences and information on the motivation for, and effects of using capitation as provider payment method in country health systems and lessons and implications for low/middle-income countries. We did narrative review and synthesis of the literature on the effects of capitation payment on primary care. Eleven articles were reviewed. Capitation payment encourages efficiency: drives down cost, serves as critical source of income for providers, promotes adherence to guidelines and policies, encourages providers to work better and give health education to patients. It, however, induces reduction in the quantity and quality of care provided and encourages skimming on inputs, underserving of patients in bad state of health, "dumping" of high risk patients and negatively affect patient-provider relationship. The illustrative evidence adduced from the review demonstrates that capitation payment in primary care can create positive incentives but could also elicit un-intended effects. However, due to differences in country context, policy makers in Ghana and other low/middle-income countries may only be guided by the illustrative evidence in their design of a context-specific capitation payment for primary care. Netherlands Fellowship Programme (NFP), Fellowship number: NFP-PhD.12/352.

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).

Saharan Dust Particle Size And Concentration Distribution In Central Ghana

NASA Astrophysics Data System (ADS)

Sunnu, A. K.

2010-12-01

A.K. Sunnu*, G. M. Afeti* and F. Resch+ *Department of Mechanical Engineering, Kwame Nkrumah University of Science and Technology (KNUST) Kumasi, Ghana. E-mail: albertsunnu@yahoo.com +Laboratoire Lepi, ISITV-Université du Sud Toulon-Var, 83162 La Valette cedex, France E-mail: resch@univ-tln.fr Keywords: Atmospheric aerosol; Saharan dust; Particle size distributions; Particle concentrations. Abstract The Saharan dust that is transported and deposited over many countries in the West African atmospheric environment (5°N), every year, during the months of November to March, known locally as the Harmattan season, have been studied over a 13-year period, between 1996 and 2009, using a location at Kumasi in central Ghana (6° 40'N, 1° 34'W) as the reference geographical point. The suspended Saharan dust particles were sampled by an optical particle counter, and the particle size distributions and concentrations were analysed. The counter gives the total dust loads as number of particles per unit volume of air. The optical particle counter used did not discriminate the smoke fractions (due to spontaneous bush fires during the dry season) from the Saharan dust. Within the particle size range measured (0.5 μm-25 μm.), the average inter-annual mean particle diameter, number and mass concentrations during the northern winter months of January and February were determined. The average daily number concentrations ranged from 15 particles/cm3 to 63 particles/cm3 with an average of 31 particles/cm3. The average daily mass concentrations ranged from 122 μg/m3 to 1344 μg/m3 with an average of 532 μg/m3. The measured particle concentrations outside the winter period were consistently less than 10 cm-3. The overall dust mean particle diameter, analyzed from the peak representative Harmattan periods over the 13-year period, ranged from 0.89 μm to 2.43 μm with an average of 1.5 μm ± 0.5. The particle size distributions exhibited the typical distribution pattern for

Community perceptions and practices of treatment seeking for childhood pneumonia: a mixed methods study in a rural district, Ghana.

PubMed

Abbey, Mercy; Chinbuah, Margaret A; Gyapong, Margaret; Bartholomew, L Kay; van den Borne, Bart

2016-08-22

The World Health Organization recommends community case management of malaria and pneumonia for reduction of under-five mortality in developing countries. Caregivers' perception and understanding of the illness influences the care a sick child receives. Studies in Ghana and elsewhere have routinely shown adequate recognition of malaria by caregivers. Similarly, evidence from Asia and some African countries have shown adequate knowledge on pneumonia. However, in Ghana, little has been documented about community awareness, knowledge, perceptions and management of childhood pneumonia particularly in the Dangme West district. Therefore this formative study was conducted to determine community perceptions of pneumonia for the purpose of informing the design and implementation of context specific health communication strategies to promote early and appropriate care seeking behaviour for childhood pneumonia. A mixed method approach was adopted. Data were obtained from structured interviews (N = 501) and eight focus group discussions made up of 56 caregivers of under-fives and eight community Key Informants. Descriptive and inference statistics were used for the quantitative data and grounded theory to guide the analysis of the qualitative data. Two-thirds of the respondents had never heard the name pneumonia. Most respondents did not know about the signs and symptoms of pneumonia. For the few who have heard about pneumonia, causes were largely attributed to coming into contact with cold temperature in various forms. Management practices mostly were self-treatment with home remedies and allopathic care. The low awareness and inadequate recognition of pneumonia implies that affected children may not receive prompt and appropriate treatment as their caregivers may misdiagnose the illness. Adequate measures need to be taken to create the needed awareness to improve care seeking behaviour.

Increasing the number of female primary school teachers in African countries: Effects, barriers and policies

NASA Astrophysics Data System (ADS)

Haugen, Caitlin S.; Klees, Steven J.; Stromquist, Nelly P.; Lin, Jing; Choti, Truphena; Corneilse, Carol

2014-12-01

Girls' education has been a high development priority for decades. While some progress has been made, girls are often still at a great disadvantage, especially in developing countries, and most especially in African countries. In sub-Saharan Africa, less than half of primary school teachers and only a quarter of secondary school teachers are women, and enrolment figures for girls are low. One common policy prescription is to increase the number of women teachers, especially in the many countries where teaching remains a predominantly male profession. This policy prescription needs to be backed by more evidence in order to significantly increase and improve its effective implementation. The available research seems to suggest that girls are more likely to enrol in schools where there are female teachers. Moreover, increasing the number of trained teachers in sub-Saharan Africa depends on more girls completing their school education. To date, however, there has been no comprehensive literature review analysing the effects of being taught by women teachers on girls' educational experience. This paper aims to make a start on filling this gap by examining the evidence on the effects in primary schools, especially in African countries. It also identifies and examines the barriers women face in becoming and staying teachers, and considers policies to remedy their situation.

Coal in sub-Saharan-African countries undergoing desertification

NASA Astrophysics Data System (ADS)

Weaver, J. N.; Brownfield, M. E.; Bergin, M. J.

Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighboring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification or will in the near future. Wood, directly or in the form of charcoal, constitutes two-thirds of the fuel used in Africa. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. The decline in biological productivity, coupled with concentration of population in areas where water is available and crops may be grown, leads to increasing shortages of wood for fuel. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins, completely or partially within the sub-Saharan region, have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin, 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. Peat can be used as an alternate fuel source and is currently being tested as a soil amendment in the agricultural sector. Coal and peat exploration and development studies are urgently required and should be initiated so the coal and peat utilization potential of each country can be determined. The overall objective of these studies is to establish, within the sub

Coal in sub-Saharan-African countries undergoing desertification

USGS Publications Warehouse

Weaver, J.N.; Brownfield, M.E.; Bergin, M.J.

1990-01-01

Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighboring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification or will in the near future. Wood, directly or in the form of charcoal, constitutes two-thirds of the fuel used in Africa. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. The decline in biological productivity, coupled with concentration of population in areas where water is available and crops may be grown, leads to increasing shortages of wood for fuel. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins, completely or partially within the sub-Saharan region, have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin, 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. Peat can be used as an alternate fuel source and is currently being tested as a soil amendment in the agricultural sector. Coal and peat exploration and development studies are urgently required and should be initiated so the coal and peat utilization potential of each country can be determined. The overall objective of these studies is to establish, within the sub

Perceptions of the Usefulness and Use of Research Conducted in Other Countries

ERIC Educational Resources Information Center

Burchett, Helen; Lavis, John N.; Mayhew, Susannah H.; Dobrow, Mark J.

2012-01-01

Semi-structured interviews in Ghana and England explored perceptions of the usefulness and use of foreign research (ie, beyond the original study country) compared to locally conducted research (ie, conducted in Ghana). There was a preference for locally conducted studies, although interviewees generally recognised the potential usefulness of…

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.

Immunogenicity of Yellow Fever Vaccine Coadministered With MenAfriVac in Healthy Infants in Ghana and Mali

PubMed Central

Roy Chowdhury, Panchali; Meier, Christian; Laraway, Hewad; Tang, Yuxiao; Hodgson, Abraham; Sow, Samba O.; Enwere, Godwin C.; Plikaytis, Brian D.; Kulkarni, Prasad S.; Preziosi, Marie-Pierre; Niedrig, Matthias

2015-01-01

Background. Yellow fever (YF) is still a major public health problem in endemic regions of Africa and South America. In Africa, one of the main control strategies is routine vaccination within the Expanded Programme on Immunization (EPI). A new meningococcal A conjugate vaccine (PsA-TT) is about to be introduced in the EPI of countries in the African meningitis belt, and this study reports on the immunogenicity of the YF-17D vaccines in infants when administered concomitantly with measles vaccine and PsA-TT. Methods. Two clinical studies were conducted in Ghana and in Mali among infants who received PsA-TT concomitantly with measles and YF vaccines at 9 months of age. YF neutralizing antibody titers were measured using a microneutralization assay. Results. In both studies, the PsA-TT did not adversely affect the immune response to the concomitantly administered YF vaccine at the age of 9 months. The magnitude of the immune response was different between the 2 studies, with higher seroconversion and seroprotection rates found in Mali vs Ghana. Conclusions. Immunogenicity to YF vaccine is unaffected when coadministered with PsA-TT at 9 months of age. Further studies are warranted to better understand the determinants of the immune response to YF vaccine in infancy. Clinical Trials Registration. ISRCTN82484612 (PsA-TT-004); PACTR201110000328305 (PsA-TT-007). PMID:26553692

Immunogenicity of Yellow Fever Vaccine Coadministered With MenAfriVac in Healthy Infants in Ghana and Mali.

PubMed

Roy Chowdhury, Panchali; Meier, Christian; Laraway, Hewad; Tang, Yuxiao; Hodgson, Abraham; Sow, Samba O; Enwere, Godwin C; Plikaytis, Brian D; Kulkarni, Prasad S; Preziosi, Marie-Pierre; Niedrig, Matthias

2015-11-15

Yellow fever (YF) is still a major public health problem in endemic regions of Africa and South America. In Africa, one of the main control strategies is routine vaccination within the Expanded Programme on Immunization (EPI). A new meningococcal A conjugate vaccine (PsA-TT) is about to be introduced in the EPI of countries in the African meningitis belt, and this study reports on the immunogenicity of the YF-17D vaccines in infants when administered concomitantly with measles vaccine and PsA-TT. Two clinical studies were conducted in Ghana and in Mali among infants who received PsA-TT concomitantly with measles and YF vaccines at 9 months of age. YF neutralizing antibody titers were measured using a microneutralization assay. In both studies, the PsA-TT did not adversely affect the immune response to the concomitantly administered YF vaccine at the age of 9 months. The magnitude of the immune response was different between the 2 studies, with higher seroconversion and seroprotection rates found in Mali vs Ghana. Immunogenicity to YF vaccine is unaffected when coadministered with PsA-TT at 9 months of age. Further studies are warranted to better understand the determinants of the immune response to YF vaccine in infancy. ISRCTN82484612 (PsA-TT-004); PACTR201110000328305 (PsA-TT-007). © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

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.

Reporting of adverse events following immunizations in Ghana - Using disproportionality analysis reporting ratios.

PubMed

Ankrah, Daniel N A; Darko, Delese M; Sabblah, George; Mantel-Teeuwisse, Aukje; Leufkens, Hubert M G

2018-01-02

Timely reporting of safety information post vaccination is pivotal for the success of any vaccination program. Reports of adverse events following immunization (AEFI) of 6 different vaccinations from Ghana were analysed for signals. De-identified data from active surveillance for AEFIs after 2009 AH1N1 influenza, yellow fever, meningitis, measles-rubella, pneumococcal-rotavirus and human papilloma virus vaccinations were used. All vaccinations occurred between January 2010 and December 2013. The ten most occurring events for each vaccination were captured and arranged using Medical Dictionary for Regulatory Authorities (MedDRA) Preferred Term (PT) and System Organ Classification (SOC) codes. Adverse event incidence rates were calculated for each vaccine type, and signals were generated using proportional reporting ratios (PRR). A total number of 5,141 reports were analysed ranging from 33 (human papilloma virus) to 1958 (measles-rubella). Between 22% and 55% of all AEFIs per vaccine type were collected on the day of vaccination. For each vaccine type, at least 87% of all reported AEFIs occurred in the first 7 days post-vaccination. Multiple reports were received per vaccine type. For the MR vaccine, urticarial recorded the highest attack rate of 6.6 (95% CI 6.2, 7.1) per 100,000 vaccines. The AEFI with the highest PRR for both human papilloma and measles-rubella vaccines was abdominal pain, recording a PRR of 8.15 (95% CI 3.46, 19.23) and 43.75 (95% CI 17.81, 107.45) respectively. These results underscore the competency of public health systems in sub-Saharan African countries (like Ghana) to identify most frequently occurring and important vaccine related safety issues.

Introduction and Rollout of a New Group A Meningococcal Conjugate Vaccine (PsA-TT) in African Meningitis Belt Countries, 2010–2014

PubMed Central

Djingarey, Mamoudou H.; Diomandé, Fabien V. K.; Barry, Rodrigue; Kandolo, Denis; Shirehwa, Florence; Lingani, Clement; Novak, Ryan T.; Tevi-Benissan, Carol; Perea, William; Preziosi, Marie-Pierre; LaForce, F. Marc

2015-01-01

Background. A group A meningococcal conjugate vaccine (PsA-TT) was developed specifically for the African “meningitis belt” and was prequalified by the World Health Organization (WHO) in June 2010. The vaccine was first used widely in Burkina Faso, Mali, and Niger in December 2010 with great success. The remaining 23 meningitis belt countries wished to use this new vaccine. Methods. With the help of African countries, WHO developed a prioritization scheme and used or adapted existing immunization guidelines to mount PsA-TT vaccination campaigns. Vaccine requirements were harmonized with the Serum Institute of India, Ltd. Results. Burkina Faso was the first country to fully immunize its 1- to 29-year-old population in December 2010. Over the next 4 years, vaccine coverage was extended to 217 million Africans living in 15 meningitis belt countries. Conclusions. The new group A meningococcal conjugate vaccine was well received, with country coverage rates ranging from 85% to 95%. The rollout proceeded smoothly because countries at highest risk were immunized first while attention was paid to geographic contiguity to maximize herd protection. Community participation was exemplary. PMID:26553672

Mainstreaming biodiversity and wildlife management into climate change policy frameworks in selected east and southern African countries

PubMed Central

Nhamo, Godwell

2016-01-01

The Rio+20 outcomes document, the Future We Want, enshrines green economy as one of the platforms to attain sustainable development and calls for measures that seek to address climate change and biodiversity management. This paper audits climate change policies from selected east and southern African countries to determine the extent to which climate change legislation mainstreams biodiversity and wildlife management. A scan of international, continental, regional and national climate change policies was conducted to assess whether they include biodiversity and/or wildlife management issues. The key finding is that many climate change policy–related documents, particularly the National Adaptation Programme of Actions (NAPAs), address threats to biodiversity and wildlife resources. However, international policies like the United Nations Framework Convention on Climate Change and Kyoto Protocol do not address the matter under deliberation. Regional climate change policies such as the East African Community, Common Market for Eastern and Southern Africa and African Union address biodiversity and/or wildlife issues whilst the Southern African Development Community region does not have a stand-alone policy for climate change. Progressive countries like Rwanda, Uganda, Tanzania and Zambia have recently put in place detailed NAPAs which are mainstream responsive strategies intended to address climate change adaptation in the wildlife sector.

Migration from Developing Countries: The Case of South African Teachers to the United Kingdom

ERIC Educational Resources Information Center

De Villiers, Rian

2007-01-01

The United Kingdom (particularly England) is the main developed country that recruits teachers from South Africa. This article provides an overview of teacher migration from South Africa to the United Kingdom over the past decade. The research focuses on the following aspects of migration: the recruitment of South African teachers; motivation for…

Access to Basic Education in Ghana: The Evidence and the Issues. Country Analytic Report

ERIC Educational Resources Information Center

Akyeampong, Kwame; Djangmah, Jerome; Oduro, Abena; Seidu, Alhassan; Hunt, Frances

2007-01-01

The analysis of access to education in Ghana builds on the Ministry of Education Sector Performance Report and the World Bank sector studies. Though access has improved it remains uneven and has not grown as fast enough to reach universal levels of participation in primary school and JSS [Junior Secondary School] by 2015. More needs to be…

Early sexual debut and associated factors among in-school adolescents in eight African countries.

PubMed

Peltzer, Karl

2010-08-01

This report examines early sexual debut (African countries. The total sample included 10 070 school children aged 15 years from nationally representative samples from eight African countries. Univariate and multivariate analyses were conducted to assess the relationship between early sexual debut and alcohol, tobacco and other drug use, mental distress, physical activity, protective factors and socioeconomic status variables. A total of 27.3% had experienced sexual debut before age 15, 38.1% among boys and 15.8% among girls. Boys and girls with sexual debut at less than age 15 were more likely to report alcohol, tobacco and drug use, truancy, poor parental or guardian connectedness, sedentary behaviour, having been in a physical fight and seriously injured, while for girls, mental distress and poor economic status and for boys, bullied and poor parental or guardian supervision were associated with early coital debut. In multivariable analysis, early sexual debut was among boys associated with currently smoking (OR = 4.45, p = 0.002) and truancy (OR = 2.02, p = 0.007) and, among girls, associated with lower education (OR = 0.22, p = 0.004), ever drunk (OR = 3.94, p = 0.016), having no close friends (OR = 3.36, p = 0.014) and poor parental connectedness (OR = 2.43, p = 0.037). The study found a high prevalence of early sexual debut among 15-year-olds in eight African countries. Risk factors identified were consistent with problem behaviour theory in which early onset of adolescent sexual behaviour is shared with other problem behaviours. Prevention programmes should broaden sexual health promotion including problem behaviour such as substance use and mental distress for boys and girls in the preteen years, before sexual debut.

Measuring Government Effectiveness and Its Consequences for Social Welfare in Sub-Saharan African Countries

ERIC Educational Resources Information Center

Sacks, Audrey; Levi, Margaret

2010-01-01

We introduce a method for measuring effective government and modeling its consequences for social welfare at the individual level. Our focus is on the experiences of citizens living in African countries where famine remains a serious threat. If a government is effective, it will be able to deliver goods that individuals need to improve their…

Africa: A Survey of Distance Education 1991. New Papers on Higher Education: Studies and Research 4.

ERIC Educational Resources Information Center

John, Magnus

Country profiles compiled through a survey of distance education in Africa form the contents of this document. International organizations and 35 countries were surveyed: Algeria; Benin; Botswana; Burkina Faso; Burundi; Cameroon; Central African Republic; Chad; Congo (Brazzaville); Djibouti; Ethiopia; Gambia; Ghana; Guinea; Ivory Coast; Kenya;…

Development of a Nationally Coordinated Evaluation Plan for the Ghana National Strategy for Key Populations

PubMed Central

Reynolds, Heidi W; Atuahene, Kyeremeh; Sutherland, Elizabeth; Amenyah, Richard; Kwao, Isaiah Doe; Larbi, Emmanuel Tettey

2015-01-01

Objective Just as HIV prevention programs need to be tailored to the local epidemic, so should evaluations be country-owned and country-led to ensure use of those results in decision making and policy. The objective of this paper is to describe the process undertaken in Ghana to develop a national evaluation plan for the Ghana national strategy for key populations. Methods This was a participatory process that involved meetings between the Ghana AIDS Commission (GAC), other partners in Ghana working to prevent HIV among key populations, and MEASURE Evaluation. The process included three two-day, highly structured yet participatory meetings over the course of 12 months during which participants shared information about on-going and planned data and identified research questions and methods. Results An evaluation plan was prepared to inform stakeholders about which data collection activities need to be prioritized for funding, who would implement the study, the timing of data collection, the research question the data will help answer, and the analysis methods. The plan discusses various methods that can be used including the recommendation for the study design using multiple data sources. It has an evaluation conceptual model, proposed analyses, proposed definition of independent variables, estimated costs for filling data gaps, roles and responsibilities of stakeholders to carry out the plan, and considerations for ethics, data sharing and authorship. Conclusion The experience demonstrates that it is possible to design an evaluation responsive to national strategies and priorities with country leadership, regardless of stakeholders' experiences with evaluations. This process may be replicable elsewhere, where stakeholders want to plan and implement an evaluation of a large-scale program at the national or subnational level that is responsive to national priorities and part of a comprehensive monitoring and evaluation system. PMID:26120495

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.

Rural perspectives on HIV/AIDS prevention: a comparative study of Thailand and Ghana.

PubMed

Aheto, Denis Worlanyo; Gbesemete, Kwame Prosper

2005-04-01

The paper compares rural perspectives in Thailand and Ghana on the level of condom acceptance in sexual relations, willingness to test oneself for HIV before and in marriage and sources of information on HIV/AIDS. We also compared the policy approaches to combating HIV/AIDS in both countries. The results indicates that in the villages studied in Thailand, all single men and the majority of the single women were in favour of using condoms in sexual relations. This group also showed a positive attitude to HIV/AIDS test before and in marriage. However, married men in rural Thailand disapproved of the use of condoms with their wives but married women in the sample population were open to the possibility of using condoms. Both married men and women were strongly against HIV/AIDS test in marriage. In contrast to Thailand, most single men in the communities studied in Ghana showed a disapproval to the use of condoms in sexual relations. However, they condoned HIV test before marriage. Married men and women in rural Ghana were against the use of condoms in sexual relations as well as HIV/AIDS test in marriage. In order to mitigate mother-to-child transmission, the Thais applied anti-retroviral drug care for HIV positive pregnant women during pregnancy and after delivery. In Ghana on the other hand, pregnant women were subject to HIV test and counselling. The mode of information acquisition on HIV/AIDS in both countries were through the media, campaigns and village volunteers. Finally, we observed that fighting poverty is a sine qua non for the success of any HIV/AIDS eradication programme.

Prevalence and time trends in overweight and obesity among urban women: an analysis of demographic and health surveys data from 24 African countries, 1991-2014.

PubMed

Amugsi, Dickson Abanimi; Dimbuene, Zacharie T; Mberu, Blessing; Muthuri, Stella; Ezeh, Alex C

2017-10-27

To examine the prevalence and trends in overweight and obesity among non-pregnant urban women in Africa over the past two and a half decades. Cross-sectional surveys conducted between 1991 and 2014. Demographic and Health Surveys (DHS), repeated cross-sectional data collected in 24 African countries. Adult non-pregnant women aged 15-49 years. The earlier DHS collected anthropometric data on only those women who had children aged 0-5 years. The main analyses were limited to this subgroup. The participants were classified as overweight (25.0-29.9 kg/m 2 ) and obese (≥30.0 kg/m 2 ). The prevalence of overweight and obesity among women increased in all the 24 countries. Trends were statistically significant in 17 of the 24 countries in the case of obesity and 13 of the 24 for overweight. In Ghana, overweight almost doubled (p=0.001) while obesity tripled (p=0.001) between 1993 and 2014. Egypt has the highest levels of overweight and obesity at 44% (95% CI 42%, 46.5%) and 39% (95% CI 36.6%, 41.8%), respectively, in 2014 and the trend showed significant increase (p=0.005) from 1995 levels. Also, obesity doubled in Kenya, Benin, Niger, Rwanda, Ivory Coast and Uganda, while tripled in Zambia, Burkina Faso, Mali, Malawi and Tanzania. Ethiopia and Madagascar had the lowest prevalence of both obesity and overweight, with overweight ranging from 7% to 12% and obesity from 1% to 4%. Overweight and obesity are increasing among women of reproductive age in urban Africa, with obesity among this age group having more than doubled or tripled in 12 of the 24 countries. There is an urgent need for deliberate policies and interventions to encourage active lifestyles and healthy eating behaviour to curb this trend in urban Africa. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Nathan Lee | NREL

Science.gov Websites

Economic Community of West African States, with an emphasis on Ghana, was used as a representative area of economic growth in developing countries Education Ph.D. and Diploma of Advanced Studies (M.S. equivalent members of the Economic Community of West African States, Renewable and Sustainable Energy Reviews (2014

Water footprint of Ghana

NASA Astrophysics Data System (ADS)

Debrah, E. R.; Odai, S. N.; Annor, F. O.; Adjei, K. A.; van der Zaag, P.

2009-04-01

Water is used in almost all human endeavour. Unlike oil, water does not have a substitute. There are many factors that affect the water consumption pattern of people. These include climatic condition, income level and agricultural practices among others. The water footprint concept has been developed in order to have an indicator of water use in relation to its consumption by people. The water footprint of a country is defined as the volume of water needed for the production of the goods and services consumed by the inhabitants of the country (Chapagain and Hoekstra, 2008). Due to the bulky nature of water, it is not in its raw state a tradable commodity though it could be traded through the exchange of goods and services from one point to the other. Closely linked to the water footprint concept is the virtual water concept. Virtual water can be defined as the volume of water required to produce a commodity or service (Chapagain and Hoekstra, 2008 and Allan, 1999). The international trade of these commodities implies flows of virtual water over large distances. The water footprint of a nation can therefore be assessed by quantifying the use of domestic water resources, taking out the virtual water flow that leaves the country and adding the virtual water flow that enters the country to it. This research focuses on the assessment and analysis of the water footprints of Ghana considering only the consumptive component of the water footprint. In addition to livestock, 13 crops were considered, 4 of which were cash crops. Data was analysed for the year 2001 to 2005 The most recent framework for the analysis of water footprint is offered by Chapagain and Hoekstra. This was adopted for the study. The water footprint calculations show that the water footprint of Ghana is about 20011 Gm³/yr. Base on this the average water footprint of a Ghanaian is 823 m³/cap/yr. Not only agricultural crops but also other products require water for their manufacture, aluminium being a

Expenditures on health research in sub-Saharan African countries: results of a questionnaire-based survey.

PubMed

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

To estimate the sources of funds for health research (revenue) and the uses of these funds (expenditure). A structured questionnaire was used to solicit financial information from health research institutions. Forty-two sub-Saharan African countries. Key informants in 847 health research institutions in the 42 sub-Saharan African countries. Expenditure on health research by institutions, funders and subject areas. An estimated total of US$ 302 million was spent on health research by institutions that responded to the survey in the World Health Organization (WHO) African Region for the biennium 2005-2006. The most notable funders for health research activities were external funding, ministries of health, other government ministries, own funds and non-profit institutions. Most types of health research performers spent significant portions of their resources on in-house research, with medical schools spending 82% and government agencies 62%. Hospitals spent 38% of their resources on management, and other institutions (universities, firms, etc.) spent 87% of their resources on capital investment. Research on human immunodeficiency virus/tuberculosis and malaria accounted for 30% of funds, followed by research on other communicable diseases and maternal, perinatal and nutritional conditions (23%). Research on major health problems of the Region, such as communicable diseases, accounts for most of the research expenditures. However, the total expenditure is very low compared with other WHO regions. © The Royal Society of Medicine.

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…

South African court rejects country's new constitution.

PubMed

1996-09-20

Fundamental principles designed to ensure that South Africa's new constitution upholds a wide range of individual rights and freedoms and establishes a responsive government with a balanced separation of powers, including recognition of the role of traditional tribal leadership, were adopted into the current interim constitution shortly before the 1994 free elections which brought Nelson Mandela and the African National Congress to power. In a judgement issued on September 6, 1996, South Africa's Constitutional Court rejected the country's new draft constitution, arguing that it failed to meet the standards of nine of the 34 principles established at the Kempton Park negotiations. The Constitutional Assembly is comprised of a joint meeting of the National Assembly and Senate. One of the court's major objections to the constitution concerned the proposed structure of rule, which was seen to give inadequate power to South Africa's nine provinces as compared with the national government. However, the bill of rights was almost entirely upheld. The bill would create a favorable environment for legalized abortion and guarantee a universal right of access to health care, including reproductive health services

Role of mobile phone technology in health education in Asian and African countries: a systematic review.

PubMed

Sahu, Madhusmita; Grover, Ashoo; Joshi, Ashish

2014-01-01

The objective of this systematic review was to explore the role of mobile phone technologies in delivering health education programs in Asian and African countries. The search engine used was Pubmed during 2008-2011. Randomised controlled trials or controlled studies that improved health outcomes through delivery of health educational interventions using cell phone or text messaging were included in the review. Results showed studies from six Asian and African countries including Philippines, China, Kenya, South Korea, Taiwan and India. Mobile phone technology has shown to improve health outcomes for chronic disease conditions such as diabetes, heart disease and hypertension. Additional conditions include obesity and cardiopulmonary resuscitation guidance. Other studies have shown improvement in self management of breast cancer and post-hospitalisation HIV and pharmaceutical care. Overall results of the present review showed that mobile phone technologies can be a possible solution to improve healthcare outcome.

Essential trauma care in Ghana: adaptation and implementation on the political tough road.

