Household Coverage with Adequately Iodized Salt Varies Greatly between Countries and by Residence Type and Socioeconomic Status within Countries: Results from 10 National Coverage Surveys.

PubMed

Knowles, Jacky M; Garrett, Greg S; Gorstein, Jonathan; Kupka, Roland; Situma, Ruth; Yadav, Kapil; Yusufali, Rizwan; Pandav, Chandrakant; Aaron, Grant J

2017-05-01

Background: Household coverage with iodized salt was assessed in 10 countries that implemented Universal Salt Iodization (USI). Objective: The objective of this paper was to summarize household coverage data for iodized salt, including the relation between coverage and residence type and socioeconomic status (SES). Methods: A review was conducted of results from cross-sectional multistage household cluster surveys with the use of stratified probability proportional to size design in Bangladesh, Ethiopia, Ghana, India, Indonesia, Niger, the Philippines, Senegal, Tanzania, and Uganda. Salt iodine content was assessed with quantitative methods in all cases. The primary indicator of coverage was percentage of households that used adequately iodized salt, with an additional indicator for salt with some added iodine. Indicators of risk were SES and residence type. We used 95% CIs to determine significant differences in coverage. Results: National household coverage of adequately iodized salt varied from 6.2% in Niger to 97.0% in Uganda. For salt with some added iodine, coverage varied from 52.4% in the Philippines to 99.5% in Uganda. Coverage with adequately iodized salt was significantly higher in urban than in rural households in Bangladesh (68.9% compared with 44.3%, respectively), India (86.4% compared with 69.8%, respectively), Indonesia (59.3% compared with 51.4%, respectively), the Philippines (31.5% compared with 20.2%, respectively), Senegal (53.3% compared with 19.0%, respectively), and Tanzania (89.2% compared with 57.6%, respectively). In 7 of 8 countries with data, household coverage of adequately iodized salt was significantly higher in high- than in low-SES households in Bangladesh (58.8% compared with 39.7%, respectively), Ghana (36.2% compared with 21.5%, respectively), India (80.6% compared with 70.5%, respectively), Indonesia (59.9% compared with 45.6%, respectively), the Philippines (39.4% compared with 17.3%, respectively), Senegal (50.7% compared with 27.6%, respectively) and Tanzania (80.9% compared with 51.3%, respectively). Conclusions: Uganda has achieved USI. In other countries, access to iodized salt is inequitable. Quality control and regulatory enforcement of salt iodization remain challenging. Notable progress toward USI has been made in Ethiopia and India. Assessing progress toward USI only through household salt does not account for potentially iodized salt consumed through processed foods.

Moving towards universal health coverage: lessons from 11 country studies.

PubMed

Reich, Michael R; Harris, Joseph; Ikegami, Naoki; Maeda, Akiko; Cashin, Cheryl; Araujo, Edson C; Takemi, Keizo; Evans, Timothy G

2016-02-20

In recent years, many countries have adopted universal health coverage (UHC) as a national aspiration. In response to increasing demand for a systematic assessment of global experiences with UHC, the Government of Japan and the World Bank collaborated on a 2-year multicountry research programme to analyse the processes of moving towards UHC. The programme included 11 countries (Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam), representing diverse geographical, economic, and historical contexts. The study identified common challenges and opportunities and useful insights for how to move towards UHC. The study showed that UHC is a complex process, fraught with challenges, many possible pathways, and various pitfalls--but is also feasible and achievable. Movement towards UHC is a long-term policy engagement that needs both technical knowledge and political know-how. Technical solutions need to be accompanied by pragmatic and innovative strategies that address the national political economy context. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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 have decided to integrate family planning programs with health services; and only 20% of African countries have announced socioeconomic development as an instrument to solve their population problems.

Benchmarks for health expenditures, services and outcomes in Africa during the 1990s.

PubMed Central

Peters, D. H.; Elmendorf, A. E.; Kandola, K.; Chellaraj, G.

2000-01-01

There is limited information on national health expenditures, services, and outcomes in African countries during the 1990s. We intend to make statistical information available for national level comparisons. National level data were collected from numerous international databases, and supplemented by national household surveys and World Bank expenditure reviews. The results were tabulated and analysed in an exploratory fashion to provide benchmarks for groupings of African countries and individual country comparison. There is wide variation in scale and outcome of health care spending between African countries, with poorer countries tending to do worse than wealthier ones. From 1990-96, the median annual per capita government expenditure on health was nearly US$ 6, but averaged US$ 3 in the lowest-income countries, compared to US$ 72 in middle-income countries. Similar trends were found for health services and outcomes. Results from individual countries (particularly Ethiopia, Ghana, Côte d'Ivoire and Gabon) are used to indicate how the data can be used to identify areas of improvement in health system performance. Serious gaps in data, particularly concerning private sector delivery and financing, health service utilization, equity and efficiency measures, hinder more effective health management. Nonetheless, the data are useful for providing benchmarks for performance and for crudely identifying problem areas in health systems for individual countries. PMID:10916913

Childhood diarrhoeal deaths in seven low- and middle-income countries

PubMed Central

Rahman, Ahmed Ehsanur; Moinuddin, Md; Molla, Mitike; Worku, Alemayehu; Hurt, Lisa; Kirkwood, Betty; Mohan, Sanjana Brahmawar; Mazumder, Sarmila; Bhutta, Zulfiqar; Raza, Farrukh; Mrema, Sigilbert; Masanja, Honorati; Kadobera, Daniel; Waiswa, Peter; Bahl, Rajiv; Zangenberg, Mike

2014-01-01

Abstract Objective To investigate the clinical characteristics of children who died from diarrhoea in low- and middle-income countries, such as the duration of diarrhoea, comorbid conditions, care-seeking behaviour and oral rehydration therapy use. Methods The study included verbal autopsy data on children who died from diarrhoea between 2000 and 2012 at seven sites in Bangladesh, Ethiopia, Ghana, India, Pakistan, Uganda and the United Republic of Tanzania, respectively. Data came from demographic surveillance sites, randomized trials and an extended Demographic and Health Survey. The type of diarrhoea was classified as acute watery, acute bloody or persistent and risk factors were identified. Deaths in children aged 1 to 11 months and 1 to 4 years were analysed separately. Findings The proportion of childhood deaths due to diarrhoea varied considerably across the seven sites from less than 3% to 30%. Among children aged 1–4 years, acute watery diarrhoea accounted for 31–69% of diarrhoeal deaths, acute bloody diarrhoea for 12–28%, and persistent diarrhoea for 12–56%. Among infants aged 1–11 months, persistent diarrhoea accounted for over 30% of diarrhoeal deaths in Ethiopia, India, Pakistan, Uganda and the United Republic of Tanzania. At most sites, more than 40% of children who died from persistent diarrhoea were malnourished. Conclusion Persistent diarrhoea remains an important cause of diarrhoeal death in young children in low- and middle-income countries. Research is needed on the public health burden of persistent diarrhoea and current treatment practices to understand why children are still dying from the condition. PMID:25378757

Social Studies in African Education.

ERIC Educational Resources Information Center

Adeyemi, Michael B., Ed.

This collection of essays is organized into two sections: Section 1 deals with general issues in social studies, while Section 2 examines social studies education in Botswana, Ethiopia, Ghana, Kenya, Malawi, Namibia, Nigeria, Tanzania, and Zambia. Essays in Section One are: (1) "The Historical Context of Education in British Colonial…

A review on Sero diversity and antimicrobial resistance patterns of Shigella species in Africa, Asia and South America, 2001-2014.

PubMed

Kahsay, Atsebaha Gebrekidan; Muthupandian, Saravanan

2016-08-30

Shigella, gram negative bacterium, is responsible for Shigellosis/bacillary dysentery. It is a global concern although it predominates in developing countries. These are Shigella dysenteriae, Shigella flexneri, Shigella boydii and Shigella sonnei. Drug resistance by Shigella species is another headache of the world. Therefore; this study aimed to review distribution of Shigella Serogroups and their antimicrobial patterns carried out in Africa, Asia and South America. A literature search was performed to identify published studies between January 2001 and December 2014. Published studies were identified using an initial search of the MEDLINE/Index Medicus Database, PubMed, Project Management Consultant, Google Scholar, Science Direct, BioMed Central and Index Copernicus. Shigella flexneri was isolated predominately from seven studies in four African countries and eight studies in five Asian countries. The countries in which eligible studies carried out were Ethiopia, Kenya, Eritrea and Ghana in Africa and Pakistan, Iran, China, Nepal and India in Asia. S. sonnei was isolated predominately from one study in Africa, four in Asia and two South America. The countries in which eligible studies carried out were Ethiopia from Africa, Thailand, Vietnam and Iran from Asia and Chile and Trinidad from South America. S. dysentery was also reported majorly from one eligible study in Egypt and one in Nepal. S. boydii did not score highest prevalence in any one of the eligible studies. Three studies from Africa, five from Asia and one from South America were reviewed for antimicrobial resistance patterns of Shigella Serogroups. In all the regions, Ampicillin developed highly resistance to almost all the Serogroups of Shigella whereas all the strains were sensitive to Ciprofloxacin. The incidence of Shigella Serogroups in the selected three regions is different. The domination of S. flexneri is observed in Africa and Asia although S. sonnei in South America is dominant. Shigella Serogroups are becoming resistance to the commonly prescribed antimicrobial drugs in developing countries.

Acceptability of locally produced ready-to-use therapeutic foods in Ethiopia, Ghana, Pakistan and India

USDA-ARS?s Scientific Manuscript database

Successful treatment of severe acute malnutrition has been achieved with ready-to-use therapeutic food (RUTF), but only 15% of children with severe acute malnutrition receive RUTF. The objective of this study was to determine whether new formulations of RUTF produced using locally available ingredie...

A comparative analysis of fertility differentials in Ghana and Nigeria.

PubMed

Olatoregun, Oluwaseun; Fagbamigbe, Adeniyi Francis; Akinyemi, Odunayo Joshua; Yusuf, Oyindamola Bidemi; Bamgboye, Elijah Afolabi

2014-09-01

Nigeria and Ghana are the most densely populated countries in the West African sub-region with fertility levels above world average. Our study compared the two countries' fertility levels and their determinants as well as the differentials in the effect of these factors across the two countries. We carried out a retrospective analysis of data from the Nigeria and Ghana Demographic Health Surveys, 2008. The sample of 33,385 and 4,916 women aged 15-49 years obtained in Nigeria and Ghana respectively was stratified into low, medium and high fertility using reported children ever born. Data was summarized using appropriate descriptive statistics. Factors influencing fertility were identified using ordinal logistic regression at 5% significance level. While unemployment significantly lowers fertility in Nigeria, it wasn't significant in Ghana. In both countries, education, age at first marriage, marital status, urban-rural residence, wealth index and use of oral contraception were the main factors influencing high fertility levels.

Biosystematics of Aedes (Neomelaniconion)

DTIC Science & Technology

1989-06-01

Coast , Ghana, Nigeria, Central African Republic, Sudan, Ethiopia, Zaire, Uganda, Kenya, Rwanda, Zambia , Malawi, Mozambique, and South Africa. In...Rift Valley fever virus. A complete understanding of the natural history of this virus is not possible without better knowledge of these mosquitoes...have been isolated from species of Neomelaniconion (20). The virus that causes Rift Valley fever , an important disease of domestic animals and humans

Educational Access in Ghana. Country Policy Brief

ERIC Educational Resources Information Center

Akyeampong, K.; Djangmah, J.; Oduro, A.; Seidu, A.; Hunt, F.

2008-01-01

This Policy Brief describes and explains patterns of access to schools in Ghana. It outlines policy and legislation on access to education and provides an analysis of access, vulnerability and exclusion. It is based on findings from the Country Analytic Report on Access to Basic Education in Ghana (Akyeampong et al, 2007) [ED508809] which can be…

Yaws

MedlinePlus

... in 5 countries (Congo, Ghana, Papua New Guinea, Solomon Islands and Vanuatu) has provided promising results and ... in 5 countries (Congo, Ghana, Papua New Guinea, Solomon Islands and Vanuatu) has provided promising results and ...

In Pursuit of the African PhD: A Critical Survey of Emergent Policy Issues in Select Sub-Saharan African Nations, Ethiopia, Ghana and South Africa

ERIC Educational Resources Information Center

Molla, Tebeje; Cuthbert, Denise

2016-01-01

After decades of decline, African higher education is now arguably in a new era of revival. With the prevalence of knowledge economy discourse, national governments in Africa and their development partners have increasingly aligned higher education with poverty reduction plans and strategies. Research capacity has become a critical development…

Understanding tobacco use and socioeconomic inequalities among men in Ghana, and Lesotho.

PubMed

Dickson, Kwamena Sekyi; Ahinkorah, Bright Opoku

2017-01-01

Tobacco use is one of the leading causes of preventable deaths and has become a significant public health issue. Previous studies have paid less attention to tobacco use and socio-economic equalities among men in developing countries. This study examines the relationship between tobacco use and socio-economic inequalities among men in Ghana and Lesotho. The study made use of data from the 2014 Demographic and Health Survey (DHS) from Ghana, and Lesotho. Binary logistic regression was employed to examine the associations between socio-economic inequality characteristics of respondents and tobacco use. The results showed that the prevalence of tobacco use was high in Lesotho (47.9%) as compared to that of Ghana (6.3%). Tobacco use was generally high across all age groups in Lesotho and in contrast, it was relatively low across all ages in Ghana. A statistically significant association was found between all the socio-economic variables and tobacco use in both countries. The prevalence of tobacco use was smaller in age group 15-24 years compared to the age groups 25-34 years and 35-59 years in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR's in Ghana are respectively 5.3 (95% CI: 3.29-8.59) and 9.7 (95% CI: 6.20-15.06), compared to respectively 1.7 (95% CI: 1.32-2.11) and 1.7 (95% CI: 1.36-2.12). Smoking prevalence was smaller in men with higher level of education compared to men with no education in both Ghana and Lesotho, although the association was weaker in Ghana. The AOR in Ghana is 0.1 (95% CI: (0.02-0.11), compared to 0.2 (95% Cl: (0.17-0.30). The prevalence of tobacco use was smaller among men in urban areas compared to rural areas in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 2.1 (95% CI: 1.67-2.73), compared to 1.6 (95% CI: (1.31-1.95). In both countries, prevalence of tobacco use was higher in men who are traditionalist/spiritualists or who had no religion compared to Christians, although the association was stronger in Ghana. The AOR in Ghana is 6.2 (95% CI: (4.42-4.09) compared to 1.7 (95% CI: (1.21-2.47). The prevalence of tobacco use was low among men with richest wealth status compared to men with poorest wealth status in both Ghana and Lesotho, although the association is weaker in Ghana. The AOR in Ghana is 0.1 (95% Cl: (0.06-0.17) compared to 0.4 (95% CI: (0.51-1.12). In relation to occupation, prevalence of tobacco use was smaller among professional workers compared to men in the Agricultural sector in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 9.3 (95% Cl: (4.54-18.99), compared to 3.5 (95% CI: (2.27-5.52). Formerly married men in both countries were more likely to use tobacco compared to currently not married men, although the prevalence was higher in Ghana. The AOR in Ghana is 1.6 (95% CI: (0.99-2.28)], compared to 1.4 (95% CI: (0.89-2.28) in Lesotho. Although similar socio-economic inequality factors provided an understanding of tobacco use among men in Ghana and Lesotho, there were variations in relation to how each factor influences tobacco use.

Population dynamics of rural Ethiopia.

PubMed

Bariabagar, H

1978-01-01

2 rounds of the national sample surveys, conducted by the central statistical office of Ethiopia during 1964-1967 and 1969-1971, provide the only comprehensive demographic data for the country and are the basis for this discussion of rural Ethiopia's population dynamics. The population of Ethiopia is predominantly rural. Agglomerations of 2000 and over inhabitants constitute about 14% of the population, and this indicates that Ethiopia has a low level of urbanization. In rural Ethiopia, international migration was negligent in the 1970's and the age structure can be assumed to be the results of past trends of fertility and mortality conditions. The reported crude birthrate (38.2), crude death rate (12.3) and infant mortality rate (90) of rural Ethiopia fall short of the averages for African countries. Prospects of population growth of rural Ethiopia would be immense. At the rate of natural increase of between 2.4 and 3.0% per annum, the population would double in 24-29 years. Regarding population issues, the programs of the National Democratic Revolution of Ethiopia faces the following main challenging problems: 1) carrying out national population censuses in order to obtain basic information for socialist planning; 2) minimizing or curtailing the existing high urban growth rates; 3) reducing rapidly growing population; and 5) mobilizing Ethiopian women to participate in the social, economic and political life of the country in order to create favorable conditions for future fertility reduction.

Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis.

PubMed

Odeyemi, Isaac A O; Nixon, John

2013-01-22

Nigeria and Ghana have recently introduced a National Health Insurance Scheme (NHIS) with the aim of moving towards universal health care using more equitable financing mechanisms. This study compares health and economic indicators, describes the structure of each country's NHIS within the wider healthcare system, and analyses impacts on equity in financing and access to health care. The World Bank and other sources were used to provide comparative health and economic data. Pubmed, Embase and EconLit were searched to locate studies providing descriptions of each NHIS and empirical evidence regarding equity in financing and access to health care. A diagrammatical representation of revenue-raising, pooling, purchasing and provision was produced in order to analyse the two countries' systems. Over the period 2000-2010, Ghana maintained a marked advantage in life expectancy, infant mortality, under-5 year mortality, and has a lower burden of major diseases. Health care expenditure is about 5% of GDP in both countries but public expenditure in 2010 was 38% of total expenditure in Nigeria and 60% in Ghana. Financing and access are less equitable in Nigeria as, inter alia, private out-of-pocket expenditure has fallen from 80% to 66% of total spending in Ghana since the introduction of its NHIS but has remained at over 90% in Nigeria; NHIS membership in Nigeria and Ghana is approximately 3.5% and 65%, respectively; Nigeria offers a variable benefits package depending on membership category while Ghana has uniform benefits across all beneficiaries. Both countries exhibit improvements in equity but there is a pro-rich and pro-urban bias in membership. Major health indicators are more favourable in Ghana and overall equity in financing and access are weaker in Nigeria. Nigeria is taking steps to expand NHIS membership and has potential to expand its public spending to achieve greater equity. However, heavy burdens of poverty, disease and remote settings make this a substantial challenge. Ghana's relative success has to be tempered by the high number of exemptions through taxation and the threat of moral hazard. The results and methods are anticipated to be informative for policy makers and researchers in both countries and other developing countries more widely.

Key informants’ perspectives on development of family medicine training programs in Ethiopia

PubMed Central

Gossa, Weyinshet; Wondimagegn, Dawit; Mekonnen, Demeke; Eshetu, Wondwossen; Abebe, Zerihun; Fetters, Michael D

2016-01-01

As a very low-income country, Ethiopia faces significant development challenges, though there is great aspiration to dramatically improve health care in the country. Family medicine has recently been recognized through national policy as one potential contributor in addressing Ethiopia’s health care challenges. Family medicine is a new specialty in Ethiopia emerging in the context of family medicine development in Sub-Saharan Africa. The Addis Ababa University family medicine residency program started in 2013 and is the first and the only family medicine program in the country as of March 2016. Stakeholders on the ground feel that family medicine is off to a good start and have great enthusiasm and optimism for its success. While the Ministry of Health has a vision for the development of family medicine and a plan for rapid upscaling of family medicine across the country, significant challenges remain. Continuing discussion about the potential roles of family medicine specialists in Ethiopia and policy-level strategic planning to place family medicine at the core of primary health care delivery in the country is needed. In addition, the health care-tier system needs to be restructured to include the family medicine specialists along with appropriately equipped health care facilities for training and practice. Key stakeholders are optimistic that family medicine expansion can be successful in Ethiopia through a coordinated effort by the Ministry of Health and collaboration between institutions within the country, other Sub-Saharan African countries, and international partners supportive of establishing family medicine in Ethiopia. PMID:27175100

Meningitis Outbreak Caused by Vaccine-Preventable Bacterial Pathogens - Northern Ghana, 2016.

PubMed

Aku, Fortress Y; Lessa, Fernanda C; Asiedu-Bekoe, Franklin; Balagumyetime, Phoebe; Ofosu, Winfred; Farrar, Jennifer; Ouattara, Mahamoudou; Vuong, Jeni T; Issah, Kofi; Opare, Joseph; Ohene, Sally-Ann; Okot, Charles; Kenu, Ernest; Ameme, Donne K; Opare, David; Abdul-Karim, Abass

2017-08-04

Bacterial meningitis is a severe, acute infection of the fluid surrounding the brain and spinal cord that can rapidly lead to death. Even with recommended antibiotic treatment, up to 25% of infected persons in Africa might experience neurologic sequelae (1). Three regions in northern Ghana (Upper East, Northern, and Upper West), located in the sub-Saharan "meningitis belt" that extends from Senegal to Ethiopia, experienced periodic outbreaks of meningitis before introduction of serogroup A meningococcal conjugate vaccine (MenAfriVac) in 2012 (2,3). During December 9, 2015-February 16, 2016, a total of 432 suspected meningitis cases were reported to health authorities in these three regions. The Ghana Ministry of Health, with assistance from CDC and other partners, tested cerebrospinal fluid (CSF) specimens from 286 patients. In the first 4 weeks of the outbreak, a high percentage of cases were caused by Streptococcus pneumoniae; followed by an increase in cases caused by Neisseria meningitidis, predominantly serogroup W. These data facilitated Ghana's request to the International Coordinating Group* for meningococcal polysaccharide ACW vaccine, which was delivered to persons in the most affected districts. Rapid identification of the etiologic agent causing meningitis outbreaks is critical to inform targeted public health and clinical interventions, including vaccination, clinical management, and contact precautions.

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,…

Smoking in Ghana: a review of tobacco industry activity.

PubMed

Owusu-Dabo, E; Lewis, S; McNeill, A; Anderson, S; Gilmore, A; Britton, J

2009-06-01

African countries are a major potential market for the tobacco industry, and the smoking epidemic is at various stages of evolution across the continent. Ghana is an African country with a low prevalence of smoking despite an active tobacco industry presence for over 50 years. This study explores potential reasons for this apparent lack of industry success. To explore the history of tobacco industry activity in Ghana and to identify potential reasons for the current low prevalence of smoking. A search was made of tobacco industry archives and other local sources to obtain data relevant to marketing and consumption of tobacco in Ghana. British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954. After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006. The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions, which may have restricted industry growth, are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date.

Nutrition -- a key issue for Africa. PANFRICO IV notes importance of strengthening nutrition activities to assist FP promotion.