PubMed

Quansah, Robert

2006-06-01

The main goal of the Essential Trauma Care (EsTC) project is to promote affordable and sustainable improvements in trauma care, on the ground in individual countries and their health care facilities. This has been occurring in several countries, including Ghana. The EsTC project has helped to solidify previously haphazard interactions between stakeholders from different sectors. It has allowed trauma care clinicians to interact more effectively with other groups, such as the Ministry of Health and the WHO country office. It has allowed the clinicians and other stakeholders to more effectively lobby government for increased attention to trauma care services. These interactions have led to a high-profile stakeholders meeting, the Road Safety and Essential Trauma Care Workshop, which has represented the highest level of attention to trauma care in the country thus far. This meeting has generated a set of policy recommendations, which has been presented to Parliament for study, and, it is hoped, adoption. To convert these recommendations to solid, sustainable action in improving care for the injured, we need to continue to engage in advocacy and to work with Parliament, the Ministry of Health, and other stakeholders, as well as to confront the deeper problems of Ghana's brain drain, civil strife, and poverty.

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.

Political commitment to tuberculosis control in Ghana.

PubMed

Amo-Adjei, Joshua

2014-01-01

As part of expanding and sustaining tuberculosis (TB) control, the Stop TB Partnership of the World Health Organization initiative has called for strong political commitment to TB control, particularly in developing countries. Framing political commitment within the theoretical imperatives of the political economy of health, this study explores the existing and the expected dimensions of political commitment to TB control in Ghana. Semi-structured in-depth interviews were conducted with 29 purposively selected staff members of the Ghana Health Service and some political officeholders. In addition, the study analysed laws, policies and regulations relevant to TB control. Four dimensions of political commitment emerged from the interviews: provision of adequate resources (financial, human and infrastructural); political authorities' participation in advocacy for TB; laws and policies' promulgation and social protection interventions. Particularly in respect to financial resources, donors such as the Global Fund to Fight AIDS, Tuberculosis and Malaria presently give more than 60% of the working budget of the programme. The documentary review showed that laws, policies and regulations existed that were relevant to TB control, albeit they were not clearly linked.

Shifting from presumptive to test-based management of malaria - technical basis and implications for malaria control in Ghana.

PubMed

Baiden, F; Malm, K; Bart-Plange, C; Hodgson, A; Chandramohan, D; Webster, J; Owusu-Agyei, S

2014-06-01

The presumptive approach was the World Health Organisation (WHO) recommended to the management of malaria for many years and this was incorporated into syndromic guidelines such as the Integrated Management of Childhood Illnesses (IMCI). In early 2010 however, WHO issued revised treatment guidelines that call for a shift from the presumptive to the test-based approach. Practically, this implies that in all suspected cases, the diagnosis of uncomplicated malaria should be confirmed using rapid test before treatment is initiated. This revision effectively brings to an end an era of clinical practice that span several years. Its implementation has important implications for the health systems in malaria-endemic countries. On the basis of research in Ghana and other countries, and evidence from program work, the Ghana National Malaria Control Program has issued revised national treatment guidelines that call for implementation of test-based management of malaria in all cases, and across all age groups. This article reviews the evidence and the technical basis for the shift to test-based management and examines the implications for malaria control in Ghana.

Delayed Primary School Enrollment and Childhood Malnutrition in Ghana. An Economic Analysis.

ERIC Educational Resources Information Center

Glewwe, Paul; Jacoby, Hanan

This study investigated why the primary school enrollment of children in poor countries is often delayed despite the prediction made by human capital theory that schooling will begin at the earliest possible age. Using data from the 1988-89 Ghana Living Standards Survey household questionnaire, the study examined the age of enrollment,…

Mobile Telemedicine Implementation with WiMAX Technology: A Case Study of Ghana.

PubMed

Tchao, Eric Tutu; Diawuo, Kwasi; Ofosu, Willie K

2017-01-01

Telemedicine has become an effective means of delivering quality healthcare in the world. Across the African continent, Telemedicine is increasingly being recognized as a way of improving access to quality healthcare. The use of technology to deliver quality healthcare has been demonstrated as an effective way of overcoming geographic barriers to healthcare in pilot Telemedicine projects in certain parts of Kumasi, Ghana. However because of poor network connectivity experienced in the pilot projects, the success of the pilot networks could not be extended to cover the whole city of Kumasi and other surrounding villages. Fortunately, recent deployment of WiMAX in Ghana has delivered higher data rates at longer distances with improved network connectivity. This paper examines the feasibility of using WiMAX in deploying a city wide Mobile Telemedicine solution. The network architecture and network parameter simulations of the proposed Mobile Telemedicine network using WiMAX are presented. Five WiMAX Base Stations have been suggested to give ubiquitous coverage to the proposed Mobile Telemedicine sites in the network using adaptive 4 × 4 MIMO antenna configurations.

Early smoking initiation and associated factors among in-school male and female adolescents in seven African countries.

PubMed

Peltzer, K

2011-09-01

This report examines the prevalence and common correlates of early smoking initiation among male and female school children across seven African countries. The total sample included 17,725 school children aged 13 to 15 years from nationally representative samples in seven African countries. Univariate and multivariate analyses were conducted to assess the relationship between early smoking initiation, health compromising behaviours, mental distress, protective factors and socio-economic status variables. Overall 15.5% had experienced smoking initiation before age 14, with the percentages 20.1% among boys and 10.9% among girls. In multivariable analysis, early smoking initiation was among boys associated with ever drunk from alcohol use (OR = 4.73, p = 0.001), ever used drugs (OR = 2.36, p = 0.04) and ever had sex (OR = 1.63, p = 0.04). Among girls, it was associated with higher education (OR = 5.77, p = 0.001), ever drunk from alcohol use (OR = 4.76, p = 0.002), parental or guardian tobacco use (OR = 2.83, p = 0.001) and suicide ideation (OR = 2.05, p = 0.02). The study found a high prevalence of early smoking initiation among 13-15 year-olds in seven African countries. Various risk factors have been identified in boys and girls who initiate smoking before age 14, forming a distinct risk group in this setting. Specific interventions are needed for boys and girls in the preteen years, before smoking initiation.

Cigarette smoking and cigarette marketing exposure among students in selected African countries: Findings from the Global Youth Tobacco Survey.

PubMed

Zhao, Luhua; Palipudi, Krishna M; Ramanandraibe, Nivo; Asma, Samira

2016-10-01

To investigate cigarette smoking prevalence and exposure to various forms of cigarette marketing among students in 10 African countries. We used data collected during 2009-2011 from the Global Youth Tobacco Survey (GYTS), a school-based cross-sectional survey of students aged 13-15years, to measure the prevalence of cigarette smoking and exposure to cigarette marketing; comparisons to estimates from 2005 to 2006 were conducted for five countries where data were available. Current cigarette smoking ranged from 3.4% to 13.6% among students aged 13-15 in the 10 countries studied, although use of tobacco products other than cigarettes was more prevalent in all countries except in Cote D'Ivoire. Cigarette smoking was higher among boys than girls in seven out of the 10 countries. Among the five countries with two rounds of surveys, a significant decrease in cigarette smoking prevalence was observed in Mauritania and Niger; these two countries also experienced a decline in three measures of cigarette marketing exposure. It is also possible that smoking prevalence might have risen faster among girls than boys. Cigarette smoking among youth was noticeable in 10 African countries evaluated, with the prevalence over 10% in Cote D'Ivoire, Mauritania, and South Africa. Cigarette marketing exposure varied by the types of marketing; traditional venues such as TV, outdoor billboards, newspapers, and magazines were still prominent. Published by Elsevier Inc.

Self-Care Knowledge of Hypertension Prevention and Control among Women in Contemporary Ghana

ERIC Educational Resources Information Center

Asmah, Emmanuel Ekow; Orkoh, Emmanuel

2017-01-01

Background: There has been a growing body of literature on hypertension in many countries, but nonavailability of data hampered empirical research on this issue in Ghana. Purpose: This article presents new and nationally representative household survey evidence on determinants and benefits of self-care knowledge of hypertension prevention and…

Does a wife's education influence spousal agreement on approval of family planning?: Random-effects Modeling using data from two West African Countries.

PubMed

Hossain, Mian; Ahmed, Saifuddin; Rogers, Laurencia

2014-05-01

Spousal approval of family planning is critical for contraceptive use. Both contraceptive use rates and women's education are low in many West-African countries and this study examines the role of wives' education in spousal agreement on approval of family planning in two sub-Saharan West African countries. We used couples' data from Demographic Health Surveys in Senegal and in Niger, conducted in 2005 and 2006, respectively. Multiple logistic regression results using multilevel modeling show that the odds of spousal agreement on approval of family planning were slightly over three times [OR: 3.16; 95% CI: 1.32 to 7.57] in Senegal and were about three times [OR: 3.07; 95% CI: 1.64 to 5.76] in Niger higher for women with more than primary education. Findings suggest that improvement in women's education could lead to spousal agreement on approval of family planning, which may lead to use of family planning in sub-Saharan African countries.

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.

Adolescent suicide in Ghana: A content analysis of media reports

PubMed Central

Quarshie, Emmanuel Nii-Boye; Osafo, Joseph; Akotia, Charity S.; Peprah, Jennifer

2015-01-01

Adolescent suicide is now a major health concern for many countries. However, there is paucity of systematic studies and lack of official statistics on adolescent suicide in Ghana. Mass media coverage of adolescent suicide (even though crude), at least, may reflect the reality of the phenomenon. With an ecological orientation, this study used qualitative content analysis to analyse the pattern of 44 media reports of adolescent suicide in Ghana from January 2001 through September 2014. Results showed that hanging was the dominant method used. The behaviour usually takes place within or near the adolescent's home environment. The act was often attributed to precursors within the microsystem (family and school) of the deceased. This study serves a seminal function for future empirical studies aimed at deeper examination of the phenomenon in order to inform prevention programmes. PMID:26015405

The Features of Development in the Pacific Countries of the African, Caribbean and Pacific Group

ERIC Educational Resources Information Center

Cuenca Garcia, Eduardo; Rodriguez Martin, Jose Antonio; Navarro Pabsdorf, Margarita

2010-01-01

In this article we present a new proposal for the measurement of development, applied to the Pacific Countries of the African, Caribbean and Pacific Group (ACP), conditional on their insularity, and with privileged relations with the European Union. Our index has been constructed attending to the criteria defined in the Goals of the Millennium…

The ''Complex Reality'' of Research Capacity Development in Mathematics Education in Southern African Development Community Countries

ERIC Educational Resources Information Center

Julie, Cyril; Mikalsen, Oyvind; Persens, Jan

2005-01-01

This paper explores how an aid-funded Ph.D.-programme in mathematics education instituted in some Southern African Development Community countries measures up to issues related to research capacity development projects. The research capacity development programme is described and reflected against mutual benefit, relevance, sustainability and…

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)

Antepartum depression and anxiety associated with disability in African women: cross-sectional results from the CDS study in Ghana and Côte d'Ivoire.

PubMed

Bindt, Carola; Appiah-Poku, John; Te Bonle, Marguerite; Schoppen, Stefanie; Feldt, Torsten; Barkmann, Claus; Koffi, Mathurin; Baum, Jana; Nguah, Samuel Blay; Tagbor, Harry; Guo, Nan; N'Goran, Eliezer; Ehrhardt, Stephan

2012-01-01

Common mental disorders, particularly unipolar depressive disorders, rank among the top 5 with respect to the global burden of disease. As a major public health concern, antepartum depression and anxiety not only affects the individual woman, but also her offspring. Data on the prevalence of common mental disorders in pregnant women in sub-Saharan Africa are scarce. We provide results from Ghana and Côte d'Ivoire. We subsequently recruited and screened n = 1030 women in the third trimester of their pregnancy for depressed mood, general anxiety, and perceived disability using the Patient Health Questionnaire depression module (PHQ-9), the 7-item Anxiety Scale (GAD-7), and the World Health Organisation Disability Assessment Schedule II (WHO-DAS 2.0, 12-item version). In addition to estimates of means and prevalence, a hierarchical linear regression model was calculated to determine the influence of antepartum depression and anxiety on disability. In Ghana, 26.6% of women showed substantially depressed mood. In Côte d'Ivoire, this figure was even higher (32.9%). Clear indications for a generalized anxiety disorder were observed in 11.4% and 17.4% of pregnant women, respectively. Comorbidity of both conditions was common, affecting about 7.7% of Ghanaian and 12.6% of Ivorian participants. Pregnant women in both countries reported a high degree of disability regarding everyday activity limitations and participation restrictions. Controlled for country and age, depression and anxiety accounted for 33% of variance in the disability score. Antepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in sub-Saharan Africa.

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

Who pays for health care in Ghana?

PubMed Central

2011-01-01

Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues

Who pays for health care in Ghana?

PubMed

Akazili, James; Gyapong, John; McIntyre, Diane

2011-06-27

Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the National

Socioeconomic inequalities in informal payments for health care: An assessment of the 'Robin Hood' hypothesis in 33 African countries.

PubMed

Kankeu, Hyacinthe Tchewonpi; Ventelou, Bruno

2016-02-01

In almost all African countries, informal payments are frequently made when accessing health care. Some literature suggests that the informal payment system could lead to quasi-redistribution among patients, with physicians playing a 'Robin Hood' role, subsidizing the poor at the expense of the rich. We empirically tested this assumption with data from the rounds 3 and 5 of the Afrobarometer surveys conducted in 18 and 33 African countries respectively, from 2005 to 2006 for round 3 and from 2011 to 2013 for round 5. In these surveys, nationally representative samples of people aged 18 years or more were randomly selected in each country, with sizes varying between 1048 and 2400 for round 3 and between 1190 and 2407 for round 5. We used the 'normalized' concentration index, the poor/rich gap and the odds ratio to assess the level of inequality in the payment of bribes to access care at the local public health facility and implemented two decomposition techniques to identify the contributors to the observed inequalities. We obtained that: i) the socioeconomic gradient in informal payments is in favor of the rich in almost all countries, indicating a rather regressive system; ii) this is mainly due to the socioeconomic disadvantage itself, to poor/rich differences in supply side factors like lack of medicines, absence of doctors and long waiting times, as well as regional disparities. Although essentially empirical, the paper highlights the need for African health systems to undergo substantial country-specific reforms in order to better protect the worse-off from financial risk when they seek care. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

Heat flow from the West African Shield

NASA Astrophysics Data System (ADS)

Brigaud, Frédéric; Lucazeau, Francis; Ly, Saidou; Sauvage, Jean François

1985-09-01

The heat flow over Precambrian shields is generally lower than over other continental provinces. Previous observations at 9 sites of the West African shield have shown that heat flow ranges from 20 mW m -2 in Niger to 38-42 mW m -2 in Liberia, Ghana and Nigeria. Since some of these values are lower than expected for Precambrian shields, it is important to find out whether or not they are representative of the entire shield before trying to derive its thermal structure. In this paper, we present new heat flow determinations from seven sites of the West African shield. These indicate that the surface heat flow is comparable with that of other Precambrian shields in the world.

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

Sanitary pad interventions for girls' education in Ghana: a pilot study.

PubMed

Montgomery, Paul; Ryus, Caitlin R; Dolan, Catherine S; Dopson, Sue; Scott, Linda M

2012-01-01

Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education. A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance. After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level. This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls' education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest that a large-scale cluster randomized

Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study

PubMed Central

Montgomery, Paul; Ryus, Caitlin R.; Dolan, Catherine S.; Dopson, Sue; Scott, Linda M.

2012-01-01

Background Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education. Methods A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance. Results After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level. Conclusion This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls' education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest

Solving the Teacher Shortage Problem in Ghana: Critical Perspectives for Understanding the Issues

ERIC Educational Resources Information Center

Cobbold, Cosmas

2015-01-01

The problem of getting sufficient numbers of qualified teachers to staff classrooms is one of the most significant public policy issues facing many countries. In Ghana, the problem of teacher shortage has been a perennial one, necessitated by educational expansion as well as adverse socio-economic and political circumstances, and exacerbated by…

Carbon emissions-income relationships with structural breaks: the case of the Middle Eastern and North African countries.

PubMed

El Montasser, Ghassen; Ajmi, Ahdi Noomen; Nguyen, Duc Khuong

2018-01-01

This article revisits the carbon dioxide (CO 2 ) emissions-GDP causal relationships in the Middle Eastern and North African (MENA) countries by employing the Rossi (Economet Theor 21:962-990, 2005) instability-robust causality test. We show evidence of significant causality relationships for all considered countries within the instability context, whereas the standard Granger causality test fails to detect causal links in any direction, except for Egypt, Iran, and Morocco. An important policy implication resulting from this robust analysis is that the income is not affected by the cuts in the CO 2 emissions for only two MENA countries, the UAE and Syria.

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

Caregivers' views on stigmatization and discrimination of people affected by leprosy in Ghana.

PubMed

Asampong, Emmanuel; Dako-Gyeke, Mavis; Oduro, Razak

2018-01-01

Leprosy is a condition that has long been associated with stigma and discrimination, even when infected persons have been cured. This paper describes stigma and discrimination as viewed by caregivers who are associated with people affected by leprosy in Ghana. A qualitative interview with semi-structured interviews were conducted for twenty caregivers. Findings indicated that caregivers were of the view that people affected by leprosy in Ghana are stigmatized and discriminated against by the larger society thus making their movements and interactions restricted to the Leprosarium. Besides, employments opportunities are unavailable to them thus making them exposed to financial challenges. The livelihood Empowerment Against poverty (LEAP) money given them is not sufficient for their daily upkeep. People affected by leprosy in Ghana are stigmatized and therefore find it difficult to interact freely with the public. The associated physical deformities with the disease also tend to impede their ability to relate to the general public. The LEAP cash given to people affected by leprosy is helpful however, it could be enhanced to keep pace with prevailing economic conditions in the country.

Public university entry in Ghana: Is it equitable?

NASA Astrophysics Data System (ADS)

Yusif, Hadrat; Yussof, Ishak; Osman, Zulkifly

2013-06-01

Public universities in Ghana are highly subsidised by the central government and account for about 80 per cent of university students in the country. Yet issues of fairness in terms of entry into the public university system have so far hardly been addressed. To find out whether participation in public university education is equitable, the authors of this paper carried out a binary logistic regression analysis. Individual data were collected from 1,129 (614 male and 515 female) final year senior high school (SHS) students for the 2009 cohort. The authors measured student, father and mother characteristics likely to influence admission to a public university. The results show that the major predictors of public university entry are students' academic ability, quality of SHS attended and number of siblings. This seems to suggest that there is a significant bias in the selection of students from different socio-economic groups for admission to highly subsidised public universities. The implication is that public financing of university education in Ghana may not be equitable.

Systematic review of school tobacco prevention programs in African countries from 2000 to 2016.

PubMed

Nishio, Akihiro; Saito, Junko; Tomokawa, Sachi; Kobayashi, Jun; Makino, Yuka; Akiyama, Takeshi; Miyake, Kimihiro; Yamamoto, Mayumi

2018-01-01

The World Bank has reported that global smoking rates declined from 2000 to 2012, with the only exception found in males in Sub-Saharan Africa. Sub-Saharan Africa is considered to be in stage one of the tobacco epidemic continuum. To address this problem, school-based programs for smoking prevention are considered cost-effective and promising. Since tobacco prevention programs are influenced by social competence or customs of each country, tobacco prevention programs that have success in Western countries are not always effective in African countries. Therefore, the current study systematically reviewed relevant literature to examine the effects of these types of programs in African countries. Online bibliographic databases and a hand search were used. We included the studies that examined the impact of school-based programs on preventing tobacco use in Africa from 2000 to 2016. Six articles were selected. Four were conducted in South Africa and two were performed in Nigeria. Four programs were systematically incorporated into annual curriculums, targeting 8th to 9th graders, while the other two were temporary programs. All programs were based on the hypothesis that providing knowledge and/or social skills against smoking would be helpful. All studies utilized smoking or polydrug use rates to compare outcomes before/after intervention. There were no significant differences between intervention and control groups in three studies, with the other three demonstrating only partial effectiveness. Additionally, three studies also examined change of knowledge/attitudes towards smoking as an outcome. Two of these showed significant differences between groups. All RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking. However, they reported no significant

Systematic review of school tobacco prevention programs in African countries from 2000 to 2016

PubMed Central

Saito, Junko; Tomokawa, Sachi; Kobayashi, Jun; Makino, Yuka; Akiyama, Takeshi; Miyake, Kimihiro; Yamamoto, Mayumi

2018-01-01

Background The World Bank has reported that global smoking rates declined from 2000 to 2012, with the only exception found in males in Sub-Saharan Africa. Sub-Saharan Africa is considered to be in stage one of the tobacco epidemic continuum. To address this problem, school-based programs for smoking prevention are considered cost-effective and promising. Since tobacco prevention programs are influenced by social competence or customs of each country, tobacco prevention programs that have success in Western countries are not always effective in African countries. Therefore, the current study systematically reviewed relevant literature to examine the effects of these types of programs in African countries. Method Online bibliographic databases and a hand search were used. We included the studies that examined the impact of school-based programs on preventing tobacco use in Africa from 2000 to 2016. Results Six articles were selected. Four were conducted in South Africa and two were performed in Nigeria. Four programs were systematically incorporated into annual curriculums, targeting 8th to 9th graders, while the other two were temporary programs. All programs were based on the hypothesis that providing knowledge and/or social skills against smoking would be helpful. All studies utilized smoking or polydrug use rates to compare outcomes before/after intervention. There were no significant differences between intervention and control groups in three studies, with the other three demonstrating only partial effectiveness. Additionally, three studies also examined change of knowledge/attitudes towards smoking as an outcome. Two of these showed significant differences between groups. Conclusion All RCTs studies showed no significant change of smoking-rate by the intervention. The effectiveness of intervention was observed only in some sub-group. The cohort studies showed school-based interventions may be effective in improving knowledge and attitudes about smoking

Prospects of the Economic Community of West African States Standby Force

DTIC Science & Technology

2006-06-16

two speak Portuguese. Member states of ECOWAS are Burkina Faso, Benin , Cape Verde, Côte d’Ivoire, Gambia, Ghana, Guinea, Guinea- 6 Bissau, Liberia...Also, the required size of the force to fulfill its mandate was not met. The countries that contributed troops were Benin , Niger and Togo (IRIN 2004...support for ECOWAS troops. Britain channeled its efforts through Ghana; Benin was supported by Belgium; France’s assistance was conveyed through Niger

Africans in America.

ERIC Educational Resources Information Center

Hart, Ayanna; Spangler, Earl

This book introduces African-American history and culture to children. The first Africans in America came from many different regions and cultures, but became united in this country by being black, African, and slaves. Once in America, Africans began a long struggle for freedom which still continues. Slavery, the Civil War, emancipation, and the…

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

Introducing vouchers for malaria prevention in Ghana and Tanzania: context and adoption of innovation in health systems.

PubMed

de Savigny, Don; Webster, Jayne; Agyepong, Irene Akua; Mwita, Alex; Bart-Plange, Constance; Baffoe-Wilmot, Aba; Koenker, Hannah; Kramer, Karen; Brown, Nick; Lengeler, Christian

2012-10-01

There are striking similarities in health system and other contexts between Tanzania and Ghana that are relevant to the scaling up of continuous delivery of insecticide treated nets (ITNs) for malaria prevention. However, specific contextual factors of relevance to ITN delivery have led implementation down very different pathways in the two countries. Both countries have made major efforts and investments to address this intervention through integrating consumer discount vouchers into the health system. Discount vouchers require arrangements among the public, private and non-governmental sectors and constitute a complex intervention in both health systems and business systems. In Tanzania, vouchers have moved beyond the planning agenda, had policies and programmes formulated, been sustained in implementation at national scale for many years and have become as of 2012 the main and only publicly supported continuous delivery system for ITNs. In Ghana national-scale implementation of vouchers never progressed beyond consideration on the agenda and piloting towards formulation of policy; and the approach was replaced by mass distribution campaigns with less dependency on or integration with the health system. By 2011, Ghana entered a phase with no publicly supported continuous delivery system for ITNs. To understand the different outcomes, we compared the voucher programme timelines, phases, processes and contexts in both countries in reference to the main health system building blocks (governance, human resources, financing, informatics, technologies and service delivery). Contextual factors which provided an enabling environment for the voucher scheme in Tanzania did not do so in Ghana. The voucher scheme was never seen as an appropriate national strategy, other delivery systems were not complementary and the private sector was under-developed. The extensive time devoted to engagement and consensus building among all stakeholders in Tanzania was an important and

Optimising design and cost-effective implementation of future pan-African dietary studies: a review of existing economic integration and nutritional indicators for scenario-based profiling and clustering of countries.

PubMed

Aglago, Elom K; Landais, Edwige; Zotor, Francis; Nicolas, Genevieve; Gunter, Marc J; Amuna, Paul; Slimani, Nadia

2018-02-01

Most of the African countries are undergoing a complex nutrition and epidemiologic transition associated with a rapid increase in the prevalence of diverse non-communicable diseases. Despite this alarming situation, the still limited and fragmented resources available in Africa impede the implementation of effective action plans to tackle the current and projected diet-disease burden. In order to address these common needs and challenges, the African Union is increasingly supporting continental approaches and strategies as reflected in the launching of the Agenda 2063 and the African regional nutrition strategy 2015-2025, among others. To assure the successful implementation of pan-African nutritional and health initiatives, cost-effective approaches considering similarities/disparities in economy, regional integration, development and nutritional aspects between countries are needed. In the absence of pre-existing models, we reviewed regional economic integration and nutritional indicators (n 13) available in international organisations databases or governmental agencies websites, for fifty-two African countries. These indicators were used to map the countries according to common languages (e.g. Arabic, English, French, Portuguese), development status (e.g. human development index), malnutrition status (e.g. obesity) and diet (e.g. staples predominantly based on either cereals or tubers). The review of the indicators showed that there exist similarities between African countries that can be exploited to benefit the continent with cross-national experiences in order to avoid duplication of efforts in the implementation of future pan-African health studies. In addition, including present and future nutrition surveillance programmes in Africa into national statistical systems might be cost-effective and sustainable in the longer term.

Assessing hand hygiene resources and practices at a large african teaching hospital.

PubMed

Owusu-Ofori, Alex; Jennings, Rebecca; Burgess, Jennifer; Prasad, Priya A; Acheampong, Faustina; Coffin, Susan E

2010-08-01

To gather baseline data on hand hygiene (HH) practices in an African hospital with a newly established infection prevention and control team. Cross-sectional, observational study. Setting. Komfo Anokye Teaching Hospital, a large teaching hospital in Ghana with approximately 1,000 beds. All hospital staff with patient contact were eligible for assessment of HH practices. HH observations were conducted using a standardized data collection tool and method based on the World Health Organization's "5 Moments of Hand Hygiene." Small-group interviews were conducted to gather additional information on perceptions of HH and barriers to its use. HH resource needs were also assessed using a standardized tool. HH was attempted in 12% of the opportunities and was performed appropriately in 4% of the opportunities. Most main wards (89%) had at least 1 functional HH station. The most commonly identified barriers to HH were limited resources and lack of knowledge on appropriate times to perform HH. We developed and applied tools to evaluate HH resources and practices in a large African hospital. These assessments were undertaken to guide future efforts to improve HH at this hospital but can also serve as a model of the way to perform a systematic assessment at acute care hospitals in developing countries.

Situation Report--Ghana, Guyana, India, Japan, Kenya, Khmer Republic, Nepal, Niger, Republic of Vietnam, Senegal, Thailand, and Trinidad and Tobago.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in twelve foreign countries are presented in these situation reports. Countries included are Ghana, Guyana, India, Japan, Kenya, Khmer Republic, Nepal, Niger, Republic of Vietnam, Senegal, Thailand, and Trinidad and Tobago. Information is provided under two topics, general background and family…

50 Years of Educational Progress and Challenge in Ghana. Research Monograph No. 33

ERIC Educational Resources Information Center

Akyeampong, Kwame

2010-01-01

In 2007 Ghana celebrated 50 years of independence from British colonial rule. The golden jubilee offered an opportunity to take stock of how the country had progressed in expanding education and the challenges for the future. This paper offers a critique of the journey, highlighting the challenges and progress. What reforms in education has taught…

Implementing Free Primary Education Policy in Malawi and Ghana: Equity and Efficiency Analysis

ERIC Educational Resources Information Center

Inoue, Kazuma; Oketch, Moses

2008-01-01

Malawi and Ghana are among the numerous Sub-Saharan Africa countries that have in recent years introduced Free Primary Education (FPE) policy as a means to realizing the 2015 Education for All and Millennium Development Goals international targets. The introduction of FPE policy is, however, a huge challenge for any national government that has…

Study on the Development of Museums for Improved Integration of the Cultural Heritage into the Education System in French-Speaking African Countries.

ERIC Educational Resources Information Center

Essomba, Joseph-Marie

Objectives for establishing museums in African countries for the purpose of teaching African history, languages, literature, and art are presented. Section 1 of the report focuses on the museum as a basis for creating an awareness of history, developing cultural individuality, laying groundwork for an endogenous form of development, and serving as…

Strategic siting and regional grid interconnections key to low-carbon futures in African countries

PubMed Central

Deshmukh, Ranjit; Ndhlukula, Kudakwashe; Radojicic, Tijana; Reilly-Moman, Jessica; Phadke, Amol; Kammen, Daniel M.; Callaway, Duncan S.

2017-01-01

Recent forecasts suggest that African countries must triple their current electricity generation by 2030. Our multicriteria assessment of wind and solar potential for large regions of Africa shows how economically competitive and low-environmental–impact renewable resources can significantly contribute to meeting this demand. We created the Multicriteria Analysis for Planning Renewable Energy (MapRE) framework to map and characterize solar and wind energy zones in 21 countries in the Southern African Power Pool (SAPP) and the Eastern Africa Power Pool (EAPP) and find that potential is several times greater than demand in many countries. Significant fractions of demand can be quickly served with “no-regrets” options—or zones that are low-cost, low-environmental impact, and highly accessible. Because no-regrets options are spatially heterogeneous, international interconnections are necessary to help achieve low-carbon development for the region as a whole, and interconnections that support the best renewable options may differ from those planned for hydropower expansion. Additionally, interconnections and selecting wind sites to match demand reduce the need for SAPP-wide conventional generation capacity by 9.5% in a high-wind scenario, resulting in a 6–20% cost savings, depending on the avoided conventional technology. Strategic selection of low-impact and accessible zones is more cost effective with interconnections compared with solutions without interconnections. Overall results are robust to multiple load growth scenarios. Together, results show that multicriteria site selection and deliberate planning of interconnections may significantly increase the economic and environmental competitiveness of renewable alternatives relative to conventional generation. PMID:28348209

Strategic siting and regional grid interconnections key to low-carbon futures in African countries

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

Wu, Grace C.; Deshmukh, Ranjit; Ndhlukula, Kudakwashe

2017-03-27

Recent forecasts suggest that African countries must triple their current electricity generation by 2030. Our multicriteria assessment of wind and solar potential for large regions of Africa shows how economically competitive and low-environmental– impact renewable resources can significantly contribute to meeting this demand. We created the Multicriteria Analysis for Planning Renewable Energy (MapRE) framework to map and characterize solar and wind energy zones in 21 countries in the Southern African Power Pool (SAPP) and the Eastern Africa Power Pool (EAPP) and find that potential is several times greater than demand in many countries. Significant fractions of demand can be quicklymore » served with “no-regrets” options—or zones that are low-cost, low-environmental impact, and highly accessible. Because no-regrets options are spatially heterogeneous, international interconnections are necessary to help achieve low-carbon development for the region as a whole, and interconnections that support the best renewable options may differ from those planned for hydropower expansion. Additionally, interconnections and selecting wind sites to match demand reduce the need for SAPP-wide conventional generation capacity by 9.5% in a high-wind scenario, resulting in a 6–20% cost savings, depending on the avoided conventional technology. Strategic selection of low-impact and accessible zones is more cost effective with interconnections compared with solutions without interconnections. In conclusion, the overall results are robust to multiple load growth scenarios. Together, results show that multicriteria site selection and deliberate planning of interconnections may significantly increase the economic and environmental competitiveness of renewable alternatives relative to conventional generation.« less

Strategic siting and regional grid interconnections key to low-carbon futures in African countries.

PubMed

Wu, Grace C; Deshmukh, Ranjit; Ndhlukula, Kudakwashe; Radojicic, Tijana; Reilly-Moman, Jessica; Phadke, Amol; Kammen, Daniel M; Callaway, Duncan S

2017-04-11

Recent forecasts suggest that African countries must triple their current electricity generation by 2030. Our multicriteria assessment of wind and solar potential for large regions of Africa shows how economically competitive and low-environmental-impact renewable resources can significantly contribute to meeting this demand. We created the Multicriteria Analysis for Planning Renewable Energy (MapRE) framework to map and characterize solar and wind energy zones in 21 countries in the Southern African Power Pool (SAPP) and the Eastern Africa Power Pool (EAPP) and find that potential is several times greater than demand in many countries. Significant fractions of demand can be quickly served with "no-regrets" options-or zones that are low-cost, low-environmental impact, and highly accessible. Because no-regrets options are spatially heterogeneous, international interconnections are necessary to help achieve low-carbon development for the region as a whole, and interconnections that support the best renewable options may differ from those planned for hydropower expansion. Additionally, interconnections and selecting wind sites to match demand reduce the need for SAPP-wide conventional generation capacity by 9.5% in a high-wind scenario, resulting in a 6-20% cost savings, depending on the avoided conventional technology. Strategic selection of low-impact and accessible zones is more cost effective with interconnections compared with solutions without interconnections. Overall results are robust to multiple load growth scenarios. Together, results show that multicriteria site selection and deliberate planning of interconnections may significantly increase the economic and environmental competitiveness of renewable alternatives relative to conventional generation.

Challenges associated with tracking resources allocation for reproductive health in sub-Saharan African countries: the UNFPA/NIDI resource flows project experience.

PubMed

Sidze, Estelle M; Beekink, Erik; Maina, Beatrice W

2015-05-05

Universal access to reproductive health services entails strengthening health systems, but requires significant resource commitments as well as efficient and effective use of those resources. A number of international organizations and governments in developing countries are putting efforts into tracking the flow of health resources in order to inform resource mobilization and allocation, strategic planning, priority setting, advocacy and general policy making. The UNFPA/NIDI-led Resource Flows Project ("The UNFPA/NIDI RF Project") has conducted annual surveys since 1997 to monitor progress achieved by developing countries in implementing reproductive health financial targets. This commentary summarizes the Project experiences and challenges in gathering data on allocation of resources for reproductive health at the domestic level in sub-Saharan African countries. One key lesson learnt from the Project experience is the need for strengthening tracking mechanisms in sub-Saharan African countries and making information on reproductive health resources and expenditures available, in particular the private sector resources.

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.

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.

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

Associations of government health expenditures, the supply of health care professionals, and country literacy with prenatal care use in ten West African countries.

PubMed

Taylor, Yhenneko J; Laditka, Sarah B; Laditka, James N; Brunner Huber, Larissa R; Racine, Elizabeth F

2017-03-01

Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.

How students perceive medical competences: a cross-cultural study between the medical course in Portugal and African Portuguese speaking countries.

PubMed

Barbosa, Joselina; Severo, Milton; Fresta, Mário; Ismail, Mamudo; Ferreira, Maria Amélia; Barros, Henrique

2011-05-25

A global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools. The information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country. The order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043). The reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some weaknesses.

How students perceive medical competences: a cross-cultural study between the Medical Course in Portugal and African Portuguese Speaking Countries

PubMed Central

2011-01-01

Background A global effort has been made in the last years to establish a set of core competences that define the essential professional competence of a physician. Regardless of the environment, culture or medical education conditions, a set of core competences is required for medical practice worldwide. Evaluation of educational program is always needed to assure the best training for medical students and ultimately best care for patients. The aim of this study was to determine in what extent medical students in Portugal and Portuguese speaking African countries, felt they have acquired the core competences to start their clinical practice. For this reason, it was created a measurement tool to evaluate self-perceived competences, in different domains, across Portuguese and Portuguese-speaking African medical schools. Methods The information was collected through a questionnaire that defines the knowledge, attitudes and skills that future doctors should acquire. The Cronbach's Alpha and Principal Components Analysis (PCA) were used to evaluate the reliability of the questionnaire. In order to remove possible confounding effect, individual scores were standardized by country. Results The order of the domain's scores was similar between countries. After standardization, Personal Attitudes and Professional Behavior showed median scores above the country global median and Knowledge alone showed median score below the country global median. In Portugal, Clinical Skills showed score below the global median. In Angola, Clinical Skills and General Skills showed a similar result. There were only significant differences between countries in Personal Attitudes (p < 0.001) and Professional Behavior (p = 0.043). Conclusions The reliability of the instrument in Portuguese and Portuguese-speaking African medical schools was confirmed. Students have perceived their level of competence in personal attitudes in a high level and in opposite, knowledge and clinical skills with some

Past and Ongoing Tsetse and Animal Trypanosomiasis Control Operations in Five African Countries: A Systematic Review

PubMed Central

Holt, Hannah R.; Selby, Richard; Guitian, Javier

2016-01-01

Background Control operations targeting Animal African Trypanosomiasis and its primary vector, the tsetse, were covering approximately 128,000 km2 of Africa in 2001, which is a mere 1.3% of the tsetse infested area. Although extensive trypanosomiasis and tsetse (T&T) control operations have been running since the beginning of the 20th century, Animal African Trypanosomiasis is still a major constraint of livestock production in sub-Saharan Africa. Methodology/Principal Findings We performed a systematic review of the existing literature describing T&T control programmes conducted in a selection of five African countries, namely Burkina Faso, Cameroon, Ethiopia, Uganda and Zambia, between 1980 and 2015. Sixty-eight documents were eventually selected from those identified by the database search. This was supplemented with information gathered through semi-structured interviews conducted with twelve key informants recruited in the study countries and selected based on their experience and knowledge of T&T control. The combined information from these two sources was used to describe the inputs, processes and outcomes from 23 major T&T control programmes implemented in the study countries. Although there were some data gaps, involvement of the target communities and sustainability of the control activities were identified as the two main issues faced by these programmes. Further, there was a lack of evaluation of these control programmes, as well as a lack of a standardised methodology to conduct such evaluations. Conclusions/Significance Past experiences demonstrated that coordinated and sustained control activities require careful planning, and evidence of successes, failures and setbacks from past control programmes represent a mine of information. As there is a lack of evaluation of these programmes, these data have not been fully exploited for the design, analyses and justification of future control programmes. PMID:28027299

Risk factors for kid mortality in West African Dwarf goats under an intensive management system in Ghana.

PubMed

Turkson, P K; Antiri, Y K; Baffuor-Awuah, O

2004-05-01

Breeding records from 1997 to 2000 for West African Dwarf goats kept under an intensive management system on the National Breeding Station at Kintampo in Ghana were analysed for the effect on mortality of sex, season and type of birth, and birth weight. The pre-weaning and post-weaning mortalities were 10% (n = 390) and 23.1% (n = 351), respectively, while the overall mortality from birth up to 12 months of age was 30.8% (n = 390). The post-weaning period recorded significantly higher proportions of deaths in males, females, single-born and twins, during the rainy and dry seasons, and for kids with low or high birth weight, compared to the pre-weaning period. There was significantly higher mortality in male kids than in female kids. The odds and risks of death for male kids were about twice those for females at post-weaning and up to 1 year of age. At pre-weaning and up to 1 year of age, a higher proportion of the dead were twins. Twins had approximately 2.5 the risk of death at pre-weaning, compared to singles. Also, kids born in the rainy season had significantly higher mortality than those born in the dry season. Kids that died by the time of weaning were significantly lighter in weight at birth than those that survived. Male kids had significantly higher mean weights at birth and at weaning, but not at 12 months of age. The significance of these findings is discussed.

Malnutrition and the disproportional burden on the poor: the case of Ghana

PubMed Central

Van de Poel, Ellen; Hosseinpoor, Ahmad Reza; Jehu-Appiah, Caroline; Vega, Jeanette; Speybroeck, Niko

2007-01-01

Background Malnutrition is a major public health and development concern in the developing world and in poor communities within these regions. Understanding the nature and determinants of socioeconomic inequality in malnutrition is essential in contemplating the health of populations in developing countries and in targeting resources appropriately to raise the health of the poor and most vulnerable groups. Methods This paper uses a concentration index to summarize inequality in children's height-for-age z-scores in Ghana across the entire socioeconomic distribution and decomposes this inequality into different contributing factors. Data is used from the Ghana 2003 Demographic and Health Survey. Results The results show that malnutrition is related to poverty, maternal education, health care and family planning and regional characteristics. Socioeconomic inequality in malnutrition is mainly associated with poverty, health care use and regional disparities. Although average malnutrition is higher using the new growth standards recently released by the World Health Organization, socioeconomic inequality and the associated factors are robust to the change of reference population. Conclusion Child malnutrition in Ghana is a multisectoral problem. The factors associated with average malnutrition rates are not necessarily the same as those associated with socioeconomic inequality in malnutrition. PMID:18045499

Making sense of condoms: social representations in young people's HIV-related narratives from six African countries.

PubMed

Winskell, Kate; Obyerodhyambo, Oby; Stephenson, Rob

2011-03-01

Condoms are an essential component of comprehensive efforts to control the HIV epidemic, both for those who know their status and for those who do not. Although young people account for almost half of all new HIV infections, reported condom use among them remains low in many sub-Saharan African countries. In order to inform education and communication efforts to increase condom use, we examined social representations of condoms among young people aged 10-24 in six African countries/regions with diverse HIV prevalence rates: Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso, and Senegal. We used a unique data source, namely 11,354 creative ideas contributed from these countries to a continent-wide scriptwriting contest, held from 1(st) February to 15(th) April 2005, on the theme of HIV/AIDS. We stratified each country sample by the sex, age (10-14, 15-19, 20-24), and urban/rural location of the author and randomly selected up to 10 narratives for each of the 12 resulting strata, netting a total sample of 586 texts for the six countries. We analyzed the narratives qualitatively using thematic data analysis and narrative-based methodologies. Differences were observed across settings in the prominence accorded to condoms, the assessment of their effectiveness, and certain barriers to and facilitators of their use. Moralization emerged as a key impediment to positive representations of condoms, while humour was an appealing means to normalize them. The social representations in the narratives identify communication needs in and across settings and provide youth-focused ideas and perspectives to inform future intervention efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

Socioeconomic differential in self-assessment of health and happiness in 5 African countries: Finding from World Value Survey.

PubMed

Adesanya A, Oluwafunmilade; Rojas, Bomar Mendez; Darboe, Amadou; Beogo, Idrissa

2017-01-01

Factors that contribute to wealth related inequalities in self-rated health (SRH) and happiness remains unclear most especially in sub-Saharan countries (SSA). This study aims to explore and compare socioeconomic differentials in SRH and happiness in five SSA countries. Using the 2010/2014 World Values Survey (WVS), we obtained a sample of 9,869 participants of age 16 and above from five SSA countries (Nigeria, Ghana, South Africa, Rwanda and Zimbabwe). Socioeconomic inequalities were quantified using the concentration index. The contribution of each predictor to concentration index's magnitude was obtained by means of regression based decomposition analysis. Poor SRH ranges from approximately 9% in Nigeria to 20% in Zimbabwe, whereas unhappiness was lower in Rwanda (9.5%) and higher in South Africa (23.3%). Concentration index was negative for both outcomes in all countries, which implies that poor SRH and unhappiness are excessively concentrated among the poorest socioeconomic strata. Although magnitudes differ across countries, however, the major contributor to wealth-related inequality in poor SRH is satisfaction with financial situation whereas for unhappiness the major contributors are level of income and satisfaction with financial situation. This study underscores an association between wealth related inequalities and poor SRH and unhappiness in the context of SSA. Improving equity in health, as suggested by the commission of social determinants of health may be useful in fighting against the unfair distribution of resources. Thus, knowledge about the self-rating of health and happiness can serve as proxy estimates for understanding the distribution of health care access and economic resources needed for well-being in resident countries.

Surface Accuracy and Pointing Error Prediction of a 32 m Diameter Class Radio Astronomy Telescope

NASA Astrophysics Data System (ADS)

Azankpo, Severin

2017-03-01

The African Very-long-baseline interferometry Network (AVN) is a joint project between South Africa and eight partner African countries aimed at establishing a VLBI (Very-Long-Baseline Interferometry) capable network of radio telescopes across the African continent. An existing structure that is earmarked for this project, is a 32 m diameter antenna located in Ghana that has become obsolete due to advances in telecommunication. The first phase of the conversion of this Ghana antenna into a radio astronomy telescope is to upgrade the antenna to observe at 5 GHz to 6.7 GHz frequency and then later to 18 GHz within a required performing tolerance. The surface and pointing accuracies for a radio telescope are much more stringent than that of a telecommunication antenna. The mechanical pointing accuracy of such telescopes is influenced by factors such as mechanical alignment, structural deformation, and servo drive train errors. The current research investigates the numerical simulation of the surface and pointing accuracies of the Ghana 32 m diameter radio astronomy telescope due to its structural deformation mainly influenced by gravity, wind and thermal loads.

Using Examinations To Improve Education: A Study in Fourteen African Countries. World Bank Technical Paper Number 165. Africa Technical Department Series.

ERIC Educational Resources Information Center

Kellaghan, Thomas; Greaney, Vincent

A detailed description is presented of the types, functions, performance levels, governance, administration, and funding of public examinations in 14 Sub-Saharan African countries with different educational traditions, based on English, French, or other backgrounds. The countries are: (1) Kenya; (2) Lesotho; (3) Mauritius; (4) Swaziland; (5)…

Black Tribal African Religion with Some Emphasis on Christianity and Islam in Africa.

ERIC Educational Resources Information Center

Emmons, Marian

This 6th grade social studies unit delves into the belief systems and external religious, cultural practices of Black Africans. It is part of a series of guides developed by the Public Education Religion Studies Center at Wright State University. Study is focused upon the Ashanti tribe of Ghana knowing that although the multiplicity of tribes have…

Case studies on the use of biotechnologies and on biosafety provisions in four African countries.

PubMed

Black, Robert; Fava, Fabio; Mattei, Niccolo; Robert, Vincent; Seal, Susan; Verdier, Valerie

2011-12-20

This review is based on a study commissioned by the European Commission on the evaluation of scientific, technical and institutional challenges, priorities and bottlenecks for biotechnologies and regional harmonisation of biosafety in Africa. Biotechnology was considered within four domains: agricultural biotechnologies ('Green'), industrial biotechnologies and biotechnologies for environmental remediation ('White'), biotechnologies in aquaculture ('Blue') and biotechnologies for healthcare ('Red'). An important consideration was the decline in partnerships between the EU and developing countries because of the original public antipathy to some green biotechnologies, particularly genetically modified organisms (GMOs) and food from GM crops in Europe. The study focus reported here was West Africa (Ghana, Senegal, Mali and Burkina Faso). The overall conclusion was that whereas high-quality research was proceeding in the countries visited, funding is not sustained and there is little evidence of practical application of biotechnology and benefit to farmers and the wider community. Research and development that was being carried out on genetically modified crop varieties was concentrating on improving food security and therefore unlikely to have significant impact on EU markets and consumers. However, there is much non-controversial green biotechnology such as molecular diagnostics for plant and animal disease and marker-assisted selection for breeding that has great potential application. Regarding white biotechnology, it is currently occupying only a very small industrial niche in West Africa, basically in the sole sector of the production of liquid biofuels (i.e., bio-ethanol) from indigenous and locally planted biomass (very often non-food crops). The presence of diffused small-scale fish production is the basis to develop and apply new (Blue) aquaculture technologies and, where the research conditions and the production sector can permit, to increase this type of

A SNP test to identify Africanized honeybees via proportion of 'African' ancestry.

PubMed

Chapman, Nadine C; Harpur, Brock A; Lim, Julianne; Rinderer, Thomas E; Allsopp, Michael H; Zayed, Amro; Oldroyd, Benjamin P

2015-11-01

The honeybee, Apis mellifera, is the world's most important pollinator and is ubiquitous in most agricultural ecosystems. Four major evolutionary lineages and at least 24 subspecies are recognized. Commercial populations are mainly derived from subspecies originating in Europe (75-95%). The Africanized honeybee is a New World hybrid of A. m. scutellata from Africa and European subspecies, with the African component making up 50-90% of the genome. Africanized honeybees are considered undesirable for bee-keeping in most countries, due to their extreme defensiveness and poor honey production. The international trade in honeybees is restricted, due in part to bans on the importation of queens (and semen) from countries where Africanized honeybees are extant. Some desirable strains from the United States of America that have been bred for traits such as resistance to the mite Varroa destructor are unfortunately excluded from export to countries such as Australia due to the presence of Africanized honeybees in the USA. This study shows that a panel of 95 single nucleotide polymorphisms, chosen to differentiate between the African, Eastern European and Western European lineages, can detect Africanized honeybees with a high degree of confidence via ancestry assignment. Our panel therefore offers a valuable tool to mitigate the risks of spreading Africanized honeybees across the globe and may enable the resumption of queen and bee semen imports from the Americas. © 2015 John Wiley & Sons Ltd.

Measuring health systems strength and its impact: experiences from the African Health Initiative.

PubMed

Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

2017-12-21

Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

Opportunities and capacity for community-based forest carbon sequestration and monitoring in Ghana

Treesearch

J. Schelhas; S. Samar; Cassandra Johnson; K. Asumadu; F. Tease; J. Stanturf; D. Blay

2010-01-01

International efforts to address global climate change will certainly include Africa’s forests, for example through efforts to reduce emissions from deforestation and forest degradation (REDD)(Sandker et al. 2010). Whether these efforts harm or provide new opportunities for rural people will depend on how programs are designed. In Ghana, as in many developing countries...

Implementation of Innovations in Higher Education: The Case of Competency-Based Training in Ghana

ERIC Educational Resources Information Center

Boahin, Peter; Hofman, W. H. Adriaan

2012-01-01

A notable trend in recent years has been the introduction of competency-based training (CBT) in vocational education and training systems in many countries. Several CBT training programmes in Ghana have been accredited and quality assured. This article explores the perception of both students and lecturers towards CBT and examines factors that…

Near East/South Asia Report, No. 2841.

DTIC Science & Technology

1983-10-24

28. Sudan 29. 600 kilo- meters 30. Zaire Benin Algeria Niger Nigeria Cameroon Tunesia Libya Chad Central African Republic Eredominantly...direction of the Libyan president. Nigeria The government in Nigeria holds Qadhdhafi responsible for unrest in the north of the country. President Shehu...interfere in the internal affairs of Nigeria for the time being. Ghana One of the few African politicians who after their Libyan-supported

DETECTION OF CANINE PARVOVIRUS ANTIGEN IN DOGS IN KUMASI, GHANA

PubMed Central

Folitse, R. D; Kodie, D.O; Amemor, E.; Dei, D.; Tasiame, W.; Burimuah, V.; Emikpe, B.O

2018-01-01

Background: Canine Parvovirus (CPV) in dogs has been documented in many countries. However, evidence of the infection is scanty in Ghana. This study was conducted to detect canine parvovirus antigen in dogs presented with diarrhoea to the Government Veterinary Clinic in Kumasi, Ghana. Materials and Methods: Faecal samples from 72 dogs presented with diarrhoea were tested for the presence of canine parvovirus antigen using commercially available rapid test kit (BIT® Rapid Colour Canine Parvovirus Ag Test Kit, BIOINDIST Co. Ltd, Korea) based on the principle of immunochromatography. Influence of breed, sex, age, vaccination history and the nature of diarrhoea were assessed. Data obtained was analysed with SPSS and subjected to the chi-square test. Significance was at α0.05 Results: We found 61.11% tested positive (44/72) for CPV. Based on sex, 61.54% of males (20/33) and 60.61% of females tested positive (24/39). A total of 65.67% of samples from puppies below 6 months were positive. 56.25% of CPV vaccinated dogs and 70.83% of unvaccinated dogs were positive respectively. 69.05% of samples from haemorrhagic diarrhoeic dogs and 50.00% from non-haemorrhagic diarrhoeic dogs were positive of CPV. Conclusion: The study is the first documented evidence of the existence of CPV in Ghana. It also revealed that absence of bloody diarrhoea does not necessarily rule out CPV infection. PMID:29302647

DETECTION OF CANINE PARVOVIRUS ANTIGEN IN DOGS IN KUMASI, GHANA.

PubMed

Folitse, R D; Kodie, D O; Amemor, E; Dei, D; Tasiame, W; Burimuah, V; Emikpe, B O

2018-01-01

Canine Parvovirus (CPV) in dogs has been documented in many countries. However, evidence of the infection is scanty in Ghana. This study was conducted to detect canine parvovirus antigen in dogs presented with diarrhoea to the Government Veterinary Clinic in Kumasi, Ghana. Faecal samples from 72 dogs presented with diarrhoea were tested for the presence of canine parvovirus antigen using commercially available rapid test kit (BIT ® Rapid Colour Canine Parvovirus Ag Test Kit, BIOINDIST Co. Ltd, Korea) based on the principle of immunochromatography. Influence of breed, sex, age, vaccination history and the nature of diarrhoea were assessed. Data obtained was analysed with SPSS and subjected to the chi-square test. Significance was at α 0.05 . We found 61.11% tested positive (44/72) for CPV. Based on sex, 61.54% of males (20/33) and 60.61% of females tested positive (24/39). A total of 65.67% of samples from puppies below 6 months were positive. 56.25% of CPV vaccinated dogs and 70.83% of unvaccinated dogs were positive respectively. 69.05% of samples from haemorrhagic diarrhoeic dogs and 50.00% from non-haemorrhagic diarrhoeic dogs were positive of CPV. The study is the first documented evidence of the existence of CPV in Ghana. It also revealed that absence of bloody diarrhoea does not necessarily rule out CPV infection.

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 mixed ecologic-cohort comparison of physical activity & weight among young adults from five populations of African origin.

PubMed

Luke, Amy; Bovet, Pascal; Plange-Rhule, Jacob; Forrester, Terrence E; Lambert, Estelle V; Schoeller, Dale A; Dugas, Lara R; Durazo-Arvizu, Ramon A; Shoham, David A; Cao, Guichan; Brage, Soren; Ekelund, Ulf; Cooper, Richard S

2014-04-24

Examination of patterns and intensity of physical activity (PA) across cultures where obesity prevalence varies widely provides insight into one aspect of the ongoing epidemiologic transition. The primary hypothesis being addressed is whether low levels of PA are associated with excess weight and adiposity. We recruited young adults from five countries (500 per country, 2500 total, ages 25-45 years), spanning the range of obesity prevalence. Men and women were recruited from a suburb of Chicago, Illinois, USA; urban Jamaica; rural Ghana; peri-urban South Africa; and the Seychelles. PA was measured using accelerometry and expressed as minutes per day of moderate-to-vigorous activity or sedentary behavior. Obesity (BMI ≥ 30) prevalence ranged from 1.4% (Ghanaian men) to 63.8% (US women). South African men were the most active, followed by Ghanaian men. Relatively small differences were observed across sites among women; however, women in Ghana accumulated the most activity. Within site-gender sub-groups, the correlation of activity with BMI and other measures of adiposity was inconsistent; the combined correlation across sites was -0.17 for men and -0.11 for women. In the ecological analysis time spent in moderate-to-vigorous activity was inversely associated with BMI (r = -0.71). These analyses suggest that persons with greater adiposity tend to engage in less PA, although the associations are weak and the direction of causality cannot be inferred because measurements are cross-sectional. Longitudinal data will be required to elucidate direction of association.

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.

Alluvial Diamond Resource Potential and Production Capacity Assessment of Ghana

USGS Publications Warehouse

Chirico, Peter G.; Malpeli, Katherine C.; Anum, Solomon; Phillips, Emily C.

2010-01-01

In May of 2000, a meeting was convened in Kimberley, South Africa, and attended by representatives of the diamond industry and leaders of African governments to develop a certification process intended to assure that rough, exported diamonds were free of conflictual concerns. This meeting was supported later in 2000 by the United Nations in a resolution adopted by the General Assembly. By 2002, the Kimberley Process Certification Scheme (KPCS) was ratified and signed by both diamond-producing and diamond-importing countries. Over 70 countries were included as members at the end of 2007. To prevent trade in 'conflict' diamonds while protecting legitimate trade, the KPCS requires that each country set up an internal system of controls to prevent conflict diamonds from entering any imported or exported shipments of rough diamonds. Every diamond or diamond shipment must be accompanied by a Kimberley Process (KP) certificate and be contained in tamper-proof packaging. The objective of this study was to assess the alluvial diamond resource endowment and current production capacity of the alluvial diamond-mining sector in Ghana. A modified volume and grade methodology was used to estimate the remaining diamond reserves within the Birim and Bonsa diamond fields. The production capacity of the sector was estimated using a formulaic expression of the number of workers reported in the sector, their productivity, and the average grade of deposits mined. This study estimates that there are approximately 91,600,000 carats of alluvial diamonds remaining in both the Birim and Bonsa diamond fields: 89,000,000 carats in the Birim and 2,600,000 carats in the Bonsa. Production capacity is calculated to be 765,000 carats per year, based on the formula used and available data on the number of workers and worker productivity. Annual production is highly dependent on the international diamond market and prices, the numbers of seasonal workers actively mining in the sector, and

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.