PubMed

1993-12-01

Malnutrition is a major concern in African countries. The incorporation of nutrition education into maternal-child health services has a direct effect on child survival and the promotion of family planning (FP). The 4th Regional Workshop on the integrated Project (PANFRICO IV) was held in Banjul, The Gambia, from September 27 through October 1, 1993, and focused on the role of nutrition in promoting the integrated project on FP, nutrition, and parasite control (IP). PANFRICO was supported by UNFPA and IPPF, and was attended by 50 participants from 15 countries, some of them IP-implementing countries such as Ethiopia, The Gambia, Ghana, Tanzania, and Zambia. Officials of UNFPA, IPPF, and JOICFP also attended the meeting, as well as two representatives of the Japan International Cooperation Agency. IPPF has supported IP since 1974 because of IP's commitment to community participation. This forum allowed participants to discuss how nutrition could be incorporated into the IP for increased acceptance of FP. Recommendations called for a stronger nutritional component in IP without losing sight of FP promotion as the main focus. The participants stressed that the improvement of the nutrition component requires government commitment, policy, analysis of the nutritional situation in planning for action, community participation (of men in particular) in implementation, intersectoral coordination of nutrition and FP strategies, and nutrition education.

Addressing the Global Burden of Chronic Kidney Disease Through Clinical and Translational Research

PubMed Central

Ojo, Akinlolu

2014-01-01

Worldwide, an estimated 200 million people have chronic kidney disease (CKD). In the United States, African Americans (AAs) have a four-fold excess risk of CKD compared to non-Hispanic white people and globally, people in the low-to-middle income countries of Asia and Sub-Saharan Africa have the highest rates of CKD. Annually, more than 500,000 individuals develop end-stage renal disease (or CKD stage 5) in Sub-Saharan Africa alone and the vast majority of these patients suffer premature mortality. The health care costs and economic burden of CKD are huge and not sustainable even in advanced Western countries. A recent discovery on the role of Apolipoprotein 1 (APOL1) G1 and G2 renal risk variants in AAs has a huge potential to unravel the etiology of CKD in both AA and other black populations. Under the National Institutes of Health (NIH)−sponsored Human Heredity and Health in Africa (H3Africa) initiative, a large prospective genetic study of CKD is being conducted in 8000 participants in four African countries (Ethiopia, Ghana, Kenya, and Nigeria; for a total population of 320 million). This and other basic research studies in the United States could potentially shed great insight into the genetics and biologic mechanisms involved in the excess predilection of Africans and AAs to CKD. PMID:25125737

Factors Affecting the Role and Employment of Peacekeeping Forces in Africa South of the Sahara.

DTIC Science & Technology

1982-12-01

reinforcing. Although abstract, the w concept is similar to that used by Emile Durkheim in his discussion of social solidarity. I rhe concept of...I Forces Involved: Support for Congolese air power: Ethiopia provided Emil a jet fighter and possibly pilots; Ghana, seven pilots and two air traffic...problems Durkheim 3 ’ encountered when he attempted to measure social solidarity. His earlier efforts to social solidarity directly through an

Literacy for Development: An African Perspective (Notes from a Sabbatical).

ERIC Educational Resources Information Center

Bhola, H. S.

This report contains one man's impressions of the state of adult literacy education in several countries of Africa and in India. The first country reported on is Ethiopia, where signs of a capitalist society were evident in that officially Marxist country, where literacy education was still a priority in the midst of a waning famine. Ethiopia had…

Legal harvest and illegal trade: Trends, challenges, and options in khat production in Ethiopia.

PubMed

Cochrane, Logan; O'Regan, Davin

2016-04-01

The production of khat in Ethiopia has boomed over the last two decades, making the country the world's leading source. Khat is now one of Ethiopia's largest crops by area of cultivation, the country's second largest export earner, and an essential source of income for millions of Ethiopian farmers. Consumption has also spread from the traditional khat heartlands in the eastern and southern regions of Ethiopia to most major cities. This steady growth in production and use has unfolded under negligible government support or regulation. Meanwhile, khat, which releases a stimulant when chewed, is considered an illicit drug in an increasing number of countries. Drawing on government data on khat production, trade, and seizures as well as research on the political, socioeconomic, and development effects of plant-based illicit narcotics industries, this commentary identifies possible considerations and scenarios for Ethiopia as the country begins to manage rising khat production, domestic consumption, and criminalization abroad. Deeply embedded in social and cultural practices and a major source of government and agricultural revenue, Ethiopian policymakers have few enviable choices. Criminalization abroad raises a small but not insignificant possibility that previously nonexistent linkages between khat and transnational organized crime and trafficking networks will emerge. Likewise, more stringent regulation of khat in Ethiopia could merge with lingering political cleavages and anti-government sentiments, exacerbating low-level domestic conflicts. Copyright © 2016 Elsevier B.V. All rights reserved.

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…

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…

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.

Smoking in Ghana: a review of tobacco industry activity

PubMed Central

Owusu-Dabo, E; Lewis, S; McNeill, A; Anderson, S; Gilmore, A; Britton, J

2009-01-01

Background: African countries are a major potential market for the tobacco industry, and the smoking epidemic is at various stages of evolution across the continent. Ghana is an African country with a low prevalence of smoking despite an active tobacco industry presence for over 50 years. This study explores potential reasons for this apparent lack of industry success. Objective: To explore the history of tobacco industry activity in Ghana and to identify potential reasons for the current low prevalence of smoking. Methods: A search was made of tobacco industry archives and other local sources to obtain data relevant to marketing and consumption of tobacco in Ghana. Findings: British American Tobacco, and latterly the International Tobacco Company and its successor the Meridian Tobacco Company, have been manufacturing cigarettes in Ghana since 1954. After an initial sales boom in the two decades after independence in 1957, the sustained further increases in consumption typical of the tobacco epidemic in most countries did not occur. Possible key reasons include the taking of tobacco companies into state ownership and a lack of foreign exchange to fund tobacco leaf importation in the 1970s, both of which may have inhibited growth at a key stage of development, and the introduction of an advertising ban in 1982. BAT ceased manufacturing cigarettes in Ghana in 2006. Conclusion: The tobacco industry has been active in Ghana for over 50 years but with variable success. The combination of an early advertising ban and periods of unfavourable economic conditions, which may have restricted industry growth, are likely to have contributed to the sustained low levels of tobacco consumption in Ghana to date. PMID:19359263

Situation Report--Dahomey, Ethiopia, Mali, and Mauritius.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in four foreign countries are presented in these situation reports. Countries included are Dahomey, Ethiopia, Mali, and Mauritius. Information is provided under two topics, general background and family planning situation, where appropriate and if it is available. General background covers ethnic…

Ghana Country Analysis Brief

EIA Publications

2016-01-01

Ghana is a small oil and natural gas producer in West Africa. Oil and natural gas production are both expected to increase within the next five years with the start of new offshore projects. Ghana exports its crude oil production to international markets, while the country’s natural gas production is used to fuel its domestic power plants.

Country Immunization Information System Assessments - Kenya, 2015 and Ghana, 2016.

PubMed

Scott, Colleen; Clarke, Kristie E N; Grevendonk, Jan; Dolan, Samantha B; Ahmed, Hussein Osman; Kamau, Peter; Ademba, Peter Aswani; Osadebe, Lynda; Bonsu, George; Opare, Joseph; Diamenu, Stanley; Amenuvegbe, Gregory; Quaye, Pamela; Osei-Sarpong, Fred; Abotsi, Francis; Ankrah, Joseph Dwomor; MacNeil, Adam

2017-11-10

The collection, analysis, and use of data to measure and improve immunization program performance are priorities for the World Health Organization (WHO), global partners, and national immunization programs (NIPs). High quality data are essential for evidence-based decision-making to support successful NIPs. Consistent recording and reporting practices, optimal access to and use of health information systems, and rigorous interpretation and use of data for decision-making are characteristics of high-quality immunization information systems. In 2015 and 2016, immunization information system assessments (IISAs) were conducted in Kenya and Ghana using a new WHO and CDC assessment methodology designed to identify root causes of immunization data quality problems and facilitate development of plans for improvement. Data quality challenges common to both countries included low confidence in facility-level target population data (Kenya = 50%, Ghana = 53%) and poor data concordance between child registers and facility tally sheets (Kenya = 0%, Ghana = 3%). In Kenya, systemic challenges included limited supportive supervision and lack of resources to access electronic reporting systems; in Ghana, challenges included a poorly defined subdistrict administrative level. Data quality improvement plans (DQIPs) based on assessment findings are being implemented in both countries. IISAs can help countries identify and address root causes of poor immunization data to provide a stronger evidence base for future investments in immunization programs.

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…

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…

Healthy firms: constraints to growth among private health sector facilities in Ghana and Kenya.

PubMed

Burger, Nicholas E; Kopf, Daniel; Spreng, Connor P; Yoong, Joanne; Sood, Neeraj

2012-01-01

Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility.

Healthy Firms: Constraints to Growth among Private Health Sector Facilities in Ghana and Kenya

PubMed Central

Burger, Nicholas E.; Kopf, Daniel; Spreng, Connor P.; Yoong, Joanne; Sood, Neeraj

2012-01-01

Background Health outcomes in developing countries continue to lag the developed world, and many countries are not on target to meet the Millennium Development Goals. The private health sector provides much of the care in many developing countries (e.g., approximately 50 percent in Sub-Saharan Africa), but private providers are often poorly integrated into the health system. Efforts to improve health systems performance will need to include the private sector and increase its contributions to national health goals. However, the literature on constraints private health care providers face is limited. Methodology/Principal Findings We analyze data from a survey of private health facilities in Kenya and Ghana to evaluate growth constraints facing private providers. A significant portion of facilities (Ghana: 62 percent; Kenya: 40 percent) report limited access to finance as the most significant barrier they face; only a small minority of facilities report using formal credit institutions to finance day to day operations (Ghana: 6 percent; Kenya: 11 percent). Other important barriers include corruption, crime, limited demand for goods and services, and poor public infrastructure. Most facilities have paper-based rather than electronic systems for patient records (Ghana: 30 percent; Kenya: 22 percent), accounting (Ghana: 45 percent; Kenya: 27 percent), and inventory control (Ghana: 41 percent; Kenya: 24 percent). A majority of clinics in both countries report undertaking activities to improve provider skills and to monitor the level and quality of care they provide. However, only a minority of pharmacies report undertaking such activities. Conclusions/Significance The results suggest that improved access to finance and improving business processes especially among pharmacies would support improved contributions by private health facilities. These strategies might be complementary if providers are more able to take advantage of increased access to finance when they have the business processes in place for operating a successful business and health facility. PMID:22383944

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…

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-being. The study shows that broader characteristics in the population rather than parental migration per se are associated with decreased levels of well-being. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Extension Agents' Awareness of Climate Change in Ethiopia

ERIC Educational Resources Information Center

Abegaz, Dagmawi M.; Wims, Padraig

2015-01-01

Purpose: The fact that highly vulnerable countries like Ethiopia face far greater challenges from climate change makes agricultural adaptation a top priority. Even though the public agriculture extension system in Ethiopia plays a central role in facilitating and supporting adaptation, very limited information is available on how aware the actual…

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

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.

African Regional Seminar for Advanced Training In Systematic Curriculum Development and Evaluation. (Achimota, Ghana, 14 July--15 August 1975). Report.

ERIC Educational Resources Information Center

Swedish International Development Authority (SIDA).

This report summarizes the African Regional Seminar for Advanced Training in Systematic Curriculum Development and Evaluation that was held at Achimota, Ghana, July 14-August 15 1975. Attending the seminar were 67 participants from 12 African countries, including Cameroon, Gambia, Ghana, Kenya, Liberia, Malawi, Nigeria, Sierra Leone, Swaziland,…

Globalization of psychology: Implications for the development of psychology in Ethiopia.

PubMed

Swancott, Rachel; Uppal, Gobinderjit; Crossley, Jon

2014-10-01

The present article reports on the variation of mental health resources across the globe and considers the merits or otherwise of the process of globalization in low- and middle-income countries (LMIC), with a specific emphasis on Ethiopia. Although globalization has gained momentum in recent years, there is a concern that the globalization of Western mental health frameworks is problematic, as these concepts have been developed in a different context and do not accommodate the current diversity in understanding in LMIC countries. The importance of understanding the mental health frameworks of LMIC like Ethiopia, prior to considering if and how aspects of high-income countries (HIC) conceptualizations may be appropriately imported, is therefore reflected upon. Traditional approaches in managing mental health difficulties and possible reasons for the limited engagement with clinical psychology in Ethiopia are considered. Current developments within the fields of mental health and clinical psychology in Ethiopia are discussed, and the need to develop more local research in order to increase understanding and evaluate treatment interventions is recognized. Further consideration and debate by Ethiopian mental health professionals as well as those from HIC are recommended, to promote both reciprocal learning and new local discourses about mental health.

Situation Report--Dominican Republic, Ethiopia, Gilbert and Ellice Islands, Laos, Liberia, Republic of Vietnam, Seychelles, Tahiti (French Polynesia).

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in eight foreign countries are presented in these situation reports. Countries included are Dominical Republic, Ethiopia, Gilbert and Ellice Islands, Laos, Liberia, Republic of Vietnam, Seychelles, and Tahiti (French Polynesia). Information is provided, where appropriate and available, under two…

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.

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.

Bibliometric trends of health economic evaluation in Sub-Saharan Africa.

PubMed

Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J

2016-08-24

Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the available health economic analyses in Africa and internationally.

Characteristics of Travellers from Bosnia and Herzegovina to Africa

PubMed Central

Obradovic, Zarema; Obradovic, Amina

2013-01-01

Conflict of interest: none declared. Introduction Travellers from Bosnia and Herzegovina (B&H) travel to different world countries. The awareness of people is changing every day and nowadays travellers seek advices related to their travel and destination more often than before. In the previous years, travellers came to Travel Clinics almost only to get the vaccines which were obligatory for entry into a country. In B&H travel clinics are a part of public health institutes. The largest Travel Clinic which provides service for the highest number of travellers is in the Public Health Institute of Sarajevo Canton, in the city of Sarajevo, which is the capital of B&H. In the last years we have seen an increasing interest for travel to Africa because the highest number of travellers travel to African countries. Objective To show the characteristics of persons travelling to Africa, the reasons of their travel, the destination countries and the types of vaccines applied. Materials and methods We used protocol books of the Travel Clinic in Public Health Institute of Sarajevo Canton and the data from individual forms of travellers. Results Persons travelling to Africa make 55% of all travellers that are advised and vaccinated in the Travel Clinic in Public Health Institute of Sarajevo Canton. There are significantly more men than women among people travelling to Africa. The highest number of travellers is in the category of working population which means age group of 20-50 years. The most visited countries are Kenya, Ethiopia, Somalia and Ghana. Travellers received the following vaccines: yellow fever, VHA, VHB, meningitis, tetanus. All travellers were given the advice on how to dress, feed and protect against malaria. PMID:24082834

Historical Analysis of the Challenges and Opportunities of Higher Education in Ethiopia

ERIC Educational Resources Information Center

Bishaw, Alemayehu; Melesse, Solomon

2017-01-01

There is a massive higher education expansion in Ethiopia. However, the efforts to expand higher education are characterized by great opportunities and significant challenges. The current higher education policy formulation and practice are the result of long history of traditional education in Ethiopia, the western countries' influence and the…

Medical physics practice and training in Ghana.

PubMed

Amuasi, John H; Kyere, Augustine K; Schandorf, Cyril; Fletcher, John J; Boadu, Mary; Addison, Eric K; Hasford, Francis; Sosu, Edem K; Sackey, Theophilus A; Tagoe, Samuel N A; Inkoom, Stephen; Serfor-Armah, Yaw

2016-06-01

Medical physics has been an indispensable and strategic stakeholder in the delivery of radiological services to the healthcare system of Ghana. The practice has immensely supported radiation oncology and medical imaging facilities over the years, while the locally established training programme continues to produce human resource to feed these facilities. The training programme has grown to receive students from other African countries in addition to local students. Ghana has been recognised by the International Atomic Energy Agency as Regional Designated Centre for Academic Training of Medical Physicists in Africa. The Ghana Society for Medical Physics collaborates with the School of Nuclear and Allied Sciences of the University of Ghana to ensure that training offered to medical physicists meet international standards, making them clinically qualified. The Society has also worked together with other bodies for the passage of the Health Profession's Regulatory Bodies Act, giving legal backing to the practice of medical physics and other allied health professions in Ghana. The country has participated in a number of International Atomic Energy Agency's projects on medical physics and has benefited from its training courses, fellowships and workshops, as well as those of other agencies such as International Organization for Medical Physics. This has placed Ghana's medical physicists in good position to practice competently and improve healthcare. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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.

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…

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

Keese, G.O.

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

Expansion vs. Quality: Emerging Issues of For-Profit Private Higher Education Institutions in Ethiopia

ERIC Educational Resources Information Center

Alemu, Daniel S.

2010-01-01

Private for-profit higher education has been rapidly expanding in developing countries worldwide since the early 1990s. This global trend has been particularly evident in Ethiopia, where only three public universities existed until 1996. By 2005, about 60 private for-profit higher education institutions had been founded in Ethiopia. This has led…

Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis

PubMed Central

2013-01-01

Background Nigeria and Ghana have recently introduced a National Health Insurance Scheme (NHIS) with the aim of moving towards universal health care using more equitable financing mechanisms. This study compares health and economic indicators, describes the structure of each country’s NHIS within the wider healthcare system, and analyses impacts on equity in financing and access to health care. Methods The World Bank and other sources were used to provide comparative health and economic data. Pubmed, Embase and EconLit were searched to locate studies providing descriptions of each NHIS and empirical evidence regarding equity in financing and access to health care. A diagrammatical representation of revenue-raising, pooling, purchasing and provision was produced in order to analyse the two countries’ systems. Results Over the period 2000–2010, Ghana maintained a marked advantage in life expectancy, infant mortality, under-5 year mortality, and has a lower burden of major diseases. Health care expenditure is about 5% of GDP in both countries but public expenditure in 2010 was 38% of total expenditure in Nigeria and 60% in Ghana. Financing and access are less equitable in Nigeria as, inter alia, private out-of-pocket expenditure has fallen from 80% to 66% of total spending in Ghana since the introduction of its NHIS but has remained at over 90% in Nigeria; NHIS membership in Nigeria and Ghana is approximately 3.5% and 65%, respectively; Nigeria offers a variable benefits package depending on membership category while Ghana has uniform benefits across all beneficiaries. Both countries exhibit improvements in equity but there is a pro-rich and pro-urban bias in membership. Conclusions Major health indicators are more favourable in Ghana and overall equity in financing and access are weaker in Nigeria. Nigeria is taking steps to expand NHIS membership and has potential to expand its public spending to achieve greater equity. However, heavy burdens of poverty, disease and remote settings make this a substantial challenge. Ghana’s relative success has to be tempered by the high number of exemptions through taxation and the threat of moral hazard. The results and methods are anticipated to be informative for policy makers and researchers in both countries and other developing countries more widely. PMID:23339606

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.

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…

The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies

PubMed Central

von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F.; Bjerregaard-Andersen, Morten; Clemens, John D.; Crump, John A.; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H.; Cosmas, Leonard; May, Jürgen; Meyer, Christian G.; Mintz, Eric D.; Montgomery, Joel M.; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R.; Wierzba, Thomas F.; Marks, Florian

2016-01-01

Background. New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Methods. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Results. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. Conclusions. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs. PMID:26933028

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

Brown, S.

This document describes the contents of a digital database containing maximum potential aboveground biomass, land use, and estimated biomass and carbon data for 1980. The biomass data and carbon estimates are associated with woody vegetation in Tropical Africa. These data were collected to reduce the uncertainty associated with estimating historical releases of carbon from land use change. Tropical Africa is defined here as encompassing 22.7 x 10{sup 6} km{sup 2} of the earth's land surface and is comprised of countries that are located in tropical Africa (Angola, Botswana, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Benin, Equatorial Guinea,more » Ethiopia, Djibouti, Gabon, Gambia, Ghana, Guinea, Ivory Coast, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Namibia, Niger, Nigeria, Guinea-Bissau, Zimbabwe (Rhodesia), Rwanda, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo, Uganda, Burkina Faso (Upper Volta), Zaire, and Zambia). The database was developed using the GRID module in the ARC/INFO{trademark} geographic information system. Source data were obtained from the Food and Agriculture Organization (FAO), the U.S. National Geophysical Data Center, and a limited number of biomass-carbon density case studies. These data were used to derive the maximum potential and actual (ca. 1980) aboveground biomass values at regional and country levels. The land-use data provided were derived from a vegetation map originally produced for the FAO by the International Institute of Vegetation Mapping, Toulouse, France.« less

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

PubMed

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

2012-12-01

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

The seismicity of Ethiopia; active plate tectonics

USGS Publications Warehouse

Mohr, P.

1981-01-01

Ethiopia, descended from the semimythical Kingdom of Punt, lies at the strategic intersection of Schmidt's jigsaw puzzle where the Red Sea, Gulf of Aden, and the African Rift System meet. Because of geologically recent uplift combined with rapid downcutting erosion by rivers, notably the Blue Nile (Abbay), Ethiopia is the most mountainous country in Africa. It is also the most volcanically active, while its historical seismicity matches that of the midocean ridges. And, in a sense, Ethiopia is host to an evoloving ocean ridge system. 

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…

Cross-Country Variation in the Sociodemographic Factors Associated with Major Depressive Episode in Norway, the United Kingdom, Ghana, and Kenya

PubMed Central

Ambugo, Eliva A.

2014-01-01

Studies based on Western samples generally show that status characteristics like gender or marital status are associated with better mental health for individuals who occupy advantageous positions, such as men or the married. However, these patterns may not hold in developing regions that differ in important ways from the West. Guided by the Stress Process Model (SPM), this study uses logistic regression to examine the effect of gender, education, and other status characteristics on major depressive episode (MDE). Similarities and differences in these associations across two Western and two African countries are also assessed. Nationally representative data for adults ages 18 years and older are from the World Health Surveys (2002-2004) for Norway (N = 943), the United Kingdom (UK: N = 1,195), Ghana (N = 3,922), and Kenya (N = 4,331). Results indicate a mixed pattern of associations between status characteristics and MDE across the four countries. Norwegian men face higher risk of MDE than Norwegian women—an anomalous finding. With some exceptions, education and employment status are not significantly related to MDE across the countries, providing little support for SPM. Marital status differences in risk of MDE are largest for Norway and smallest for Ghana. For the UK, men face lower risk of MDE than women across levels of mastery, and the gender gap in MDE is larger at higher levels of mastery. Overall, there is some heterogeneity in the associations between status characteristics and MDE even in somewhat similar environments like Ghana and Kenya. This study extends the reach of SPM to settings in sub-Saharan Africa, and contributes to the sparse empirical literature on the prevalence and sociodemographic correlates of MDE in the general populations of Ghana and Kenya. PMID:24875047

Cross-country variation in the sociodemographic factors associated with major depressive episode in Norway, the United Kingdom, Ghana, and Kenya.