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

Leveraging ongoing research to evaluate the health impacts of South Africa's salt reduction strategy: a prospective nested cohort within the WHO-SAGE multicountry, longitudinal study

PubMed Central

Charlton, Karen; Menyanu, Elias; Biritwum, Richard Berko; Naidoo, Nirmala; Pieterse, Chiné; Madurai, Savathree (Lorna); Baumgartner, Jeannine; Asare, George A; Thiele, Elizabeth; Schutte, Aletta E; Kowal, Paul

2016-01-01

Introduction Attempting to curb the rising epidemic of hypertension, South Africa implemented legislation in June 2016 mandating maximum sodium levels in a range of manufactured foods that contribute significantly to population salt intake. This natural experiment, comparing two African countries with and without salt legislation, will provide timely information on the impact of legislative approaches addressing the food supply to improve blood pressure in African populations. This article outlines the design of this ongoing prospective nested cohort study. Methods and analysis Baseline sodium intake was assessed in a nested cohort of the WHO Study on global AGEing and adult health (WHO-SAGE) wave 2 (2014–2015), a multinational longitudinal study on the health and well-being of adults and the ageing process. The South African cohort consisted of randomly selected households (n=4030) across the country. Spot and 24-hour urine samples are collected in a random subsample (n=1200) and sodium, potassium, creatinine and iodine analysed. Salt behaviour and sociodemographic data are captured using face-to-face interviews, alongside blood pressure and anthropometric measures. Ghana, the selected control country with no formal salt policy, provided a nested subsample (n=1200) contributing spot and 24-hour urine samples from the SAGE Ghana cohort (n=5000). Follow-up interviews and urine collection (wave 3) in both countries will take place in 2017 (postlegislation) to assess change in population-level sodium intake and blood pressure. Ethics and dissemination SAGE was approved by the WHO Ethics Review Committee (reference number RPC149) with local approval from the North-West University Human Research Ethics Committee and University of the Witwatersrand Human Research Ethics Committee (South Africa), and University of Ghana Medical School Ethics and Protocol Review Committee (Ghana). The results of the study will be published in peer-reviewed international journals

Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study.

PubMed

Gyamfi, Joyce; Plange-Rhule, Jacob; Iwelunmor, Juliet; Lee, Debbie; Blackstone, Sarah R; Mitchell, Alicia; Ntim, Michael; Apusiga, Kingsley; Tayo, Bamidele; Yeboah-Awudzi, Kwasi; Cooper, Richard; Ogedegbe, Gbenga

2017-02-02

Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses' knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH). A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses' satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management. A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses' knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention. Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana. Trial registration for parent TASSH study: NCT01802372 . Registered February 27, 2013.

Household characteristics for older adults and study background from SAGE Ghana Wave 1.

PubMed

Biritwum, Richard B; Mensah, George; Minicuci, Nadia; Yawson, Alfred E; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

2013-06-11

29.6% in the Volta region. The overall rate of access to improved sanitation was just 14.9%. The findings show significant regional differences, with the three Northern Regions having worse education, income, and sanitation levels, compared to Southern and Central Regions of the country. Household characteristics and intra-household dynamics have been shown to influence health and health-seeking behaviors across a number of contexts and countries, and play a fundamental role in the well-being of older Ghanaians. SAGE Ghana is part of a multi-country study using standardized questionnaires and tested methodologies to provide household level data required to inform policy on the growing population of older adults in Ghana. With the good response rates and measures instituted to assure quality of data, this article demonstrates the high quality data and research methods of SAGE.

Household characteristics for older adults and study background from SAGE Ghana Wave 1

PubMed Central

Biritwum, Richard B.; Mensah, George; Minicuci, Nadia; Yawson, Alfred E.; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

2013-01-01

drinking water, with the lowest at 29.6% in the Volta region. The overall rate of access to improved sanitation was just 14.9%. The findings show significant regional differences, with the three Northern Regions having worse education, income, and sanitation levels, compared to Southern and Central Regions of the country. Conclusion Household characteristics and intra-household dynamics have been shown to influence health and health-seeking behaviors across a number of contexts and countries, and play a fundamental role in the well-being of older Ghanaians. SAGE Ghana is part of a multi-country study using standardized questionnaires and tested methodologies to provide household level data required to inform policy on the growing population of older adults in Ghana. With the good response rates and measures instituted to assure quality of data, this article demonstrates the high quality data and research methods of SAGE. PMID:23759325

Treatment outcomes in a safety observational study of dihydroartemisinin/piperaquine (Eurartesim(®)) in the treatment of uncomplicated malaria at public health facilities in four African countries.

PubMed

Adjei, Alexander; Narh-Bana, Solomon; Amu, Alberta; Kukula, Vida; Nagai, Richard Afedi; Owusu-Agyei, Seth; Oduro, Abraham; Macete, Eusebio; Abdulla, Salim; Halidou, Tinto; Sie, Ali; Osei, Isaac; Sevene, Esperance; Asante, Kwaku-Poku; Mulokozi, Abdunoor; Compaore, Guillaume; Valea, Innocent; Adjuik, Martin; Baiden, Rita; Ogutu, Bernhards; Binka, Fred; Gyapong, Margaret

2016-01-27

Dihydroartemisinin-piperaquine (DHA-PQ) is one of five WHO recommended artemisinin combination therapy (ACT) for the treatment of uncomplicated malaria. However, little was known on its post-registration safety and effectiveness in sub-Saharan Africa. DHA-PQ provides a long post-treatment prophylactic effect against re-infection; however, new infections have been reported within a few weeks of treatment, especially in children. This paper reports the clinical outcomes following administration of DHQ-PQ in real-life conditions in public health facilities in Burkina Faso, Ghana, Mozambique, and Tanzania for the treatment of confirmed uncomplicated malaria. An observational, non-comparative, longitudinal study was conducted on 10,591 patients with confirmed uncomplicated malaria visiting public health facilities within seven health and demographic surveillance system sites in four African countries (Ghana, Tanzania, Burkina Faso, Mozambique) between September 2013 and April 2014. Patients were treated with DHA-PQ based on body weight and followed up for 28 days to assess the clinical outcome. A nested cohort of 1002 was intensely followed up. Clinical outcome was assessed using the proportion of patients who reported signs and symptoms of malaria after completing 3 days of treatment. A total of 11,097 patients were screened with 11,017 enrolled, 94 were lost to follow-up, 332 withdrew and 10,591 (96.1%) patients aged 6 months-85 years met protocol requirements for analysis. Females were 52.8 and 48.5% were <5 years of age. Malaria was diagnosed by microscopy and rapid diagnostic test in 69.8% and 29.9%, respectively. At day 28, the unadjusted risk of recurrent symptomatic parasitaemia was 0.5% (51/10,591). Most of the recurrent symptomatic malaria patients (76%) were children <5 years. The mean haemoglobin level decreased from 10.6 g/dl on day 1 to 10.2 g/dl on day 7. There was no significant renal impairment in the nested cohort during the first 7 days of follow

Caregivers’ views on stigmatization and discrimination of people affected by leprosy in Ghana

PubMed Central

Dako–Gyeke, Mavis; Oduro, Razak

2018-01-01

Background Leprosy is a condition that has long been associated with stigma and discrimination, even when infected persons have been cured. This paper describes stigma and discrimination as viewed by caregivers who are associated with people affected by leprosy in Ghana. Methods A qualitative interview with semi-structured interviews were conducted for twenty caregivers. Results Findings indicated that caregivers were of the view that people affected by leprosy in Ghana are stigmatized and discriminated against by the larger society thus making their movements and interactions restricted to the Leprosarium. Besides, employments opportunities are unavailable to them thus making them exposed to financial challenges. The livelihood Empowerment Against poverty (LEAP) money given them is not sufficient for their daily upkeep. Conclusion People affected by leprosy in Ghana are stigmatized and therefore find it difficult to interact freely with the public. The associated physical deformities with the disease also tend to impede their ability to relate to the general public. The LEAP cash given to people affected by leprosy is helpful however, it could be enhanced to keep pace with prevailing economic conditions in the country. PMID:29377890

Cervical Cancer Knowledge, Perceptions and Screening Behaviour Among Female University Students in Ghana.

PubMed

Binka, Charity; Nyarko, Samuel H; Doku, David T

2016-06-01

Cervical cancer is becoming a leading cause of death among women in developing countries. Nevertheless, little is known regarding knowledge and perception of cervical cancer and screening behaviour particularly among female tertiary students in Ghana. This study sought to examine the knowledge and perceptions of cervical cancer and screening behaviour among female students in the University of Cape Coast and Ghana Institute of Management and Public Administration in Ghana. A cross-sectional survey design was adopted for the study. Systematic and stratified random sampling techniques were used to select 410 participants for the study. The study found that the participants lacked knowledge on specific risk factors and symptoms of cervical cancer. Also, even though the participants had a fair perception of cervical cancer, they had a poor cervical cancer screening behaviour. Awareness of cervical cancer was significantly influenced by religious affiliation while cervical cancer screening was significantly determined by the working status of the participants. Specific knowledge on cervical cancer and its risk factors as well as regular screening behaviour is paramount to the prevention of cervical cancer. Consequently, the University Health Services should focus on promoting regular cervical cancer awareness campaigns and screening among the students particularly, females.

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.

Elevated hypertension risk for African-origin populations in biracial societies: modeling the Epidemiologic Transition Study.

PubMed

Cooper, Richard S; Forrester, Terrence E; Plange-Rhule, Jacob; Bovet, Pascal; Lambert, Estelle V; Dugas, Lara R; Cargill, Kathryn E; Durazo-Arvizu, Ramon A; Shoham, David A; Tong, Liping; Cao, Guichan; Luke, Amy

2015-03-01

Blood pressures in persons of African descent exceed those of other racial/ethnic groups in the United States. Whether this trait is attributable to the genetic factors in African-origin populations, or a result of inadequately measured environmental exposures, such as racial discrimination, is not known. To study this question, we conducted a multisite comparative study of communities in the African diaspora, drawn from metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles. At each site, 500 participants between the age of 25 and 49 years, with approximately equal sex balance, were enrolled for a longitudinal study of energy expenditure and weight gain. In this study, we describe the patterns of blood pressure and hypertension observed at baseline among the sites. Mean SBP and DBP were very similar in the United States and South Africa in both men and women, although among women, the prevalence of hypertension was higher in the United States (24 vs. 17%, respectively). After adjustment for multiple covariates, relative to participants in the United States, SBP was significantly higher among the South Africans by 9.7 mmHg (P < 0.05) and significantly lower for each of the other sites: for example, Jamaica: -7.9 mmHg (P = 0.06), Ghana: -12.8 mmHg (P < 0.01) and Seychelles: -11.1 mmHg (P = 0.01). These data are consistent with prior findings of a blood pressure gradient in societies of the African diaspora and confirm that African-origin populations with lower social status in multiracial societies, such as the United States and South Africa, experience more hypertension than anticipated based on anthropometric and measurable socioeconomic risk factors.

On the mathematical analysis of Ebola hemorrhagic fever: deathly infection disease in West African countries.

PubMed

Atangana, Abdon; Goufo, Emile Franc Doungmo

2014-01-01

For a given West African country, we constructed a model describing the spread of the deathly disease called Ebola hemorrhagic fever. The model was first constructed using the classical derivative and then converted to the generalized version using the beta-derivative. We studied in detail the endemic equilibrium points and provided the Eigen values associated using the Jacobian method. We furthered our investigation by solving the model numerically using an iteration method. The simulations were done in terms of time and beta. The study showed that, for small portion of infected individuals, the whole country could die out in a very short period of time in case there is not good prevention.

A comparative review of governments' views on objectives and policy instruments in the field of population and development.

PubMed

1982-01-01

It is possible to assess population policies through statements and decisions taken by governments as they reflect the views and commitments of political authorities in the field of population and development. Cases in the following African countries are reviewed with focus on objectives and policy instruments: Algeria; Angola; Benin; Botswana; Cape Verde; Central African Republic; Congo; Djibouti; Egypt; Ethiopia; Guinea; Gabon; Gambia; Ghana; Equatorial Guinea; Guinea-Bissau; Ivory Coast; Kenya; Lesotho; Liberia; Libyan Arab Jamahiriya; Madagascar; Malawi; Mali; Mauritania; Mauritius; Morocco; Mozambique; Niger; Nigeria; Rwanda; Sao Tome and Principe; Senegal; Seychelles; Sierra Leone; Somalia; Sudan; Swaziland; Togo; Tunisia; Uganda; United Republic of Cameroon; Tanzania; Upper Volta; Zaire; Zambia; and Zimbabwe. The information presented was drawn from the following publications: UN Population Division, "Population Policy Briefs: Current Situation in Developing Countries and Selected Territories," and UNFPA, "Population Programs and Projects," Volume 2, 1980-1981. On the basis of this review the following conclusions are drawn, which could indicate areas in which technical assistance to the Economic Commission for Africa (ECA) member States would be required: among the 50 country members of ECA, 34 countries (68%) have as a development objective the reduction of mortality, and in particular, maternal and child mortality; the 2nd important objective is stabilizing or improving spatial distribution of population, and 44% of the 50 countries have adopted this objective which involves the distribution of population from 1 place to another within a country; the 3rd important objective consists of restricting the migratory flow from rural areas to urban areas; the countries of Botswana, Egypt, Ghana, Kenya, Lesotho, Mauritius, Morocco, Rwanda, Seychelles, Swaziland, and Tunisia adopted the objective of reducing the rate of population growth; 34% of African countries

Making sense of condoms: social representations in young people’s HIV-related narratives from six African countries

PubMed Central

Winskell, Kate; Obyerodhyambo, Oby; Stephenson, Rob

2011-01-01

Condoms are an essential component of comprehensive efforts to control the HIV epidemic, both for those who know their status and for those who do not. Although young people account for almost half of all new HIV infections, reported condom use among them remains low in many sub-Saharan African countries. In order to inform education and communication efforts to increase condom use, we examined social representations of condoms among young people aged 10–24 in six African countries/regions with diverse HIV prevalence rates: Swaziland, Namibia, Kenya, South-East Nigeria, Burkina Faso, and Senegal. We used a unique data source, namely 11,354 creative ideas contributed from these countries to a continent-wide scriptwriting contest, held from 1st February to 15th April 2005, on the theme of HIV/AIDS. We stratified each country sample by the sex, age (10–14, 15–19, 20–24), and urban/rural location of the author and randomly selected up to 10 narratives for each of the 12 resulting strata, netting a total sample of 586 texts for the six countries. We analyzed the narratives qualitatively using thematic data analysis and narrative-based methodologies. Differences were observed across settings in the prominence accorded to condoms, the assessment of their effectiveness, and certain barriers to and facilitators of their use. Moralization emerged as a key impediment to positive representations of condoms, while humour was an appealing means to normalize them. The social representations in the narratives identify communication needs in and across settings and provide youth-focused ideas and perspectives to inform future intervention efforts. PMID:21388731

Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

ERIC Educational Resources Information Center

Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

2016-01-01

Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

``We also wanted to learn'': Narratives of change from adults literate in African languages

NASA Astrophysics Data System (ADS)

Trudell, Joel; Cheffy, Ian

2017-10-01

This article discusses the impact of literacy programmes on those who learned to read and write in their own African languages. It draws on adult learners' reflections on the significance of literacy and numeracy in their everyday lives as evidenced in interviews conducted in 2014 and 2015 in rural sites in five African countries: Ethiopia, Kenya, Cameroon, Burkina Faso and Ghana. The research approach was influenced by the Most Significant Change (MSC) method of monitoring and evaluation, which collects and examines narratives that reveal beneficiaries' perceptions of change related to a given programme. This study emulates this approach in that it seeks to learn about perceived changes attributed to literacy acquisition from the perspectives of the beneficiaries, without imposing pre-established indicators. In the rural adult learners' view, literacy enabled lifelong learning outcomes that rivalled the results of primary schooling. Literacy programme graduates demonstrated extensive ongoing learning after they learned to read, write and calculate, consequently acquiring new literacy practices and new understandings of themselves. Even though many of those interviewed had been unable to attend school, they viewed the practices of reading and writing that they developed outside of school as equivalent to the practices of adults who had been educated in primary school.

The genetic diversity of merozoite surface antigen 1 (MSA-1) among Babesia bovis detected from cattle populations in Thailand, Brazil and Ghana.

PubMed

Nagano, Daisuke; Sivakumar, Thillaiampalam; De De Macedo, Alane Caine Costa; Inpankaew, Tawin; Alhassan, Andy; Igarashi, Ikuo; Yokoyama, Naoaki

2013-11-01

In the present study, we screened blood DNA samples obtained from cattle bred in Brazil (n=164) and Ghana (n=80) for Babesia bovis using a diagnostic PCR assay and found prevalences of 14.6% and 46.3%, respectively. Subsequently, the genetic diversity of B. bovis in Thailand, Brazil and Ghana was analyzed, based on the DNA sequence of merozoite surface antigen-1 (MSA-1). In Thailand, MSA-1 sequences were relatively conserved and found in a single clade of the phylogram, while Brazilian MSA-1 sequences showed high genetic diversity and were dispersed across three different clades. In contrast, the sequences from Ghanaian samples were detected in two different clades, one of which contained only a single Ghanaian sequence. The identities among the MSA-1 sequences from Thailand, Brazil and Ghana were 99.0-100%, 57.5-99.4% and 60.3-100%, respectively, while the similarities among the deduced MSA-1 amino acid sequences within the respective countries were 98.4-100%, 59.4-99.7% and 58.7-100%, respectively. These observations suggested that the genetic diversity of B. bovis based on MSA-1 sequences was higher in Brazil and Ghana than in Thailand. The current data highlight the importance of conducting extensive studies on the genetic diversity of B. bovis before designing immune control strategies in each surveyed country.

Religion and women's health in Ghana: insights into HIV/AIDs preventive and protective behavior.

PubMed

Takyi, Baffour K

2003-03-01

Since the late 1970s when the first cases of HIV/AIDS were identified in Africa, there has been an upsurge of research on the epidemic. Although religious involvement may be germane to AIDS protective and risk behavior, few of these studies deal with religion and AIDS. This article contributes to the discourse on religion and health in Africa by analysing the interrelationship between religion and AIDS behavior in Ghana, a West African country at the early stages of the AIDS epidemic, and one where religious activities are more pronounced. We explore whether a woman's knowledge of HIV/AIDS is associated with her religious affiliation, and whether religious affiliation influences AIDS preventive (protective) attitudes. Findings from our analysis of Ghanaian data indicate that religious affiliation has a significant effect on knowledge of AIDS. However, we did not find religious affiliation to be associated with changes in specific protective behavior, particularly the use of condoms. The limitations and implications of the study are discussed, promising directions for further research on religion and AIDS protective and risk behaviors are also discussed, and the design and development of culturally sensitive programs to help in the ongoing AIDS prevention efforts in the region are proposed.

The development of sustainable emergency care in ghana: physician, nursing and prehospital care training initiatives.

PubMed

Martel, John; Oteng, Rockefeller; Mould-Millman, Nee-Kofi; Bell, Sue Anne; Zakariah, Ahmed; Oduro, George; Kowalenko, Terry; Donkor, Peter

2014-10-01

Ghana's first Emergency Medicine residency and nursing training programs were initiated in 2009 and 2010, respectively, at Komfo Anokye Teaching Hospital in the city of Kumasi in association with Kwame Nkrumah University of Science and Technology and the Universities of Michigan and Utah. In addition, the National Ambulance Service was commissioned initially in 2004 and has developed to include both prehospital transport services in all regions of the country and Emergency Medical Technician training. Over a decade of domestic and international partnership has focused on making improvements in emergency care at a variety of institutional levels, culminating in the establishment of comprehensive emergency care training programs. We describe the history and status of novel postgraduate emergency physician, nurse, and prehospital provider training programs as well as the prospect of creating a board certification process and formal continuing education program for practicing emergency physicians. Significant strides have been made in the development of emergency care and training in Ghana over the last decade, resulting in the first group of Specialist-level emergency physicians as of late 2012, as well as development of accredited emergency nursing curricula and continued expansion of a national Emergency Medical Service. This work represents a significant move toward in-country development of sustainable, interdisciplinary, team-based emergency provider training programs designed to retain skilled health care workers in Ghana and may serve as a model for similar developing nations. Copyright © 2014 Elsevier Inc. All rights reserved.

Ocular health assessment of cocoa farmers in a rural community in Ghana.

PubMed

Boadi-Kusi, Samuel Bert; Hansraj, Rekha; Kumi-Kyereme, Akwasi; Mashige, Khathutshelo Percy; Awusabo-Asare, Kofi; Ocansey, Stephen; Kyei, Samuel

2014-01-01

Cocoa farming provides employment for over 800,000 households in rural Ghana, with the country currently touted as the second largest producer of cocoa worldwide. Agriculture is one of the riskiest occupations for the eyes due to the numerous ocular hazards on farms. The authors conducted an ocular health assessment among cocoa farmers at Mfuom, a rural community in the Central Region of Ghana, to examine the ocular health status and the ocular safety measures used by cocoa farmers. A structured questionnaire was used to evaluate demographic characteristics, ocular injuries, and utilization of eye care services and ocular protection, and a clinical examination was used to evaluate their ocular status. Cocoa farmers were at high risk for ocular injuries and farm-related vision disorders and utilized eye care services and ocular protection poorly. Ocular condition identified were mainly refractive error (28.6%), cataract (20.0%), glaucoma (11.7%), conjunctivitis (13%), pterygium (2.7%), and cornea opacity (2.2%). There is a need for the introduction of an interventional eye care program to help address the ocular health challenges identified among the farmers. This can be done through collaborative efforts by educational institutions, government, and other role players in the agricultural industry to improve the quality of life of the vulnerable cocoa farmers in rural Ghana.

Knowledge and beliefs about cervical cancer screening among men in Kumasi, Ghana.

PubMed

Williams, M S; Amoateng, P

2012-09-01

The age-standardized mortality rate for cervical cancer in Ghana, West Africa is more than three times the global cervical cancer mortality rate (27.6/100,000 vs. 7.8/100,000 respectively). The Pap test and visual inspection with acetic acid are available at public and private hospitals in Ghana. Approximately, 2.7% of Ghanaian women obtain cervical cancer screenings regularly. Men in middle-income countries play a key role in cervical cancer prevention. Increasing spousal support for cervical cancer screening may increase screening rates in Ghana. Five focus groups were conducted with Ghanaian men (N = 29) to assess their cervical cancer and cervical cancer screening knowledge and beliefs. The qualitative data was analyzed via indexed coding. Targets for education interventions were identified including inaccurate knowledge about cervical cancer and stigmatizing beliefs about cervical cancer risk factors. Cultural taboos regarding women's health care behaviours were also identified. Several participants indicated that they would be willing to provide spousal support for cervical cancer screening if they knew more about the disease and the screening methods. Men play a significant role in the health behaviours of some Ghanaian women. Cervical cancer education interventions targeting Ghanaian men are needed to correct misconceptions and increase spousal support for cervical cancer screening.

Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African countries.

PubMed

Bankole, Akinrinola; Biddlecom, Ann; Guiella, Georges; Singh, Susheela; Zulu, Eliya

2007-12-01

Adolescents are a key target group for HIV and pregnancy prevention efforts, yet very little is known about the youngest adolescents: those under age 15. New survey data from 12-14 year olds in Burkina Faso, Ghana, Malawi and Uganda are used to describe their sexual activity, knowledge about HIV, STIs and pregnancy prevention, and sources of sexual and reproductive health information, including sex education in schools. Results show that very young adolescents are already beginning to be sexually active and many believe their close friends are sexually active. They have high levels of awareness but little in-depth knowledge about pregnancy and HIV prevention. Multiple information sources are used and preferred by very young adolescents. Given their needs for HIV, STI and pregnancy prevention information that is specific and practical and considering that the large majority are attending school in most countries in Sub-Saharan Africa, school-based sex education is a particularly promising avenue for reaching adolescents under age 15.

Health workforce development: a needs assessment study in French speaking African countries.

PubMed

Chastonay, Philippe; Moretti, Roberto; Zesiger, Véronique; Cremaschini, Marco; Bailey, Rebecca; Pariyo, George; Kabengele, Emmanuel Mpinga

2013-05-01

In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential trainees and training institutions in nine French-speaking African countries. A needs assessment was conducted in the target countries according to four approaches: (1) Review at national level of health challenges. (2) Semi-directed interviews with heads of relevant training institutions. (3) Focus group discussions with key-informants. (4) A questionnaire-based study targeting health professionals identified as potential trainees. A needs assessment showed important public health challenges in the field of health workforce development among the target countries (e.g. unequal HRH distribution in the country, ageing of HRH, lack of adequate training). It also showed a demand for education and training institutions that are able to offer a training programme in health workforce development, and identified training objectives and core competencies useful to potential employers and future trainees (e.g. leadership, planning/evaluation, management, research skill). In combining various approaches our study was able to show a general demand for health managers who are able to plan, develop and manage a nation's health workforce. It also identified specific competencies that should be developed through an education and training program in public health with a focus on health workforce development.

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.

Prevalence of bovine tuberculosis in a dairy cattle farm and a research farm in Ghana.

PubMed

Asante-Poku, Adwoa; Aning, Kwame G; Boi-Kikimoto, Bashiru; Yeboah-Manu, Dorothy

2014-04-23

The aim of the study was to estimate the prevalence of bovine tuberculosis (BTB) and to identify the mycobacterial species causing BTB in a dairy farm and research farm. Six hundred and eighty-five cattle were screened for BTB by using the Comparative intradermal tuberculin test (CTT). Positive reactors were slaughtered and carcasses were taken for isolation of mycobacterial species. This was followed by speciation of isolates using both standard conventional and molecular assays. Seventeen of the cattle were positive by CTT, giving a crude BTB prevalence of 2.48% among cattle from the two farms. Six of the 17 samples (35.30%) yielded positive acid-fast bacilli cultures and three of the isolates were identified as Mycobacterium tuberculosis complex (MTBC), which were sub-divided into two Mycobacterium tuberculosis sensu scrito (Mtb) and one Mycobacterium africanum; the remaining three were Mycobacterium other than tuberculoisis (MOTT). Spoligotyping further characterised the two Mtb isolates as Ghana (spoligotype Data Base 4 number 53) and Latin American Mediterranean (LAM), whilst spoligotyping and Single Nucleotide Polymorphism (SNP) analysis typed the M. africanum as West African 1. Microseq 500 analysis identified two of the MOTT as Mycobacterium flavescens and Mycobacterium Moriokaense respectively, whilst the remaining one could not be identified. This study observed the prevalence of bovine TB among cattle from two farms in Ghana as 2.48% and confirms the public health importance of M. africanum as a pathogen in Ghana.

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

Identity in Africa's Internal Conflicts.

ERIC Educational Resources Information Center

Deng, Francis M.

1996-01-01

Identifies and defines four models of internal ethnic conflict and discusses those conflicts within various African nations. The corresponding models and countries include Integration Model: Botswana and Somalia; Managed Diversity Model: Ghana, Cote d'Ivorie, Kenya, and Nigeria; Ambivalent Accommodation Model: Ethiopia and Djibouti; and Acute…

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.

Monitoring of pesticide residues of five notable vegetables at Agbogbloshie market in Accra, Ghana.

PubMed

Osei-Fosu, P; Donkor, A K; Nyarko, S; Nazzah, N K; Asante, I K; Kingsford-Adabo, R; Arkorful, N A

2014-11-01

The study monitored the concentrations of pesticide residues in vegetables arriving at Agbogbloshie, a central market in the Accra Metropolis from different parts of Ghana and beyond. A total of 810 samples of 5 different vegetables from Central, Volta, Greater Accra, Ashanti, Eastern Regions, and neighboring country (Togo) were collected from January 2009 through to December 2011. In all, 18 % of the samples had no detectable residues, 62 % were below the maximum residue limits (MRLs), and 20 % also exceeded the EU (MRLs) adopted values. Overall, lettuce contained the highest number of residues above their MRLs besides cucumber and cabbage. The pesticide residues were mainly organophosphates and synthetic pyrethroids. The results demonstrate the need for continuous monitoring of pesticide residues in vegetables arriving at the various major markets in Ghana.

Economic Aspects of Agricultural Development in Africa. A Selective Annotated Reading List of Reports and Studies Concerning 40 African Countries During the Period 1960 - 1969.

ERIC Educational Resources Information Center

Neville-Rolfe, Edmund, Comp.

Some 1394 research studies from various African countries are annotated in this bibliography, which is divided into 37 country sections with a separate section (Africa General) for studies dealing with the continent as a whole, with geographical regions, or with groups of countries. The publications listed and summarized were published primarily…

Timing of Orphanhood, Early Sexual Debut, and Early Marriage in Four Sub-Saharan African Countries

PubMed Central

Chae, Sophia

2014-01-01

According to a growing body of literature, some orphans are at heightened risk of early sexual debut and early marriage. This study examines a rarely explored aspect of orphanhood: the timing and type of parental death and their relationship to these outcomes. The study also explores whether education mediates orphans’ risk of early sexual initiation and early marriage. The data are drawn from the 2004 National Survey of Adolescents, which includes interviews with 12–19-year-old adolescents in Burkina Faso, Ghana, Malawi, and Uganda. Results from discrete-time event history analysis indicate that female double orphans, regardless of timing of orphanhood, have greater odds of early sexual debut than do nonorphans. Education explains little of their increased risk. In contrast, male orphans of any type reveal no increased vulnerability to early sexual debut. Uganda is the only country where female orphans, specifically double orphans and those who are paternal orphans before age 10, have greater odds of early marriage, with education accounting for a small portion of the risk. PMID:23719999

Implementing large-scale food fortification in Ghana: lessons learned.

PubMed

Nyumuah, Richard Odum; Hoang, Thuy-Co Caroline; Amoaful, Esi Foriwa; Agble, Rosanna; Meyer, Marc; Wirth, James P; Locatelli-Rossi, Lorenzo; Panagides, Dora

2012-12-01

adverse sensory effects, which have led producers to reduce the dosage of premix in wheat flour. Challenges to access to premix experienced by small producers can be overcome with a central procurement model in which the distributor leverages the overall volume by tendering for a consolidated order. The SBC model has the potential to be expanded and to considerably increase the coverage of the population consuming iodized salt in Ghana. Successful implementation of the cost-effective iCheck CHROMA rapid test device should be replicated in other countries where quality control of fortified vegetable oil is a challenge, and extended to additional food vehicles, such as wheat flour and salt. Only a reduced impact on iron deficiency in Ghana can be expected, given the low level of fortificant added to the wheat flour. An integrated approach, with complementary programs including additional iron-fortified food vehicles, should be explored to maximize health impact.

Gender attitudes and fertility aspirations among young men in five high fertility East African countries.

PubMed

Snow, Rachel C; Winter, Rebecca A; Harlow, Siobán D

2013-03-01

The relationship between women's attitudes toward gender equality and their fertility aspirations has been researched extensively, but few studies have explored the same associations among men. Using recent Demographic and Health Survey data from five high fertility East African countries, we examine the association between young men's gender attitudes and their ideal family size. Whereas several DHS gender attitude responses were associated with fertility aspirations in select countries, men's greater tolerance of wife beating was consistently associated with higher fertility aspirations across all countries, independent of education, income, or religion. Our findings highlight the overlapping values of male authority within marriage and aspirations for large families among young adult males in East Africa. Total lifetime fertility in East Africa remains among the highest worldwide: thus, governments in the region seeking to reduce fertility may need to explicitly scrutinize and address the reproduction of prevailing masculine values. © 2013 The Population Council, Inc.

Measurement and decomposition of socioeconomic inequality in single and multimorbidity in older adults in China and Ghana: results from the WHO study on global AGEing and adult health (SAGE).

PubMed

Kunna, Rasha; San Sebastian, Miguel; Stewart Williams, Jennifer

2017-05-15

Globally people are living longer and enduring non-communicable diseases (NCDs) many of which co-occur as multimorbidity. Demographic and socioeconomic factors are determinants of inequalities and inequities in health. There is a need for country-specific evidence of NCD inequalities in developing countries where populations are ageing rapidly amid economic and social change. The study measures and decomposes socioeconomic inequality in single and multiple NCD morbidity in adults aged 50 and over in China and Ghana. The data source is the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). Nationally representative cross-sectional data collected from adults in China (n = 11,814) and Ghana (n = 4,050) are analysed. Country populations are ranked by a socioeconomic index based on ownership of household assets. The study uses a decomposed concentration index (CI) of single and multiple NCD morbidity (multimorbidity) covering arthritis, diabetes, angina, stroke, asthma, depression, chronic lung disease and hypertension. The CI quantifies the extent of overall inequality on each morbidity measure. The decomposition utilises a regression-based approach to examine individual contributions of demographic and socioeconomic factors, or determinants, to the overall inequality. In China, the prevalence of single and multiple NCD morbidity was 64.7% and 53.4%, compared with 65.9% and 55.5% respectively in Ghana. Inequalities were significant and more highly concentrated among the poor in China (single morbidity CI = -0.0365: 95% CI = -0.0689,-0.0040; multimorbidity CI = -0.0801: 95% CI = -0.1233,-0.0368;). In Ghana inequalities were significant and more highly concentrated among the rich (single morbidity CI = 0.1182; 95% CI = 0.0697, 0.1668; multimorbidity CI = 0.1453: 95% CI = 0.0794, 0.2083). In China, rural residence contributed most to inequality in single morbidity (36.4%) and the wealth

Equity in financing and use of health care in Ghana, South Africa, and Tanzania: implications for paths to universal coverage.

PubMed

Mills, Anne; Ataguba, John E; Akazili, James; Borghi, Jo; Garshong, Bertha; Makawia, Suzan; Mtei, Gemini; Harris, Bronwyn; Macha, Jane; Meheus, Filip; McIntyre, Di

2012-07-14

Universal coverage of health care is now receiving substantial worldwide and national attention, but debate continues on the best mix of financing mechanisms, especially to protect people outside the formal employment sector. Crucial issues are the equity implications of different financing mechanisms, and patterns of service use. We report a whole-system analysis--integrating both public and private sectors--of the equity of health-system financing and service use in Ghana, South Africa, and Tanzania. We used primary and secondary data to calculate the progressivity of each health-care financing mechanism, catastrophic spending on health care, and the distribution of health-care benefits. We collected qualitative data to inform interpretation. Overall health-care financing was progressive in all three countries, as were direct taxes. Indirect taxes were regressive in South Africa but progressive in Ghana and Tanzania. Out-of-pocket payments were regressive in all three countries. Health-insurance contributions by those outside the formal sector were regressive in both Ghana and Tanzania. The overall distribution of service benefits in all three countries favoured richer people, although the burden of illness was greater for lower-income groups. Access to needed, appropriate services was the biggest challenge to universal coverage in all three countries. Analyses of the equity of financing and service use provide guidance on which financing mechanisms to expand, and especially raise questions over the appropriate financing mechanism for the health care of people outside the formal sector. Physical and financial barriers to service access must be addressed if universal coverage is to become a reality. European Union and International Development Research Centre. Copyright © 2012 Elsevier Ltd. All rights reserved.

Genome-wide ancestry of 17th-century enslaved Africans from the Caribbean.

PubMed

Schroeder, Hannes; Ávila-Arcos, María C; Malaspinas, Anna-Sapfo; Poznik, G David; Sandoval-Velasco, Marcela; Carpenter, Meredith L; Moreno-Mayar, José Víctor; Sikora, Martin; Johnson, Philip L F; Allentoft, Morten Erik; Samaniego, José Alfredo; Haviser, Jay B; Dee, Michael W; Stafford, Thomas W; Salas, Antonio; Orlando, Ludovic; Willerslev, Eske; Bustamante, Carlos D; Gilbert, M Thomas P

2015-03-24

Between 1500 and 1850, more than 12 million enslaved Africans were transported to the New World. The vast majority were shipped from West and West-Central Africa, but their precise origins are largely unknown. We used genome-wide ancient DNA analyses to investigate the genetic origins of three enslaved Africans whose remains were recovered on the Caribbean island of Saint Martin. We trace their origins to distinct subcontinental source populations within Africa, including Bantu-speaking groups from northern Cameroon and non-Bantu speakers living in present-day Nigeria and Ghana. To our knowledge, these findings provide the first direct evidence for the ethnic origins of enslaved Africans, at a time for which historical records are scarce, and demonstrate that genomic data provide another type of record that can shed new light on long-standing historical questions.

Genome-wide ancestry of 17th-century enslaved Africans from the Caribbean

PubMed Central

Schroeder, Hannes; Ávila-Arcos, María C.; Malaspinas, Anna-Sapfo; Sandoval-Velasco, Marcela; Carpenter, Meredith L.; Moreno-Mayar, José Víctor; Sikora, Martin; Johnson, Philip L. F.; Allentoft, Morten Erik; Samaniego, José Alfredo; Haviser, Jay B.; Dee, Michael W.; Stafford, Thomas W.; Salas, Antonio; Orlando, Ludovic; Willerslev, Eske; Bustamante, Carlos D.; Gilbert, M. Thomas P.

2015-01-01

Between 1500 and 1850, more than 12 million enslaved Africans were transported to the New World. The vast majority were shipped from West and West-Central Africa, but their precise origins are largely unknown. We used genome-wide ancient DNA analyses to investigate the genetic origins of three enslaved Africans whose remains were recovered on the Caribbean island of Saint Martin. We trace their origins to distinct subcontinental source populations within Africa, including Bantu-speaking groups from northern Cameroon and non-Bantu speakers living in present-day Nigeria and Ghana. To our knowledge, these findings provide the first direct evidence for the ethnic origins of enslaved Africans, at a time for which historical records are scarce, and demonstrate that genomic data provide another type of record that can shed new light on long-standing historical questions. PMID:25755263

Using ICT for Education and Sustainable Development among the Underserved in Africa

ERIC Educational Resources Information Center

Kwapong, Olivia A. T. Frimpong

2009-01-01

The potential of ICT for education and sustainable development cannot be underestimated. Using cases from some African countries and data from deprived regions in Ghana, this paper discusses the opportunities and challenges in ICT for education and sustainable development in underserved areas in Africa. Much as infrastructural development,…

Missed opportunities and barriers for vaccination: a descriptive analysis of private and public health facilities in four African countries.

PubMed

Olorunsaiye, Comfort Zuyeali; Langhamer, Margaret Shaw; Wallace, Aaron Stuart; Watkins, Margaret Lyons

2017-01-01

Missed opportunities and barriers to vaccination limit progress toward achieving high immunization coverage and other global immunization goals. Little is known about vaccination practices contributing to missed opportunities and barriers among private healthcare providers in Africa. Service Provision Assessments (SPA) of representative samples of health facilities in four African countries (Kenya, Tanzania, Senegal, Malawi) in 2010-2015 were used to describe missed opportunities and barriers for vaccination in public, private for-profit, private not-for-profit and faith-based facilities. Data included vaccination practices, observations during sick child and antenatal visits, and exit interviews following sick child visits. Data from 3,219 health facilities, 11,613 sick child visits and 8,698 antenatal visits were included. A smaller proportion of for-profit facilities offered child vaccination services (country range, 25-37%) than did public facilities (range, 90-96%). The proportion of facilities offering pentavalent vaccine (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenza type b antigens) daily ranged 0-77% across countries and facility types. Less than 33% of for-profit facilities in any country offered measles vaccination daily. A minority of public or private providers assessed the child's vaccination status during a sick child visit (range by country and facility type, 14-44%), or offered tetanus toxoid during antenatal visits (range, 19-51%). Very few providers discussed the importance of newborn vaccination. Substantial missed opportunities for, and barriers to, vaccination were identified across this representative sample of health facilities in four African countries. Strategies are needed to ensure that private and public providers implement practices to minimize barriers and missed opportunities for vaccination.

Missed opportunities and barriers for vaccination: a descriptive analysis of private and public health facilities in four African countries

PubMed Central

Olorunsaiye, Comfort Zuyeali; Langhamer, Margaret Shaw; Wallace, Aaron Stuart; Watkins, Margaret Lyons

2017-01-01

Introduction Missed opportunities and barriers to vaccination limit progress toward achieving high immunization coverage and other global immunization goals. Little is known about vaccination practices contributing to missed opportunities and barriers among private healthcare providers in Africa. Methods Service Provision Assessments (SPA) of representative samples of health facilities in four African countries (Kenya, Tanzania, Senegal, Malawi) in 2010-2015 were used to describe missed opportunities and barriers for vaccination in public, private for-profit, private not-for-profit and faith-based facilities. Data included vaccination practices, observations during sick child and antenatal visits, and exit interviews following sick child visits. Results Data from 3,219 health facilities, 11,613 sick child visits and 8,698 antenatal visits were included. A smaller proportion of for-profit facilities offered child vaccination services (country range, 25-37%) than did public facilities (range, 90-96%). The proportion of facilities offering pentavalent vaccine (diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenza type b antigens) daily ranged 0-77% across countries and facility types. Less than 33% of for-profit facilities in any country offered measles vaccination daily. A minority of public or private providers assessed the child’s vaccination status during a sick child visit (range by country and facility type, 14-44%), or offered tetanus toxoid during antenatal visits (range, 19-51%). Very few providers discussed the importance of newborn vaccination. Conclusion Substantial missed opportunities for, and barriers to, vaccination were identified across this representative sample of health facilities in four African countries. Strategies are needed to ensure that private and public providers implement practices to minimize barriers and missed opportunities for vaccination. PMID:29296141

Comparative Analysis of Breast Cancer Phenotypes in African American, White American, and West Versus East African patients: Correlation Between African Ancestry and Triple-Negative Breast Cancer.

PubMed

Jiagge, Evelyn; Jibril, Aisha Souleiman; Chitale, Dhananjay; Bensenhaver, Jessica M; Awuah, Baffour; Hoenerhoff, Mark; Adjei, Ernest; Bekele, Mahteme; Abebe, Engida; Nathanson, S David; Gyan, Kofi; Salem, Barbara; Oppong, Joseph; Aitpillah, Francis; Kyei, Ishmael; Bonsu, Ernest Osei; Proctor, Erica; Merajver, Sofia D; Wicha, Max; Stark, Azadeh; Newman, Lisa A

2016-11-01

Triple-negative breast cancer (TNBC) is more common among African American (AA) and western sub-Saharan African breast cancer (BC) patients compared with White/Caucasian Americans (WA) and Europeans. Little is known about TNBC in east Africa. Invasive BC diagnosed 1998-2014 were evaluated: WA and AA patients from the Henry Ford Health System in Detroit, Michigan; Ghanaian/west Africans from the Komfo Anokye Teaching Hospital in Kumasi, Ghana; and Ethiopian/east Africans from the St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. Histopathology and immunohistochemistry for estrogen receptor (ER), progesterone receptor (PR), and HER2/neu expression was performed in Michigan on formalin-fixed, paraffin-embedded samples from all cases. A total of 234 Ghanaian (mean age 49 years), 94 Ethiopian (mean age 43 years), 272 AA (mean age 60 years), and 321 WA (mean age 62 years; p = 0.001) patients were compared. ER-negative and TNBC were more common among Ghanaian and AA compared with WA and Ethiopian cases (frequency ER-negativity 71.1 and 37.1 % vs. 19.8 and 28.6 % respectively, p < 0.0001; frequency TNBC 53.2 and 29.8 % vs. 15.5 and 15.0 %, respectively, p < 0.0001). Among patients younger than 50 years, prevalence of TNBC remained highest among Ghanaians (50.8 %) and AA (34.3 %) compared with WA and Ethiopians (approximately 16 % in each; p = 0.0002). This study confirms an association between TNBC and West African ancestry; TNBC frequency among AA patients is intermediate between WA and Ghanaian/West Africans consistent with genetic admixture following the west Africa-based trans-Atlantic slave trade. TNBC frequency was low among Ethiopians/East Africans; this may reflect less shared ancestry between AA and Ethiopians.

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

Mobile Health for Mental Health in West Africa: The Case for Ghana.

PubMed

Ben-Zeev, Dror

2018-03-15

Although underdeveloped in mental health care, the sub-Saharan country of Ghana is advanced in telecommunications. In this context, innovative mobile health (mHealth) approaches may help to overcome limited infrastructure (lack of clinics, trained professionals, and landlines) and to address significant unmet public mental health needs. The Technology in Mental Health editor reports on travels to Ghana to assess the viability of mHealth for mental health initiatives in the region. He found that stakeholders from all sectors (patients, providers, government officials, and traditional and faith healers) were open to exploring whether mHealth approaches could promote more humane care, reduce human rights violations, and improve the clinical outcomes of those in need. mHealth strategies that use audio and video content to overcome barriers associated with limited literacy may be most suitable. To succeed, any mHealth model must be culturally and contextually adapted to fit the needs, beliefs, and capacities of Ghanaian users.

Road accident fatality risks for "vulnerable" versus "protected" road users in northern Ghana.

PubMed

Damsere-Derry, James; Palk, Gavan; King, Mark

2017-10-03

Road traffic injuries (RTIs) are a serious epidemic that claims more than a million lives across the globe each year. The burden of RTIs is particularly pronounced in Africa and other low- and middle-income countries. The unfavorable disparity of the burden of road trauma in the world is largely attributable to unsafe vehicles, lack of appropriate road infrastructure, and the predominance of vulnerable road users (VRUs) in developing countries. However, little research exists in northern Ghana to highlight the scale and risk of death among road users. The objective of this research was to establish the relative risk of death among road users in northern Ghana. Crash data from police reports between 2007 and 2011 were analyzed for the Upper Regions of Ghana. Conditional probabilities and multivariable logistic regression techniques were used to report proportions and adjusted odds ratios (AORs), respectively. Generally, crashes in northern Ghana were extremely severe; that is, 35% of all injury related collisions were fatal. The proportion of fatal casualties ranged between 21% among victims of sideswipe collisions and 41% among pedestrians and victims of rear-end collisions. Though males were 6 times more likely to die than females overall, females were more likely to die as pedestrians (90% of all female casualty deaths) and males were more likely to die as riders/drivers (78% of all male casualty deaths). Pedestrians were 3 times more likely to die (odds ratio [OR] = 3.1; 95% confidence interval [CI], 2.4 to 4.1) compared with drivers/riders. Compared with drivers, the odds of death among cyclists was about 4 times higher (AOR = 3.6; 95% CI, 2.3 to 5.6) and about 2 times higher among motorcyclists (AOR = 1.6; 95% CI, 1.2 to 2.2). Compared with casualties aged between 30 and 59 years, children under 10 years and those aged 60 years and above were independently 2 times more likely to die in traffic collisions. Provision of requisite road infrastructure is vital

Immunologic and virological response to ART among HIV infected individuals at a tertiary hospital in Ghana.

PubMed

Obiri-Yeboah, Dorcas; Pappoe, Faustina; Baidoo, Ibrahim; Arthur, Francis; Hayfron-Benjamin, Anna; Essien-Baidoo, Samuel; Kwakye-Nuako, Godwin; Ayisi Addo, Stephen

2018-05-21

The need to study the outcome of Antiretroviral Therapy (ART) among Human Immunodeficiency Virus (HIV) infected individuals in Ghana, a sub-Saharan African country crucial in the era of the "Treat All" policy. The aim of this study was to analyze selected determinants of immunological and virological response to ART among HIV infected individuals in a tertiary facility in Cape Coast, Ghana. An analytical cross sectional study with a retrospective component was conducted in the Cape Coast Teaching Hospital (CCTH), Central Region. Clients aged 18 years and above attending the HIV Clinics for ART and who were on ART for 6 months or more were recruited. The viral loads, CD4 count and other socio-demographic data were analyzed using STATA version 13 (STATA Corp, Texas USA). Descriptive analysis was done and presented with appropriate measures of central tendencies. In addition, bivariate and multivariate analysis was carried out with p value of 0.05 interpreted as evidence of association between variables. A total of 440 participants were included in this study with a mean age of 45.5 (±11.6) years. The mean CD4 count at baseline, 6 months on ART and currently at study recruitment were 215.1 cells/mm 3 (±152.6), 386.6 cells/mm 3 (±178.5), and 579.6 cells/mm 3 (±203.0) respectively. After 6 months and 12 months on ART, the number who had achieved viral copies < 1000/ml were 149 (47.0%) and 368 (89.6%) respectively. There was strong evidence of an association between having CD4 count < 350 cells/mm 3 after 6 months on ART and having a diagnosis of tuberculosis since HIV diagnosis (aOR 8.5, 95% CI 1.1-73.0, p = 0.05) and clients having plasma viral load > 1000 copies/ml after 6 months on ART (aOR 2.0, 95% CI 1.2-3.2, p = 0.01). There was good response to ART among clients, high virological suppression and immunological recovery hence low rates of change to second line ART regimen in this cohort studied. With strict adherence to the national policy

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Education reform for the expansion of mother-tongue education in Ghana

NASA Astrophysics Data System (ADS)

Rosekrans, Kristin; Sherris, Arieh; Chatry-Komarek, Marie

2012-10-01

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, including the intermittent of mother tongue in early childhood schooling to facilitate English language and literacy instruction, prospects for a bold move towards multilingual education have emerged from a coalescence of forces inside and outside of Ghanaian education policy circles. This article discusses how the inertia of a dated language policy and a historic disregard for Ghana's multilingual landscape by the country's own policy makers are being overcome, at least partially, by progressive powers of change, albeit not without challenge. It undertakes an analysis of how a policy environment that supports bilingual education was created in order to implement a comprehensive and innovative multilingual programme, the National Literacy Acceleration Program (NALAP), which was rolled out across the nation's schools in early 2010. Having been involved in the process of designing NALAP, the authors describe the development of standards of learning and materials, as well as innovative aspects of a constructivist teacher education approach. The paper concludes with recommendations for further research, including combining a change process for key stakeholders and randomised language and literacy assessment with social marketing research in a unified approach.

Challenging the Orthodoxy of Literacy: Realities of Moving from Personal to Community Empowerment through "Reflect" in Ghana

ERIC Educational Resources Information Center

Tagoe, Michael

2008-01-01

In the last decade, the "Reflect" approach--an alternative to the "great divide" theory of literacy--has gained wider currency in developing countries because of its ability to deal with social, cultural and political issues by placing the identification and solution of local problems in the hands of local people. In Ghana,…

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

'How to know what you need to do': a cross-country comparison of maternal health guidelines in Burkina Faso, Ghana and Tanzania.

PubMed

Baker, Ulrika; Tomson, Göran; Somé, Mathias; Kouyaté, Bocar; Williams, John; Mpembeni, Rose; Massawe, Siriel; Blank, Antje; Gustafsson, Lars L; Eriksen, Jaran

2012-04-13

Initiatives to raise the quality of care provided to mothers need to be given priority in Sub Saharan Africa (SSA). The promotion of clinical practice guidelines (CPGs) is a common strategy, but their implementation is often challenging, limiting their potential impact. Through a cross-country perspective, this study explored CPGs for maternal health in Burkina Faso, Ghana, and Tanzania. The objectives were to compare factors related to CPG use including their content compared with World Health Organization (WHO) guidelines, their format, and their development processes. Perceptions of their availability and use in practice were also explored. The overall purpose was to further the understanding of how to increase CPGs' potential to improve quality of care for mothers in SSA. The study was a multiple case study design consisting of cross-country comparisons using document review and key informant interviews. A conceptual framework to aid analysis and discussion of results was developed, including selected domains related to guidelines' implementability and use by health workers in practice in terms of usability, applicability, and adaptability. The study revealed few significant differences in content between the national guidelines for maternal health and WHO recommendations. There were, however, marked variations in the format of CPGs between the three countries. Apart from the Ghanaian and one of the Tanzanian CPGs, the levels of both usability and applicability were assessed as low or medium. In all three countries, the use of CPGs by health workers in practice was perceived to be limited. Our cross-country study suggests that it is not poor quality of content or lack of evidence base that constitute the major barrier for CPGs to positively impact on quality improvement in maternal care in SSA. It rather emphasises the need to prioritise the format of guidelines to increase their usability and applicability and to consider these attributes together with

Antigenic Detection of Human Strain of Influenza Virus A (H3N2) in Swine Populations at Three Locations in Nigeria and Ghana during the Dry Early Months of 2014.

PubMed

Adeola, O A; Olugasa, B O; Emikpe, B O

2016-03-01

Since the first detection of human H3N2 influenza virus in Taiwanese pigs in 1970, infection of pigs with wholly human viruses has been known to occur in other parts of the world. These viruses, referred to as human-like H3N2 viruses, have been known to cause clinical and subclinical infections of swine populations. Due to the paucity and complete unavailability of information on transmission of influenza viruses from other species, especially humans, to swine in Nigeria and Ghana, respectively, this study was designed to investigate the presence and prevalence of a human strain of influenza A (H3N2) in swine populations at three locations in two cities within these two West African countries in January and February, 2014. Using stratified random technique, nasal swab specimens were collected from seventy-five (75) pigs at two locations in Ibadan, Nigeria and from fifty (50) pigs in Kumasi, Ghana. These specimens were tested directly by a sensitive Quantitative Solid Phase Antigen-detection Sandwich ELISA using anti-A/Brisbane/10/2007 haemagglutinin monoclonal antibody. Influenza virus A/Brisbane/10/2007 (H3N2) was detected among pigs at the three study locations, with an aggregate prevalence of 4.0% for the two locations in Ibadan, Nigeria and also 4.0% for Kumasi, Ghana. Transmission of influenza viruses from other species to swine portends serious sinister prospects for genetic reassortment and evolvement of novel viruses. We therefore recommend that further studies should be carried out to investigate the presence of other circulating human and avian influenza viruses in swine populations in West Africa and also determine the extent of genetic reassortment of strains circulating among these pigs. This would provide an early warning system for detection of novel influenza viruses, which could have pandemic potentials. © 2015 Blackwell Verlag GmbH.

The Nature of E-Learning Adoption by Stakeholders of a University in Africa

ERIC Educational Resources Information Center

Ansong, Eric; Boateng, Richard; Boateng, Sheena L.; Anderson, Augustus B.

2017-01-01

Studies looking at the nature of technology adoption from a multi-dimensional perspective have remained below expectation especially in African countries. This study, therefore, sought to explore the nature of e-learning adoption in the University of Ghana using a multi-stakeholder approach. A quantitative survey approach was adopted for this…

Sequence diversity among badnavirus isolates infecting yam (Dioscorea spp.) in Ghana, Togo, Benin and Nigeria.

PubMed

Eni, A O; Hughes, J d'A; Asiedu, R; Rey, M E C

2008-01-01

We analysed the sequence diversity in the reverse transcriptase (RT)/ribonuclease H (RNaseH) coding region of 19 badnavirus isolates infecting yam (Dioscorea spp.) in Ghana, Togo, Benin, and Nigeria. Phylogenetic analysis of the deduced amino acid sequences revealed that the isolates are broadly divided into two distinct species, each clustering with Dioscorea alata bacilliform virus (DaBV) and Dioscorea sansibarensis bacilliform virus (DsBV). Fourteen isolates had 90-96% amino acid identity with DaBV, while four isolates had 83-84% amino acid identity with DsBV. One isolate from Benin, BN4Dr, was distinct and had 77 and 75% amino acid identity with DaBV and DsBV, respectively, and may be a member of a new badnavirus species infecting yam in West Africa. Viruses of the two main species were present in Ghana, Togo and Benin and were observed to infect both D. alata and D. rotundata indiscriminately. This is the first confirmed report of DsBV infection in yam in Ghana and Togo. The results of this study demonstrate that members of two distinct species of badnaviruses infect yam in the West African yam zone and suggest a putative new species, BN4Dr. We also conclude that these species are not confined to limited geographic regions or specific for yam host species. However, the three badnavirus species are serologically related. The sequence information obtained from this study can be used to develop PCR-based diagnostics to detect members of the various species and/or strains of badnaviruses infecting yam in West Africa.

Plea to African heads-of-state: join the fight.

PubMed

Tyson, R

1997-10-01

Uganda's president, Yoweri Museveni, is the only African head-of-state who has led an all-out, extended campaign against AIDS, and Uganda is the only African country to realize a decline in HIV rates since the epidemic began spreading across central and southern Africa in the 1980s. While South Africa's President Nelson Mandela has spoken about AIDS in international forums, his country's programs against AIDS are in disarray. Rather than adopt a position of leadership against HIV/AIDS, African leaders have most often tried to cover up or ignore the AIDS threat. Zimbabwe and Nigeria are briefly discussed as examples. More than 100 delegates attended the HIV/AIDS workshop at the fourth African-African American Summit held in Harare, July 1997. After listening for 2 days to medical experts describe how the epidemic is destroying African economies and social structures, task force members called upon leaders of the 40 sub-Saharan African countries to acknowledge the threat of AIDS in their countries and to fight against the epidemic.

Tobacco--its role in the economy and the health of African countries.

PubMed

1985-01-01

In Africa the issue of smoking and health is complicated by the fact that in many countries tobacco is grown commercially and is relied upon to bring in foreign exchange through export, of revenue for the government if sold on the home market. Consequently, in some nations the ministries of health and of agriculture are working at cross purposes. This contradiction is recognized in the report issued recently of a World Health Organization (WHO) seminar on smoking and health organized for English-speaking Member States of the WHO African Region, and held in Zambia. In opening the seminar, the prime minister of Zambia, Mr. N. Mundia, stated that governments had an obligation to educate people on the risks involved in the use of tobacco but that this could pose a moral dilemma where tobacco production made an apparently significant contribution to the economy. Additionally, he warned that developing countries are considered valuable markets by tobacco companies and stressed that if the promotion of tobacco products by such companies represented a threat "to the health of our people, we cannot let it happen." This point was endorsed by Mr. W.C. Mwambazi, the National WHO Program Coordinator who stated that smoking was on the increase in many developing countries as a result of unscrupulous marketing practices by cigarette manufacturers and that smoking was a major threat to the realization of health for all by the year 2000. Aspects of smoking and health that have special relevance for Africa are emphasized in the report. The few studies carried out in Africa tend to confirm findings from the developed world that smoking increases the risk of cancer and coronary heart disease. Not only is tobacco smoked in Africa, but it is chewed and taken as snuff, and these uses also entail a risk to health. Case studies included in the report show that transnational tobacco companies take full advantage of the present lack of legislation in most African countries on the promotion

Disparities in Cardiovascular Research Output and Citations From 52 African Countries: A Time‐Trend, Bibliometric Analysis (1999–2008)

PubMed Central

Bloomfield, Gerald S.; Baldridge, Abigail; Agarwal, Anubha; Huffman, Mark D.; Colantonio, Lisandro D.; Bahiru, Ehete; Ajay, Vamadevan S.; Prabhakaran, Poornima; Lewison, Grant; Prabhakaran, Dorairaj

2015-01-01

Background Cardiovascular research output and citations of publications from Africa have historically been low yet may be increasing. However, data from the continent are limited. Methods and Results To evaluate the cardiovascular research output and citations from 52 African countries between 1999 and 2008, we created a bibliometric filter to capture cardiovascular research articles published in the Web of Knowledge based on specialist journals and title words. Two coauthors with expertise in cardiovascular medicine tested and refined this filter to achieve >90% precision and recall. We matched retrieved records with their associated citation reports and calculated the running 5‐year citation count postpublication, including the year of publication. Publications from Africa were identified by author addresses. South Africa published 872 cardiovascular research papers, Egypt 393, Tunisia 264, and Nigeria 192 between 1999 and 2008. The number of publications increased over the time period for a small number of countries (range 0.1 to 4.8 more publications per year by fractional count). Most countries' citations were low (<50), but citations were greatest for South Africa (7063), Egypt (2557), Tunisia (903), and Nigeria (540). The same countries had the greatest annual increase in 5‐year citation index values: 65 (95% CI: 30, 99) for South Africa, 46 (34, 58) for Egypt, 22 (15, 28) for Tunisia, and 8 (2, 14) for Nigeria. The burden of cardiovascular disease had a weak and inconsistent relationship to cardiovascular publications (r2=0.07, P=0.05). Greater gross domestic product was associated with more cardiovascular publications in 2008 (r2=0.53, P<0.0001). Conclusions The increases in cardiovascular research outputs from Africa are concentrated in a few countries. The reasons for regional differences in research outputs require further investigation, particularly relative to competing disease burdens. Higher prioritization of cardiovascular research funding from

Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality.