PubMed

Ambugo, Eliva A

2014-07-01

Studies based on Western samples generally show that status characteristics like gender or marital status are associated with better mental health for individuals who occupy advantageous positions, such as men or the married. However, these patterns may not hold in developing regions that differ in important ways from the West. Guided by the Stress Process Model (SPM), this study uses logistic regression to examine the effect of gender, education, and other status characteristics on major depressive episode (MDE). Similarities and differences in these associations across two Western and two African countries are also assessed. Nationally representative data for adults ages 18 years and older are from the World Health Surveys (2002-2004) for Norway (N = 943), the United Kingdom (UK: N = 1195), Ghana (N = 3922), and Kenya (N = 4331). Results indicate a mixed pattern of associations between status characteristics and MDE across the four countries. Norwegian men face higher risk of MDE than Norwegian women-an anomalous finding. With some exceptions, education and employment status are not significantly related to MDE across the countries, providing little support for SPM. Marital status differences in risk of MDE are largest for Norway and smallest for Ghana. For the UK, men face lower risk of MDE than women across levels of mastery, and the gender gap in MDE is larger at higher levels of mastery. Overall, there is some heterogeneity in the associations between status characteristics and MDE even in somewhat similar environments like Ghana and Kenya. This study extends the reach of SPM to settings in sub-Saharan Africa, and contributes to the sparse empirical literature on the prevalence and sociodemographic correlates of MDE in the general populations of Ghana and Kenya. Copyright © 2014 Elsevier Ltd. All rights reserved.

Oil: Lessons from Comparative Perspectives for Ghana

NASA Astrophysics Data System (ADS)

Osei-Boakye, Maame Frema

Oil as it relates to maintenance of energy consumption is becoming a very important acquired resource all around the world. This thesis focuses on Ghana as a place where recent oil discoveries have taken place, to assess the current policies being put in place to avoid the oil pitfalls of their other African counterparts and to examine oil models that could possibly work to reinforce a positive outcome for the new found oil industry in Ghana. These research aims were met through extensive research of relevant literature. The research resulted in the finding that the Ghanaian government would benefit from a combination of economic models that have been used in the past (spend all, save all and spend interest only). The main conclusion that has resulted from this research is that through strong fiscal policies towards the Ghanaian oil industry Ghana should be able to maintain a relatively stable economy which in turn will produce a stable country all around. This research argues that by creating strong policies and using a combination of the econometric oil models this will help Ghana account for the immediate need for things like infrastructure while also saving money for when/if the oil is no longer being produced in the country.

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 water security should be considered. Agricultural practices that have improved yields and reduced water footprints should be identified and evaluated for their relative contribution to higher water productivity and to guide investments in agricultural extension and technology. Crops should be selected based on their comparative advantage relative to the water footprint and yields as well as their contribution to livelihoods and economic growth. Water resource management and planning needs to meet water demands for economic development while protecting and enhancing ecosystem services. Trade-offs between water resources allocation to grow food crops versus export crops and resulting reliance on internal versus external water resources for food security should be assessed and used to guide decisions. Achievement of the Sustainable Development Goals will require a multi-pronged approach to improving agricultural practices, strengthening farmers' livelihoods, increasing food security and protecting water security. The water footprint as it has been used in this study can support sustainable development by building an understanding of the water consumed and polluted in producing goods and identifying the opportunities for improving water efficiency and land productivity.

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.

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

Achieving Universal General Secondary Education in Ethiopia in Line with the Middle-Income Country Vision: A Reality or a Dream?

ERIC Educational Resources Information Center

Gbre-eyesus, Mulugeta Tsegai

2017-01-01

This article analyses the challenges facing secondary education in the context of Ethiopia's Growth and transformation Plan (GtP) for 2010/11-2014/15 and its stated goal of becoming a middle-income country by 2025. It does not aim to provide a definitive set of recommendations for universalising general secondary education to meet the demands of a…

Causes of Grade Nine Students' Grade Retention in General Secondary Schools of Dabat Woreda in North Gondar, Ethiopia

ERIC Educational Resources Information Center

Eyasu, Nahom

2017-01-01

One of the great problems of Ethiopia for the educational arena is retention. Averagely 8.07% of each year of the secondary education students is repeated due to lack of achievement in this country. The percentage of retention in a country shows what proportion of students is regularly repeated in the same grade and who are, therefore, committing…

Prevalence of Malnutrition and Associated Factors among Children in Rural Ethiopia

PubMed Central

Endris, Neima; Asefa, Henok

2017-01-01

Background Child malnutrition continues to be the leading public health problem in developing countries. In Ethiopia, malnutrition is a leading cause of child illness and death. Recently the composite index of anthropometric failure (CIAF) has been implemented to measure the prevalence of malnutrition. This index presents a more complete picture compared with the previous conventional indices. In this study, CIAF was used to determine the prevalence of malnutrition among children aged 0–59 months in rural Ethiopia. Methods Data was extracted from the 2014 Ethiopian Mini Demographic and Health Survey (EMDHS) for this study. A total of 3095 children were included in the analysis. The composite index of anthropometric failure (CIAF) was used to measure the nutritional status of the children. Logistic regression was fitted, to identify factors associated with malnutrition among children in rural Ethiopia, using STATA 13. Result The prevalence of malnutrition among rural children in Ethiopia was 48.5%. Age of the children, preceding birth interval, educated status of mother, wealth status, and region were factors independently associated with nutritional status of children in rural Ethiopia. Conclusion The prevalence of malnutrition among children in rural Ethiopia was high. A child older than 12 months, having uneducated mother, living in a household with poor wealth status, born with short birth interval, and living in some region of the country are associated with increased odds of being malnourished. PMID:28596966

Prevalence of Malnutrition and Associated Factors among Children in Rural Ethiopia.

PubMed

Endris, Neima; Asefa, Henok; Dube, Lamessa

2017-01-01

Child malnutrition continues to be the leading public health problem in developing countries. In Ethiopia, malnutrition is a leading cause of child illness and death. Recently the composite index of anthropometric failure (CIAF) has been implemented to measure the prevalence of malnutrition. This index presents a more complete picture compared with the previous conventional indices. In this study, CIAF was used to determine the prevalence of malnutrition among children aged 0-59 months in rural Ethiopia. Data was extracted from the 2014 Ethiopian Mini Demographic and Health Survey (EMDHS) for this study. A total of 3095 children were included in the analysis. The composite index of anthropometric failure (CIAF) was used to measure the nutritional status of the children. Logistic regression was fitted, to identify factors associated with malnutrition among children in rural Ethiopia, using STATA 13. The prevalence of malnutrition among rural children in Ethiopia was 48.5%. Age of the children, preceding birth interval, educated status of mother, wealth status, and region were factors independently associated with nutritional status of children in rural Ethiopia. The prevalence of malnutrition among children in rural Ethiopia was high. A child older than 12 months, having uneducated mother, living in a household with poor wealth status, born with short birth interval, and living in some region of the country are associated with increased odds of being malnourished.

Fertility and Life Satisfaction in Rural Ethiopia.

PubMed

Conzo, Pierluigi; Fuochi, Giulia; Mencarini, Letizia

2017-08-01

Despite recent strong interest in the link between fertility and subjective well-being, the focus has centered on developed countries. For poorer countries, in contrast, the relationship remains rather elusive. Using a well-established panel survey-the Ethiopian Rural Household Survey (ERHS)-we investigate the empirical relationship between fertility and life satisfaction in rural Ethiopia, the largest landlocked country in Africa. Consistent with the fertility theories for developing countries and with the sociodemographic characteristics of rural Ethiopia, we hypothesize that this relationship varies by gender and across life stages, being more positive for men and for parents in old age. Indeed, our results suggest that older men benefit the most in terms of life satisfaction from having a large number of children, while the recent birth of a child is detrimental for the subjective well-being of women at reproductive ages. We address endogeneity issues by using lagged life satisfaction in ordinary least squares regressions, through fixed-effects estimation and the use of instrumental variables.

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 quintiles contributed most to inequality in multimorbidity (39.0%). In Ghana, the wealth quintiles contributed 24.5% to inequality in single morbidity and body mass index contributed 16.2% to the inequality in multimorbidity. The country comparison reflects different stages of economic development and social change in China and Ghana. More studies of this type are needed to inform policy-makers about the patterning of socioeconomic inequalities in health, particularly in developing countries undergoing rapid epidemiological and demographic transitions.

Sociodemographic Determinants of Malaria among Under-Five Children in Ghana.

PubMed

Nyarko, Samuel Harrenson; Cobblah, Anastasia

2014-01-01

Background. Malaria is an entrenched global health challenge particularly in the sub-Saharan African countries. However, in Ghana, little is known about the determinants of malaria prevalence among under-five children. As such, this study sought to examine the sociodemographic factors that determine malaria among under-five children in Ghana. Methods. This paper used secondary data drawn from the 2008 Ghana Demographic and Health Survey. Bivariate analysis and complementary log-log regression models were used to examine the determinants of malaria prevalence among under-five children in Ghana for the study period. Results. The results therefore revealed that region of residence, age of child, and ownership of mosquito net were the key predictors of malaria cases among under-five children in Ghana for the five-year period preceding the survey. Conclusion. It is therefore imperative that special education on prevention of malaria should be intensified by the National Malaria Control Programme in all the regions in order to reduce malaria prevalence particularly among under-five children in Ghana.

The Affordable Medicines Facility-malaria (AMFm): are remote areas benefiting from the intervention?

PubMed

Ye, Yazoume; Arnold, Fred; Noor, Abdisalan; Wamukoya, Marilyn; Amuasi, John; Blay, Samuel; Mberu, Blessing; Ren, Ruilin; Kyobutungi, Catherine; Wekesah, Frederick; Gatakaa, Hellen; Toda, Mitsuru; Njogu, Julius; Evance, Illah; O'Connell, Kathryn; Shewchuk, Tanya; Thougher, Sarah; Mann, Andrea; Willey, Barbara; Goodman, Catherine; Hanson, Kara

2015-10-09

To assess the availability, price and market share of quality-assured artemisinin-based combination therapy (QAACT) in remote areas (RAs) compared with non-remote areas (nRAs) in Kenya and Ghana at end-line of the Affordable Medicines Facility-malaria (AMFm) intervention. Areas were classified by remoteness using a composite index computed from estimated travel times to three levels of service centres. The index was used to five categories of remoteness, which were then grouped into two categories of remote and non-remote areas. The number of public or private outlets with the potential to sell or distribute anti-malarial medicines, screened in nRAs and RAs, respectively, was 501 and 194 in Ghana and 9980 and 2353 in Kenya. The analysis compares RAs with nRAs in terms of availability, price and market share of QAACT in each country. QAACT were similarly available in RAs as nRAs in Ghana and Kenya. In both countries, there was no statistical difference in availability of QAACT with AMFm logo between RAs and nRAs in public health facilities (PHFs), while private-for-profit (PFP) outlets had lower availability in RA than in nRAs (Ghana: 66.0 vs 82.2 %, p < 0.0001; Kenya: 44.9 vs 63.5 %, p = <0.0001. The median price of QAACT with AMFm logo for PFP outlets in RAs (USD1.25 in Ghana and USD0.69 in Kenya) was above the recommended retail price in Ghana (US$0.95) and Kenya (US$0.46), and much higher than in nRAs for both countries. QAACT with AMFm logo represented the majority of QAACT in RAs and nRAs in Kenya and Ghana. In the PFP sector in Ghana, the market share for QAACT with AMFm logo was significantly higher in RAs than in nRAs (75.6 vs 51.4 %, p < 0.0001). In contrast, in similar outlets in Kenya, the market share of QAACT with AMFm logo was significantly lower in RAs than in nRAs (39.4 vs 65.1 %, p < 0.0001). The findings indicate the AMFm programme contributed to making QAACT more available in RAs in these two countries. Therefore, the AMFm approach can inform other health interventions aiming at reaching hard-to-reach populations, particularly in the context of universal access to health interventions. However, further examination of the factors accounting for the deep penetration of the AMFm programme into RAs is needed to inform actions to improve the healthcare delivery system, particularly in RAs.

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 in the 70+ years age group, in women, among urban residents and in those with at least secondary education. Quitting tobacco use also increased with increasing income levels. Tobacco use among older adults in Ghana was associated with older men living in rural locations, chronic ill-health and reduced life satisfaction. A high proportion of older adults have stopped using tobacco, demonstrating the possibilities for effective public health interventions. Health risk reduction strategies through targeted anti-smoking health campaigns, improvement in access to health and social protection (such as health insurance) will reduce health risks among older persons who use tobacco.

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

Gender inequalities and demographic behavior.

PubMed

1995-01-01

A summary was provided of the central findings about gender inequalities in Egypt, India, Ghana, and Kenya published by the Population Council in 1994. These countries exhibited gender inequalities in different ways: the legal, economic, and educational systems; family planning and reproductive health services; and the health care system. All countries had in common a high incidence of widowhood. Widowhood was linked with high levels of insecurity, which were linked with high fertility. Children thus became insurance in old age. In Ghana, women's insecurity was threatened through high levels of marital instability and polygyny. In Egypt, insecurity was translated into economic vulnerability because of legal discrimination against women when family systems were disrupted. In India and all four countries, insecurity was reflective of limited access to education, an impediment to economic autonomy. In all four countries, women's status was inferior due to limited control over reproductive decision making about childbearing limits and contraception. In India, the cultural devaluation of girls contributed to higher fertility to satisfy the desire for sons. In India and Egypt, family planning programs were dominated by male-run organizations that were more concerned about demographic objectives than reproductive health. The universal inequality was the burden women carry for contraception. Family planning programs have ignored the local realities of reproductive behavior, family structures, and gender relations. The assumption that husbands and wives have similar fertility goals or that fathers fully share the costs of children is mistaken in countries such as Ghana. Consequently, fertility has declined less than 13% in Ghana, but fertility has declined by over 30% in Kenya. Family planning programs must be aware of gender issues.

The State of Information and Communication Technology and Health Informatics in Ghana

PubMed Central

Achampong, Emmanuel Kusi

2012-01-01

Information and Communication Technology (ICT) has become a major tool in delivery of health services and has had an innovative impact on quality of life. ICT is affecting the way healthcare is delivered to clients. In this paper, we discuss the state of ICT and health informatics in Ghana. We also discuss the state of various relevant infrastructures for the successful implementation of ehealth projects. We analyse the past and present state of health informatics in Ghana, in comparison to other African countries. We also review the challenges facing successful implementation of health informatics projects in Ghana and suggest possible solutions. PMID:23569633

Key Issues and Policy Considerations in Promoting Lifelong Learning in Selected African Countries: Ethiopia, Kenya, Namibia, Rwanda and Tanzania. UIL Publication Series on Lifelong Learning Policies and Strategies. No. 1

ERIC Educational Resources Information Center

Walters, Shirley; Yang, Jim; Roslander, Peter

2014-01-01

This cross-national study focuses on key issues and policy considerations in promoting lifelong learning in Ethiopia, Kenya, Namibia, Rwanda, and Tanzania (the five African countries that took part in a pilot workshop on "Developing Capacity for Establishing Lifelong Learning Systems in UNESCO Member States: at the UNESCO Institute for…

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.

Spoligotyping based genetic diversity of Mycobacterium tuberculosis in Ethiopia: a systematic review.

PubMed

Tulu, Begna; Ameni, Gobena

2018-03-27

Understanding the types of strains and lineages of Mycobacterium tuberculosis (M. tuberculosis) circulating in a country is of paramount importance for tuberculosis (TB) control program of that country. The main aim of this study was to review and compile the results of studies conducted on strains and lineages of M. tuberculosis in Ethiopia. A systematic search and review of articles published on M. tuberculosis strains and lineages in Ethiopia were made. PubMed and Google Scholar databases were considered for the search while the keywords used were M. tuberculosis, molecular epidemiology, molecular typing spoligotyping and Ethiopia. Twenty-one studies were considered in this review and a total of 3071 M. tuberculosis isolates and 3067 strains were included. These studies used spoligotyping and identified five lineages including Indo-Ocean, East Asian/Beijing, East African-Indian, Euro-American and Ethiopian in a proportion of 7.1%, 0.2%, 23.0%, 64.8%, and 4.1%, respectively. Thus, Euro-American was the most frequently (64.8%) occurring Lineage while East Asian was the least (0.2%) frequently occurring Lineage in the country. Surprisingly, the Ethiopian Lineage seemed to be localized to northeastern Ethiopia. In addition, the top five clades identified by this review were T, CAS, H, Manu and Ethiopian comprising of 48.0%, 23.0%, 11.0%, 6.0% and 4.1% of the strains, respectively. Furthermore, predominant shared types (spoligotype patterns) identified were SIT149, SIT53, SIT25, SIT37, and SIT21, each consisting of 420, 343, 266, 162 and 102 isolates, respectively, while, on the other hand, 15% of the strains were orphan. According to the summary of the results of this review, diversified strains and lineages of M. tuberculosis were found in Ethiopia, and the frequencies of occurrence of these strains and lineages were variable in different regions of the country. This systematic review is registered in the PRISMA with the registration number of 42017059263.

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 lower than in men, although the social patterns of tobacco use were similar to those in men. Tobacco control strategies should target the poor, not/least educated, and agricultural and unskilled workers, who are the most vulnerable social groups in sub-Saharan Africa.

Generating evidence to narrow the treatment gap for mental disorders in sub-Saharan Africa: rationale, overview and methods of AFFIRM.

PubMed

Lund, C; Alem, A; Schneider, M; Hanlon, C; Ahrens, J; Bandawe, C; Bass, J; Bhana, A; Burns, J; Chibanda, D; Cowan, F; Davies, T; Dewey, M; Fekadu, A; Freeman, M; Honikman, S; Joska, J; Kagee, A; Mayston, R; Medhin, G; Musisi, S; Myer, L; Ntulo, T; Nyatsanza, M; Ofori-Atta, A; Petersen, I; Phakathi, S; Prince, M; Shibre, T; Stein, D J; Swartz, L; Thornicroft, G; Tomlinson, M; Wissow, L; Susser, E

2015-06-01

There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.

Sexually transmitted diseases in Ethiopia. Social factors contributing to their spread and implications for developing countries.

PubMed

Plorde, D S

1981-12-01

Sexually transmitted diseases in developing countries are causing concern to those responsible for their control and eradication. To gain a better understanding of the problems involved in a country struggling with development, the economic and psychosocial factors influencing the spread of STD in Ethiopia have been studied. Increased migration and urbanisation and the changing role of women have led to a rise in prostitution. Thus changes in the social structure--particularly in relation to the education and employment of women--and improved medical services are essential for the long-term control of STD.

Blending local scale information for developing agricultural resilience in Ethiopia

USGS Publications Warehouse

Funk, Christopher C.; Husak, Gregory; Mahiny, A.S; Eilerts, Gary; Rowland, James

2013-01-01

This brief article looks at the intersection of climate, land cover/land use, and population trends in the world's most food insecure country, Ethiopia. As a result of warming in the Indian and Western Pacific oceans, Ethiopia has experienced substantial drying over the past 20 years. We intersect the spatial pattern of this drying with high resolution climatologies, maps of agricultural expansion, population data, and socioeconomic livelihoods information to suggest that the coincidence of drying and agricultural expansion in south-central Ethiopia is likely adversely affecting a densely populated region with high levels of poverty and low wage levels.

Epidemiology of elephantiasis with special emphasis on podoconiosis in Ethiopia: A literature review.

PubMed

Yimer, Mulat; Hailu, Tadesse; Mulu, Wondemagegn; Abera, Bayeh

2015-06-01

Elephantiasis is a symptom of a variety of diseases that is characterized by the thickening of the skin and underlying tissues, especially in the legs, male genitals and female breasts. Some conditions having this symptom include: Elephantiasis nostras, due to longstanding chronic lymphangitis; Elephantiasis tropica or lymphatic filariasis, caused by a number of parasitic worms, particularly Wuchereria bancrofti; non-filarial elephantiasis or podoconiosis, an immune disease caused by heavy metals affecting the lymph vessels; proteus syndrome, the genetic disorder of the so-called Elephant Man, etc. Podoconiosis is a type of lower limb tropical elephantiasis distinct from lymphatic filariasis. Lymphatic filariasis affects all population at risk, whereas podoconiosis predominantly affects barefoot subsistence farmers in areas with red volcanic soil. Ethiopia is one of the countries with the highest number of podoconiosis patients since many people are at risk to red-clay soil exposure in many parts of the country. The aim of this review was to know the current status and impact of podoconiosis and its relevance to elephantiasis in Ethiopia. To know the epidemiology and disease burden, the literatures published by different scholars were systematically reviewed. The distribution of the disease and knowledge about filarial elephantiasis and podoconiosis are not well known in Ethiopia. It is relatively well studied in southern Ethiopia but data from other parts of the country are limited. Moreover, programmes that focus on diagnosis, treatment, prevention and control of filarial elephantiasis and podoconiosis are also non-existent even in endemic areas. Furthermore, the disease mapping has not been carried out country-wide. Therefore, in order to address these gaps, Ethiopian Ministry of Health needs to take initiative for undertaking concrete research and mapping of the disease in collaboration with stakeholders.

Growth faltering and recovery in children aged 1-8 years in four low- and middle-income countries: Young Lives.

PubMed

Lundeen, Elizabeth A; Behrman, Jere R; Crookston, Benjamin T; Dearden, Kirk A; Engle, Patrice; Georgiadis, Andreas; Penny, Mary E; Stein, Aryeh D

2014-09-01

We characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting. Data came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries. We analysed length/height measurements for children at ages 1, 5 and 8 years. Children (n 7171) in Ethiopia, India, Peru and Vietnam. Mean height-for-age Z-score (HAZ) at age 1 year ranged from -1·51 (Ethiopia) to -1·08 (Vietnam). From age 1 to 5 years, mean HAZ increased by 0·27 in Ethiopia (P < 0·001) and decreased among the other cohorts (range: -0·19 (Peru) to -0·32 (India); all P < 0·001). From 5 to 8 years, mean HAZ increased in all cohorts (range: 0·19 (India) to 0·38 (Peru); all P < 0·001). Prevalence of stunting (HAZ<-2·0) at 1 year ranged from 21 % (Vietnam) to 46 % (Ethiopia). From age 1 to 5 years, stunting prevalence decreased by 15·1 percentage points in Ethiopia (P < 0·001) and increased in the other cohorts (range: 3·0 percentage points (Vietnam) to 5·3 percentage points (India); all P ≤ 0·001). From 5 to 8 years, stunting prevalence decreased in all cohorts (range: 5·0 percentage points (Vietnam) to 12·7 percentage points (Peru); all P < 0·001). The incidence of becoming stunted between ages 1 to 5 years ranged from 11 % (Vietnam) to 22 % (India); between ages 5 to 8 years, it ranged from 3 % (Peru) to 6 % (India and Ethiopia). The incidence of recovery from stunting between ages 1 and 5 years ranged from 27 % (Vietnam) to 53 % (Ethiopia); between ages 5 and 8 years, it ranged from 30 % (India) to 47 % (Ethiopia). We found substantial recovery from early stunting among children in four low- and middle-income countries.

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)…

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…

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…

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…

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…

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…

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.

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.

The impact of household wealth on child survival in Ghana.

PubMed

Lartey, Stella T; Khanam, Rasheda; Takahashi, Shingo

2016-11-22

Improving child health is one of the major policy agendas for most of the governments, especially in the developing countries. These governments have been implementing various strategies such as improving healthcare financing, improving access to health, increasing educational level, and income level of the household to improve child health. Despite all these efforts, under-five and infant mortality rates remain high in many developing nations. Some previous studies examined how economic development or household's economic condition contributes to child survival in developing countries. In Ghana, the question as to what extent does economic circumstances of households reduces infant and child mortality still remain largely unanswered. Thus, the purpose of this study is to investigate the extent to which wealth affects the survival of under-five children, using data from the Demographic and Health Survey (DHS) of Ghana. In this study, we use four waves of data from Demographic and Health Surveys (DHS) of Ghana from 1993 to 2008. The DHS is a detailed data set that provides comprehensive information on households and their demographic characteristics in Ghana. Data was obtained by distributing questionnaires to women (from 6000 households) of reproductive age between 15 and 49 years, which asked, among other things, their birth history information. The Weibull hazard model with gamma frailty was used to estimate wealth effect, as well as the trend of wealth effect on child's survival probability. We find that household wealth status has a significant effect on the child survival in Ghana. A child is more likely to survive when he/she is from a household with high wealth status. Among other factors, birth spacing and parental education were found to be highly significant to increase a child's survival probability. Our findings offer plausible mechanisms for the association of household wealth and child survival. We therefore suggest that the Government of Ghana strengthens and sustains improved livelihood programs, which reduce poverty. They should also take further initiatives that will increase adult education and improve health knowledge. To the best of our knowledge, this is the first study in Ghana that combines four cross sectional data sets from DHS to study a policy-relevant question. We extend Standard Weibull hazard model into Weibull hazard model with gamma frailty, which gives us a more accurate estimation. Finally, the findings of this study are of interest not only because they provide insights into the determinants of child health in Ghana and other developing countries, but they also suggest policies beyond the scope of health.

The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies.

PubMed

von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F; Bjerregaard-Andersen, Morten; Clemens, John D; Crump, John A; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H; Cosmas, Leonard; May, Jürgen; Meyer, Christian G; Mintz, Eric D; Montgomery, Joel M; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R; Wierzba, Thomas F; Marks, Florian

2016-03-15

New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Tropical Africa: Land Use, Biomass, and Carbon Estimates for 1980 (and updated for the year 2000) (NDP-055)

DOE Data Explorer

Brown, Sandra [University of Illinois, Urbana, IL (USA); Winrock International, Arlington, Virginia (USA); Gaston, Greg [University of Illinois, Urbana, IL (USA); Oregon State University; Beaty, T. W. [Carbon Dioxide Information Analysis Center (CDIAC), Oak Ridge National Laboratory, Oak Ridge, TN (USA); Olsen, L. M. [Carbon Dioxide Information Analysis Center (CDIAC), Oak Ridge National Laboratory, Oak Ridge, TN (USA)

2001-01-01

This document describes the contents of a digital database containing maximum potential aboveground biomass, land use, and estimated biomass and carbon data for 1980. The biomass data and carbon estimates are associated with woody vegetation in Tropical Africa. These data were collected to reduce the uncertainty associated with estimating historical releases of carbon from land use change. Tropical Africa is defined here as encompassing 22.7 x 10E6 km² of the earth's land surface and is comprised of countries that are located in tropical Africa (Angola, Botswana, Burundi, Cameroon, Cape Verde, Central African Republic, Chad, Congo, Benin, Equatorial Guinea, Ethiopia, Djibouti, Gabon, Gambia, Ghana, Guinea, Ivory Coast, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritania, Mozambique, Namibia, Niger, Nigeria, Guinea-Bissau, Zimbabwe (Rhodesia), Rwanda, Senegal, Sierra Leone, Somalia, Sudan, Tanzania, Togo,Uganda, Burkina Faso (Upper Volta), Zaire, and Zambia). The database was developed using the GRID module in the ARC/INFO (TM geographic information system. Source data were obtained from the Food and Agriculture Organization (FAO), the U.S. National Geophysical Data Center, and a limited number of biomass-carbon density case studies. These data were used to derive the maximum potential and actual (ca. 1980) aboveground biomass values at regional and country levels. The land-use data provided were derived from a vegetation map originally produced for the FAO by the International Institute of Vegetation Mapping, Toulouse, France.

An Epidemiological Trend of Urogenital Schistosomiasis in Ethiopia

PubMed Central

Chala, Bayissa; Torben, Workineh

2018-01-01

Schistosomiasis is a major public health problem in Ethiopia. Currently, the prevalence of the disease can possibly be heightened due to man-made ecological transformations particularly related to the recent development programs involving irrigation and construction of dams. The expansion of some of the water resource development projects has been cited enhancing the upsurge of urogenital schistosomiasis mainly in the lower altitude areas of the country. In connection to the extensive initiation of development projects in low altitude areas of the country, simultaneous and adequate attentions have never been given to address a pre-assessment of health impacts of the development programs prior to launching the projects. Helpful appraisals focusing on evaluation of epidemiology of urogenital schistosomiasis in Ethiopia have not been explored. Therefore, the current review attempts to trace an overall picture of the epidemiological status of urogenital schistosomiasis in the country; the past and existing trends of urogenital schistosomiasis surveys and control programs of the country are reviewed. Essential recommendations are highlighted for possible inputs in future control design strategies of national control program of schistosomiasis. PMID:29556490

Causes of childhood blindness in a developing country and an underdeveloped country.

PubMed

Santos-Bueso, E; Dorronzoro-Ramírez, E; Gegúndez-Fernández, J A; Vinuesa-Silva, J M; Vinuesa-Silva, I; García-Sánchez, J

2015-05-01

The causes of childhood blindness depend on factors such as geographic location or the human development index of the populations under study. The main causes in developed countries are genetic and hereditary diseases, while infectious and contagious diseases, together with nutritional and vitamin deficiencies, are the main causes in underdeveloped countries (UDCs). Study of the causes of blindness among children admitted to a regional centre in Nador, Morocco, and among children in Mekele, Ethiopia. The study was carried out in collaboration with two non-governmental organizations based in Madrid, Spain. First, we worked with Fudación Adelias in June 2010, and with Proyecto Visión in October 2012. The study comprised a total of 27 children in Morocco and 85 in Ethiopia. The average age of the children was 10.92 and 6.94 years, respectively. The main causes of blindness in Morocco were hereditary pathologies (25.92%) and refractive errors (14.82%), although trauma (7.40%) and corneal disease (7.40%) are relevant. Among the children from Ethiopia, corneal disease (27.05%) and trauma (20%) were the main causes of blindness, while congenital and hereditary diseases had a lower prevalence (4.70%). The causes of blindness depend on the human development index of the populations under study. While corneal disease and trauma are the main causes observed in UDCs like Ethiopia, hereditary pathologies and refractive errors are the main causes within the Moroccan population studied. A mixed form can be observed in this country, as the cause of blindness found in developed countries, such as congenital and hereditary pathologies which are present alongside the causes normally found in LDCs. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

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-effectiveness. Conclusions Both Ghana and Cameroon require a comprehensive and integrative approach to chronic disease intervention that combines structural, community and individual strategies. We outline research and practice gaps and best practice models within and outside Africa that can instruct the development of future interventions. PMID:20403170

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

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.

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.

Indirect child mortality estimation technique to identify trends of under-five mortality in Ethiopia.

PubMed

Ayele, Dawit G; Zewotir, Temesgen; Mwambi, Henry

2016-03-01

In sub-Saharan African countries, the chance of a child dying before the age of five years is high. The problem is similar in Ethiopia, but it shows a decrease over years. The 2000; 2005 and 2011 Ethiopian Demographic and Health Survey results were used for this work. The purpose of the study is to detect the pattern of under-five child mortality overtime. Indirect child mortality estimation technique is adapted to examine the under-five child mortality trend in Ethiopia. From the result, it was possible to see the trend of under-five child mortality in Ethiopia. The under-five child mortality shows a decline in Ethiopia. From the study, it can be seen that there is a positive correlation between mother and child survival which is almost certain in any population. Therefore, this study shows the trend of under-five mortality in Ethiopia and decline over time.

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…

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,…

"Children of the Street": Sexual Citizenship and the Unprotected Lives of Ghanaian Street Youth

ERIC Educational Resources Information Center

Oduro, Georgina Yaa

2012-01-01

Youth-sensitive policies are gradually gaining recognition in Africa. The release of the recent publication "Children in Ghana" by the Ministry of Women and Children's Affairs (MOWAC) and UNICEF-Ghana attests to the value the country places on young people's perspectives. Guided by Richardson's conceptual framework on sexual citizenship,…

Does parental migration really benefit left-behind children? Comparative evidence from Ethiopia, India, Peru and Vietnam.

PubMed

Viet Nguyen, Cuong

2016-03-01

Millions of children are left behind when their parents migrate from home to another place. This study examines whether parental migration can affect health and cognitive ability of left-behind children aged at 5-8 years old in Ethiopia, India, Peru, and Vietnam. It uses data on 7725 children in the four countries collected from Young Lives surveys in 2007 and 2009. It finds that although parental migration helps families increase per capita consumption, it does not improve health and cognitive ability of children. The effect of parental migration varies across different countries and different types of migration. In Ethiopia, parental migration does not have a significant effect on children. However, parental migration reduces health outcomes of children in other three countries and decreases cognitive ability test scores in India and Vietnam. The negative effect on children tends to be higher for long-term parental migration than short-term parental migration. Copyright © 2016 Elsevier Ltd. All rights reserved.

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…

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…

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…

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…

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

Reflections on Meeting the Needs of Children with Disabilities in Ethiopia

ERIC Educational Resources Information Center

Kurtz, Kimberly M.; Shepherd, Terry L.

2011-01-01

In many countries, children with disabilities seldom receive the educational services they need. Economic instability has often forced a reduction in services for children with disabilities. Cultural values have also impacted support for children with disabilities. A special education residential facility in Ethiopia that serves orphaned children…

Molecular characterization of Xanthomonas strains responsible for bacterial leaf spot of tomato in Ethiopia

USDA-ARS?s Scientific Manuscript database

Bacterial spot of tomato (BST) is a major constraint to tomato production in Ethiopia and many other countries leading to significant crop losses. In the present study, using pathogenicity tests, sensitivity to copper and streptomycin, and multilocus sequence analysis, a diverse group of Xanthomonas...

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

PubMed

Al-Bader, Sara; Daar, Abdallah S; Singer, Peter A

2010-12-13

Science, technology and innovation have long played a role in Ghana's vision for development, including in improving its health outcomes. However, so far little research has been conducted on Ghana's capacity for health innovation to address local diseases. This research aims to fill that gap, mapping out the key actors involved, highlighting examples of indigenous innovation, setting out the challenges ahead and outlining recommendations for strengthening Ghana's health innovation system. Case study research methodology was used. Data were collected through reviews of academic literature and policy documents and through open-ended, face-to-face interviews with 48 people from across the science-based health innovation system. Data was collected over three visits to Ghana from February 2007 to August 2008, and stakeholders engaged subsequently. Ghana has strengths which could underpin science-based health innovation in the future, including health and biosciences research institutions with strong foreign linkages and donor support; a relatively strong regulatory system which is building capacity in other West African countries; the beginnings of new funding forms such as venture capital; and the return of professionals from the diaspora, bringing expertise and contacts. Some health products and services are already being developed in Ghana by individual entrepreneurs, which are innovative in the sense of being new to the country and, in some cases, the continent. They include essential medicines, raw pharmaceutical materials, new formulations for pediatric use and plant medicines at various stages of development. While Ghana has many institutions concerned with health research and its commercialization, their ability to work together to address clear health goals is low. If Ghana is to capitalize on its assets, including political and macroeconomic stability which underpin investment in health enterprises, it needs to improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system.

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.

Current and projected prevalence of arterial hypertension in sub-Saharan Africa by sex, age and habitat: an estimate from population studies.

PubMed

Twagirumukiza, Marc; De Bacquer, Dirk; Kips, Jan G; de Backer, Guy; Stichele, Robert Vander; Van Bortel, Luc M

2011-07-01

In sub-Saharan Africa (SSA), data on hypertension prevalence in terms of urban or rural and sex difference are lacking, heterogeneous or contradictory. In addition, there are no accurate estimates of hypertension burden. To estimate the age-specific and sex-specific prevalence of arterial hypertension in SSA in urban and rural adult populations. We searched for population studies, conducted from 1998 through 2008 in SSA. We extracted data from selected studies on available prevalences and used a logistic regression model to estimate all age/sex/habitat (urban/rural)/country-specific prevalences for SSA up to 2008 and 2025. On the basis of the United Nations Population Fund data for 2008 and predictions for 2025, we estimated the number of hypertensives in both years. Seventeen studies pertaining to 11 countries were analysed. The overall prevalence rate of hypertension in SSA for 2008 was estimated at 16.2% [95% confidence interval (CI) 14.1-20.3], ranging from 10.6% in Ethiopia to 26.9% in Ghana. The estimated prevalence was 13.7% in rural areas, 20.7% in urban areas, 16.8% in males, and 15.7% in women. The total number of hypertensives in SSA was estimated at 75 million (95% CI 65-93 million) in 2008 and at 125.5 million (95% CI 111.0-162.9 million) by 2025. The estimated number of hypertensives in 2008 is nearly four times higher than the last (2005) estimate of the World Health Organization Regional Office for Africa. Prevalences were significantly higher in urban than in rural populations. Population data are lacking in many countries underlining the need for national surveys.

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/

Common risk factors for chronic non-communicable diseases among older adults in China, Ghana, Mexico, India, Russia and South Africa: the study on global AGEing and adult health (SAGE) wave 1.

PubMed

Wu, Fan; Guo, Yanfei; Chatterji, Somnath; Zheng, Yang; Naidoo, Nirmala; Jiang, Yong; Biritwum, Richard; Yawson, Alfred; Minicuci, Nadia; Salinas-Rodriguez, Aaron; Manrique-Espinoza, Betty; Maximova, Tamara; Peltzer, Karl; Phaswanamafuya, Nancy; Snodgrass, James J; Thiele, Elizabeth; Ng, Nawi; Kowal, Paul

2015-02-06

Behavioral risk factors such as tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol are known and modifiable contributors to a number of NCDs and health mediators. The purpose of this paper is to describe the distribution of main risk factors for NCDs by socioeconomic status (SES) among adults aged 50 years and older within a country and compare these risk factors across six lower- and upper-middle income countries. The study population in this paper draw from SAGE Wave 1 and consisted of adults aged 50-plus from China (N=13,157), Ghana (N=4,305), India (N=6,560), Mexico (N=2,318), the Russian Federation (N=3,938) and South Africa (N=3,836). Seven main common risk factors for NCDs were identified: daily tobacco use, frequent heavy drinking, low level physical activity, insufficient vegetable and fruit intake, high risk waist-hip ratio, obesity and hypertension. Multiple risk factors were also calculated by summing all these risk factors. The prevalence of daily tobacco use ranged from 7.7% (Ghana) to 46.9% (India), frequent heavy drinker was the highest in China (6.3%) and lowest in India (0.2%), and the highest prevalence of low physical activity was in South Africa (59.7%). The highest prevalence of respondents with high waist-to-hip ratio risk was 84.5% in Mexico, and the prevalence of self-reported hypertension ranging from 33% (India) to 78% (South Africa). Obesity was more common in South Africa, the Russia Federation and Mexico (45.2%, 36% and 28.6%, respectively) compared with China, India and Ghana (15.3%, 9.7% and 6.4%, respectively). China, Ghana and India had a higher prevalence of respondents with multiple risk factors than Mexico, the Russia Federation and South Africa. The occurrence of three and four risk factors was more prevalent in Mexico, the Russia Federation and South Africa. There were substantial variations across countries and settings, even between upper-middle income countries and lower-middle income countries. The baseline information on the magnitude of the problem of risk factors provided by this study can help countries and health policymakers to set up interventions addressing the global non-communicable disease epidemic.

International land deals, local people's livelihood, and environment nexus (How to create win-win land deals in Ethiopia?)

NASA Astrophysics Data System (ADS)

Teklemariam Gebremeskel, Dereje; Witlox, Frank; Azadi, Hossein; Haile, Mitiku; Nyssen, Jan

2013-04-01

Following the global raise in demand for food and biofuel production, transnational companies are acquiring large scale agricultural land in developing countries such as Ethiopia. Considering land as one of the factors to be outsourced for development, the government of Ethiopia is supplying millions of hectares of land to transnational companies in the form of longterm lease. Many of the companies which engage in large scale land acquisition are of Indian, Chinese, Ethiopian diaspora, German, Malaysian, Italian, British, Dutch, Turkish, and Saudi-Arabian origin. The boom in the acquisition of farm land in the country has sparked an all-rounded debate among civil society groups, international institutions, nongovernmental organizations and independent development experts. The common reflections concerning the land deals in Ethiopia and elsewhere contain much rhetoric and hype which lack analysis of the real situation "on the ground" giving different connotations such as 'land grabbing', 'agricultural outsourcing', 'neo-colonialism', 'agrarian colonialism', and 'land underdevelopment'. However, deforestation, soil degradation, marginalization of local indigenous communities, and minimally unfair gains from investment by the host country are among the real points of concern arising out of the long term land lease contracts. Scientific evidence is lacking concerning the pragmatic impacts of large scale agricultural land acquisitions by transnational companies upon the natural environment (forest and land), local peoples' livelihood, and the contacting parties (the host country and the companies). The major objective of this study is to investigate the impacts in the context of Ethiopia, orienting to reinvent win-win land use models which constitute sustainable land use, local peoples' livelihood and the company-host country interests. To achieve this overall objective, the study employs a number of methods and methodologies constituting both qualitative and quantitative data analyses at different levels of focus ranging from household and farm levels to national and transnational. The study focuses on the western lowlands of Ethiopia where there are many companies engaged in large scale commercial farming, where 75% of it is below 1500 m a.s.l with average annual temperature of 20-25°C and annual rainfall of 500-1800 mm. Some preliminary exploratory findings indicate that there is massive land use conversion (deforestation) and 'voluntary' displacement of indigenous communities, which requires further triangulation. Key words: agricultural outsourcing; environmental services; land grabbing; sustainable livelihood; soil conservation

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.

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.

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 (including degree of consultations during the design stage and communication during implementation stage) and the low priority of mental health. Although the influencing factors represent similar categories, more influences were identified on MHIS implementation, compared with the design stage. Different influences appear to be related within, and across, the MHIS design and implementation and may reinforce or negate each other thus leading to the multiplier or minimization effects. The wider context, similar to other studies, is important in ensuring the success of such interventions. Future MHIS strengthening interventions can consider three policy implications which emerged from our analysis and experience: enhancing consultations during the intervention design, better consideration of implementation challenges during design, and better recognition of relations between different influences.

The SARE tool for rabies control: Current experience in Ethiopia.

PubMed

Coetzer, A; Kidane, A H; Bekele, M; Hundera, A D; Pieracci, E G; Shiferaw, M L; Wallace, R; Nel, L H

2016-11-01

The Stepwise Approach towards Rabies Elimination (SARE) tool was developed through a joint effort of the Food and Agriculture Organization (FAO) of the United Nations and the Global Alliance for Rabies Control (GARC), to provide a standard mechanism for countries to assess their rabies situation and measure progress in eliminating the disease. Because the African continent has the highest per capita death rate from rabies, and Ethiopia is estimated to have the second largest number of rabies deaths of all African countries, Ethiopia undertook a self-assessment by means of the Stepwise Approach towards Rabies Elimination (SARE) tool. In February 2016, the Ethiopian government hosted an intersectoral consultative meeting in an effort to assess the progress that has been made towards the control and elimination of canine rabies. The SARE assessment identified a number of critical gaps, including poor inter-sectoral collaboration and limited availability and access to dog vaccine, while the existence of a surveillance system for rabies and legislation for outbreak declaration and response were among the strengths identified. The SARE tool enabled key criteria to be prioritized, thereby accelerating the National Strategy and ensuring that Ethiopia will progress rapidly in line with the goals set by the global community for the elimination of human rabies deaths by 2030. Although the analysis showed that Ethiopia is still in the early stages of rabies control (Stage 0.5/5), the country shows great promise in terms of developing a SARE-guided National Rabies Prevention and Control Strategy. Copyright © 2016 Elsevier B.V. All rights reserved.

Assessing political priority for reproductive health in Ethiopia.

PubMed

Prata, Ndola; Summer, Anna

2015-11-01

Ethiopia is among the top six countries contributing to the highest numbers of maternal deaths globally. The Ethiopian total fertility rate was estimated at 4.8 in 2011, and the use of contraceptives by married women was 29%. Lack of knowledge, cultural stigma surrounding abortion, and barriers to access of services contribute to persistently high rates of unsafe abortion and abortion-related mortality. This study seeks to assess the generation and institutionalization of political priority for reproductive health within the political systems of Ethiopia. Interviews with key policy makers, government ministers, academics, and leaders of prominent non-governmental organizations in Ethiopia between July 2010 and January 2011 were conducted, using Shiffman and Smith's Framework, to analyse the key actors and ideas behind the shift towards prioritization of reproductive health in Ethiopia, as well as the political context and primary characteristics of the issues that propelled progressive action in reproductive health in that country. Some of the key lessons point to the readiness of the Ethiopian government to reform and to improve the socio-economic status of the population. The role of civil society organizations working alongside the government was crucial to creating a window of opportunity in a changing political climate to achieve gains in reproductive health. To our knowledge, this is the first time Shiffman and Smith's Framework has been used for reproductive health policies. We conclude that Ethiopian experience fits well within this framework for understanding prioritization of global health issues and may serve as a model for other sub-Saharan African countries. Copyright © 2015 Elsevier Inc. All rights reserved.

Communities and community genetics in Ethiopia.

PubMed

Tadesse, Luche; Tafesse, Fikru; Hamamy, Hanan

2014-01-01

The rates of congenital and genetic disorders in low and middle income countries are similar or might be higher than in high income countries due to a multitude of risk factors and the dearth of community genetic services. To direct effective preventive, diagnostic and counseling services, collecting data on the incidence and prevalence of various congenital and genetic disorders and their risk factors is a pre-requisite for establishing genetic services at the community level and mainly at the primary health care setting. This brief review is meant to assess the available epidemiological data in Ethiopia pertaining to congenital and genetic disorders on which the future community genetic services could be built. Existing epidemiological data on congenital and genetic disorders in Ethiopia is limited, and the few studies conducted revealed that folate and iodine deficiencies are prevalent among women in the reproductive age. Pregnant women's infection with syphilis and rubella is prevailing. Based on available data, cleft lip and palate, congenital heart diseases, club-foot, and gastro-intestinal malformations are the most common birth defects in Ethiopia. Community based studies to accurately demonstrate the incidence and prevalence levels of these disorders are almost unavailable. To plan for organization and implementation of community genetic services at the primary health care level in Ethiopia, conducting standardized epidemiological studies is currently highly recommended.

Communities and community genetics in Ethiopia

PubMed Central

Tadesse, Luche; Tafesse, Fikru; Hamamy, Hanan

2014-01-01

The rates of congenital and genetic disorders in low and middle income countries are similar or might be higher than in high income countries due to a multitude of risk factors and the dearth of community genetic services. To direct effective preventive, diagnostic and counseling services, collecting data on the incidence and prevalence of various congenital and genetic disorders and their risk factors is a pre-requisite for establishing genetic services at the community level and mainly at the primary health care setting. This brief review is meant to assess the available epidemiological data in Ethiopia pertaining to congenital and genetic disorders on which the future community genetic services could be built. Existing epidemiological data on congenital and genetic disorders in Ethiopia is limited, and the few studies conducted revealed that folate and iodine deficiencies are prevalent among women in the reproductive age. Pregnant women's infection with syphilis and rubella is prevailing. Based on available data, cleft lip and palate, congenital heart diseases, club-foot, and gastro-intestinalmalformations are the most common birth defects in Ethiopia. Community based studies to accurately demonstrate the incidence and prevalence levels of these disorders are almost unavailable. To plan for organization and implementation of community genetic services at the primary health care level in Ethiopia, conducting standardized epidemiological studies is currently highly recommended. PMID:25404975

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,…

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…

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…

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...