PubMed

L'Engle, Kelly; Sefa, Eunice; Adimazoya, Edward Akolgo; Yartey, Emmanuel; Lenzi, Rachel; Tarpo, Cindy; Heward-Mills, Nii Lante; Lew, Katherine; Ampeh, Yvonne

2018-01-01

Generating a nationally representative sample in low and middle income countries typically requires resource-intensive household level sampling with door-to-door data collection. High mobile phone penetration rates in developing countries provide new opportunities for alternative sampling and data collection methods, but there is limited information about response rates and sample biases in coverage and nonresponse using these methods. We utilized data from an interactive voice response, random-digit dial, national mobile phone survey in Ghana to calculate standardized response rates and assess representativeness of the obtained sample. The survey methodology was piloted in two rounds of data collection. The final survey included 18 demographic, media exposure, and health behavior questions. Call outcomes and response rates were calculated according to the American Association of Public Opinion Research guidelines. Sample characteristics, productivity, and costs per interview were calculated. Representativeness was assessed by comparing data to the Ghana Demographic and Health Survey and the National Population and Housing Census. The survey was fielded during a 27-day period in February-March 2017. There were 9,469 completed interviews and 3,547 partial interviews. Response, cooperation, refusal, and contact rates were 31%, 81%, 7%, and 39% respectively. Twenty-three calls were dialed to produce an eligible contact: nonresponse was substantial due to the automated calling system and dialing of many unassigned or non-working numbers. Younger, urban, better educated, and male respondents were overrepresented in the sample. The innovative mobile phone data collection methodology yielded a large sample in a relatively short period. Response rates were comparable to other surveys, although substantial coverage bias resulted from fewer women, rural, and older residents completing the mobile phone survey in comparison to household surveys. Random digit dialing of mobile

Survey research with a random digit dial national mobile phone sample in Ghana: Methods and sample quality

PubMed Central

Sefa, Eunice; Adimazoya, Edward Akolgo; Yartey, Emmanuel; Lenzi, Rachel; Tarpo, Cindy; Heward-Mills, Nii Lante; Lew, Katherine; Ampeh, Yvonne

2018-01-01

Introduction Generating a nationally representative sample in low and middle income countries typically requires resource-intensive household level sampling with door-to-door data collection. High mobile phone penetration rates in developing countries provide new opportunities for alternative sampling and data collection methods, but there is limited information about response rates and sample biases in coverage and nonresponse using these methods. We utilized data from an interactive voice response, random-digit dial, national mobile phone survey in Ghana to calculate standardized response rates and assess representativeness of the obtained sample. Materials and methods The survey methodology was piloted in two rounds of data collection. The final survey included 18 demographic, media exposure, and health behavior questions. Call outcomes and response rates were calculated according to the American Association of Public Opinion Research guidelines. Sample characteristics, productivity, and costs per interview were calculated. Representativeness was assessed by comparing data to the Ghana Demographic and Health Survey and the National Population and Housing Census. Results The survey was fielded during a 27-day period in February-March 2017. There were 9,469 completed interviews and 3,547 partial interviews. Response, cooperation, refusal, and contact rates were 31%, 81%, 7%, and 39% respectively. Twenty-three calls were dialed to produce an eligible contact: nonresponse was substantial due to the automated calling system and dialing of many unassigned or non-working numbers. Younger, urban, better educated, and male respondents were overrepresented in the sample. Conclusions The innovative mobile phone data collection methodology yielded a large sample in a relatively short period. Response rates were comparable to other surveys, although substantial coverage bias resulted from fewer women, rural, and older residents completing the mobile phone survey in

Frequency of glucose-6-phosphate dehydrogenase deficiency in malaria patients from six African countries enrolled in two randomized anti-malarial clinical trials

PubMed Central

2011-01-01

Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is common in populations living in malaria endemic areas. G6PD genotype and phenotype were determined for malaria patients enrolled in the chlorproguanil-dapsone-artesunate (CDA) phase III clinical trial programme. Methods Study participants, aged > 1 year, with microscopically confirmed uncomplicated Plasmodium falciparum malaria, and haemoglobin ≥ 70 g/L or haematocrit ≥ 25%, were recruited into two clinical trials conducted in six African countries (Burkina Faso, Ghana, Kenya, Nigeria, Tanzania, Mali). G6PD genotype of the three most common African forms, G6PD*B, G6PD*A (A376G), and G6PD*A- (G202A, A542T, G680T and T968C), were determined and used for frequency estimation. G6PD phenotype was assessed qualitatively using the NADPH fluorescence test. Exploratory analyses investigated the effect of G6PD status on baseline haemoglobin concentration, temperature, asexual parasitaemia and anti-malarial efficacy after treatment with CDA 2/2.5/4 mg/kg or chlorproguanil-dapsone 2/2.5 mg/kg (both given once daily for three days) or six-dose artemether-lumefantrine. Results Of 2264 malaria patients enrolled, 2045 had G6PD genotype available and comprised the primary analysis population (1018 males, 1027 females). G6PD deficiency prevalence was 9.0% (184/2045; 7.2% [N = 147] male hemizygous plus 1.8% [N = 37] female homozygous), 13.3% (273/2045) of patients were heterozygous females, 77.7% (1588/2045) were G6PD normal. All deficient G6PD*A- genotypes were A376G/G202A. G6PD phenotype was available for 64.5% (1319/2045) of patients: 10.2% (134/1319) were G6PD deficient, 9.6% (127/1319) intermediate, and 80.2% (1058/1319) normal. Phenotype test specificity in detecting hemizygous males was 70.7% (70/99) and 48.0% (12/25) for homozygous females. Logistic regression found no significant effect of G6PD genotype on adjusted mean baseline haemoglobin (p = 0.154), adjusted mean baseline temperature (p = 0.9617), or

Frequency of glucose-6-phosphate dehydrogenase deficiency in malaria patients from six African countries enrolled in two randomized anti-malarial clinical trials.

PubMed

Carter, Nick; Pamba, Allan; Duparc, Stephan; Waitumbi, John N

2011-08-17

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is common in populations living in malaria endemic areas. G6PD genotype and phenotype were determined for malaria patients enrolled in the chlorproguanil-dapsone-artesunate (CDA) phase III clinical trial programme. Study participants, aged > 1 year, with microscopically confirmed uncomplicated Plasmodium falciparum malaria, and haemoglobin ≥ 70 g/L or haematocrit ≥ 25%, were recruited into two clinical trials conducted in six African countries (Burkina Faso, Ghana, Kenya, Nigeria, Tanzania, Mali). G6PD genotype of the three most common African forms, G6PD*B, G6PD*A (A376G), and G6PD*A- (G202A, A542T, G680T and T968C), were determined and used for frequency estimation. G6PD phenotype was assessed qualitatively using the NADPH fluorescence test. Exploratory analyses investigated the effect of G6PD status on baseline haemoglobin concentration, temperature, asexual parasitaemia and anti-malarial efficacy after treatment with CDA 2/2.5/4 mg/kg or chlorproguanil-dapsone 2/2.5 mg/kg (both given once daily for three days) or six-dose artemether-lumefantrine. Of 2264 malaria patients enrolled, 2045 had G6PD genotype available and comprised the primary analysis population (1018 males, 1027 females). G6PD deficiency prevalence was 9.0% (184/2045; 7.2% [N = 147] male hemizygous plus 1.8% [N = 37] female homozygous), 13.3% (273/2045) of patients were heterozygous females, 77.7% (1588/2045) were G6PD normal. All deficient G6PD*A- genotypes were A376G/G202A. G6PD phenotype was available for 64.5% (1319/2045) of patients: 10.2% (134/1319) were G6PD deficient, 9.6% (127/1319) intermediate, and 80.2% (1058/1319) normal. Phenotype test specificity in detecting hemizygous males was 70.7% (70/99) and 48.0% (12/25) for homozygous females. Logistic regression found no significant effect of G6PD genotype on adjusted mean baseline haemoglobin (p = 0.154), adjusted mean baseline temperature (p = 0.9617), or adjusted log mean baseline

Traditional healers as service providers in Ghana's National Health Insurance Scheme: the wrong way forward?

PubMed

Barimah, Kofi Bobi

2013-01-01

Concerned with the negative impacts of user fees on healthcare access and utilisation, following the enactment of a law in 2003, the Ghanaian government replaced the 'cash-and-carry' system with a National Health Insurance Scheme (NHIS). Even though many Ghanaians rely on traditional medicine (TRM) for reasons of culture, cost and personal preference, the incipient NHIS does not cover the services of TRM practitioners. Consultations with health policy-makers suggest that, in as much as the government recognises the invaluable contributions of TRM practitioners and would like to incorporate them in the incipient scheme, the provision of TRM in the country is still too disorganised, with few if any formal protocols and codes of conduct. Consequently, the inclusion of TRM practitioners in the NHIS is premature. This scholarly review seeks to bring TRM and its practitioners into the mainstream of healthcare provision in Ghana. Possibilities for medical pluralism in Ghana will be discussed with reference to best practices in countries such as China, India and Vietnam. This paper promotes medical pluralism in the form of Active Collaboration Between Fully Recognised Health Systems where there will be equity, mutual respect and understanding among traditional healers and physicians.

Levels and Seasonal Variability of Persistent Organic Pollutants in Rural and Urban Atmosphere of Southern Ghana

NASA Astrophysics Data System (ADS)

Adu-Kumi, Sam; Klanova, Jana; Holoubek, Ivan

2010-05-01

Concentrations of persistent organic pollutants (POPs) in air are reported from the first full year of the RECETOX-Africa Air Monitoring (MONET_AFRICA) Project. Passive air samplers composed of polyurethane foam disks (PUF-disk samplers) were deployed for sampling background air concentrations from January-December 2008 at two urban sites in Ghana, namely, Ghana Atomic Energy Commission (Biotechnology and Nuclear Agricultural Research Institute, Kwabenya); and Ghana Meteorological Agency (East Legon). Another set of PUF-disk samplers were deployed at a rural/agricultural location (Lake Bosumtwi) from July-November 2008. For the purposes of this study, 28 days was the sampling period for polyaromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs); and 3 months for OCPs (Drins) and dioxins/furans (PCDD/Fs) respectively. MONET_AFRICA constituted part of the activities under the Global Monitoring Plan (GMP) for the effectiveness evaluation (Article 16) of the Stockholm Convention on POPs and the air sampling survey was conducted at 26 sites across the African continent with the aim to establish baseline information on contamination of ambient air with persistent organic pollutants (POPs) as a reference for future monitoring programmes in the region. For the pesticides, endosulfans constituted the highest contaminants measured followed by HCHs and DDTs in that order. The large temporal variability in the pesticide concentrations suggested seasonal application of endosulfans and γ-HCH. Levels of endosulfans were initially found to be below detection limit during the first sampling period (January - March 2008) but recorded the highest concentration than any other pesticide from all 16 sites in the African region during the second sampling period (April - June 2008). Concentrations of DDTs and HCHs were generally low throughout the sampling periods. p,p'-DDE/p,p'-DDT ratio in ambient air showed that the metabolite DDE was the

Diagnostic Accuracy, Sensitivity, and Specificity of Executive Function Tests in Moderate Traumatic Brain Injury in Ghana.

PubMed

Adjorlolo, Samuel

2018-06-01

The sociocultural differences between Western and sub-Saharan African countries make it imperative to standardize neuropsychological tests in the latter. However, Western-normed tests are frequently administered in sub-Saharan Africa because of challenges hampering standardization efforts. Yet a salient topical issue in the cross-cultural neuropsychology literature relates to the utility of Western-normed neuropsychological tests in minority groups, non-Caucasians, and by extension Ghanaians. Consequently, this study investigates the diagnostic accuracy, sensitivity, and specificity of executive function (EF) tests (The Stroop Test, Trail Making Test, and Controlled Oral Word Association Test), and a Revised Quick Cognitive Screening Test (RQCST) in a sample of 50 patients diagnosed with moderate traumatic brain injury and 50 healthy controls in Ghana. The EF test scores showed good diagnostic accuracy, with area under the curve (AUC) values of the Trail Making Test scores ranging from .746 to .902. With respect to the Stroop Test scores, the AUC values ranged from .793 to .898, while Controlled Oral Word Association Test had AUC value of .787. The RQCST scores discriminated between the groups, with AUC values ranging from .674 to .912. The AUC values of composite EF score and a neuropsychological score created from EF and RQCST scores were .936 and. 942, respectively. Additionally, the Stroop Test, Trail Making Test, EF composite score, and RQCST scores showed good to excellent sensitivities and specificities. In general, this study has shown that commonly used EF tests in Western countries have diagnostic accuracy, sensitivity, and specificity when administered in Ghanaian samples. The findings and implications of the study are discussed.

Regulation of genomic and biobanking research in Africa: a content analysis of ethics guidelines, policies and procedures from 22 African countries.

PubMed

de Vries, Jantina; Munung, Syntia Nchangwi; Matimba, Alice; McCurdy, Sheryl; Ouwe Missi Oukem-Boyer, Odile; Staunton, Ciara; Yakubu, Aminu; Tindana, Paulina

2017-02-02

The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when. In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance

Optimizing the African VLBI Network for Astronomy and Geodesy

NASA Astrophysics Data System (ADS)

de Witt, A.; Mayer, D.; MacLeod, G.; Combrinck, L.; Petrov, L.; Nickola, M.

2016-12-01

The African VLBI Network will be a pan-African network of radio telescopes comprised of converted redundant satellite Earth-station antennas and new purpose-built radio telescopes. The first of these antennas, in Ghana, is currently being converted to a radio telescope and current funding is estimated to permit the conversion of two more antennas in Africa. These antennas will initially be equipped with a 5-GHz and 6.7-GHz receiver and the next receiver likely to be fitted is a 1.4-1.7-GHz receiver. While it would be advantageous for the AVN antennas to be able to participate also in geodetic and astrometric VLBI observations, there is no funding currently for this. In this paper we re-visit the scientific justifications for the AVN in an attempt to optimize the AVN for each science case, both astronomical and geodetic.

76 FR 69290 - Report on Countries That Are Candidates for Millennium Challenge Account Eligibility in Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... countries to achieve lasting economic growth and poverty reduction. The Act requires the Millennium... to reduce poverty and generate economic growth in the country. These steps include the submission of... Dem. Rep. of the Congo Djibouti Ethiopia Gambia, The Ghana Guinea Guinea-Bissau Haiti Honduras India...

Regional variation in shea butter lipid and triterpene composition in four African countries.

PubMed

Di Vincenzo, Daria; Maranz, Steve; Serraiocco, Arnaldo; Vito, Raffaella; Wiesman, Zeev; Bianchi, Giorgio

2005-09-21

The triacylglycerol, fatty acid, and polycyclic triterpene compositions of shea butter were determined for 150 samples from the sub-Saharan countries of Mali, Burkina Faso, Nigeria, and Uganda. The compositional profiles showed high variability in all three classes of compounds. Shea butter is made up mainly of four triglycerides (TAG) differing in carbon number (CN) by two, starting from CN 50 to CN 56. The greatest source of variation was in the CN 54 TAG. Shea butter is characterized by 16 saturated and unsaturated fatty acids in greatly varying proportion, the major ones being the even homologues in the range of C(16)-C(20). Oleic acid is dominant in Ugandan provenances, whereas stearic acid is dominant in West African shea butter. Acetyl and cinnamyl polycyclic triterpene means for countries ranged from 3.69 to 12.57%, with the highest values found in Nigerian provenances. Statistical comparisons of fat composition show that the geographic distance between shea populations is reflected in the degree of separation of their chemical profiles.

Health-Needs Assessment for West African Immigrants in Greater Providence, RI.

PubMed

Adu-Boahene, Akosua Boadiwaa; Laws, Michael Barton; Dapaah-Afriyie, Kwame

2017-01-06

African immigrants in the United States may experience barriers to health-care access and effectiveness. This mixed-methods study used paper-based surveys of people (N=101) in the target population from Nigeria, Ghana, and Liberia, recruited through convenience and snowball sampling. Semi-structured interviews were conducted with 3 clergy members who pastor churches with large Nigerian, Ghanaian, and Liberian populations, respectively; and five physicians and a clinical pharmacist who serve African immigrants. Length of stay in the United States was associated with the health status of refugee children. Undocumented immigration status was associated with lack of health insurance. Cardiovascular diseases, uterine fibroids and stress-related disorders were the most prevalent reported conditions. Regardless of English fluency, many immigrants are unfamiliar with medical terminology. African immigrants in the state of Rhode Island need more health education and resources to navigate the US health-care system. [Full article available at http://rimed.org/rimedicaljournal-2017-01.asp].

The role of power in health policy dialogues: lessons from African countries.

PubMed

Mwisongo, Aziza; Nabyonga-Orem, Juliet; Yao, Theodore; Dovlo, Delanyo

2016-07-18

Policy-making is a dynamic process involving the interplay of various factors. Power and its role are some of its core components. Though power exerts a profound role in policy-making, empirical evidence suggests that health policy analysis has paid only limited attention to the role of power, particularly in policy dialogues. This exploratory study, which used qualitative methods, had the main aim of learning about and understanding policy dialogues in five African countries and how power influences such processes. Data were collected using key informant interviews. An interview guide was developed with standardised questions and probes on the policy dialogues in each country. This paper utilises these data plus document review to understand how power was manifested during the policy dialogues. Reference is made to the Arts and Tatenhove conceptual framework on power dimensions to understand how power featured during the policy dialogues in African health contexts. Arts and Tatenhove conceptualise power in policy-making in relational, dispositional and structural layers. Our study found that power was applied positively during the dialogues to prioritise agendas, fast-track processes, reorganise positions, focus attention on certain items and foster involvement of the community. Power was applied negatively during the dialogues, for example when position was used to control and shape dialogues, which limited innovation, and when knowledge power was used to influence decisions and the direction of the dialogues. Transitive power was used to challenge the government to think of implementation issues often forgotten during policy-making processes. Dispositional power was the most complex form of power expressed both overtly and covertly. Structural power was manifested socially, culturally, politically, legally and economically. This study shows that we need to be cognisant of the role of power during policy dialogues and put mechanisms in place to manage its

National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities

PubMed Central

van der Broek, Ankie; Jansen, Christel; de Bruijn, Hilde; Schultsz, Constance

2017-01-01

Background The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. Objectives This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening. Method National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013. Results Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39) and finances and budget were the least addressed (< 5/39). Countries lagging behind in national laboratory strategic planning at the end of 2013 (17/39) were more likely to be francophone countries located in West-Central Africa (13/17) and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure. Conclusion The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board. PMID:28879152

Evaluating the impact of the national health insurance scheme of Ghana on out of pocket expenditures: a systematic review.

PubMed

Okoroh, Juliet; Essoun, Samuel; Seddoh, Anthony; Harris, Hobart; Weissman, Joel S; Dsane-Selby, Lydia; Riviello, Robert

2018-06-07

Approximately 150 million people suffer from financial catastrophe annually because of out-of-pocket expenditures (OOPEs) on health. Although the National Health Insurance Scheme (NHIS) of Ghana was designed to promote universal health coverage, OOPEs as a proportion of total health expenditures remains elevated at 26%, exceeding the WHO's recommendations of less than 15-20%. To determine whether enrollment in the NHIS reduces the likelihood of OOPEs and catastrophic health expenditures (CHEs) in Ghana, we undertook a systematic review of the published literature. We searched for quantitative articles published in English between January 1, 2003 and August 22, 2017 in PubMed, Google Scholar, Economic Literature, Global Health, PAIS International, and African Index Medicus. Two independent authors (J.S.O. & S.E.) reviewed the articles for inclusion, extracted the data, and conducted a quality assessment of the studies. We accepted the World Health Organization definition of catastrophic health expenditures which is out of pocket payments for health care which exceeds 20% of annual house hold income, 10% of household expenditures, or 40% of subsistence expenditures (total household expenditures net food expenditures). Of the 1094 articles initially identified, 7 were eligible for inclusion. These were cross-sectional household studies published between 2008 and 2016 in Ghana. They demonstrated that the uninsured paid 1.4 to 10 times more in out-of-pocket payments (OOPs) and were more likely to incur CHEs than the insured. Yet, 6 to 18% of insured households made catastrophic payments for healthcare and all studies reported insured members making OOPs for medicines. Evidence suggests that the national health insurance scheme of Ghana over the last 14 years has made some impact on reducing OOPEs, and yet healthcare costs remain catastrophic for a large proportion of insured households in Ghana. Future studies need to explore reasons for the persistence of OOPs for

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.

Genetic structure in four West African population groups

PubMed Central

Adeyemo, Adebowale A; Chen, Guanjie; Chen, Yuanxiu; Rotimi, Charles

2005-01-01

Background Africa contains the most genetically divergent group of continental populations and several studies have reported that African populations show a high degree of population stratification. In this regard, it is important to investigate the potential for population genetic structure or stratification in genetic epidemiology studies involving multiple African populations. The presences of genetic sub-structure, if not properly accounted for, have been reported to lead to spurious association between a putative risk allele and a disease. Within the context of the Africa America Diabetes Mellitus (AADM) Study (a genetic epidemiologic study of type 2 diabetes mellitus in West Africa), we have investigated population structure or stratification in four ethnic groups in two countries (Akan and Gaa-Adangbe from Ghana, Yoruba and Igbo from Nigeria) using data from 372 autosomal microsatellite loci typed in 493 unrelated persons (986 chromosomes). Results There was no significant population genetic structure in the overall sample. The smallest probability is associated with an inferred cluster of 1 and little of the posterior probability is associated with a higher number of inferred clusters. The distribution of members of the sample to inferred clusters is consistent with this finding; roughly the same proportion of individuals from each group is assigned to each cluster with little variation between the ethnic groups. Analysis of molecular variance (AMOVA) showed that the between-population component of genetic variance is less than 0.1% in contrast to 99.91% for the within population component. Pair-wise genetic distances between the four ethnic groups were also very similar. Nonetheless, the small between-population genetic variance was sufficient to distinguish the two Ghanaian groups from the two Nigerian groups. Conclusion There was little evidence for significant population substructure in the four major West African ethnic groups represented in the AADM

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.

Forensic data and microvariant sequence characterization of 27 Y-STR loci analyzed in four Eastern African countries.

PubMed

Iacovacci, Giuseppe; D'Atanasio, Eugenia; Marini, Ornella; Coppa, Alfredo; Sellitto, Daniele; Trombetta, Beniamino; Berti, Andrea; Cruciani, Fulvio

2017-03-01

By using the recently introduced 6-dye Yfiler ® Plus multiplex, we analyzed 462 males belonging to 20 ethnic groups from four eastern African countries (Eritrea, Ethiopia, Djibouti and Kenya). Through a Y-STR sequence analysis, combined with 62 SNP-based haplogroup information, we were able to classify observed microvariant alleles at four Y-STR loci as either monophyletic (DYF387S1 and DYS458) or recurrent (DYS449 and DYS627). We found evidence of non-allelic gene conversion among paralogous STRs of the two-copy locus DYF387S1. Twenty-two diallelic and triallelic patterns observed at 13 different loci were found to be significantly over-represented (p<10 -6 ) among profiles obtained from cell lines compared to those from blood and saliva. Most of the diallelic/triallelic patterns from cell lines involved recurrent mutations at rapidly mutating loci (RM Y-STRs) included in the multiplex (p<10 -2 ). At haplotype level, intra-population diversity indices were found to be among the lowest so far reported for the Yfiler ® Plus, while statistically significant differences among countries and ethnic groups were detected when considering haplotype frequencies alone (F ST ) or by using molecular distances among haplotypes (Φ ST ). The strong population subdivision observed is probably the consequence of the patrilineal social organization of most eastern African ethnic groups, and suggests caution in the use of country-based haplotype frequency distributions for forensic inferences in this region. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Human resources in health research institutions in sub-Saharan African countries: results of a questionnaire-based survey.

PubMed

Kebede, Derege; Zielinski, Chris; Mbondji, Peter Ebongue; Sanou, Issa; Kouvividila, Wenceslas; Lusamba-Dikassa, Paul-Samson

2014-05-01

To describe human capacity and staff movement in national health research institutions in 42 sub-Saharan African countries. A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Eight hundred and forty-seven health research institutions in 42 sub-Saharan African countries. Key informants from 847 health research institutions. The availability, mix and quality of human resources in health research institutions. On average, there were 122 females employed per respondent health research institution, compared with 159 males. For researchers, the equivalent figures were nine females to 17 males. The average annual gross salary of researchers varied between US$ 12,260 for staff with 5-10 years of experience and US$ 14,772 for the institution head. Of those researchers who had joined the institution in the previous 12 months, 55% were employed on a full-time basis. Of the researchers who left the institutions in the same period, 71% had a full-time contract. Among all those who left, those who left to a non-research sector and to another country accounted for two-thirds. The study revealed significant gaps in the area of human capacity development for research in Africa. The results showed a serious shortage of qualified staff engaged in health research, with a dearth of staff that held at least a master's degree or doctoral degree. Major efforts will be required to strengthen human resource capacity, including addressing the lack of motivation or time for research on the part of existing capable staff. © The Royal Society of Medicine.

Molecular characterization of Cryptosporidium and Giardia in farmers and their ruminant livestock from the Coastal Savannah zone of Ghana.

PubMed

Squire, Sylvia Afriyie; Yang, Rongchang; Robertson, Ian; Ayi, Irene; Ryan, Una

2017-11-01

Cryptosporidium and Giardia are major causes of diarrhoea in developing countries including Ghana, however, nothing is known about the species and subtypes of Cryptosporidium and Giardia in farmers and their ruminant livestock in this country. A total of 925 faecal samples from humans (n=95), cattle (n=328), sheep (n=217) and goats (n=285), were screened for Cryptosporidium and Giardia by quantitative PCR (qPCR) at the 18S rRNA and glutamate dehydrogenase (gdh) loci respectively. Cryptosporidium positives were typed by sequence analysis of 18S and 60kDa glycoprotein (gp60) loci amplicons. Giardia positives were typed at the triose phosphate isomerase (tpi), beta-giardin (bg) and gdh loci. The prevalence of Cryptosporidium and Giardia by qPCR was 8.4% and 10.5% in humans, 26.5% and 8.5% in cattle, 34.1% and 12.9% in sheep, and 33.3% and 12.3% in goat faecal samples, respectively. G. duodenalis assemblages A and B were detected in humans and assemblage E was detected in livestock. Cryptosporidium parvum was the only species identified in humans; C. andersoni, C. bovis, C. ryanae and C. ubiquitum were identified in cattle; C. xiaoi, C. ubiquitum and C. bovis in sheep; and C. xiaoi, C. baileyi and C. parvum in goats. This is the first molecular study of Cryptosporidium and Giardia in livestock in Ghana. The identification of zoonotic species and the identification of C. parvum subtype IIcA5G3q in livestock, which has previously been identified in children in Ghana, suggests potential zoonotic transmission. Further studies on larger numbers of human and animal samples, and on younger livestock are required to better understand the epidemiology and transmission of Cryptosporidium and Giardia in Ghana. Copyright © 2017 Elsevier B.V. All rights reserved.