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…

Hydro-economic Risk Assessment in the Eastern Nile River Basin

NASA Astrophysics Data System (ADS)

Arjoon, D.; Tilmant, A.; Mohamed, Y.

2013-12-01

In 2011, the Ethiopian government announced plans for the construction of the Grand Renaissance Dam (GRD) on the Blue Nile, just east of its border with Sudan, at a cost of almost 5 billion dollars. The project is expected to generate over 15 TWh of energy and will include a reservoir of more than 60 km3 capacity, which roughly corresponds to the average annual flow of the Blue Nile. This project is part of a larger scheme, by the government, to expand its hydroelectric power capacity, however, the scheme faces strong opposition from downstream Egypt and Sudan. Egypt and Sudan are highly dependent on flows that originate in Ethiopia (it has been estimated that 86% of Nile flow originates in the Ethiopian highlands). The Ethiopian government argues that the dam would supply electricity for Ethiopians as well as generate surplus energy for export to neighboring countries. The Ethiopians also argue that the huge reservoir would generate positive externalities downstream by reducing floods and providing more constant and predictable lows. This study attempts to provide an independent analysis of the hydrologic and economic risks faced by downstream countries when GRD will be online. To achieve this, an integrated, stochastic hydro-economic model of the entire Eastern Nile basin is used to analyze various development and management scenarios. The results indicate that if countries agree to co- operative management of the Eastern Nile River basin, GRD would indeed significantly increase basin-wide benefits, especially in Ethiopia and in Sudan. An alternative management scenario, whereby GRD would be operated by Sudan and Egypt, does not yield significant economic gains in these countries. However, massive unilateral irrigation developments in Ethiopia will be detrimental for all countries, including Ethiopia itself, due to the huge opportunity costs involved.

Complex care systems in developing countries: breast cancer patient navigation in Ethiopia.

PubMed

Dye, Timothy D; Bogale, Solomon; Hobden, Claire; Tilahun, Yared; Hechter, Vanessa; Deressa, Teshome; Bizé, Marion; Reeler, Anne

2010-02-01

As the global visibility and importance of breast cancer increases, especially in developing countries, ensuring that countries strengthen and develop health systems that support prevention, diagnosis, and treatment of a complex chronic disease is a priority. Understanding how breast cancer patients navigate health systems to reach appropriate levels of care is critical in assessing and improving the health system response in countries to an increasing breast cancer burden in their populations. Ethiopia has accelerated attention to breast cancer, expanding clinical and public health efforts at diagnosing and treating breast cancer earlier and more efficiently. This project used a mixed-method approach to assessing patient navigation of the healthcare system that resulted in care at the cancer referral hospital for Ethiopia (Tikur Anbessa Hospital [TAH]). In total, 69 patients representative of the entire breast cancer clinical population at TAH were interviewed. Navigation chains are widely divergent and typically involve 3 or more care nodes until they reach the referral hospital. Patients who consult traditional healers have significantly more care nodes to reach the referral hospital than others, and patients who have direct access to local and regional hospitals have the smallest number of care nodes. Patients report moving laterally from 1 health institution to another or regressing to lower levels of care, sometimes complicated by reinvolving traditional healers. The care system can be streamlined for breast cancer patients in Ethiopia to facilitate patient access to available and clinically effective diagnostic and treatment services in the country, largely through improving local primary care and hospital capacity to provide basic breast cancer services and improve detection and referral. Copyright 2009 American Cancer Society.

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.

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.

Ethiopia: an emerging family planning success story.

PubMed

Olson, David J; Piller, Andrew

2013-12-01

From 1990 to 2011, contraceptive use in Ethiopia increased ninefold and the total fertility rate fell from 7.0 to 4.8. These are two dramatic illustrations of a family planning success story that has emerged over the last two decades and is still emerging. What are the main elements of this success? We posit that the four most significant factors are: political will, generous donor support, nongovernmental and public-private partnerships, and the government's establishment of a network of health extension workers. In this study, we look at these factors and how their interaction increased the proportion of women having both the desire to use and ability to access contraceptives. Also highlighted are some of the key lessons learned in Ethiopia that are relevant to other African countries interested in emulating the country's success. © 2013 The Population Council, Inc.

Including Students with Disabilities in Education for All: Lessons from Ethiopia

ERIC Educational Resources Information Center

Franck, Brittany; Joshi, Devin K.

2017-01-01

This article addresses the inclusion of students with disabilities into the Education for All and Sustainable Development Goals agenda through a case study of Ethiopia, a country aiming to promote inclusive education amidst rapidly rising school enrolments. The article begins with a review of debates concerning inclusive education in the Global…

First report of Phakopsora pachyrhizi causing rust on soybean in Ethiopia

USDA-ARS?s Scientific Manuscript database

Soybean rust, caused by the fungal pathogen P. pachyrhizi, has been reported in 10 African countries since the first report in Uganda in 1996. In 2016, a severe epidemic caused “clouds” of urediniospores to be observed when walking through fields in mid-October 2016 in Jimma Ethiopia. In the first ...

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 to emulation. The Ghana experience illustrates that in adopting health financing systems that function well, countries need to customise systems (policy customisation) to suit their socio-economic, political and administrative settings. Home-grown health financing systems that resonate with social values will also need to be found in the process of translation. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

``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.

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

Energy and the agroeconomic complexity of Ethiopia

NASA Astrophysics Data System (ADS)

Karakatsanis, Georgios

2016-04-01

Since the Industrial Revolution, modern agriculture has transformed from a net energy supplier to a net energy user, via the extensive use fossil fuels -that substituted solar energy inputs- and petroleum derivative products (fertilizers) (Pimentel and Pimentel 2008; Woods et al. 2010). This condenses a significant overview of agricultural energetics, especially for economies set on their first stage of development, growth and economic diversification, such as Ethiopia. Ethiopia is the Blue Nile's most upstream country, constituting a very sensitive hydroclimatic area. Since 2008, Ethiopian agriculture experiences a boost in energy use and agricultural value-added per worker, due to the rapid introduction of oil-fueled agricultural machinery that increased productivity and allowed crop diversification. Agriculture in Ethiopia accounts for ~82% of its total exports, ~45% of its Gross Domestic Product (GDP) and ~75% of its total labor force. In addition, Ethiopia's agricultural sector is equipped with a set of new financial tools to deal with hydroclimatic extremes, like the 1983-85 droughts that deteriorated its crop output, causing a devastating famine. In fact, Ethiopia's resilience from the (most) recent drought (2015-16) has been remarkable. These facts signify that Ethiopia satisfies the necessary conditions to become a regional agritrade gravity center in the Blue Nile, granted that the dispersion of agricultural trade comprises a primary tool for securing food supply. As gravity equations have been used to model global trade webs (Tinbergen 1962), similar principles may apply to agritrade as well, for identifying emergent topological structures and supply chains. By examining the relation between energy inputs in agriculture with crop diversification and value-added chains of Ethiopia's agritrade, we could extract accurate information on the importance of energy for the country's agroeconomic complexity and regionalization trend across its first stages of development. Via the use of entropy we may identify patterns of agritrade agglomeration or dispersal; alternatively study the continuity or fragmentation of Ethiopia's agritrade gravity field. Agglomeration towards Ethiopian agricultural supply would indicate the upgrade of the country's supply stability and -therefore- importance in the global agritrade web. Keywords: Industrial Revolution, net energy, diversification, Blue Nile, hydroclimatic extremes, agritrade, gravity, value-added, complexity, regionalization, entropy References 1. Tinbergen, J. (1962), Shaping the World Economy: Suggestions for an International Economic Policy, The Twentieth Century Fund, New York 2. Pimentel, David and Marcia H. Pimentel (2008), Food, Energy and Society (3rd Ed.), CRC Press, Taylor and Francis Group 3. Woods, Jeremy et al. (2010), Energy and the food system, Philosophical Transactions of the Royal Society B, 365, 2991-3006

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.

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

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.

Perspectives on optimization of vaccination and immunization of Ethiopian children/women: what should and can we further do? Why and how?

PubMed

Gebremariam, Mulugeta Betre

2012-04-01

Vaccination and immunization of children and child-bearing women, in particular, is uniquely important public health intervention Ethiopia inclusive. In spite of the promising progresses, much is desired toward the ultimate optimization, effectiveness and protection. This analytical discourse-recourse piece of work aimed at flagging the optimization perspectives on the basis of readily available information. CONTEXT, MATERIALS AND METHODS: The study emerged consequent to the review and capacity enhancement workshop of experts on Reaching Every District (RED) strategy of the Eastern and Southern African countries which was hosted by the WHO Afro Country Support Team for Eastern and Southern Africa in Harare, Zimbabwe, 28 February, - 03, March 2012. The study, essentially, is a qualitative analytical review of the pertinent literature with a particular focus on Ethiopia. Both peer reviewed and published and gray (unpublished) pertinent literature were solicited and reviewed systematically. The analytical discourse focused on performance progresses, achievements, opportunities, gaps/shortcomings, challenges and threats and perspectives. Vaccination-immunization performance evidences which were consolidated by the WHO Afro Country Support Team served the starting point to the central analytical discussion. KEY FINDINGS AND REFLECTIONS: Without underestimating the progresses and successes registered thus far, however, there indeed are quite many areas that warrant further discourse and/or recourse in Ethiopia in particular. Compared with other member countries, the size of the unimmunized, reporting quality, fragileness of systems, weak capacity, resource limitation, and others in particular respect to Ethiopia deserve further concerted attention. Districts with under 80% DPT3 coverage were still too many for Ethiopia by 2010/11. Whilst the challenges appeared prevalent, but more so effective and maximal use of the readily available opportunities appeared even more crucial. Further and dynamic optimization is desired more than ever before. Presumably promising and realistic enough recommendation perspectives are duly highlighted.

A climate trend analysis of Ethiopia

USGS Publications Warehouse

Funk, Christopher C.; Rowland, Jim; Eilerts, Gary; Kebebe, Emebet; Biru, Nigist; White, Libby; Galu, Gideon

2012-01-01

This brief report, drawing from a multi-year effort by the U.S. Agency for International Development (USAID) Famine Early Warning Systems Network (FEWS NET), examines recent trends in March-June, June-September, and March-September rainfall and temperature, identifying significant reductions in rainfall and increases in temperature over time in many areas of Ethiopia. Conclusions: * Spring and summer rains in parts of Ethiopia have declined by 15-20 percent since the mid-1970s. * Substantial warming across the entire country has exacerbated the dryness.* An important pattern of observed existing rainfall declines coincides with heavily populated areas of the Rift Valley in south-central Ethiopia, and is likely already adversely affecting crop yields and pasture conditions. * Rapid population growth and the expansion of farming and pastoralism under a drier, warmer climate regime could dramatically increase the number of at-risk people in Ethiopia during the next 20 years.* Many areas of Ethiopia will maintain moist climate conditions, and agricultural development in these areas could help offset rainfall declines and reduced production in other areas.

"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…

New Border Crossings for the Interaction Hypothesis: The Effects of Feedback on Gonja Speakers Learning English in a Rural School in Ghana

ERIC Educational Resources Information Center

Sherris, Ari; Burns, M. Susan

2015-01-01

While Ghanaians in urban and rural settings are multilingual, English is the language of Ghanaian newspapers, politicians, the courts, much of television and radio in the metropolitan centres of the country. Indeed, urban Ghanaian adolescents have expanding opportunities to use English, the only official language of Ghana, even when not in school.…

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…

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 clearly enabling difference, as was public sector support of the private sector. This contributed to the alignment of partner action behind a single co-ordinated strategy at service delivery level which in turn gave confidence to the business sector and avoided the 'interference' of competing delivery systems that occurred in Ghana. Principles of systems thinking for intervention design correctly emphasize the importance of enabling contexts and stakeholder management.

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

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.

Self-reported cataracts in older adults in Ghana: sociodemographic and health related factors.

PubMed

Yawson, Alfred E; Ackuaku-Dogbe, Edith M; Seneadza, Nana A Hagan; Mensah, George; Minicuci, Nadia; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul; Biritwum, Richard B

2014-09-12

Changes in function of sensory organs with increasing age have significant impact on health and wellbeing of older persons. This paper describes cataract, a chronic eye condition, self-reported among older adults in Ghana and the need for improving access to eye care services. This work was based on the World Health Organization's multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. SAGE Wave 1 in Ghana was conducted in 2007-2008 in a nationally representative sample of 4278 older adults, ≥ 50 years. Data were obtained on sociodemographic and health factors related to self-reported cataracts in older persons in Ghana. Data were analysed using descriptive measures (frequencies and proportions), chi-square test for associations in categorical outcome measures, and logistic regression for predictors of cataracts with SPSS version 21. Overall prevalence of self-reported cataracts among 4278 older adults in Ghana was 5.4%. Prevalence was proportionately higher for women (5.9%) than men (4.7%). Reported cataracts increased with age, among urban residents, in older adults living without partners and among those with the worse life satisfaction index. Older adults in lower income groups, poorly educated or living alone had difficulty seeking vision care services. Prevalence was 8.4% among persons with diabetes, 10.4% among hypertensives and 11.4% in persons with previous history of stroke. Among older persons who had ever used alcohol or tobacco, prevalence rates of reported cataracts were 5.7% and 4.9%, respectively. Logistic regression analysis indicated that increasing age, lower income status and self-reported hypertension were significantly associated with cataract among older adults in Ghana. Cataract is prevalent in older people in Ghana with approximately 1 in 20 people aged 50 years or older reporting a previous diagnosis of cataract. As cataract surgery is restorative, a public health approach on behavioural modification, well structured national outreach eye care services (for rural residents), inclusion of basic eye health services at sub-district levels, increased family support and national health insurance for older persons is indicated.

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.

Co-Creating a Psychiatric Resident Program with Ethiopians, for Ethiopians, in Ethiopia: The Toronto Addis Ababa Psychiatry Project (TAAPP)

ERIC Educational Resources Information Center

Alem, Atalay; Pain, Clare; Araya, Mesfin; Hodges, Brian D.

2010-01-01

Background: Globalization in medical education often means a "brain drain" of desperately needed health professionals from low- to high-income countries. Despite the best intentions, partnerships that simply transport students to Western medical schools for training have shockingly low return rates. Ethiopia, for example, has sent…

Educational Reform and Teacher Education in Ethiopia: Does the Tail Wag the Dog?

ERIC Educational Resources Information Center

Honig, Benson

Ethiopia, a country with 82 distinctly different languages and ethnic groups, has recently emerged from decades of civil war. In the process of restoring civilian rule, alliances have formed between a wide spectrum of local interest groups. Education generally, and language policy more specifically, continues to be one of the most contentious…

Technical Vocational Education and Training for Micro-Enterprise Development in Ethiopia: A Solution or Part of the Problem?

ERIC Educational Resources Information Center

Gondo, Tendayi; Dafuleya, Gift

2010-01-01

Technical vocational education and training (TVET) programmes have recently received increased attention as an area of priority for stimulating growth in developed and developing countries. This paper considers the situation in Ethiopia where the promotion of micro and small-sized enterprises (MSEs) has been central to the development and…

Globalization, Public Policy, and "Knowledge Gap": Ethiopian Youth and the HIV/AIDS Pandemic

ERIC Educational Resources Information Center

Fetene, Getnet Tizazu; Dimitriadis, Greg

2010-01-01

Set against trans- or supra-national policy initiatives which have framed the HIV/AIDS pandemic as in part a pedagogical issue, this paper critically explores local understandings of sexual practices (generally) as well as of HIV/AIDS (more specifically) among young people in the sub-Saharan African country of Ethiopia. Ethiopia has the third…

The Role of Ethiopia's Public Universities in Achieving the United Nations Sustainable Development Goals

ERIC Educational Resources Information Center

O'Keeffe, Paul

2016-01-01

In recent years, the Ethiopian government has embarked on an ambitious agriculture development strategy aimed at raising Ethiopia to the status of a middle-income-level country by 2025. Encouraged by the international development push behind the United Nations Sustainable Development Goals (SDGs), the rapid expansion of public universities has…

The changing face of women in physics in Ghana

NASA Astrophysics Data System (ADS)

Andam, Aba Bentil; Amponsah, Paulina Ekua; Nsiah-Akoto, Irene; Gyamfi, Kwame; Hood, Christiana Odumah

2013-03-01

Ghana is said to be the first independent sub-Saharan African country outside South Africa to promote science education and the application of science in industrial and social development. It has long been recognized that many schools' science curricula extend the extracurricular activities of boys more than those of girls. In order to bridge this gap, efforts have been made to give girls extra assistance in the learning of science by exposing them to science activities through specific camps, road shows, exhibitions, and so on. The best known of such efforts is the Science, Technology, and Mathematics Education (STME) camps and clinics for girls, which started in Ghana 23 years ago. Since our attendance at the Third International Conference on Women in Physics in Seoul, Korea, a lot has been achieved to further improve female science education, and this credit goes to STME. The first female nuclear engineer from Ghana graduated from the University of Ghana in March 2010.

Prevalence and correlates of contraceptive use among female adolescents in Ghana.

PubMed

Nyarko, Samuel H

2015-08-19

Adolescence is a critical stage in the life course and evidence suggests that even though contraceptive use has been steadily increasing among women in Ghana over the past years, contraceptive prevalence and determinants among female adolescents is quite lacking. This paper examines the prevalence and correlates of contraceptive use among female adolescents in Ghana. The paper used data from the 2008 Ghana Demographic and Health survey. Bivariate analysis was carried out to determine the contraceptive prevalence among female adolescents while logistic regression analysis was applied to examine the correlates of female adolescent contraceptive use. The study founded that female adolescent contraceptive use was significantly determined by age of adolescent, education, work status, knowledge of ovulatory cycle, visit of health facility and marital status. This has implications for adolescent sexual and reproductive health programmes in Ghana. It is therefore essential to intensify girl child education and strengthen the provision of family planning information and services for female adolescents in the country.

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 Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Redefining Entrepreneurial Learning Paradigms in Developing Countries: A Case Study of Ghana

ERIC Educational Resources Information Center

Owusu-Manu, D.; Afrane, S. K.; Badu, E.; Edwards, D. J.; Brown, M.

2013-01-01

In a rapidly changing world of knowledge exchange, innovation and technological advancements, entrepreneurship continues to fuel economic growth in both developed and developing countries. In the developed world, an increased influx of graduate entrepreneurs sustains economic growth whilst, in contrast, developing countries continue to suffer from…

Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey.

PubMed

Lakew, Yihunie; Reda, Ayalu A; Tamene, Habtamu; Benedict, Susan; Deribe, Kebede

2013-09-26

Modern contraceptive use persists to be low in most African countries where fertility, population growth, and unmet need for family planning are high. Though there is an evidence of increased overall contraceptive prevalence, a substantial effort remains behind in Ethiopia. This study aimed to identify factors associated with modern contraceptive use and to examine its geographical variations among 15-49 married women in Ethiopia. We conducted secondary analysis of 10,204 reproductive age women included in the 2011 Ethiopia Demographic and Health Survey (DHS). The survey sample was designed to provide national, urban/rural, and regional representative estimates for key health and demographic indicators. The sample was selected using a two-stage stratified sampling process. Bivariate and multivariate logistic regressions were applied to determine the prevalence of modern contraceptive use and associated factors in Ethiopia. Being wealthy, more educated, being employed, higher number of living children, being in a monogamous relationship, attending community conversation, being visited by health worker at home strongly predicted use of modern contraception. While living in rural areas, older age, being in polygamous relationship, and witnessing one's own child's death were found negatively influence modern contraceptive use. The spatial analysis of contraceptive use revealed that the central and southwestern parts of the country had higher prevalence of modern contraceptive use than that of the eastern and western parts. The findings indicate significant socio-economic, urban-rural and regional variation in modern contraceptive use among reproductive age women in Ethiopia. Strengthening community conversation programs and female education should be given top priority.

Characterisation of adopters and non-adopters of dairy technologies in Ethiopia and Kenya.

PubMed

Kebebe, E G; Oosting, S J; Baltenweck, I; Duncan, A J

2017-04-01

While there is a general consensus that using dairy technologies, such as improved breeds of dairy cows, can substantially increase farm productivity and income, adoption of such technologies has been generally low in developing countries. The underlying reasons for non-adoption of beneficial technologies in the dairy sector are not fully understood. In this study, we characterised adopters and non-adopters of dairy technologies in Ethiopia and Kenya based on farmers' resources ownership in order to identify why many farmers in Ethiopia and Kenya have not adopted improved dairy technologies. As compared to non-adopters, farmers who adopt dairy technology own relatively more farm resources. The result signals that differences in resource endowments could lead to divergent technology adoption scenarios. Results show that a higher proportion of sample smallholders in Kenya have adopted dairy technologies than those in Ethiopia. Except for the use of veterinary services, fewer than 10% of sample farmers in Ethiopia have adopted dairy technologies-less than half the number of adopters in Kenya. The higher level of dairy technology adoption in Kenya can be ascribed partly to the long history of dairy development, including improvements in the value chain for the delivery of inputs, services and fluid milk marketing. Interventions that deal with the constraints related to access to farm resources and input and output markets could facilitate uptake of dairy technology in developing countries.

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.

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

Novel Sources of Stripe Rust Resistance Identified by Genome-Wide Association Mapping in Ethiopian Durum Wheat (Triticumturgidumssp. durum)

USDA-ARS?s Scientific Manuscript database

Stripe rust of wheat, caused by Puccinia striiformis f. sp. tritici (Pst), is a global concern for wheat production and has been increasingly destructive in Ethiopia,as well as in the United States and many other countries. As Ethiopia has a long history of stripe rust epidemics, its native wheat ge...

Health, Nutrition and Informal Education of Pre-School Children in South-West Ethiopia.

ERIC Educational Resources Information Center

Negussie, Birgit

This report discusses the roles of health, nutrition and informal education in the preschool education of children in southwest Ethiopia. Information for the report is drawn from data from a study of traditional maternity and child care in the Southern Shewa region of the country. Mother and child health is a priority in Ethiopian health planning.…

Teachers' Career Ladder Policy in Ethiopia: An Opportunity for Professional Growth or ''a Stick Disguised as a Carrot?''

ERIC Educational Resources Information Center

Tekleselassie, Abebayehu A.

2005-01-01

In response to the ever-declining status of the teaching profession, and its adverse effects on the country's educational system, the Federal Ministry of Education in Ethiopia introduced a policy of the teachers' career ladder in 1994. While reformers believe that the introduction of the policy has improved the condition of the teaching…

Political Geographies of Academic Development in Jamaica, Ethiopia and Japan: Reflections on the Impossibilities of Neutrality

ERIC Educational Resources Information Center

Chisholm, Mervin E.; Jimma, Tefera Tadesse; Tatsuya, Natsume; Manathunga, Catherine

2012-01-01

The purpose of this dialogue was to begin grappling with notions of neutrality and academic development in three non-western contexts: (1) Jamaica; (2) Ethiopia; and (3) Japan. The authors were asked to describe the political geography of academic development in their countries and to explore questions of neutrality. This dialogue therefore tries…

Prevalence of Escherichia coli O157:H7 in beef cattle at slaughter and beef carcasses at retail shops in Ethiopia

USDA-ARS?s Scientific Manuscript database

Background: There is paucity of information regarding the epidemiology of Escherichia coli O157: H7 in developing countries. In this study, we investigated the occurrence of E. coli O157: H7 associated with beef cattle at processing plants and at retail shops in Ethiopia. Methods: Various samples we...

Medical technologies in developing countries: a feasibility study on the maintenance of medical equipment in Ethiopia.

PubMed

Bracale, M; Pepino, A

1994-03-01

The authors report the results of a feasibility study, sponsored by the Italian Foreign Ministry, of setting up a Regional Centre for the Management and Maintenance of Medical Technologies in Ethiopia. After some general considerations regarding the problems of co-operation in this field, the authors draft some concrete proposals for an operative programme.

Khat Use and Its Impact on Academic Performance: The Case of Jimma University, Ethiopia

ERIC Educational Resources Information Center

Abafita, Jemal; Chala, Badassa Wolteji; Eba, Kasahun; Kim, Kyung-Ryang; Kim, Chang-Soo

2015-01-01

The use or misuse of addictive substances like khat has become widespread among the youths especially in countries where the substance is produced and/or consumed. In this paper, we examine whether khat use has any impact on the academic achievement of university students with particular reference to undergraduates in Jimma University, Ethiopia.…

The Integrated Women's Empowering Programme (IWEP) as an Example for Establishing Basic Structures of a Nationwide Adult Education System in a Poor Country

ERIC Educational Resources Information Center

Sandhaas, Bernd

2008-01-01

Within Ethiopia's overall development strategy, the Integrated Women's Empowerment Programme (IWEP) aims to develop, test and implement a comprehensive nationwide approach to empower women and their households in selected areas of all regions/national states of Ethiopia. The programme provides functional literacy education and livelihood skills…

Adult Basic Literacy "Initiatives" in Ethiopia: Change and Continuity

ERIC Educational Resources Information Center

Kenea, Ambissa

2014-01-01

The major purpose of the study was to look into change and continuity in the policy and practices of adult basic literacy initiatives in Ethiopia and to deduce lessons that can be drawn from the experiences for the future of adult basic literacy program in the country and elsewhere. Data was obtained through critical review of documents on the…

Improving Primary School Practice and School-College Linkage in Ethiopia through Collaborative Action Research

ERIC Educational Resources Information Center

Worku, Mulugeta Yayeh

2017-01-01

In Ethiopia, as elsewhere in the world, action research is recognized as a valuable and cost-effective form of inquiry to improve classroom and school practices. It has been given due consideration, both by the Ministry of Education and teacher education institutes of the country. Nevertheless, studies conducted on the practice of action research…

Teaching Child Psychiatry in Ethiopia: Challenges and Rewards

PubMed Central

Teshima, John

2008-01-01

Introduction Ethiopia is a country of 81 million people, half of whom are children. The prevalence of psychiatric disorders in children ranges from 3.5–23.2%. However, there are very limited mental health resources in the country, including few psychiatrists. Thus the training of more psychiatrists, including providing them with expertise in child psychiatry, is an imperative. Method The article briefly reviews the development of the Toronto Addis Ababa Psychiatry Project (TAAPP), a collaborative program between the University of Toronto and Addis Ababa University designed to help train psychiatry residents in Ethiopia. The article then focuses on the author’s experiences on one recent trip to Ethiopia to provide some of this training. Results Formal teaching sessions as well as clinical supervision were provided to the Ethiopian residents. Content had to be adapted to be relevant to the Ethiopian context, but teaching approaches did not have to be modified significantly. The Ethiopian residents were very enthusiastic learners and made quick changes to their practices based on the teaching. Conclusion Collaborative programs such as TAAPP may be important mechanisms to improve the training of psychiatrists internationally, especially when there are limited local educational resources. PMID:18769645

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.

The development of cardiac surgery in West Africa-the case of Ghana

PubMed Central

Edwin, Frank; Tettey, Mark; Aniteye, Ernest; Tamatey, Martin; Sereboe, Lawrence; Entsua-Mensah, Kow; Kotei, David; Baffoe-Gyan, Kofi

2011-01-01

West Africa is one of the poorest regions of the world. The sixteen nations listed by the United Nations in this sub-region have some of the lowest gross domestic products in the world. Health care infrastructure is deficient in most of these countries. Cardiac surgery, with its heavy financial outlay is unavailable in many West African countries. These facts notwithstanding, some West African countries have a proud history of open heart surgery not very well known even in African health care circles. Many African health care givers are under the erroneous impression that the cardiovascular surgical landscape of West Africa is blank. However, documented reports of open-heart surgery in Ghana dates as far back as 1964 when surface cooling was used by Ghanaian surgeons to close atrial septal defects. Ghana's National Cardiothoracic Center is still very active and is accredited by the West African College of Surgeons for the training of cardiothoracic surgeons. Reports from Nigeria indicate open-heart surgery taking place from 1974. Cote D'Ivoire had reported on its first 300 open-heart cases by 1983. Senegal reported open-heart surgery from 1995 and still runs an active center. Cameroon started out in 2009 with work done by an Italian group that ultimately aims to train indigenous surgeons to run the program. This review traces the development and current state of cardiothoracic surgery in West Africa with Ghana's National Cardiothoracic Center as the reference. It aims to dispel the notion that there are no major active cardiothoracic centers in the West African sub-region. PMID:22355425

Perspectives on reasons for non-adherence to medication in persons with schizophrenia in Ethiopia: a qualitative study of patients, caregivers and health workers.

PubMed

Teferra, Solomon; Hanlon, Charlotte; Beyero, Teferra; Jacobsson, Lars; Shibre, Teshome

2013-06-17

Levels of non-adherence to antipsychotic medication in persons with schizophrenia in rural African settings have been shown to be comparable to those found in high-income countries. Improved understanding of the underlying reasons will help to inform intervention strategies relevant to the context. A qualitative study was conducted among persons with schizophrenia (n = 24), their caregivers (n = 19), research field workers (n = 7) and health workers (n = 1) involved in the ongoing population-based cohort study, 'The Butajira Study on Course and Outcome of Schizophrenia and Bipolar Disorder', based in rural Ethiopia. Six focus group discussions and 9 in-depth interviews were conducted to elicit perspectives on non-adherence to antipsychotic medication. Thematic analysis was used to identify prominent perspectives. Predominant reasons for non-adherence specific to a low-income country setting included inadequate availability of food to counter appetite stimulation and the perceived strength of antipsychotic medications. The vital role of the family or other social support in the absence of a statutory social safety net was emphasised. Expectations of cure, rather than need for continuing care, were reported to contribute to non-adherence in the longer-term. Many of the factors associated with non-adherence in high-income countries were also considered important in Ethiopia, including lack of insight, failure to improve with treatment, medication side effects, substance abuse, stigma and dissatisfaction with the attitude of the care provider. This study identifies additional barriers to medication adherence faced by persons with schizophrenia in Ethiopia compared to those in high-income countries. In this era of scaling up of mental health care, greater attention to provision of social and financial assistance will potentially improve adherence and thereby enable patients to benefit more fully from medication.

National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

PubMed

Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

2017-01-01

Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age-standardized death rates in Ethiopia in 2015. Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. However, the country's performance regarding non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, was minimal, causing these diseases to join the leading causes of premature mortality and death rates in 2015. While the country is progressing toward universal health coverage, prevention and control strategies in Ethiopia should consider the double burden of common infectious diseases and non-communicable diseases: lower respiratory infections, diarrhea, tuberculosis, HIV/AIDS, cardiovascular disease, cancer, and diabetes. Prevention and control strategies should also pay special attention to the leading causes of premature mortality and death rates caused by non-communicable diseases: cardiovascular disease, cancer, and diabetes. Measuring further progress requires a data revolution in generating, managing, analyzing, and using data for decision-making and the creation of a full vital registration system in the country.

National mortality burden due to communicable, non-communicable, and other diseases in Ethiopia, 1990-2015: findings from the Global Burden of Disease Study 2015.

PubMed

Misganaw, Awoke; Haregu, Tilahun N; Deribe, Kebede; Tessema, Gizachew Assefa; Deribew, Amare; Melaku, Yohannes Adama; Amare, Azmeraw T; Abera, Semaw Ferede; Gedefaw, Molla; Dessalegn, Muluken; Lakew, Yihunie; Bekele, Tolesa; Mohammed, Mesoud; Yirsaw, Biruck Desalegn; Damtew, Solomon Abrha; Krohn, Kristopher J; Achoki, Tom; Blore, Jed; Assefa, Yibeltal; Naghavi, Mohsen

2017-07-21

Ethiopia lacks a complete vital registration system that would assist in measuring disease burden and risk factors. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) estimates to describe the mortality burden from communicable, non-communicable, and other diseases in Ethiopia over the last 25 years. GBD 2015 mainly used cause of death ensemble modeling to measure causes of death by age, sex, and year for 195 countries. We report numbers of deaths and rates of years of life lost (YLL) for communicable, maternal, neonatal, and nutritional (CMNN) disorders, non-communicable diseases (NCDs), and injuries with 95% uncertainty intervals (UI) for Ethiopia from 1990 to 2015. CMNN causes of death have declined by 65% in the last two-and-a-half decades. Injury-related causes of death have also decreased by 70%. Deaths due to NCDs declined by 37% during the same period. Ethiopia showed a faster decline in the burden of four out of the five leading causes of age-standardized premature mortality rates when compared to the overall sub-Saharan African region and the Eastern sub-Saharan African region: lower respiratory infections, tuberculosis, HIV/AIDS, and diarrheal diseases; however, the same could not be said for ischemic heart disease and other NCDs. Non-communicable diseases, together, were the leading causes of age-standardized mortality rates, whereas CMNN diseases were leading causes of premature mortality in 2015. Although lower respiratory infections, tuberculosis, and diarrheal disease were the leading causes of age-standardized death rates, they showed major declines from 1990 to 2015. Neonatal encephalopathy, iron-deficiency anemia, protein-energy malnutrition, and preterm birth complications also showed more than a 50% reduction in burden. HIV/AIDS-related deaths have also decreased by 70% since 2005. Ischemic heart disease, hemorrhagic stroke, and ischemic stroke were among the top causes of premature mortality and age-standardized death rates in Ethiopia in 2015. Ethiopia has been successful in reducing deaths related to communicable, maternal, neonatal, and nutritional deficiency diseases and injuries by 65%, despite unacceptably high maternal and neonatal mortality rates. However, the country's performance regarding non-communicable diseases, including cardiovascular disease, diabetes, cancer, and chronic respiratory disease, was minimal, causing these diseases to join the leading causes of premature mortality and death rates in 2015. While the country is progressing toward universal health coverage, prevention and control strategies in Ethiopia should consider the double burden of common infectious diseases and non-communicable diseases: lower respiratory infections, diarrhea, tuberculosis, HIV/AIDS, cardiovascular disease, cancer, and diabetes. Prevention and control strategies should also pay special attention to the leading causes of premature mortality and death rates caused by non-communicable diseases: cardiovascular disease, cancer, and diabetes. Measuring further progress requires a data revolution in generating, managing, analyzing, and using data for decision-making and the creation of a full vital registration system in the country.

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.

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

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2014-01-01

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

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

Geographical variation and factors influencing modern contraceptive use among married women in Ethiopia: evidence from a national population based survey

PubMed Central

2013-01-01

Background Modern contraceptive use persists to be low in most African countries where fertility, population growth, and unmet need for family planning are high. Though there is an evidence of increased overall contraceptive prevalence, a substantial effort remains behind in Ethiopia. This study aimed to identify factors associated with modern contraceptive use and to examine its geographical variations among 15–49 married women in Ethiopia. Methods We conducted secondary analysis of 10,204 reproductive age women included in the 2011 Ethiopia Demographic and Health Survey (DHS). The survey sample was designed to provide national, urban/rural, and regional representative estimates for key health and demographic indicators. The sample was selected using a two-stage stratified sampling process. Bivariate and multivariate logistic regressions were applied to determine the prevalence of modern contraceptive use and associated factors in Ethiopia. Results Being wealthy, more educated, being employed, higher number of living children, being in a monogamous relationship, attending community conversation, being visited by health worker at home strongly predicted use of modern contraception. While living in rural areas, older age, being in polygamous relationship, and witnessing one’s own child’s death were found negatively influence modern contraceptive use. The spatial analysis of contraceptive use revealed that the central and southwestern parts of the country had higher prevalence of modern contraceptive use than that of the eastern and western parts. Conclusion The findings indicate significant socio-economic, urban–rural and regional variation in modern contraceptive use among reproductive age women in Ethiopia. Strengthening community conversation programs and female education should be given top priority. PMID:24067083

Re-Orienting Ethiopia's Educational Policy in the Classical Humanist Perspectives of Renaissance Utopias

ERIC Educational Resources Information Center

Debele, Meskerem L.

2018-01-01

Ethiopia has launched a grand scheme of renaissance to realise fast-paced economic growth. The two Growth and Transformation Plans spanning five years each (2010/11-2015/16 and 2016/17- 2020/21) outlined major targets towards which the country intends to mobilise all its resources. In the education sector, this vision is understood as producing a…

"Sexual Violence Is Not Good for Our Country's Development". Students' Interpretations of Sexual Violence in a Secondary School in Addis Ababa, Ethiopia

ERIC Educational Resources Information Center

Le Mat, Marielle L. J.

2016-01-01

It has been increasingly recognised that sexual violence in schools is one of the major concerns with regard to promoting sexual and reproductive health and rights. This paper examines how boys and girls define, experience, and interpret sexual violence in a secondary school in Addis Ababa, Ethiopia, and considers from their perspectives, how…

Introducing medical genetics services in Ethiopia using the MiGene Family History App.

PubMed

Quinonez, Shane C; Yeshidinber, Abate; Lourie, Michael A; Bekele, Delayehu; Mekonnen, Yemisrach; Nigatu, Balkachew; Metaferia, Gesit; Jebessa, Solomie

2018-06-11

Almost all low-income countries and many middle-income countries lack the capacity to deliver medical genetics services. We developed the MiGene Family History App (MFHA), which assists doctors with family history collection and population-level epidemiologic analysis. The MFHA was studied at St. Paul's Hospital in Addis Ababa, Ethiopia. A needs assessment was used to assess Ethiopian physicians' experience with genetics services. The MFHA then collected patient data over a 6-month period. The majority of doctors provide genetics services, with only 16% reporting their genetics knowledge is sufficient. A total of 1699 patients from the pediatric ward (n = 367), neonatal intensive care unit (NICU) (n = 477), and antenatal clinic (n = 855) were collected using the MFHA with a 4% incidence of a MFHA-screened condition present. The incidence was 11.7% in the pediatric ward, 3% in the NICU, and 0.5% in the antenatal clinic. Heart malformations (5.5% of patients) and trisomy 21 (4.4% of patients) were the most common conditions in the pediatric ward. Medical genetics services are needed in Ethiopia. As other countries increase their genetics capacity, the MFHA can provide fundamental genetics services and collect necessary epidemiologic data.

Does emotion and its daily fluctuation correlate with depression? A cross-cultural analysis among six developing countries.

PubMed

Chan, Derwin K C; Zhang, Xin; Fung, Helene H; Hagger, Martin S

2015-03-01

Utilizing a World Health Organization (WHO) multi-national dataset, the present study examined the relationships between emotion, affective variability (i.e., the fluctuation of emotional status), and depression across six developing countries, including China (N=15,050); Ghana (N=5,573); India (N=12,198); Mexico (N=5,448); South Africa (N=4,227); and Russia (N=4,947). Using moderated logistic regression and hierarchical multiple regression, the effects of emotion, affective variability, culture, and their interactions on depression and depressive symptoms were examined when statistically controlling for a number of external factors (i.e., age, gender, marital status, education level, income, smoking, alcohol drinking, physical activity, sedentary behavior, and diet). The results revealed that negative emotion was a statistically significant predictor of depressive symptoms, but the strength of association was smaller in countries with a lower incidence of depression (i.e., China and Ghana). The association between negative affective variability and the risk of depression was higher in India and lower in Ghana. Findings suggested that culture not only was associated with the incidence of depression, but it could also moderate the effects of emotion and affective variability on depression or the experience of depressive symptoms. Copyright © 2014 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Understanding the causes and consequences of injuries to adolescents growing up in poverty in Ethiopia, Andhra Pradesh (India), Vietnam and Peru: a mixed method study.

PubMed

Morrow, Virginia; Barnett, Inka; Vujcich, Daniel

2014-01-01

The World Health Organization estimates that almost half of all premature deaths among 15- to 19-year olds can be attributed to injuries with most (95%) fatal injuries occurring in low- and middle-income countries. Yet the evidence base for adolescent injuries in low-income countries is poor. This article uses a mixed method approach to gain an understanding of patterns, causes and consequences of unintentional injuries among adolescents aged between 14 and 16 years in four low-income country settings. Survey data collected in 2009 in Ethiopia, India (Andhra Pradesh), Peru and Vietnam (from ~900 adolescents in each country) were integrated with qualitative research (conducted between 2007 and 2011) with a nested sample of older cohort children in Ethiopia (n = 25) and India (n = 25) using an iterative process. Logistic regression models were fitted to examine potential risk factors for injuries. Injuries were a concern for adolescents in all countries and occurred during work, recreation and sports or transportation. Being male was associated with an increased risk for all types of injuries, whereas being poor was only significantly associated with work injuries. Area of residence (urban vs rural) made a difference in some countries and for some kinds of injuries as did perceived health status. Qualitative findings highlight the consequences of injuries not only for the adolescents but also for the social and economic status of the entire household. Injury prevention programmes need to be specific to cultural and environmental settings, expectations of adolescent's responsibilities and responsive to the context of poverty.

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, presented at national and international conferences, and summarised as research and policy briefs. PMID:27903563

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, amounting to a process best conceived as germination as opposed to emulation. The Ghana experience illustrates that in adopting health financing systems that function well, countries need to customise systems (policy customisation) to suit their socio-economic, political and administrative settings. Home-grown health financing systems that resonate with social values will also need to be found in the process of translation PMID:28812815

Feasibility of rapid ethical assessment for the Ethiopian health research ethics review system.

PubMed

Addissie, Adamu; Davey, Gail; Newport, Melanie; Farsides, Bobbie; Feleke, Yeweyenhareg

2015-01-01

One of the challenges in the process of ethical medical research in developing countries, including Ethiopia, is translating universal principles of medical ethics into appropriate informed consent documents and their implementation. Rapid Ethical Assessment (REA) has been suggested as a feasible approach to meet this application gap. In the past few years REA has been employed in few research project in Ethiopia and have been found to be a useful and practical approach. Feasibility assessment of REA for the Ethiopian research setting was conducted between 2012-2013 in order to inform the subsequent introduction of REA into research ethics review and governance system in the country. REA was found to be an appropriate, relevant and feasible venture. We argue that REA can be integrated as part of the ethics review and governance system in Ethiopia. REA tools and techniques are considered relevant and acceptable to the Ethiopian research community, with few practical challenges anticipated in their implementation. REA are considered feasible for integration in the Ethiopian ethics review system.

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.

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

Physician emigration from sub-Saharan Africa to the United States: analysis of the 2011 AMA physician masterfile.

PubMed

Tankwanchi, Akhenaten Benjamin Siankam; Ozden, Cağlar; Vermund, Sten H

2013-01-01

The large-scale emigration of physicians from sub-Saharan Africa (SSA) to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. We analyzed physician data from the World Health Organization (WHO) Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM) on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370) were SSA-trained, 20% (n = 2,126) were US-trained, and 12% (n = 1,323) were trained outside both SSA and the US. We estimated active physicians (age ≤ 70 years) to represent 96% (n = 10,377) of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (-156). The increase in last-decade migration was >50% in Nigeria (+1,113) and Ghana (+243), >100% in Ethiopia (+274), and >200% (+244) in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175) of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984-1999) of the structural adjustment programs. Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading destination for SSA physicians emigrating from the continent of greatest need. Please see later in the article for the Editors' Summary.

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.

Physician Emigration from Sub-Saharan Africa to the United States: Analysis of the 2011 AMA Physician Masterfile

PubMed Central

Tankwanchi, Akhenaten Benjamin Siankam; Özden, Çağlar; Vermund, Sten H.

2013-01-01

Background The large-scale emigration of physicians from sub-Saharan Africa (SSA) to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. Methods and Findings We analyzed physician data from the World Health Organization (WHO) Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM) on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370) were SSA-trained, 20% (n = 2,126) were US-trained, and 12% (n = 1,323) were trained outside both SSA and the US. We estimated active physicians (age ≤70 years) to represent 96% (n = 10,377) of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (−156). The increase in last-decade migration was >50% in Nigeria (+1,113) and Ghana (+243), >100% in Ethiopia (+274), and >200% (+244) in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175) of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984–1999) of the structural adjustment programs. Conclusion Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading destination for SSA physicians emigrating from the continent of greatest need. Please see later in the article for the Editors' Summary PMID:24068894

Expansion vs. Quality: Emerging Issues of For-Profit Private Higher Education Institutions in Ethiopia

NASA Astrophysics Data System (ADS)

Alemu, Daniel S.

2010-02-01

Private for-profit higher education has been rapidly expanding in developing countries worldwide since the early 1990s. This global trend has been particularly evident in Ethiopia, where only three public universities existed until 1996. By 2005, about 60 private for-profit higher education institutions had been founded in Ethiopia. This has led to mixed feelings among the Ethiopian public. While some laud the opportunities and advantages these new institutions bring, others are apprehensive that the quality of education might be compromised by an expansion motivated by monetary gain. This article sheds light on these paradoxes and provides suggestions for policy and practices.

Who will be there when women deliver? Assuring retention of obstetric providers.

PubMed

Anderson, Frank W J; Mutchnick, Ian; Kwawukume, E Y; Danso, K A; Klufio, C A; Clinton, Y; Yun, Luke Lu; Johnson, Timothy R B

2007-11-01

The Safe Motherhood Initiative has highlighted the need for improved health services with skilled attendants at delivery and the provision of emergency obstetric care. "Brain drain" has hampered this process and has been particularly prevalent in Ghana. Between 1993 and 2000, 68% of Ghanaian trained medical school graduates left the country. In 1989, postgraduate training in obstetrics and gynecology was established in Ghana, and as of November 2006, 37 of the 38 specialists who have completed the program have stayed in the country, most working in the public sector providing health care and serving as faculty. Interviews with graduates in 2002 found that the first and single-most important factor related to retention was the actual presence of a training program leading to specialty qualification in obstetrics and gynecology by the West African College of Surgeons. Economic and social factors also played major roles in a graduates' decision to stay in Ghana to practice. This model deserves replication in other countries that have a commitment to sustainable development, human resource and health services capacity building, and maternal mortality reduction. A network of University partnerships between departments of obstetrics and gynecology in developed and developing countries throughout the world sharing internet resources, clinical information, training curriculum and assessment techniques could be created. Grand rounds could be shared through teleconferencing, and faculty exchanges would build capacity for all faculty and enrich both institutions. Through new partnerships, creating opportunity for medical school graduates to become obstetrician-gynecologists may reduce brain drain and maternal mortality.