One-shot exogenous interventions increase subsequent coordination in Denmark, Spain and Ghana

PubMed Central

Thorsen, Bo Jellesmark

2017-01-01

Everyday, we are bombarded with periodic, exogenous appeals and instructions on how to behave. How do these appeals and instructions affect subsequent coordination? Using experimental methods, we investigate how a one-time exogenous instruction affects subsequent coordination among individuals in a lab. Participants play a minimum effort game repeated 5 times under fixed matching with a one-time behavioral instruction in either the first or second round. Since coordination behavior may vary across countries, we run experiments in Denmark, Spain and Ghana, and map cross-country rankings in coordination with known national measures of fractualization, uncertainty avoidance and long-term orientation. Our results show that exogenous interventions increase subsequent coordination, with earlier interventions yielding better coordination than later interventions. We also find that cross-country rankings in coordination map with published national measures of fractualization, uncertainty avoidance, and long-term orientation. PMID:29145411

One-shot exogenous interventions increase subsequent coordination in Denmark, Spain and Ghana.

PubMed

Abatayo, Anna Lou; Thorsen, Bo Jellesmark

2017-01-01

Everyday, we are bombarded with periodic, exogenous appeals and instructions on how to behave. How do these appeals and instructions affect subsequent coordination? Using experimental methods, we investigate how a one-time exogenous instruction affects subsequent coordination among individuals in a lab. Participants play a minimum effort game repeated 5 times under fixed matching with a one-time behavioral instruction in either the first or second round. Since coordination behavior may vary across countries, we run experiments in Denmark, Spain and Ghana, and map cross-country rankings in coordination with known national measures of fractualization, uncertainty avoidance and long-term orientation. Our results show that exogenous interventions increase subsequent coordination, with earlier interventions yielding better coordination than later interventions. We also find that cross-country rankings in coordination map with published national measures of fractualization, uncertainty avoidance, and long-term orientation.

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.

Kwame Nkrumah University of Science and Technology School of Veterinary Medicine (KNUST SVM) A Model of "One-Health Concept" Application to Veterinary Education in West Africa.

PubMed

Folitse, R D; Agyemang, T Opoku; Emikpe, B O; Evarefe, O D; Atawalna, J

2014-12-01

Veterinary education in West Africa had been skewed over decades with Nigeria and Senegal leading in the training of veterinarians in the subregion. Most nationals from Ghana, Sierra Leone, Gambia as well as francophone countries within the subregion were trained in East Africa, Europe and South America. The aim of this paper is to provide an insight into the need for veterinary education in other West African countries including Ghana Information was sourced from individuals, literatures and other relevant archives on the history, current state and future approaches to veterinary education in Ghana. The advantages, challenges and coping strategies for application of the Principles of "The One World One Health concept" to veterinary education with the use of the medical professionals in the delivery were presented. This approach to veterinary education by Kwame Nkrumah University of Science and Technology School of Veterinary Medicine showcases a means to meet the health challenges of the twenty first century which demand pragmatic innovation to solve disease challenges.

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.

African Games of Strategy: A Teaching Manual. African Outreach Series, No. 2.

ERIC Educational Resources Information Center

Crane, Louise

Appreciation of African games has increased in this country; especially board games which have been popularized through commercial versions. African games are invaluable resources for studying subjects requiring mathematical concepts, as well as social studies, history, geography, and languages. This manual presents some of the better known…

English Teaching Profiles from the British Council: Burma, Cyprus, Czechoslovakia, Ethiopia, Ghana, India, Lesotho, New Zealand, Pakistan, Qatar, Malaysia.

ERIC Educational Resources Information Center

British Council, London (England). English Language and Literature Div.

The role of English and the status of English language instruction is reported for Burma, Cyprus, Czechoslovakia, Ethiopia, Ghana, India, Lesotho, New Zealand, Pakistan, Qatar, and Malaysia. The profile for each country contains a summary of English instruction within and outside of the educational system, teacher supply and qualifications,…

The first private sector health insurance company in Ghana.

PubMed

Huff-Rousselle, M; Akuamoah-Boateng, J

1998-01-01

This article analyses the development of Ghana's first private sector health insurance company, the Nationwide Medical Insurance Company. Taking both policy and practical considerations into account (stakeholders' perspectives, economic viability, equity and efficiency), it is structured around key questions which help to define the position and roles of stakeholders--the insurance agency itself, contributors, beneficiaries, and providers--and how they relate to one another and the insurance scheme. These relationships will to a large extent determine Nationwide's long-term success or failure. By creating a unique alliance between physician providers and private sector companies, Nationwide has used employers' interest in cost containment and physicians' interest in expanding their client base as an entrée into the virgin territory of health insurance, and created a hybrid variety of private sector insurance with some of the attributes of a health maintenance organization or managed care. The case study is unusual in that, while public sector programs are often open to academic scrutiny, researchers have rarely had access to detailed data on the establishment of a single private sector insurance company in a developing country. Given that Ghana is planning to launch a national health insurance plan, the article concludes by considering what the experience of this private sector initiative might have to offer public sector planners.

Contraceptive Methods Accessed in Volta Region, Ghana, 2009-2014.

PubMed

Wilson, Himiede W; Ameme, Donne K; Ilesanmi, Olayinka Stephen

2017-01-01

In 2016, Volta Region was one of the two regions in Ghana that recorded a high prevalence of teenage pregnancy, accounting for 15.5% of all adolescent pregnancies in the country. This study aimed to determine the prevalence of contraceptive methods accessed by person, place, and time in Volta Region, Ghana, 2009-2014. We carried out a secondary analysis of contraceptive use data derived from the District Health Information Management System (DHIMS) 2 for Volta Region, between 2009 and 2014. We calculated proportions and described trends. Over the five-year period, there were 673,409 (75.0%) acceptors of family planning out of a total 897, 645 males and females of reproductive age. The proportion of family planning acceptors increased gradually from 18% in 2009 to 23% in 2014. Contraceptive methods were most commonly accessed by male and female between 20 and 29 years. The most common methods of contraceptives accessed were injectables among females accounting for about 70% and condoms accounting for over 90% among males. All the districts in Volta Region did not access contraceptives adequately. The Volta Regional Health Directorate should encourage and support research to ascertain factors influencing uptake of contraceptive methods in all the districts.

Persistent Issues in African Education. Occasional Papers in Continuing Education, Number 16.

ERIC Educational Resources Information Center

Ampene, E. Kwasi

Important issues in African education involve the effects of the colonial education system on African subjects and their countries' political and socio-economic development. Of interest are some countries' efforts to correct dysfunctions resulting from the colonial system. Following independence, the state of education in many African countries in…

Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium.

PubMed

Yang, Ju Dong; Mohamed, Essa A; Aziz, Ashraf O Abdel; Shousha, Hend I; Hashem, Mohamed B; Nabeel, Mohamed M; Abdelmaksoud, Ahmed H; Elbaz, Tamer M; Afihene, Mary Y; Duduyemi, Babatunde M; Ayawin, Joshua P; Gyedu, Adam; Lohouès-Kouacou, Marie-Jeanne; Ndam, Antonin W Ndjitoyap; Moustafa, Ehab F; Hassany, Sahar M; Moussa, Abdelmajeed M; Ugiagbe, Rose A; Omuemu, Casimir E; Anthony, Richard; Palmer, Dennis; Nyanga, Albert F; Malu, Abraham O; Obekpa, Solomon; Abdo, Abdelmounem E; Siddig, Awatif I; Mudawi, Hatim M Y; Okonkwo, Uchenna; Kooffreh-Ada, Mbang; Awuku, Yaw A; Nartey, Yvonne A; Abbew, Elizabeth T; Awuku, Nana A; Otegbayo, Jesse A; Akande, Kolawole O; Desalegn, Hailemichael M; Omonisi, Abidemi E; Ajayi, Akande O; Okeke, Edith N; Duguru, Mary J; Davwar, Pantong M; Okorie, Michael C; Mustapha, Shettima; Debes, Jose D; Ocama, Ponsiano; Lesi, Olufunmilayo A; Odeghe, Emuobor; Bello, Ruth; Onyekwere, Charles; Ekere, Francis; Igetei, Rufina; Mah'moud, Mitchell A; Addissie, Benyam; Ali, Hawa M; Gores, Gregory J; Topazian, Mark D; Roberts, Lewis R

2017-02-01

Hepatocellular carcinoma is a leading cause of cancer-related death in Africa, but there is still no comprehensive description of the current status of its epidemiology in Africa. We therefore initiated an African hepatocellular carcinoma consortium aiming to describe the clinical presentation, management, and outcomes of patients with hepatocellular carcinoma in Africa. We did a multicentre, multicountry, retrospective observational cohort study, inviting investigators from the African Network for Gastrointestinal and Liver Diseases to participate in the consortium to develop hepatocellular carcinoma research databases and biospecimen repositories. Participating institutions were from Cameroon, Egypt, Ethiopia, Ghana, Ivory Coast, Nigeria, Sudan, Tanzania, and Uganda. Clinical information-demographic characteristics, cause of disease, liver-related blood tests, tumour characteristics, treatments, last follow-up date, and survival status-for patients diagnosed with hepatocellular carcinoma between Aug 1, 2006, and April 1, 2016, were extracted from medical records by participating investigators. Because patients from Egypt showed differences in characteristics compared with patients from the other countries, we divided patients into two groups for analysis; Egypt versus other African countries. We undertook a multifactorial analysis using the Cox proportional hazards model to identify factors affecting survival (assessed from the time of diagnosis to last known follow-up or death). We obtained information for 2566 patients at 21 tertiary referral centres (two in Egypt, nine in Nigeria, four in Ghana, and one each in the Ivory Coast, Cameroon, Sudan, Ethiopia, Tanzania, and Uganda). 1251 patients were from Egypt and 1315 were from the other African countries (491 from Ghana, 363 from Nigeria, 277 from Ivory Coast, 59 from Cameroon, 51 from Sudan, 33 from Ethiopia, 21 from Tanzania, and 20 from Uganda). The median age at which hepatocellular carcinoma was diagnosed

Policy perspectives on post pandemic influenza vaccination in Ghana and Malawi.

PubMed

Sambala, Evanson Z; Manderson, Lenore

2017-02-28

In the late 1990s, in the context of renewed concerns of an influenza pandemic, countries such as Ghana and Malawi established plans for the deployment of vaccines and vaccination strategies. A new pandemic was declared in mid-June 2009, and by April 2011, Ghana and Malawi vaccinated 10% of the population. We examine the public health policy perspectives on vaccination as a means to prevent the spread of infection under post pandemic conditions. In-depth interviews were conducted with 46 policymakers (Ghana, n = 24; Malawi, n = 22), identified through snowballing sampling. Interviews were supplemented by field notes and the analysis of policy documents. The use of vaccination to interrupt the pandemic influenza was affected by delays in the procurement, delivery and administration of vaccines, suboptimal vaccination coverage, refusals to be vaccinated, and the politics behind vaccination strategies. More generally, rolling-out of vaccination after the transmission of the influenza virus had abated was influenced by policymakers' own financial incentives, and government and foreign policy conditionality on vaccination. This led to confusion about targeting and coverage, with many policymakers justifying that the vaccination of 10% of the population would establish herd immunity and so reduce future risk. Ghana succeeded in vaccinating 2.3 million of the select groups (100% coverage), while Malawi, despite recourse to force, succeeded only in vaccinating 1.15 million (74% coverage of select groups). For most policymakers, vaccination coverage was perceived as successful, despite that vaccination delays and coverage would not have prevented infection when influenza was at its peak. While the vaccination strategy was problematic and implemented too late to reduce the effects of the 2009 epidemic, policy makers supported the overall goal of pandemic influenza vaccination to interrupt infection. In this context, there was strong support for governments engaging

"If I Should Stop Teaching Now, Where Will I Go?" Turnover Intentions among High School Teachers in Ghana

ERIC Educational Resources Information Center

Adusei, Henry; Sarfo, Jacob Owusu; Manukure, Portia; Cudjoe, Josephine

2016-01-01

Teachers form one of the essential professional groups in the development domain of every country. Although most senior high school teachers in Ghana complains about poor conditions of service, a lot of them are still at post. The key research goal was to explore the retaining factors of senior high school teachers, within their existing…

African female immigration to the United States and its policy implications

PubMed Central

Thomas, Kevin J.A.; Logan, Ikubolajeh

2014-01-01

This study examines the dynamics of female African immigration and settlement in the United States and discusses the research and policy implications for these processes. It highlights a significant surge in female immigration from African than non-African countries in recent years. This surge is driven by female immigration from Africa’s countries most populous countries, from countries affected by civil conflicts, and from English-speaking countries in the region. African women are also more likely to arrive as unmarried single than other female immigrants. In addition, they had the highest prevalence of Bachelors, Masters, or Doctorate degrees among women in the US. African females were also about twice more likely to be enrolled in US Educational institutions compared to other women. Those in the labor force were more likely to work as nursing professionals than in technical occupational groups such as engineering and computing. The study concludes by discussing the research and policy implications of these findings for countries in the developing world. PMID:25097267

Resistance and change: a multiple streams approach to understanding health policy making in Ghana.

PubMed

Kusi-Ampofo, Owuraku; Church, John; Conteh, Charles; Heinmiller, B Timothy

2015-02-01

Although much has been written on health policy making in developed countries, the same cannot be said of less developed countries, especially in Africa. Drawing largely on available historical and government records, newspaper publications, parliamentary Hansards, and published books and articles, this article uses John W. Kingdon's multiple streams framework to explain how the problem, politics, and policy streams converged for Ghana's National Health Insurance Scheme (NHIS) to be passed into law in 2003. The article contends that a change in government in the 2000 general election opened a "policy window" for eventual policy change from "cash-and-carry" to the NHIS. Copyright © 2015 by Duke University Press.

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…

Examining the influence of antenatal care visits and skilled delivery on neonatal deaths in Ghana.

PubMed

Lambon-Quayefio, Monica P; Owoo, Nkechi S

2014-10-01

Many Sub-Saharan African countries may not achieve the Millennium Development goal of reducing child mortality by 2015 partly due to the stalled reduction in neonatal deaths, which constitute about 60% of infant deaths. Although many studies have emphasized the importance of accessible maternal healthcare as a means of reducing maternal and child mortality, very few of these studies have explored the affordability and accessibility concerns of maternal healthcare on neonatal mortality. This study bridges this research gap as it aims to investigate whether the number of antenatal visits and skilled delivery are associated with the risk of neonatal deaths in Ghana. Using individual level data of women in their reproductive years from the 2008 Demographic and Health Survey, the study employs an instrumental variable strategy to deal with the potential endogeneity of antenatal care visits. Estimates from the instrumental variable estimation show that antenatal care visits reduce the risk of neonatal death by about 2%, while older women have an approximately 0.2% higher risk of losing their neonates than do younger women. Findings suggest that women who attend antenatal visits have a significantly lower probability of losing their babies in the first month of life. Further, results show that women's age significantly affects the risk of losing their babies in the neonatal stage. However, the study finds no significant effect of skilled delivery and education on neonatal mortality.

Mapping Population-Level Spatial Access to Essential Surgical Care in Ghana Using Availability of Bellwether Procedures.

PubMed

Stewart, Barclay T; Tansley, Gavin; Gyedu, Adam; Ofosu, Anthony; Donkor, Peter; Appiah-Denkyira, Ebenezer; Quansah, Robert; Clarke, Damian L; Volmink, Jimmy; Mock, Charles

2016-08-17

Conditions that can be treated by surgery comprise more than 16% of the global disease burden. However, 5 billion people do not have access to essential surgical care. An estimated 90% of the 87 million disability-adjusted life-years incurred by surgical conditions could be averted by providing access to timely and safe surgery in low-income and middle-income countries. Population-level spatial access to essential surgery in Ghana is not known. To assess the performance of bellwether procedures (ie, open fracture repair, emergency laparotomy, and cesarean section) as a proxy for performing essential surgery more broadly, to map population-level spatial access to essential surgery, and to identify first-level referral hospitals that would most improve access to essential surgery if strengthened in Ghana. Population-based study among all households and public and private not-for-profit hospitals in Ghana. Households were represented by georeferenced census data. First-level and second-level referral hospitals managed by the Ministry of Health and all tertiary hospitals were included. Surgical data were collected from January 1 to December 31, 2014. All procedures performed at first-level referral hospitals in Ghana in 2014 were used to sort each facility into 1 of the following 3 hospital groups: those without capability to perform all 3 bellwether procedures, those that performed 1 to 11 of each procedure, and those that performed at least 12 of each procedure. Candidates for targeted capability improvement were identified by cost-distance and network analysis. Of 155 first-level referral hospitals managed by the Ghana Health Service and the Christian Health Association of Ghana, 123 (79.4%) reported surgical data. Ninety-five (77.2%) did not have the capability in 2014 to perform all 3 bellwether procedures, 24 (19.5%) performed 1 to 11 of each bellwether procedure, and 4 (3.3%) performed at least 12. The essential surgical procedure rate was greater in bellwether

Mapping Population-Level Spatial Access to Essential Surgical Care in Ghana Using Availability of Bellwether Procedures

PubMed Central

Stewart, Barclay T.; Tansley, Gavin; Gyedu, Adam; Ofosu, Anthony; Donkor, Peter; Appiah-Denkyira, Ebenezer; Quansah, Robert; Clarke, Damian L.; Volmink, Jimmy; Mock, Charles

2017-01-01

IMPORTANCE Conditions that can be treated by surgery comprise more than 16% of the global disease burden. However, 5 billion people do not have access to essential surgical care. An estimated 90% of the 87 million disability-adjusted life-years incurred by surgical conditions could be averted by providing access to timely and safe surgery in low-income and middle-income countries. Population-level spatial access to essential surgery in Ghana is not known. OBJECTIVES To assess the performance of bellwether procedures (ie, open fracture repair, emergency laparotomy, and cesarean section) as a proxy for performing essential surgery more broadly, to map population-level spatial access to essential surgery, and to identify first-level referral hospitals that would most improve access to essential surgery if strengthened in Ghana. DESIGN, SETTING, AND PARTICIPANTS Population-based study among all households and public and private not-for-profit hospitals in Ghana. Households were represented by georeferenced census data. First-level and second-level referral hospitals managed by the Ministry of Health and all tertiary hospitals were included. Surgical data were collected from January 1 to December 31, 2014. MAIN OUTCOMES AND MEASURES All procedures performed at first-level referral hospitals in Ghana in 2014 were used to sort each facility into 1 of the following 3 hospital groups: those without capability to perform all 3 bellwether procedures, those that performed 1 to 11 of each procedure, and those that performed at least 12 of each procedure. Candidates for targeted capability improvement were identified by cost-distance and network analysis. RESULTS Of 155 first-level referral hospitals managed by the Ghana Health Service and the Christian Health Association of Ghana, 123 (79.4%) reported surgical data. Ninety-five (77.2%) did not have the capability in 2014 to perform all 3 bellwether procedures, 24 (19.5%) performed 1 to 11 of each bellwether procedure, and 4 (3

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.

Ghana.

PubMed

1981-09-01

The government of Ghana sees the country's population as a valuable natural resource and emphasizes national population policy as an important part of overall socioeconomic planning and development. A formal system of development planning has been in effect since 1951. Decennial censuses are conducted relatively regularly but vital registration is thought to be incomplete. The current population size is 11,679,000 and the current rate of natural increase (3.1%) is considered too high, constraining the achievement of socioeconomic development. The high rate of growth is taxing on employment and public services. High fertility rates are influenced both by regional norms, such as early and universal marriage, and demographic factors, i.e., an increasingly higher proportion of the population in the 0-14 age group. The government sponsors family planning services which can be obtained free or at subsidized rates and seeks to upgrade the health and living standards of the population. Sterilization is permitted for medical reasons only, and abortions are restricted. Crude death rates have declined steadily and are currently estimated at 21-23/1000 population. The infant mortality rate is approximately 125.7/1000 live births. These rates are considered unacceptable and budget allocations for curative and preventive services have continuously risen. Uneven regional distribution of services continues to be problematic. Efforts to curb immigration in 1969 are thought to have resulted in the current satisfactory situation. Restrictive measures to prevent the emigration of skilled personnel are in effect. 60-65% of the population are urban dwellers and the proportion is expected to increase. The current spatial distribution of the population is considered inappropriate, rapid urbanization is causing rural depopulation, overburdening urban services and accentuating rural-urban disparaties. 2 approaches to the problem have been implemented: the urban increase is accomodated by

Length of time in Ghana is associated with the likelihood of exclusive breastfeeding among Liberian refugees living in Buduburam.

PubMed

Woldeghebriel, Meley; Hromi-Fiedler, Amber; Lartey, Anna; Gallego-Perez, Daniel; Sandow, Adam; Pérez-Escamilla, Rafael

2017-07-01

While literature describing immigrant's breastfeeding practices exists, especially among those living within developed countries, there is a significant gap in knowledge on how the host culture may influence the EBF behaviors of refugees, especially those living in protracted situations within sub-Saharan Africa. A cross-sectional study was conducted in the Buduburam Refugee Settlement in Ghana from July-August 2008 to explore the association between the amount of time living in Ghana and exclusive breastfeeding practices among Liberian refugees and Ghanaians in surround villages. The study included 480 women: 239 Liberians living in 12 settlement zones (in two of which Liberians and Ghanaians co-exist), 121 Ghanaians living in two settlement zones, and 120 Ghanaians living in nearby urban village of Awutu. Liberian mothers who lived in Ghana at least eight years were significantly more likely to exclusively breastfeed (OR: 1.78, 95% CI: 1.02, 3.09) compared to Ghanaian mothers living in Awutu. These findings suggest that increased time living in Buduburam improved the chances of EBF success among Liberians, perhaps as a result of unique EBF education/support opportunities offered in the settlement to Liberian refugees that were not readily available to Ghanaians. Further research to understand the "mechanisms" explaining exclusive breastfeeding differences as a function of time spent in host country is needed for improving breastfeeding support in refugee settlements and host communities. © 2016 John Wiley & Sons Ltd.

Self-estimates of intelligence: a study in two African countries.

PubMed

Furnham, Adrian; Callahan, Ines; Akande, Debo

2004-05-01

Black and White South Africans (n = 181) and Nigerians (n = 135) completed a questionnaire concerning the estimations of their own and their relatives' (father, mother, sister, brother) multiple intelligences as well as beliefs about the IQ concept. In contrast to previous results (A. Furnham, 2001), there were few gender differences in self-estimates. In a comparison of Black and White South Africans, it was clear the Whites gave higher estimates for self, parents, and brothers. However, overall IQ estimates for self and all relatives hovered around the mean of 100. When Black South Africans and Nigerians were compared, there were both gender and nationality differences on the self-estimates with men giving higher self-estimates than women and Nigerians higher self-estimates than South Africans. There were also gender and nationality differences in the answers to questions about IQ. The authors discuss possible reasons for the relatively few gender differences in this study compared with other studies as well as possible reasons for the cross-cultural difference.

A Comparative Study of Teachers' Pedagogical Competencies in Supporting Children with Learning Difficulties in Primary Schools in Ghana and Brunei Darussalam

ERIC Educational Resources Information Center

Abosi, Okechukwu; Alhassan, Abdul Razak Kuyini

2017-01-01

Teachers' pedagogical competencies level is increasingly affecting the implementation of inclusive education policy in many countries. The aimed at comparing primary school teachers' competence levels in supporting children with learning difficulties in Brunei Darussalam and Ghana. Descriptive survey design was used and 188 primary school teachers…

Stakeholders Perspectives on the Success Drivers in Ghana’s National Health Insurance Scheme – Identifying Policy Translation Issues

PubMed Central

Fusheini, Adam; Marnoch, Gordon; Gray, Ann Marie

2017-01-01

Background: Ghana’s National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa. While the success, especially in coverage and financial access has been highlighted by many authors, insufficient attention has been paid to critical and context-specific factors. This paper seeks to fill that gap. Methods: Based on an empirical qualitative case study of stakeholders’ views on challenges and success factors in four mutual schemes (district offices) located in two regions of Ghana, the study uses the concept of policy translation to assess whether the Ghana scheme could provide useful lessons to other African and developing countries in their quest to implement social/NHISs. Results: In the study, interviewees referred to both ‘hard and soft’ elements as driving the "success" of the Ghana scheme. The main ‘hard elements’ include bureaucratic and legal enforcement capacities; IT; financing; governance, administration and management; regulating membership of the scheme; and service provision and coverage capabilities. The ‘soft’ elements identified relate to: the background/context of the health insurance scheme; innovative ways of funding the NHIS, the hybrid nature of the Ghana scheme; political will, commitment by government, stakeholders and public cooperation; social structure of Ghana (solidarity); and ownership and participation. Conclusion: Other developing countries can expect to translate rather than re-assemble a national health insurance programme in an incomplete and highly modified form over a period of years

Roadblocks Hampering the Professional Development of Geoscientists in AFRICA.- a Case Study from the Ghanaian Perspective

NASA Astrophysics Data System (ADS)

Kabore, A.

2010-12-01

Ghana, like many African countries is in a strategic position to promote the development of early-career geoscientist because of the huge potential in terms of geological resources, huge number of interested students, and a number of institutions for training geoscientists. Ghana is often described as the gateway to Africa. As a result, situations that hamper the development of early career geoscientists in Ghana are likely to be replicated in many African countries. Over the last few decades, several institutions have been created to develop the technical-geoscientific expertise, and to deal with the disparity that exists between the amount of work that needs to be done in the geosciences and the small number of geoscientists working in the profession. There are more than four universities in Ghana that offer the study of geosciences. Available statistics indicate that the number of students enrolled in these institutions has seen a distinct increase over the last few decades. However, a significant percentage of the graduates from these institutions do not work in their core profession or even in closely-aligned disciplines. Unfortunately, the problem of a small national geosciences workforce is more pronounced today than it was over the last few decades. This problem is not a result of the lack of trained geoscientists, but rather a combination of several factors which may be socio-economic, cultural, passion, lack of mentorship etc. This presentation will focus on the broad challenges and institutional difficulties that geosciences graduates and early career professional face in Ghana and in Africa. Several recommendations will be proposed to address these problems and foster the establishment of professional development resources to boost the flow of geosciences graduates into the profession. These proposed resources will enable graduates to develop not only the skills and experience needed in the profession, but also the passion to become future leaders

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

Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana.

PubMed

Awuah, Raphael Baffour; Asante, Paapa Yaw; Sakyi, Lionel; Biney, Adriana A E; Kushitor, Mawuli Komla; Agyei, Francis; de-Graft Aikins, Ama

2018-04-16

In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria

Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol.

PubMed

Watkins, David A; Tulloch, Nathaniel L; Anderson, Molly E; Barnhart, Scott; Steyn, Krisela; Levitt, Naomi S

2016-04-16

People living with HIV (PLHIV) in African countries are living longer due to the rollout of antiretroviral drug therapy programs, but they are at increasing risk of non-communicable diseases (NCDs). However, there remain many gaps in detecting and treating NCDs in African health systems, and little is known about how NCDs are being managed among PLHIV. Developing integrated chronic care models that effectively prevent and treat NCDs among PLHIV requires an understanding of the current patterns of care delivery and the major barriers and facilitators to health care. We present a systematic review protocol to synthesize studies of healthcare delivery for an important subset of NCDs, cardiovascular and metabolic diseases (CMDs), among African PLHIV. We plan to search electronic databases and reference lists of relevant studies published in African settings from January 2003 to the present. Studies will be considered if they address one or both of our major objectives and focus on health care for one or more of six interrelated CMDs (ischemic heart disease, stroke, heart failure, hypertension, diabetes, and hyperlipidemia) in PLHIV. Our first objective will be to estimate proportions of CMD patients along the "cascade of care"-i.e., screened, diagnosed, aware of the diagnosis, initiated on treatment, adherent to treatment, and with controlled disease. Our second objective will be to identify unique barriers and facilitators to health care faced by PLHIV in African countries. For studies deemed eligible for inclusion, we will assess study quality and risk of bias using previously published criteria. We will extract study data using standardized instruments. We will meta-analyze quantitative data at each level of the cascade of care for each CMD (first objective). We will use meta-synthesis techniques to understand and integrate qualitative data on health-related behaviors (second objective). CMDs and other NCDs are becoming major health concerns for African PLHIV. The

The Correlation Between Poverty and Access to Essential Surgical Care in Ghana: A Geospatial Analysis

PubMed Central

Stewart, Barclay T.; Gyedu, Adam; Boakye, Godfred; Lewis, Daniel; Hoogerboord, Marius; Mock, Charles

2017-01-01

Background Surgical disease burden falls disproportionately on individuals in low- and middle-income countries. These populations are also the least likely to have access to surgical care. Understanding the barriers to access in these populations is therefore necessary to meet the global surgical need. Methods Using geospatial methods, this study explores the district-level variation of two access barriers in Ghana: poverty and spatial access to care. National survey data were used to estimate the average total household expenditure (THE) in each district. Estimates of the spatial access to essential surgical care were generated from a cost-distance model based on a recent surgical capacity assessment. Correlations were analyzed using regression and displayed cartographically. Results Both THE and spatial access to surgical care were found to have statistically significant regional variation in Ghana (p < 0.001). An inverse relationship was identified between THE and spatial access to essential surgical care (β −5.15 USD, p < 0.001). Poverty and poor spatial access to surgical care were found to co-localize in the northwest of the country. Conclusions Multiple barriers to accessing surgical care can coexist within populations. A careful understanding of all access barriers is necessary to identify and target strategies to address unmet surgical need within a given population. PMID:27766400

African leaders' views on critical human resource issues for the implementation of family medicine in Africa.