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

PubMed

Dapaah, Jonathan Mensah; Spronk, Rachel

2016-12-01

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

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

Who is being served least by family planning providers? A study of modern contraceptive use in Ghana, Tanzania And Zimbabwe.

PubMed

Clements, Steve; Madise, Nyovani

2004-08-01

This study was conducted to identify the poorest and other vulnerable sub-groups being served least by family planning providers. The study was set in three countries in sub-Saharan Africa, namely, Ghana, Tanzania and Zimbabwe. This region generally has a low but increasing uptake of modern contraceptive methods. As the use of family planning providers increases, there is a need to understand who is not being served and why. Logistic regression analyses of demographic and health survey data were conducted to identify the characteristics and geographical areas of women who are not using modern contraceptive methods. The results show some similarities among the countries in those using modern methods the least. However, a number of groups were country specific. Identifying the poorest women with the lowest use of modern methods is best done by assessing their household amenities or their partner's status rather than theirs.

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.

Biomedical laboratory science education: standardising teaching content in resource-limited countries.

PubMed

Arneson, Wendy; Robinson, Cathy; Nyary, Bryan

2013-01-01

There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA). Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS) lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates.

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.

The Potential of a Multimedia Open Educational Resource Module in Enhancing Effective Teaching and Learning in a Postgraduate Agricultural Program: Experience From AgShare Project Model

ERIC Educational Resources Information Center

Hassen, Jemal Yousuf

2013-01-01

Graduate programs in agriculture in developing countries such as in Ethiopia are often designed in cognizance of the need for skilled manpower for agricultural development. In Ethiopia, the contribution of graduates of agricultural graduate programs to the attempt to transform smallholder agriculture has become a matter of urgency in the face of…

Sickness absenteeism and associated factors among horticulture employees in lume district, southeast Ethiopia.

PubMed

Tadesse, Sebsibe; Ebrahim, Kamil; Gizaw, Zemichael

2015-01-01

Sickness absenteeism is the major occupational health problem in developing countries where the majority of working population are engaged in hazardous sectors, such as agriculture. However, there is a dearth of studies clarifying the situation in most of Subsaharan African countries, like Ethiopia. The present study determined the magnitude of sickness absenteeism and associated factors among horticulture employees in Lume District, southeast Ethiopia. An institutional-based cross-sectional study was conducted among horticulture employees in Lume District, southeast Ethiopia from March to May 2014. Stratified sampling followed by simple random sampling techniques was used to select the study participants. A pre-tested and structured questionnaire was used to collect data. Multivariable analyses were employed to see the effect of explanatory variables on dependent variable. The magnitude of sickness absenteeism was 58.8 % [95 % CI: (54.9, 62.5)] in the past three months. Absence of periodic medical checkup, working for more than 48 h per week, working overtime, job dissatisfaction, and job stress were factors significantly associated with sickness absenteeism. In this study a relatively higher rate of sickness absenteeism was reported compared to other studies. Interventions to reduce sickness absenteeism should focus on areas, such as periodic medical checkup, monitoring work schedules, improving employees' job satisfaction, and managing job stress.

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.

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.

The Audio-Visual Services in Fifteen African Countries. Comparative Study on the Administration of Audio-Visual Services in Advanced and Developing Countries. Part Four. First Edition.

ERIC Educational Resources Information Center

Jongbloed, Harry J. L.

As the fourth part of a comparative study on the administration of audiovisual services in advanced and developing countries, this UNESCO-funded study reports on the African countries of Cameroun, Republic of Central Africa, Dahomey, Gabon, Ghana, Kenya, Libya, Mali, Nigeria, Rwanda, Senegal, Swaziland, Tunisia, Upper Volta and Zambia. Information…

Human Heredity and Health (H3) in Africa Kidney Disease Research Network: A Focus on Methods in Sub-Saharan Africa.

PubMed

Osafo, Charlotte; Raji, Yemi Raheem; Burke, David; Tayo, Bamidele O; Tiffin, Nicki; Moxey-Mims, Marva M; Rasooly, Rebekah S; Kimmel, Paul L; Ojo, Akinlolu; Adu, Dwomoa; Parekh, Rulan S

2015-12-07

CKD affects an estimated 14% of adults in sub-Saharan Africa, but very little research has been done on the cause, progression, and prevention of CKD there. As part of the Human Heredity and Health in Africa (H3Africa) Consortium, the H3Africa Kidney Disease Research Network was established to study prevalent forms of kidney disease in sub-Saharan Africa and increase the capacity for genetics and genomics research. The study is performing comprehensive phenotypic characterization and analyzing environmental and genetic factors from nine clinical centers in four African countries (Ghana, Nigeria, Ethiopia, and Kenya) over a 5-year period. Approximately 4000 participants with specified kidney disease diagnoses and 4000 control participants will be enrolled in the four African countries. In addition, approximately 50 families with hereditary glomerular disease will be enrolled. The study includes both pediatric and adult participants age <1 to 74 years across a broad spectrum of kidney diseases secondary to hypertension-attributed nephropathy, diabetes, HIV infection, sickle cell disease, biopsy-proven glomerular disease, and CKD of unknown origin. Clinical and demographic data with biospecimens are collected to assess clinical, biochemical, and genetic markers of kidney disease. As of March 2015, a total of 3499 patients and controls have been recruited and 1897 had complete entry data for analysis. Slightly more than half (50.2%) of the cohort is female. Initial quality control of clinical data collection and of biosample and DNA analysis is satisfactory, demonstrating that a clinical research infrastructure can be successfully established in Africa. This study will provide clinical, biochemical, and genotypic data that will greatly increase the understanding of CKD in sub-Saharan Africa. Copyright © 2015 by the American Society of Nephrology.

Podoconiosis in Ethiopia: From Neglect to Priority Public Health Problem

PubMed Central

Deribe, Kebede; Kebede, Biruck; Mengistu, Belete; Negussie, Henok; Sileshi, Mesfin; Tamiru, Mossie; Tomczyk, Sara; Tekola-Ayele, Fasil; Davey, Gail; Fentaye, Amha

2017-01-01

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated master plan for NTDs. An integrated lymphoedema management guideline has been developed. Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this. PMID:28878431

Podoconiosis in Ethiopia: From Neglect to Priority Public Health Problem.

PubMed

Deribe, Kebede; Kebede, Biruck; Mengistu, Belete; Negussie, Henok; Sileshi, Mesfin; Tamiru, Mossie; Tomczyk, Sara; Tekola-Ayele, Fasil; Davey, Gail; Fentaye, Amha

2017-01-01

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated master plan for NTDs. An integrated lymphoedema management guideline has been developed. Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this.

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.

Strategies and Initiatives in Acculturation: Voices from Ghana

ERIC Educational Resources Information Center

Boafo-Arthur, Susan; Attah, Dzifa A.; Boafo-Arthur, Ama; Akoensi, Thomas D.

2017-01-01

Culture shock and acculturation are salient aspects of any international study trip. Over the years, many institutions have devised several strategies to help international students transition to life in the host country. However, most of these strategies are insensitive to diverse cultural or country specifics. Drawing from Social Learning…

Experiences of leadership in health care in sub-Saharan Africa.

PubMed

Curry, Leslie; Taylor, Lauren; Chen, Peggy Guey-Chi; Bradley, Elizabeth

2012-09-13

Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. We conducted a qualitative study using in-person interviews with individuals (n = 17) in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their country's minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Interviews were audio recorded and professionally transcribed. Data analysis was performed by a five-person multidisciplinary team using the constant comparative method, facilitated by ATLAS.ti 5.0 software. Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context. Developing such skills may require more time and a deeper level of engagement and collaboration than is typically invested in efforts to strengthen health systems.

Ethiopia.

PubMed

1988-07-01

Ethiopia lies in the Horn of Africa at the southern end of the Red Sea. It has the distinction of being the oldest independent country in Africa. In 1936, fascist Italy invaded and occupied Ethiopia, but Ethiopia regained its independence 5 years later with the help of colonial British forces. In 1974, civil unrest led to a coup and the armed forces deposed Emperor Haile Selassie. Today, the socialist government has a national legislature and a new constitution, both of which were created 13 years after the revolution. This government is faced with armed separatist movements in the autonomous regions of Eritrea and Tigre and also with periodic border conflicts with Somali forces. These conflicts combined with a massive drought in 1983-1985 and another in 1987 led to widespread famine in which an estimated 7.9 million people faced starvation and up to 1 million people died. Ethiopia has the potential for self-sufficiency in grains, livestock, vegetables, and fruits. Yet it's agriculture has been plagued not only with drought; but also soil degradation caused by overgrazing, deforestation, and high population density; dislocation due to the economy's rapid centralization; and government policies that do not provide incentives to producers. Still agriculture provides the basis of the nation's economy. Ethiopia has good relations with the Soviet Union, and the foreign policy of Ethiopia generally supports and parallels that of the USSR. After the revolution, the United States' relationship with Ethiopia has cooled because of differences over human rights. The US does assist with drought relief, however.

A westward extension of the tropical Pacific warm pool leads to March through June drying in Kenya and Ethiopia

USGS Publications Warehouse

Williams, A. Park; Funk, Christopher C.

2010-01-01

An estimated 14.3 million people are currently (July 2010) food insecure in Kenya and Ethiopia, and the U.S. government has spent more than $972 million on food aid in these two countries since 2009 (USAID, 2010). This insecurity stems from recent drought and rapid population growth that has outpaced agricultural development (Funk and others, 2008; Funk and Brown, 2009). Previous work by Funk and others (2005, 2008) and Verdin and others (2005) has linked drought conditions in Kenya and Ethiopia with warm sea surface temperatures (SSTs) in the Indian Ocean. Recent work has shown that Indian Ocean SSTs substantially affect rainfall in this region from March through June (Funk and others, 2008; Funk and Verdin, 2009). This season is known as the 'long rains' in Kenya and the 'Belg' rains in Ethiopia.

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.

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.

Travel history and malaria infection risk in a low-transmission setting in Ethiopia: a case control study

PubMed Central

2013-01-01

Background Malaria remains the leading communicable disease in Ethiopia, with around one million clinical cases of malaria reported annually. The country currently has plans for elimination for specific geographic areas of the country. Human movement may lead to the maintenance of reservoirs of infection, complicating attempts to eliminate malaria. Methods An unmatched case–control study was conducted with 560 adult patients at a Health Centre in central Ethiopia. Patients who received a malaria test were interviewed regarding their recent travel histories. Bivariate and multivariate analyses were conducted to determine if reported travel outside of the home village within the last month was related to malaria infection status. Results After adjusting for several known confounding factors, travel away from the home village in the last 30 days was a statistically significant risk factor for infection with Plasmodium falciparum (AOR 1.76; p=0.03) but not for infection with Plasmodium vivax (AOR 1.17; p=0.62). Male sex was strongly associated with any malaria infection (AOR 2.00; p=0.001). Conclusions Given the importance of identifying reservoir infections, consideration of human movement patterns should factor into decisions regarding elimination and disease prevention, especially when targeted areas are limited to regions within a country. PMID:23347703

The role of Ethiopia's public universities in achieving the United Nations Sustainable Development Goals

NASA Astrophysics Data System (ADS)

O'Keeffe, Paul

2016-12-01

In recent years, the Ethiopian government has embarked on an ambitious agriculture development strategy aimed at raising Ethiopia to the status of a middle-income-level country by 2025. Encouraged by the international development push behind the United Nations Sustainable Development Goals (SDGs), the rapid expansion of public universities has taken centre stage in facilitating the country's aim of equipping a new generation with the expertise needed to fuel the country's economic development. While impressive strides have been made over the last two decades, various development challenges threaten to derail this promising progress. This article examines three of the main challenges - urbanisation, climate change and food security - and the potential for universities to address them. Based on a study using key informant analysis research with 50 experts in Ethiopian education and development, the author concludes that the developing public university system offers promising capabilities to assist the country on its developmental path despite many inherent problems.

Visceral Leishmaniasis in Ethiopia: An Evolving Disease

PubMed Central

Leta, Samson; Dao, Thi Ha Thanh; Mesele, Frehiwot; Alemayehu, Gezahegn

2014-01-01

Visceral leishmaniasis (also known as kala-azar) is classified as one of the most neglected tropical diseases. It is becoming a growing health problem in Ethiopia, with endemic areas that are continually spreading. The annual burden of visceral leishmaniasis (VL) in Ethiopia is estimated to be between 4,500 and 5,000 cases, and the population at risk is more than 3.2 million. There has been a change in the epidemiology of VL in Ethiopia. Over the last decades, almost all cases and outbreaks of VL were reported from arid and semi-arid parts of the country; however, recent reports indicated the introduction of this disease into the highlands. Migration of labourers to and from endemic areas, climatic and environmental changes, and impaired immunity due to HIV/AIDS and malnutrition resulted in the change of VL epidemiology. HIV spurs the spread of VL by increasing the risk of progression from asymptomatic infection towards full VL. Conversely, VL accelerates the onset of AIDS. In Ethiopia, VL epidemiology remains complex because of the diversity of risk factors involved, and its control is becoming an increasing challenge. This paper reviews the changes in epidemiology of VL in Ethiopia and discusses some of the possible explanations for these changes. The prospects for novel approaches to VL control are discussed, as are the current and future challenges facing Ethiopia's public health development program. PMID:25188253

Some structural aspects of urbanization in Ethiopia.

PubMed

Rafiq, M; Hailemariam, A

1987-07-01

This article studies the emerging patterns of urbanization in Ethiopia. Over the period from 1967-1984, a number of structural changes have occurred which are likely to play a dominant role in the future urban growth in Ethiopia. In spite of its long history of settled population, Ethiopia did not witness sustained growth of urban centers. Ethiopia is 1 of the least urbanized areas in the Third World. A 3rd aspect of urbanization in Ethiopia is the wide range of regional differentials in the level of urbanization. Most of the urban population is concentrated in 2 administrative regions--Shoa and Eritrea. A more balanced urban growth may, inter alia, involve a better spread in terms of higher education, industrialization, provision of health and social services, and the development of communication and commercial infrastructure. Another striking feature of urbanization in Ethiopia is that growth has not been disproportionately concentrated in the largest urban centers. The largest urban centers have not assumed an inordinately higher level of primacy. The basic form of the curve depicting the relationship between the size of a locality and its rank has remained unchanged over the period. The post-revolution land reforms and the new socioeconomic structure emerging from reorganization of the society appear to have a rural-urban migration inhibiting effect. Some of the country's regional differentials may be associated with environmental factors.

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia

PubMed Central

Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna

2016-01-01

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. PMID:27591203

The nutrition transition and adolescents' diets in low- and middle-income countries: a cross-cohort comparison.

PubMed

Aurino, Elisabetta; Fernandes, Meena; Penny, Mary E

2017-01-01

To investigate changes in dietary diversity and dietary composition among adolescents in four developing countries. We analysed dietary diversity and consumption of seven food groups and foods with added sugars as reported by adolescents from two cohorts growing up 8 years apart, when they were aged about 12 years. Ethiopia, India (Andhra Pradesh), Peru and Vietnam in 2006 and 2013. Adolescents (n 3659) from the older cohort (OC) born in 1995/96 and adolescents (n 7422) from the younger cohort (YC) born in 2001/02 (N 11 081). Controlling for other factors, dietary diversity increased in Peru (OC=4·89, YC=5·34, P<0·001) and Ethiopia (OC=3·52, YC=3·94, P=0·001). Dietary diversity was stable in India (OC=4·28, YC=4·29, P=0·982) and Vietnam (OC=4·71, YC=4·73, P=0·814); however, changes in dietary composition were observed. YC adolescents were more likely to consume eggs (India: +32 %, P=0·038; Vietnam: +50 %, P<0·001) and milk and dairy (India: +12 %, P=0·029; Vietnam: +46 %, P<0·001). Other notable shifts included meat consumption in Peru (+72 %, P<0·001) and consumption of fruit and vegetables in Ethiopia (+36 %, P<0·001). Compared with OC, the prevalence of added sugar consumption was greater among the YC in Ethiopia (+35 %, P=0·001) and Vietnam (+44 % P<0·001). Between 2006 and 2013, disparities in dietary diversity associated with household wealth and place of residence declined, although this varied by country. No marked gender disparities in dietary diversity were evident. We found significant changes over time in dietary diversity among adolescents in four countries consistent with the hypothesis of the nutrition transition.

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

USGS Publications Warehouse

Gill, H.E.

1969-01-01

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

Regression Analysis to Identify Factors Associated with Household Salt Iodine Content at the Sub-National Level in Bangladesh, India, Ghana and Senegal

PubMed Central

Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Nahar, Baitun; Touré, Ndeye Khady; Amoaful, Esi Foriwa; Gorstein, Jonathan

2018-01-01

Regression analyses of data from stratified, cluster sample, household iodine surveys in Bangladesh, India, Ghana and Senegal were conducted to identify factors associated with household access to adequately iodised salt. For all countries, in single variable analyses, household salt iodine was significantly different (p < 0.05) between strata (geographic areas with representative data, defined by survey design), and significantly higher (p < 0.05) among households: with better living standard scores, where the respondent knew about iodised salt and/or looked for iodised salt at purchase, using salt bought in a sealed package, or using refined grain salt. Other country-level associations were also found. Multiple variable analyses showed a significant association between salt iodine and strata (p < 0.001) in India, Ghana and Senegal and that salt grain type was significantly associated with estimated iodine content in all countries (p < 0.001). Salt iodine relative to the reference (coarse salt) ranged from 1.3 (95% CI 1.2, 1.5) times higher for fine salt in Senegal to 3.6 (95% CI 2.6, 4.9) times higher for washed and 6.5 (95% CI 4.9, 8.8) times higher for refined salt in India. Sub-national data are required to monitor equity of access to adequately iodised salt. Improving household access to refined iodised salt in sealed packaging, would improve iodine intake from household salt in all four countries in this analysis, particularly in areas where there is significant small-scale salt production. PMID:29671774

Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam123

PubMed Central

Humphries, Debbie L; Dearden, Kirk A; Crookston, Benjamin T; Fernald, Lia C; Stein, Aryeh D; Woldehanna, Tassew; Penny, Mary E; Behrman, Jere R

2015-01-01

Background: Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. Objectives: We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index–for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. Methods: We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n = 1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ∼1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). Results: Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, −0.33; India, −0.53; Peru, −0.31; and Vietnam, −0.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, −0.21; India, −0.32; Peru, −0.14; and Vietnam, −0.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8–30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4–19.3%) in other countries. Conclusions: In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam. PMID:26084361

Cross-Sectional and Longitudinal Associations between Household Food Security and Child Anthropometry at Ages 5 and 8 Years in Ethiopia, India, Peru, and Vietnam.

PubMed

Humphries, Debbie L; Dearden, Kirk A; Crookston, Benjamin T; Fernald, Lia C; Stein, Aryeh D; Woldehanna, Tassew; Penny, Mary E; Behrman, Jere R

2015-08-01

Poor childhood nutritional status has lifetime effects and food insecurity is associated with dietary practices that can impair nutritional status. We assessed concurrent and subsequent associations between food insecurity and height-for-age z scores (HAZs) and body mass index-for-age z scores (BMI-Zs); evaluated associations with transitory and chronic food insecurity; and tested whether dietary diversity mediates associations between food insecurity and nutritional status. We used data from the Young Lives younger cohort composed of children in Ethiopia (n = 1757), India (n = 1825), Peru (n = 1844), and Vietnam (n = 1828) recruited in 2002 (round 1) at ∼1 y old, with subsequent data collection at 5 y in 2006 (round 2) and 8 y in 2009 (round 3). Children from food-insecure households had significantly lower HAZs in all countries at 5 y (Ethiopia, -0.33; India, -0.53; Peru, -0.31; and Vietnam, -0.68 HAZ; all P < 0.001), although results were attenuated after controlling for potential confounders (Ethiopia, -0.21; India, -0.32; Peru, -0.14; and Vietnam, -0.27 HAZ; P < 0.01). Age 5 y food insecurity predicted the age 8 y HAZ, but did not add predictive power beyond HAZ at age 5 y in Ethiopia, India, or Peru. Age 5 y food insecurity predicted the age 8 y BMI-Z even after controlling for the 5 y BMI-Z, although associations were not significant after the inclusion of additional confounding variables (Ethiopia, P = 0.12; India, P = 0.29; Peru, P = 0.16; and Vietnam, P = 0.51). Chronically food-insecure households had significantly lower HAZs than households that were consistently food-secure, although BMI-Zs did not differ by chronic food-insecurity status. Dietary diversity mediated 18.8-30.5% of the association between food security and anthropometry in Vietnam, but mediated to a lesser degree (8.4-19.3%) in other countries. In 4 countries, food insecurity at 5 y of age was associated with both HAZ and BMI-Z at age 8 y, although the association was attenuated after adjusting for other household factors and anthropometry at age 5 y, and remained significant only for the HAZ in Vietnam. © 2015 American Society for Nutrition.

Spatial patterns of multidrug resistant tuberculosis and relationships to socio-economic, demographic and household factors in northwest Ethiopia.

PubMed

Alene, Kefyalew Addis; Viney, Kerri; McBryde, Emma S; Clements, Archie C A

2017-01-01

Understanding the geographical distribution of multidrug-resistant tuberculosis (MDR-TB) in high TB burden countries such as Ethiopia is crucial for effective control of TB epidemics in these countries, and thus globally. We present the first spatial analysis of multidrug resistant tuberculosis, and its relationship to socio-economic, demographic and household factors in northwest Ethiopia. An ecological study was conducted using data on patients diagnosed with MDR-TB at the University of Gondar Hospital MDR-TB treatment centre, for the period 2010 to 2015. District level population data were extracted from the Ethiopia National and Regional Census Report. Spatial autocorrelation was explored using Moran's I statistic, Local Indicators of Spatial Association (LISA), and the Getis-Ord statistics. A multivariate Poisson regression model was developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using a Bayesian Markov chain Monte Carlo (MCMC) simulation approach with Gibbs sampling, in WinBUGS. A total of 264 MDR-TB patients were included in the analysis. The overall crude incidence rate of MDR-TB for the six-year period was 3.0 cases per 100,000 population. The highest incidence rate was observed in Metema (21 cases per 100,000 population) and Humera (18 cases per 100,000 population) districts; whereas nine districts had zero cases. Spatial clustering of MDR-TB was observed in districts located in the Ethiopia-Sudan and Ethiopia-Eritrea border regions, where large numbers of seasonal migrants live. Spatial clustering of MDR-TB was positively associated with urbanization (RR: 1.02; 95%CI: 1.01, 1.04) and the percentage of men (RR: 1.58; 95% CI: 1.26, 1.99) in the districts; after accounting for these factors there was no residual spatial clustering. Spatial clustering of MDR-TB, fully explained by demographic factors (urbanization and percent male), was detected in the border regions of northwest Ethiopia, in locations where seasonal migrants live and work. Cross-border initiatives including options for mobile TB treatment and follow up are important for the effective control of MDR-TB in the region.