PubMed

Moosa, Shabir; Downing, Raymond; Essuman, Akye; Pentz, Stephen; Reid, Stephen; Mash, Robert

2014-01-17

The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team-based primary health care. Whilst these

Under the Sun or in the Shade? Jua Kali in African Countries. National Policy Definition in Technical and Vocational Education: Beyond the Formal Sector. A Subregional Seminar for Eastern and Southern African Countries (Nairobi, Kenya, September 15-19, 1997). International project on Technical and Vocational Education (UNEVOC).

ERIC Educational Resources Information Center

United Nations Educational, Scientific, and Cultural Organization, Berlin (Germany).

This document is a comprehensive report a subregional seminar for eastern and southern African countries on the Jua Kali movement. (Jua Kali, "hot sun" in Swahili, refers to the informal or nonformal sector of the economy.) Section 1 explains the role of the International Project on Technical and Vocational Education (UNEVOC) in the…

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.

Dog rabies data reported to multinational organizations from Southern and Eastern African countries.

PubMed

Beyene, Tariku Jibat; Mourits, Monique C M; Hogeveen, Henk

2017-06-08

Rabies is one of the viral diseases with the highest case fatality rate in humans. The main transmission route to humans is through bites, especially of infected dogs. Decisions on the allocation of resources to control and reduce the socio-economic impacts of rabies require reliable data. Several national, regional and international organizations have been gathering rabies data for more than a decade. The objective of this paper was to examine the consistencies in the number of dog rabies cases reported to different multinational organizations by Southern and Eastern African countries and to explore the presence of any time trend among the reported rabies data. Data was systematically extracted from the databases of the Southern and Eastern African Rabies Group-SEARG and the World Organization for Animal Health/World animal health information-OIE/WAHID. Despite differences in entities by which data have been reported to the two organisations, reported numbers were significantly correlated (Spearman's rho = 0.52, P < 0.001). The reported data did not indicate the presence of any trend in the number of reported dog rabies outbreaks. Inconsistencies in the reported numbers were observed between the databases, possibly due to the fact that human and animal health authorities report separately to the organisations involved in addition to the use of indefinite definitions of report categories set by report receiving organizations.

The Politico-Economic Challenges of Ghana's National Health Insurance Scheme Implementation.

PubMed

Fusheini, Adam

2016-04-27

National/social health insurance schemes have increasingly been seen in many low- and middle-income countries (LMICs) as a vehicle to universal health coverage (UHC) and a viable alternative funding mechanism for the health sector. Several countries, including Ghana, have thus introduced and implemented mandatory national health insurance schemes (NHIS) as part of reform efforts towards increasing access to health services. Ghana passed mandatory national health insurance (NHI) legislation (ACT 650) in 2003 and commenced nationwide implementation in 2004. Several peer review studies and other research reports have since assessed the performance of the scheme with positive rating while challenges also noted. This paper contributes to the literature on economic and political implementation challenges based on empirical evidence from the perspectives of the different category of actors and institutions involved in the process. Qualitative in-depth interviews were held with 33 different category of participants in four selected district mutual health insurance schemes in Southern (two) and Northern (two) Ghana. This was to ascertain their views regarding the main challenges in the implementation process. The participants were selected through purposeful sampling, stakeholder mapping, and snowballing. Data was analysed using thematic grouping procedure. Participants identified political issues of over politicisation and political interference as main challenges. The main economic issues participants identified included low premiums or contributions; broad exemptions, poor gatekeeper enforcement system; and culture of curative and hospital-centric care. The study establishes that political and economic factors have influenced the implementation process and the degree to which the policy has been implemented as intended. Thus, we conclude that there is a synergy between implementation and politics; and achieving UHC under the NHIS requires political stewardship. Political

Longitudinal estimation of Plasmodium falciparum prevalence in relation to malaria prevention measures in six sub-Saharan African countries.

PubMed

Drakeley, Chris; Abdulla, Salim; Agnandji, Selidji Todagbe; Fernandes, José Francisco; Kremsner, Peter; Lell, Bertrand; Mewono, Ludovic; Bache, Bache Emmanuel; Mihayo, Michael Gabriel; Juma, Omar; Tanner, Marcel; Tahita, Marc Christian; Tinto, Halidou; Diallo, Salou; Lompo, Palpouguini; D'Alessandro, Umberto; Ogutu, Bernhards; Otieno, Lucas; Otieno, Solomon; Otieno, Walter; Oyieko, Janet; Asante, Kwaku Poku; Dery, Dominic Bon-Ereme; Adjei, George; Adeniji, Elisha; Atibilla, Dorcas; Owusu-Agyei, Seth; Greenwood, Brian; Gesase, Samwel; Lusingu, John; Mahende, Coline; Mongi, Robert; Segeja, Method; Adjei, Samuel; Agbenyega, Tsiri; Agyekum, Alex; Ansong, Daniel; Bawa, John Tanko; Boateng, Harry Owusu; Dandalo, Léonard; Escamilla, Veronica; Hoffman, Irving; Maenje, Peter; Martinson, Francis; Carter, Terrell; Leboulleux, Didier; Kaslow, David C; Usuf, Effua; Pirçon, Jean-Yves; Bahmanyar, Edith Roset

2017-10-27

Plasmodium falciparum prevalence (PfPR) is a widely used metric for assessing malaria transmission intensity. This study was carried out concurrently with the RTS,S/AS01 candidate malaria vaccine Phase III trial and estimated PfPR over ≤ 4 standardized cross-sectional surveys. This epidemiology study (NCT01190202) was conducted in 8 sites from 6 countries (Burkina Faso, Gabon, Ghana, Kenya, Malawi, and Tanzania), between March 2011 and December 2013. Participants were enrolled in a 2:1:1 ratio according to age category: 6 months-4 years, 5-19 years, and ≥ 20 years, respectively, per year and per centre. All sites carried out surveys 1-3 while survey 4 was conducted only in 3 sites. Surveys were usually performed during the peak malaria parasite transmission season, in one home visit, when medical history and malaria risk factors/prevention measures were collected, and a blood sample taken for rapid diagnostic test, microscopy, and haemoglobin measurement. PfPR was estimated by site and age category. Overall, 6401 (survey 1), 6411 (survey 2), 6400 (survey 3), and 2399 (survey 4) individuals were included in the analyses. In the 6 months-4 years age group, the lowest prevalence (assessed using microscopy) was observed in 2 Tanzanian centres (4.6% for Korogwe and 9.95% for Bagamoyo) and Lambaréné, Gabon (6.0%), while the highest PfPR was recorded for Nanoro, Burkina Faso (52.5%). PfPR significantly decreased over the 3 years in Agogo (Ghana), Kombewa (Kenya), Lilongwe (Malawi), and Bagamoyo (Tanzania), and a trend for increased PfPR was observed over the 4 surveys for Kintampo, Ghana. Over the 4 surveys, for all sites, PfPR was predominantly higher in the 5-19 years group than in the other age categories. Occurrence of fever and anaemia was associated with high P. falciparum parasitaemia. Univariate analyses showed a significant association of anti-malarial treatment in 4 surveys (odds ratios [ORs]: 0.52, 0.52, 0.68, 0.41) and bed net use in 2

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

Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya

PubMed Central

Sieverding, Maia; Onyango, Cynthia

2018-01-01

Background Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers’ perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa—the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. Methods In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers’ reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Results Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers’ participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. Conclusions In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force

Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya.

PubMed

Sieverding, Maia; Onyango, Cynthia; Suchman, Lauren

2018-01-01

Incorporating private healthcare providers into social health insurance schemes is an important means towards achieving universal health coverage in low and middle income countries. However, little research has been conducted about why private providers choose to participate in social health insurance systems in such contexts, or their experiences with these systems. We explored private providers' perceptions of and experiences with participation in two different social health insurance schemes in Sub-Saharan Africa-the National Health Insurance Scheme (NHIS) in Ghana and the National Hospital Insurance Fund (NHIF) in Kenya. In-depth interviews were held with providers working at 79 facilities of varying sizes in three regions of Kenya (N = 52) and three regions of Ghana (N = 27). Most providers were members of a social franchise network. Interviews covered providers' reasons for (non) enrollment in the health insurance system, their experiences with the accreditation process, and benefits and challenges with the system. Interviews were coded in Atlas.ti using an open coding approach and analyzed thematically. Most providers in Ghana were NHIS-accredited and perceived accreditation to be essential to their businesses, despite challenges they encountered due to long delays in claims reimbursement. In Kenya, fewer than half of providers were NHIF-accredited and several said that their clientele were not NHIF enrolled. Understanding of how the NHIF functioned was generally low. The lengthy and cumbersome accreditation process also emerged as a major barrier to providers' participation in the NHIF in Kenya, but the NHIS accreditation process was not a major concern for providers in Ghana. In expanding social health insurance, coordinated efforts are needed to increase coverage rates among underserved populations while also accrediting the private providers who serve those populations. Market pressure was a key force driving providers to gain and maintain accreditation

Evaluation of a learner-designed course for teaching health research skills in Ghana

PubMed Central

Bates, Imelda; Ansong, Daniel; Bedu-Addo, George; Agbenyega, Tsiri; Akoto, Alex Yaw Osei; Nsiah-Asare, Anthony; Karikari, Patrick

2007-01-01

Background In developing countries the ability to conduct locally-relevant health research and high quality education are key tools in the fight against poverty. The objective of our study was to evaluate the effectiveness of a novel UK accredited, learner-designed research skills course delivered in a teaching hospital in Ghana. Methods Study participants were 15 mixed speciality health professionals from Komfo Anokye Teaching Hospital, Kumasi, Ghana. Effectiveness measures included process, content and outcome indicators to evaluate changes in learners' confidence and competence in research, and assessment of the impact of the course on changing research-related thinking and behaviour. Results were verified using two independent methods. Results 14/15 learners gained research competence assessed against UK Quality Assurance Agency criteria. After the course there was a 36% increase in the groups' positive responses to statements concerning confidence in research-related attitudes, intentions and actions. The greatest improvement (45% increase) was in learners' actions, which focused on strengthening institutional research capacity. 79% of paired before/after responses indicated positive changes in individual learners' research-related attitudes (n = 53), 81% in intention (n = 52) and 85% in action (n = 52). The course had increased learners' confidence to start and manage research, and enhanced life-long skills such as reflective practice and self-confidence. Doing their own research within the work environment, reflecting on personal research experiences and utilising peer support and pooled knowledge were critical elements that promoted learning. Conclusion Learners in Ghana were able to design and undertake a novel course that developed individual and institutional research capacity and met international standards. Learning by doing and a supportive peer community at work were critical elements in promoting learning in this environment where tutors were scarce

Study of the influencing factors of the blood levels of toxic elements in Africans from 16 countries.

PubMed

Henríquez-Hernández, Luis Alberto; Luzardo, Octavio P; Boada, Luis D; Carranza, Cristina; Pérez Arellano, José Luis; González-Antuña, Ana; Almeida-González, Maira; Barry-Rodríguez, Carlos; Zumbado, Manuel; Camacho, María

2017-11-01

Africa's economy is growing faster than any other continent and it has been estimated that the middle class in Africa now exceeds 350 million people. This has meant a parallel increase in the importation of consumer goods and in the implementation of communication and information technologies (ICT), but also in the generation of large quantities of e-waste. However, inadequate infrastructure development remains a major constraint to the continent's economic growth and these highly toxic residues are not always adequately managed. Few studies have been conducted to date assessing the possible association between socioeconomic development factors, including e-waste generation, and blood levels of inorganic elements in African population. To disclose the role of geographical, anthropogenic, and socioeconomic development determinants on the blood levels of Ag, Al, As, Be, Cd, Co, Cr, Hg, Ni, Pb, Sb, and V -all of them frequently found in e-waste-, an immigrant population-based study was made including a total of 245 subjects from 16 countries recently arrived to the Canary Islands (Spain). Women presented higher levels of blood elements than men, and Northern Africans (Moroccans) were the most contaminated. People from low-income countries exhibited significantly lower blood levels of inorganic elements than those from middle-income countries. We found a significant association between the use of motor vehicles and the implementation of information and communication technologies (ICT) and the level of contamination. Immigrants from the countries with a high volume of imports of second-hand electronic equipment, telephone and internet use had higher levels of inorganic elements. In general terms, the higher level of economic development the higher the blood levels of inorganic pollutants, suggesting that the economic development of Africa, in parallel to e-waste generation and the existence of informal recycling sites, have directly affected the level of contamination

Alcohol consumption in relation to maternal deaths from induced-abortions in Ghana

PubMed Central

2012-01-01

Introduction The fight against maternal deaths has gained attention as the target date for Millennium Development Goal 5 approaches. Induced-abortion is one of the leading causes of maternal deaths in developing countries which hamper this effort. In Ghana, alcohol consumption and unwanted pregnancies are on the ascendancy. We examined the association between alcohol consumption and maternal mortality from induced-abortion. We further analyzed the factors that lie behind the alcohol consumption patterns in the study population. Method The data we used was extracted from the Ghana Maternal Health Survey 2007. This was a national survey conducted across the 10 administrative regions of Ghana. The survey identified 4203 female deaths through verbal autopsy, among which 605 were maternal deaths in the 12 to 49 year-old age group. Analysis was done using Statistical software IBM SPSS Statistics 20. A case control study design was used. Cross-tabulations and logistic regression models were used to investigate associations between the different variables. Results Alcohol consumption was significantly associated with abortion-related maternal deaths. Women who had ever consumed alcohol (OR adjusted 2.6, 95% CI 1.38–4.87), frequent consumers (OR adjusted 2.6, 95% CI 0.89–7.40) and occasional consumers (OR adjusted 2.7, 95% CI 1.29–5.46) were about three times as likely to die from abortion-related causes compared to those who abstained from alcohol. Maternal age, marital status and educational level were found to have a confounding effect on the observed association. Conclusion Policy actions directed toward reducing abortion-related deaths should consider alcohol consumption, especially among younger women. Policy makers in Ghana should consider increasing the legal age for alcohol consumption. We suggest that information on the health risks posed by alcohol and abortion be disseminated to communities in the informal sector where vulnerable groups can best be

Wastage in the health workforce: some perspectives from African countries.

PubMed

Dovlo, Delanyo

2005-08-10

Sub-Saharan Africa faces a human resources crisis in the health sector. Over the past two decades its population has increased substantially, with a significant rise in the disease burden due to HIV/AIDS and recurrent communicable diseases and an increased incidence of noncommunicable diseases. This increased demand for health services is met with a rather low supply of health workers, but this notwithstanding, sub-Saharan African countries also experience significant wastage of their human resources stock. This paper is a desk review to illustrate suggestions that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers. The paper suggests data types for use in measuring various forms of "wastage". "Direct" wastage--or avoidable increases in loss of staff through factors such as emigration and death--is on the rise, perhaps as a result of the HIV/AIDS epidemic. "Indirect" wastage--which is the result of losses in output and productivity from health professionals' misapplied skills, absenteeism, poor support and lack of supervision--is also common. HIV/AIDS represents a special cause of wastage in Africa. Deaths of health workers, fear of infection, burnout, absenteeism, heavy workloads and stress affect productivity. The paper reviews strategies that have been proposed and/or implemented. It suggests areas needing further attention, including: developing and using indicators for monitoring and managing wastage; enhancing motivation and morale of health workers; protecting and valuing the health worker with enhanced occupational safety and welfare systems; and establishing the moral leadership to effectively tackle HIV/AIDS and the brain drain.

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.

Injuries among Artisanal and Small-Scale Gold Miners in Ghana

PubMed Central

Kyeremateng-Amoah, E.; Clarke, Edith E.

2015-01-01

Artisanal and small-scale gold miners are confronted with numerous hazards often resulting in varying degrees of injuries and fatalities. In Ghana, like many developing countries, there is paucity of information on the causes and nature of the accidents that result in the injuries. The study was a retrospective, cross sectional type that examined the records of injuries of artisanal and small-scale gold miners presented to the emergency department of a district hospital in the Eastern Region of Ghana from 2006 to 2013. The causes, types, and outcomes of reported injuries were analyzed for 72 cases. Occurrences of mining accidents reported in selected Ghanaian media during the year 2007–2012 were also analyzed to corroborate the causes of the accidents. Fractures and contusions constituted the most frequently occurring injuries, with collapse of the mine pits and falls being the most frequent cause of accidents reported both by the hospital and media records. This study shows that though varied degrees of injuries occur among the miners, the potential for serious injuries is substantial. Measures to reduce the incidence of injuries and fatalities should include education and training on the use of safe working tools and means of creating a safe working environment. PMID:26404345

Oncology pharmacy units: a safety policy for handling hazardous drugs and related waste in low- and middle-income African countries-Angolan experience.

PubMed

da Conceição, Ana Vaz; Bernardo, Dora; Lopes, Lygia Vieira; Miguel, Fernando; Bessa, Fernanda; Monteiro, Fernando; Santos, Cristina; Oliveira, Blasques; Santos, Lúcio Lara

2015-01-01

In African countries, higher rates of late-stage cancers at the time of first diagnosis are a reality. In this context, hazardous drugs (HDs), such as chemotherapy, play an important role and have immense benefits for patients' treatment. HDs should be handled under specific conditions. At least a class 5 environment primary engineering control (PEC), physically located in an appropriate buffer area, is mandatory for sterile HDs compounding, as well as administrative control, personal protective equipment, work practices and other engineering and environmental controls, in order to protect the environment, patient, and worker. The aim of this study is to describe the Angolan experience regarding the development of oncology pharmacy units and discuss international evidence-based guidelines on handling HDs and related waste. Measures to incorporate modern and economical solutions to upgrade or build adequate and safe facilities and staff training, in order to comply with international guidelines in this area, are crucial tasks for African countries of low and middle income.

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.

The contribution of community leadership upon the performance of mutual health organisations in Ghana.

PubMed

Adomah-Afari, Augustine

2015-01-01

The purpose of this paper is to investigate the effect of social dynamics on the performance of mutual health organisations (MHOs) exploring the influence of community wealth and community leadership on policy implementation. Four operating district mutual health insurance schemes were selected using geographical locations, among other criteria, as case studies. Data were gathered through interviews and documentary review. The findings were analysed using community field and social capital theories. Traditional leaders like the Chiefs serve as the pivot around which social and human capital of the communities revolve in the developmental process of the country. Lack of exhaustive examination of the financial and institutional viability issues of the MHOs. Future studies could assess the interplay between financial, institutional and social viability models when measuring the financial and overall sustainability of MHOs. Health policy makers need to involve traditional leaders in the formulation and implementation of national policies since their acceptance or rejection of central government policy could have negative consequences. Ghana is a dynamic country and there is the need to utilise existing social networks: inter-family and inter-tribal relationships to ensure the viability of MHOs. There is and can be a successful interplay between public sector funding and community sector revenue mobilisation for financing the health sector in Ghana. This justifies the complementarity between government funding and community's resource mobilisation efforts in the health sector.

Child marriage and associated outcomes in northern Ghana: a cross-sectional study.

PubMed

de Groot, Richard; Kuunyem, Maxwell Yiryele; Palermo, Tia

2018-02-26

Child marriage is a human rights violation disproportionately affecting girls in lower- and middle-income countries and has serious public health implications. In Ghana, one in five girls marry before their 18th birthday and one in 20 girls is married before her 15th birthday. This paper uses a unique dataset from Northern Ghana to examine the association between child marriage and adverse outcomes for women among a uniquely vulnerable population. Baseline data from on ongoing impact evaluation of a government-run cash transfer programme was used. The sample consisted of 1349 ever-married women aged 20-29 years from 2497 households in the Northern and Upper East regions of Ghana. We estimated a series of ordinary least squares (OLS) and logistic regression models to examine associations of child marriage with health, fertility, contraception, child mortality, social support, stress and agency outcomes among women, controlling for individual characteristics and household-level factors. Child marriage in this sample was associated with increased odds of poorer health, as measured by difficulties in daily activities (OR = 2.08; CI 1.28-3.38 among women 20-24 years and OR = 1.58; CI 1.19-2.12 among women 20-29 years), increased odds of child mortality among first-born children (OR = 2.03; CI 1.09-3.77 among women 20-24 years) and lower odds of believing that one's life is determined by their own actions (OR = 0.42; CI 0.25-0.72 among women 20-24 years and OR = 0.54; CI 0.39-0.75 among women 20-29 years). Conversely, child marriage was associated with lower levels of reported stress (regression coefficient = - 1.18; CI -1.84--0.51 among women 20-29 years). Child marriage is common in Northern Ghana and is associated with poor health, increased child mortality, and low agency among women in this sample of extremely poor households. While not much is known about effective measures to combat child marriage in the context of Ghana

Overview, methods and results of multi-country community-based maternal and newborn care economic analysis.

PubMed

Daviaud, Emmanuelle; Owen, Helen; Pitt, Catherine; Kerber, Kate; Bianchi Jassir, Fiorella; Barger, Diana; Manzi, Fatuma; Ekipara-Kiracho, Elizabeth; Greco, Giulia; Waiswa, Peter; Lawn, Joy E

2017-10-01

Home visits for pregnancy and postnatal care were endorsed by the WHO and partners as a complementary strategy to facility-based care to reduce newborn and maternal mortality. This article aims to synthesise findings and implications from the economic analyses of community-based maternal and newborn care (CBMNC) evaluations in seven countries. The evaluations included five cluster randomized trials (Ethiopia, Ghana, South Africa, Tanzania, Uganda) and programmatic before/after assessments (Bolivia, Malawi). The economic analyses were undertaken using a standardized, comparable methodology the 'Cost of Integrated Newborn Care' Tool, developed by the South African Medical Research Council, with Saving Newborn Lives and a network of African economists. The main driver of costs is the number of community health workers (CHWs), determined by their time availability, as fixed costs per CHW (equipment, training, salary/stipend, supervision and management), independent from the level of activity (number of mothers visited) represented over 96% of economic and financial costs in five of the countries. Unpaid volunteers are not necessarily a cheap option. An integrated programme with multi-purpose paid workers usually has lower costs per visit but requires innovative management, including supervision to ensure that coverage, or quality of care are not compromised since these workers have many other responsibilities apart from maternal and newborn health. If CHWs reach 95% of pregnant women in a standardized 100 000 population, the additional financial cost in all cases would be under USD1 per capita. In five of the six countries, the programme would be highly cost-effective (cost per DALY averted < GDP/capita) by WHO threshold even if they only achieved a reduction of 1 neonatal death per 1000 live births. These results contribute useful information for implementation planning and sustainability of CBMNC programmes. © The Author 2017. Published by Oxford University

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.

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

Quantitative targets in DND and ICPD-PA: the prospects for West Africa.

PubMed

1999-01-01

This article presents an overview of the population estimates and projections of the UN for total fertility rates (TFRs), contraceptive prevalence rates, infant mortality rates (IMRs), and life expectancy at birth (LEAB) in West Africa. Countries with a good potential to reach a TFR of 4 children or less within 10-15 years are Cote d'Ivoire, Ghana, Nigeria, and perhaps Gambia and Guinea, while the TFRs of countries such as Niger and Mali will remain above 5 in the coming decade. Low contraceptive prevalence is one of the reasons behind the slow progress in attaining low fertility levels in the subregion. When basing the data on this indicator, it appears that only Ghana and Cape Verde will attain the target of 20% by the year 2000 and 40% by the year 2010. Moreover, IMRs will continue to decline, but none of the West African countries will reach the quantitative objectives set in the Dakar/Ngor Declaration (DND) and in the International Conference on Population and Development Programme of Action (ICPD-PA). Similarly, considerable improvements will be seen in the LEAB during the next decade, but, with the exception of Cape Verde and Ghana, none of the other countries are expected to come close to the goals set in the DND and ICPD-PA.

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.

The experience of Ghana in implementing a user fee exemption policy to provide free delivery care.

PubMed

Witter, Sophie; Arhinful, Daniel Kojo; Kusi, Anthony; Zakariah-Akoto, Sawudatu

2007-11-01

In resource-poor countries, the high cost of user fees for deliveries limits access to skilled attendance, and contributes to maternal and neonatal mortality and the impoverishment of vulnerable households. A growing number of countries are experimenting with different approaches to tackling financial barriers to maternal health care. This paper describes an innovative scheme introduced in Ghana in 2003 to exempt all pregnant women from payments for delivery, in which public, mission and private providers could claim back lost user fee revenues, according to an agreed tariff. The paper presents part of the findings of an evaluation of the policy based on interviews with 65 key informants in the health system at national, regional, district and facility level, including policymakers, managers and providers. The exemption mechanism was well accepted and appropriate, but there were important problems with disbursing and sustaining the funding, and with budgeting and management. Staff workloads increased as more women attended, and levels of compensation for services and staff were important to the scheme's acceptance. At the end of 2005, a national health insurance scheme, intended to include full maternal health care cover, was starting up in Ghana, and it was not yet clear how the exemptions scheme would fit into it.

Prevalence of Loss of All Teeth (Edentulism) and Associated Factors in Older Adults in China, Ghana, India, Mexico, Russia and South Africa †

PubMed Central

Peltzer, Karl; Hewlett, Sandra; Yawson, Alfred E.; Moynihan, Paula; Preet, Raman; Wu, Fan; Guo, Godfrey; Arokiasamy, Perianayagam; Snodgrass, James J.; Chatterji, Somnath; Engelstad, Mark E.; Kowal, Paul

2014-01-01

Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention. PMID:25361046

Secondhand tobacco smoke exposure in selected public places (PM2.5 and air nicotine) and non-smoking employees (hair nicotine) in Ghana.

PubMed

Agbenyikey, Wilfred; Wellington, Edith; Gyapong, John; Travers, Mark J; Breysse, Patrick N; McCarty, Kathleen M; Navas-Acien, Ana

2011-03-01

Secondhand tobacco smoke (SHS) exposure is a global public health problem. Ghana currently has no legislation to prevent smoking in public places. To provide data on SHS levels in hospitality venues in Ghana the authors measured (1) airborne particulate matter <2.5 μm (PM(2.5)) and nicotine concentrations and (2) hair nicotine concentrations in non-smoking employees. Quantifying SHS exposure will provide evidence needed to develop tobacco control legislation. PM(2.5) was measured for 30 min in 75 smoking and 13 non-smoking venues. Air nicotine concentrations were measured for 7 days in 8 smoking and 2 non-smoking venues. Additionally, 63 non-smoking employees provided hair samples for nicotine analysis. Compared to non-smoking venues, smoking venues had markedly elevated PM(2.5) (median 553 [IQR 259-1038] vs 16.0 [14.0-17.0]μg/m(3)) and air nicotine (1.83 [0.91-4.25] vs 0.03 [0.02-0.04]μg/m(3)) concentrations. Hair nicotine concentrations were also higher in non-smoking employees working in smoking venues (median 2.49 [0.46-6.84] ng/mg) compared to those working in non-smoking venues (median 0.16 [0.08-0.79]ng/mg). Hair nicotine concentrations correlated with self-reported hours of SHS exposure (r=0.35), indoor air PM(2.5) concentrations (r=0.47) and air nicotine concentrations (r=0.63). SHS levels were unacceptably high in public places in Ghana where smoking is allowed, despite a relatively low-smoking prevalence in the country. This is one of the first studies to ascertain SHS and hair nicotine in Africa. Levels were comparable to those measured in American, Asian and European countries without or before smoking bans. Implementing a comprehensive smoke-free legislation that protects workers and customers from exposure to secondhand smoke is urgently needed in Ghana.

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

Leisure time physical activity and sedentary behavior and substance use among in-school adolescents in eight African countries.

PubMed

Peltzer, Karl

2010-12-01

Physical inactivity leads to higher morbidity and mortality from chronic non-communicable diseases. In high income countries, studies have measured school population level physical activity and substance use, but comparable data are lacking from most African countries. To study the relationship between self-reported leisure time physical activity frequency and sedentary behavior and alcohol, tobacco, and other drug use behaviors among school children. A cross-sectional survey was conducted with the total sample of 24,593 school children aged 13 to 15 years from nationally representative samples from eight African countries. Univariate and multivariate analyses were conducted to assess the relationship between physical activity frequency, six measures of alcohol, tobacco, and other drug use, socioeconomic status, and mental health variables. In all, only 14.2% of the school children were frequently physically active (5 days and more in a week, at least 60 min/day) during leisure time; this was significantly higher among boys than girls. Ugandan and Kenyan school children were most physically active (17.7% and 16.0%, respectively), and Zambian and Senegalese the least (9.0% and 10.9%, respectively). Frequency of alcohol consumption and higher socioeconomic status were significantly associated with leisure time physical activity, while tobacco, illicit drug use, and mental health variables were not. Leisure time sedentary behavior of five and more hours spent sitting on a usual day were highly associated with all substance use variables. These findings suggest that leisure time physical activity frequency is associated with frequency of alcohol use and not with tobacco and illicit drug use, and leisure time sedentary behavior is highly associated with alcohol, tobacco, and drug use among adolescents.