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.

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.

Biomedical laboratory science education: standardising teaching content in resource-limited countries

PubMed Central

Robinson, Cathy; Nyary, Bryan

2013-01-01

Background There is a worldwide shortage of qualified laboratory personnel to provide adequate testing for the detection and monitoring of diseases. In an effort to increase laboratory capacity in developing countries, new skills have been introduced into laboratory services. Curriculum revision with a focus on good laboratory practice is an important aspect of supplying entry-level graduates with the competencies needed to meet the current needs. Objectives Gaps in application and problem-solving competencies of newly graduated laboratory personnel were discovered in Ethiopia, Tanzania and Kenya. New medical laboratory teaching content was developed in Ethiopia, Tanzania and Kenya using national instructors, tutors, and experts and consulting medical laboratory educators from the United States of America (USA). Method Workshops were held in Ethiopia to create standardised biomedical laboratory science (BMLS) lessons based on recently-revised course objectives with an emphasis on application of skills. In Tanzania, course-module teaching guides with objectives were developed based on established competency outcomes and tasks. In Kenya, example interactive presentations and lesson plans were developed by the USA medical laboratory educators prior to the workshop to serve as resources and templates for the development of lessons within the country itself. Results The new teaching materials were implemented and faculty, students and other stakeholders reported successful outcomes. Conclusions These approaches to updating curricula may be helpful as biomedical laboratory schools in other countries address gaps in the competencies of entry-level graduates. PMID:29043162

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana.

PubMed

Fenny, Ama P

2017-01-01

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.

Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease's, Eradication Strategies and Challenges to the End Game.

PubMed

Beyene, Habtamu Bedimo; Bekele, Abyot; Shifara, Amanu; Ebstie, Yehenew A; Desalegn, Zelalem; Kebede, Zeyede; Mulugeta, Abate; Deribe, Kebede; Tadesse, Zerihun; Abebe, Tamrat; Kebede, Biruck; Abrha, Getaneh; Jima, Daddi

2017-01-01

Dracunculiasis, also named Guinea Worm Disease (GWD), is one of the Neglected Tropical Diseases (NTDs) caused by a parasitic nematode known as Dracunculus medinensis and has been known since antiquity as 'fiery serpent' from Israelites. It is transmitted to humans via drinking contaminated water containing infective copepods. Given, its feasibility for eradication, the Guinea Worm Eradication Program (GWEP) was launched in 1980 with the aim of eradicating the disease. Since its inception, GWEP has made an extraordinary progress in interrupting transmission. Globally, the number of reported cases reduced from 3.5 million in 20 countries in 1986 to only 22 cases in 2015 from only four countries namely South Sudan, Mali, Chad and Ethiopia. Since Mali has interrupted transmission of GWD in 2016, currently, the disease remains endemic in only three sub-Saharan African countries namely, South Sudan, Chad and Ethiopia. Each endemic country has its own national Guinea Worm Eradication Program. In Ethiopia, the Ethiopian Dracunculiasis Eradication Program (EDEP) which was established in 1993 has made remarkable move towards interruption of disease transmission and now the endgame is fast approaching. The EDEP with support mainly from The Carter Center, WHO, and UNICEF has reduced GWD by more than 99% from 1994 to 2015. In 2015, only 3 indigenous cases in humans and 14 in animals (13 in dogs and 1 in baboon) were reported. In 2016, 3 human cases, 14 dogs and 2 baboon infections were reported.. Refugee influx from the Republic of South Sudan (RSS), increased animal infections with unknown role in transmission of Dracunculiasis, the presence of hard to reach communities and lack of safe water sources in remote non-village areas remain among important challenges at this final stage of GWD eradication in Ethiopia. This paper reviews progress made towards Guinea Worm Eradication with a focus on the experience of the Ethiopian Dracunculiasis Eradication Program (EDEP), and intervention strategies that need further intensification to realize the endgame. Eradication strategies encompassing community education for behavioral change including raising awareness towards cash reward for reporting Guniea Worm Disease (GWD) and animal infection, case containment, surveillance systems, provision of safe water supply, and ABATE chemical application are discussed. It also summarizes challenges the end game faces and recommendations to strengthen the eradication effort.

Elimination of Guinea Worm Disease in Ethiopia; Current Status of the Disease’s, Eradication Strategies and Challenges to the End Game

PubMed Central

Beyene, Habtamu Bedimo; Bekele, Abyot; Shifara, Amanu; Ebstie, Yehenew A.; Desalegn, Zelalem; Kebede, Zeyede; Mulugeta, Abate; Deribe, Kebede; Tadesse, Zerihun; Abebe, Tamrat; Kebede, Biruck; Abrha, Getaneh; Jima, Daddi

2017-01-01

Dracunculiasis, also named Guinea Worm Disease (GWD), is one of the Neglected Tropical Diseases (NTDs) caused by a parasitic nematode known as Dracunculus medinensis and has been known since antiquity as ‘fiery serpent’ from Israelites. It is transmitted to humans via drinking contaminated water containing infective copepods. Given, its feasibility for eradication, the Guinea Worm Eradication Program (GWEP) was launched in 1980 with the aim of eradicating the disease. Since its inception, GWEP has made an extraordinary progress in interrupting transmission. Globally, the number of reported cases reduced from 3.5 million in 20 countries in 1986 to only 22 cases in 2015 from only four countries namely South Sudan, Mali, Chad and Ethiopia. Since Mali has interrupted transmission of GWD in 2016, currently, the disease remains endemic in only three sub-Saharan African countries namely, South Sudan, Chad and Ethiopia. Each endemic country has its own national Guinea Worm Eradication Program. In Ethiopia, the Ethiopian Dracunculiasis Eradication Program (EDEP) which was established in 1993 has made remarkable move towards interruption of disease transmission and now the endgame is fast approaching. The EDEP with support mainly from The Carter Center, WHO, and UNICEF has reduced GWD by more than 99% from 1994 to 2015. In 2015, only 3 indigenous cases in humans and 14 in animals (13 in dogs and 1 in baboon) were reported. In 2016, 3 human cases, 14 dogs and 2 baboon infections were reported.. Refugee influx from the Republic of South Sudan (RSS), increased animal infections with unknown role in transmission of Dracunculiasis, the presence of hard to reach communities and lack of safe water sources in remote non-village areas remain among important challenges at this final stage of GWD eradication in Ethiopia. This paper reviews progress made towards Guinea Worm Eradication with a focus on the experience of the Ethiopian Dracunculiasis Eradication Program (EDEP), and intervention strategies that need further intensification to realize the endgame. Eradication strategies encompassing community education for behavioral change including raising awareness towards cash reward for reporting Guniea Worm Disease (GWD) and animal infection, case containment, surveillance systems, provision of safe water supply, and ABATE chemical application are discussed. It also summarizes challenges the end game faces and recommendations to strengthen the eradication effort. PMID:28878428

Systematic review on traditional medicinal plants used for the treatment of malaria in Ethiopia: trends and perspectives.

PubMed

Alebie, Getachew; Urga, Befikadu; Worku, Amha

2017-08-01

Ethiopia is endowed with abundant medicinal plant resources and traditional medicinal practices. However, available research evidence on indigenous anti-malarial plants is highly fragmented in the country. The present systematic review attempted to explore, synthesize and compile ethno-medicinal research evidence on anti-malarial medicinal plants in Ethiopia. A systematic web search analysis and review was conducted on research literature pertaining to medicinal plants used for traditional malaria treatment in Ethiopia. Data were collected from a total of 82 Ethiopian studies meeting specific inclusion criteria including published research articles and unpublished thesis reports. SPSS Version 16 was used to summarize relevant ethno-botanical/medicinal information using descriptive statistics, frequency, percentage, tables, and bar graphs. A total of 200 different plant species (from 71 families) used for traditional malaria treatment were identified in different parts of Ethiopia. Distribution and usage pattern of anti-malarial plants showed substantial variability across different geographic settings. A higher diversity of anti-malarial plants was reported from western and southwestern parts of the country. Analysis of ethno-medicinal recipes indicated that mainly fresh leaves were used for preparation of remedies. Decoction, concoction and eating/chewing were found to be the most frequently employed herbal remedy preparation methods. Notably, anti-malarial herbal remedies were administered by oral route. Information on potential side effects of anti-malarial herbal preparations was patchy. However, some anti-malarial plants were reported to have potentially serious side effects using different local antidotes and some specific contra-indications. The study highlighted a rich diversity of indigenous anti-malarial medicinal plants with equally divergent herbal remedy preparation and use pattern in Ethiopia. Baseline information gaps were observed in key geographic settings. Likewise, herbal remedy toxicity risks and countermeasures generally entailed more exhaustive investigation. Experimental research and advanced chemical analysis are also required to validate the therapeutic potential of anti-malarial compounds from promising plant species.

76 FR 55419 - Report on Countries That Are Candidates for Millennium Challenge Account Eligibility in Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-07

... programs that advance the progress of such countries to achieve lasting economic growth and poverty [[Page...) investments in its people; and (b) considering the opportunity to reduce poverty and generate economic growth...; Ghana, Guinea, Haiti, Honduras, India, Kenya, Kyrgyz Republic, Lao PDR, Lesotho, Liberia, Malawi, Mali...

A Survey of Library Services to Children and Young Adults in Selected Developing Countries in Africa and Asia.

ERIC Educational Resources Information Center

Craver, Kathleen W.

1985-01-01

Review of developments in children and young adult library services since 1979 discusses three factors that complicate methods used to combat illiteracy problem: population growth, language, and undeveloped readership. Countries studied are Libya, Kenya, Tanzania, Angola, Zambia, Zimbabwe, Ghana, Nigeria, Gambia, Thailand, Singapore, Philippines,…

Establishing space activities in non-space faring nations: An example of university-based strategic planning

NASA Astrophysics Data System (ADS)

Faure, Pauline; Cho, Mengu; Maeda, George

2018-07-01

In 2015, Kyushu Institute of Technology initiated the Joint Global Multi-Nation Birds Satellite (BIRDS) program. As of September 2017, young professionals from Bangladesh, Ghana, Nigeria, Thailand, Mongolia, Philippines, Malaysia, and Bhutan are being involved in BIRDS program. To help the young professionals acquiring the right tools and preparing them to successfully establish indigenous space activities, the space strategic planning project was established in February 2017. During the project, young professionals from Bangladesh, Ghana, Mongolia, and Bhutan were invited to think about the strategy their home country should be following in the next ten years to achieve their country's goals in terms of space sciences, engineering, and utilization, while respecting the country needs and constraints. In this paper, the efforts undertaken by the different young professionals are reported and the guidelines for each country space strategic planning are described. From this work, the authors aim at promoting space activities development in non-space faring nations and encouraging non-space faring nations to find their right strategy to achieve sustainable indigenous space activities despite the nation's constraints.

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed Central

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-01-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific. PMID:21729919

Comparing private sector family planning services to government and NGO services in Ethiopia and Pakistan: how do social franchises compare across quality, equity and cost?

PubMed

Shah, Nirali M; Wang, Wenjuan; Bishai, David M

2011-07-01

Policy makers in developing countries need to assess how public health programmes function across both public and private sectors. We propose an evaluation framework to assist in simultaneously tracking performance on efficiency, quality and access by the poor in family planning services. We apply this framework to field data from family planning programmes in Ethiopia and Pakistan, comparing (1) independent private sector providers; (2) social franchises of private providers; (3) non-government organization (NGO) providers; and (4) government providers on these three factors. Franchised private clinics have higher quality than non-franchised private clinics in both countries. In Pakistan, the costs per client and the proportion of poorest clients showed no differences between franchised and non-franchised private clinics, whereas in Ethiopia, franchised clinics had higher costs and fewer clients from the poorest quintile. Our results highlight that there are trade-offs between access, cost and quality of care that must be balanced as competing priorities. The relative programme performance of various service arrangements on each metric will be context specific.

Mapping Distribution and Forecasting Invasion of Prosopis juliflora in Ethiopia's Afar Region

NASA Astrophysics Data System (ADS)

West, A. M.; Wakie, T.; Luizza, M.; Evangelista, P.

2014-12-01

Invasion of non-native species is among the most critical threats to natural ecosystems and economies world-wide. Mesquite (which includes some 45 species) is an invasive deciduous tree which is known to have an array of negative impacts on ecosystems and rural livelihoods in arid and semi-arid regions around the world, dominating millions of hectares of land in Asia, Africa, Australia and the Americas. In Ethiopia, Prosopis juliflora (the only reported mesquite) is the most pervasive plant invader, threatening local livelihoods and the country's unique biodiversity. Due to its rapid spread and persistence, P. juliflora has been ranked as one of the leading threats to traditional land use, exceeded only by drought and conflict. This project utilized NASA's Earth Observing System (EOS) data and species distribution modeling to map current infestations of P. juliflora in the Afar region of northeastern Ethiopia, and forecast its suitable habitat across the entire country. This project provided a time and cost-effective strategy for conducting risk assessments of invasive mesquite and subsequent monitoring and mitigation efforts by land managers and local communities.

PREVALENCE OF BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER IN AFRICANS AND AFRICANS IN THE DIASPORA.

PubMed

Yeboah, E D

2016-01-01

There have been several publications on population or community prevalence of benign prostatic hyperplasia and prostate cancer from various countries and races but few reports are from Africa on Africans. A review on the prevalence of benign prostatic hyperplasia and prostate cancer in Africans and other races. The current literature on prevalence of benign prostatic hyperplasia (BPH), prostate cancer (PC), and benign prostatic hyperplasia co-existing with prostate cancer in Africans and other races is reviewed. Benign prostatic hyperplasia (BPH) prevalence in Ghana is responsible for 60% acute retention of urine and 28.6% of haematuria. Worldwide prevalence of BPH varies from 20 - 62% in men over 50 years and this includes USA, UK, Japan and Ghana. Reports from South Africa indicate prevalence of over 50% in adult males of 60 years. BPH co-existing with PC - Reports from USA, UK and Japan and Ghana reveal moderate association of BPH and PC. The co-existence of PC in patients being treated for BPH is 3 - 20% Prostate Cancer prevalence - There is high prevalence in USA, Scandinavian Countries, African Americans (AA) and Caribbean blacks. Ghana, Trinidad & Tobago have reported high prevalence of 6 -10% in men aged 50 years and above but others reported low prevalence in Africans from Africa. The low reporting from Africa of 10 - 40:100,000 is attributable to under reporting, absence of PSA screening/testing, lack of reliable cancer registries and poor medical facilities. Economic Costs of BPH and PC: BPH in the USA national direct costs are estimated at U$4Billion and individual costs of US$1536 annually. In Ghana, individual costs for BPH medications range from US$300 - 550 per year and cost for simple prostatectomy/TURP is estimated at US$1100. For prostate cancer, individual direct costs from Europe range from 6,575 - 12,000 euros, £2818.00 UK and over U$12,000 - 20,000 in USA per annum. In Ghana, individual direct costs ranges, for radical prostatectomy and external beam radiotherapy US$1250 - 1500, for brachytherapy 9,000 Euros, for hormonal therapy US$1600 - 3200) per year and US$510 for orchidectomy. Recent evidence although sparse indicate there is high prevalence of BPH and PC in Africans and men of African descent in diaspora, the low prevalence of BPH and PC reported from some African countries is likely to under reporting and future prevalence studies both in the living and deceased are recommended to reveal the true prevalence of BPH and PC in Africans though screening for PC in the living remains controversial.

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.

Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability.

PubMed

Daviaud, Emmanuelle; Besada, Donnela; Leon, Natalie; Rohde, Sarah; Sanders, David; Oliphant, Nicholas; Doherty, Tanya

2017-06-01

Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduced to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level scale-up implications. The paper focuses on costs to provider (health system and donors) to inform planning and budgeting, and does not cover cost-effectiveness. The analysis combines annualised set-up costs and 1 year implementation costs to calculate incremental economic and financial costs per treatment from a provider perspective. Affordability is assessed by calculating the per capita financial cost of the program as a percentage of the public health expenditure per capita. Time and financial implications of a 30% increase in utilization were modeled. Country scale-up is modeled for all children under 5 in rural areas. Utilization of iCCM services varied from 0.05 treatment/y/under-five in Ethiopia to over 1 in Niger. There were between 10 and 603 treatments/community health worker (CHW)/y. Consultation cost represented between 93% and 22% of economic costs per treatment influenced by the level of utilization. Weighted economic cost per treatment ranged from US$ 13 (2015 USD) in Ghana to US$ 2 in Malawi. CHWs spent from 1 to 9 hours a week on iCCM. A 30% increase in utilization would add up to 2 hours a week, but reduce cost per treatment (by 20% in countries with low utilization). Country scale up would amount to under US$ 0.8 per capita total population (US$ 0.06-US$0.74), between 0.5% and 2% of public health expenditure per capita but 8% in Niger. iCCM addresses unmet needs and impacts on under 5 mortality. An economic cost of under US$ 1/capita/y represents a sound investment. Utilization remains low however, and strategies must be developed as a priority to improve demand. Continued donor support is required to sustain iCCM services and strengthen its integration within national health systems.

Neonatal care practices in sub-Saharan Africa: a systematic review of quantitative and qualitative data.

PubMed

Bee, Margaret; Shiroor, Anushree; Hill, Zelee

2018-04-16

Recommended immediate newborn care practices include thermal care (immediate drying and wrapping, skin-to-skin contact after delivery, delayed bathing), hygienic cord care and early initiation of breastfeeding. This paper systematically reviews quantitative and qualitative data from sub-Saharan Africa on the prevalence of key immediate newborn care practices and the factors that influence them. Studies were identified by searching relevant databases and websites, contacting national and international academics and implementers and hand-searching reference lists of included articles. English-language published and unpublished literature reporting primary data from sub-Saharan Africa (published between January 2001 and May 2014) were included if it met the quality criteria. Quantitative prevalence data were extracted and summarized. Qualitative data were synthesized through thematic analysis, with deductive coding used to identify emergent themes within each care practice. A framework approach was used to identify prominent and divergent themes. Forty-two studies were included as well as DHS data - only available for early breastfeeding practices from 33 countries. Results found variation in the prevalence of immediate newborn care practices between countries, with the exception of skin-to-skin contact after delivery which was universally low. The importance of keeping newborn babies warm was well recognized, although thermal care practices were sub-optimal. Similar factors influenced practices across countries, including delayed drying and wrapping because the birth attendant focused on the mother; bathing newborns soon after delivery to remove the dirt and blood; negative beliefs about the vernix; applying substances to the cord to make it drop off quickly; and delayed breastfeeding because of a perception of a lack of milk or because the baby needs to sleep after delivery or does not showing signs of hunger. The majority of studies included in this review came from five countries (Ethiopia, Ghana, Malawi, Tanzania and Uganda). There is a need for more research from a wider geographical area, more research on newborn care practices at health facilities and standardization in measuring newborn care practices. The findings of this study could inform behaviour change interventions to improve the uptake of immediate newborn care practices.

Chronic viral hepatitis: policy, regulation, and strategies for its control and elimination in Ethiopia.

PubMed

Shiferaw, Fassil; Letebo, Mekitew; Bane, Abate

2016-08-11

Hepatitis B and C are silent killers not yet recognized as major public health challenges in many developing countries with huge disease burden. In Ethiopia, Hepatitis B is endemic with an average prevalence of 10.8 %, and the prevalence of Hepatitis C is 2 %. The prevalence of both infections, however, is likely to be underreported due to the lack of diagnostic facilities and appropriate surveillance systems. Ethiopia is also among the many Sub-Sahara African countries lacking a coordinated and systematic national response to chronic viral hepatitis. The objective of this study is to examine the current level of response to viral Hepatitis B & C in Ethiopia with the aim to bring identified gaps to the attention of relevant stakeholders and policy makers. This cross-sectional qualitative study was based on semi-structured in-depth interviews with 21 key informants from health facilities, health offices, pharmaceutical companies, regulatory bodies, professional association and blood bank units. Participants were selected purposively based on their role in the national hepatitis response. The investigators also reviewed available policy and strategy documents, standards of practice and surveys, and paid visits to pharmaceutical premises to check the availability of antiviral drugs. Thematic analysis was employed to make sense of the data. During the data analysis process, all the authors critically read the materials, and data was triangulated by source, interpreter view and thematic perspective to ensure accurate representation and comprehensiveness, and validation of the interviewees' responses. Once each investigator reviewed the data independently, the team reached a common understanding of the scope and contexts of the information attained. Data were subsequently reduced to key concepts, and case stories were taken with successive revisions. The key concepts were later coded into most basic meaningful categories. The World Health Organization (WHO) global hepatitis response framework was used to organize the analysis. Ethiopia is in the process of preparing strategic plan and guidelines for viral hepatitis. However, the country still lacks the required partnerships, and resource mobilization as a national health response is limited. Community awareness on the disease transmission and its sequel is poor. Viral hepatitis screening services are not widely available except for the occasional mandatory medical checkups for work or travel purposes. Healthcare providers often take no further action after diagnosing patients with viral hepatitis due to lack of treatment guidelines and strategic frameworks for screening, diagnosis, and treatment. Besides, drugs that are effective in the treatment of viral hepatitis are not available, mainly due to regulatory challenges. Viral hepatitis and its disease burden are getting little attention in Ethiopia and many low-income countries. The levels of technical guidance and financial support from the international community are low. To date, the response to the infections in Ethiopia is patchy. Thus, the country needs to formulate policy and strategies in the areas of disease surveillance, risk group identification and screening, use of the birth dose of hepatitis B vaccine, and care and treatment. Improving availability of data on viral hepatitis, access to low-cost generic drugs and developing and dissemination of treatment guidelines are also critical. Leveraging the successful Health Extension Program for a hepatitis response, and exploring ways to learn from and integrate into the HIV/AIDS program should also be considered.

An analysis of socio-demographic patterns in child malnutrition trends using Ghana demographic and health survey data in the period 1993-2008.

PubMed

Amugsi, Dickson A; Mittelmark, Maurice B; Lartey, Anna

2013-10-16

A small but growing body of research indicates that progress in reducing child malnutrition is substantially uneven from place to place, even down to the district level within countries. Yet child malnutrition prevalence and trend estimates available for public health planning are mostly available only at the level of global regions and/or at country level. To support carefully targeted intervention to reduce child malnutrition, public health planners and policy-makers require access to more refined prevalence data and trend analyses than are presently available. Responding to this need in Ghana, this report presents trends in child malnutrition prevalence in socio-demographic groups within the country's geographic regions. The study uses the Ghana Demographic and Health Surveys (GDHS) data. The GDHS are nationally representative cross-sectional surveys that have been carried out in many developing countries. These surveys constitute one of the richest sources of information currently available to examine time trends in child malnutrition. Data from four surveys were used for the analysis: 1993, 1998, 2003 and 2008. The results show statistically significant declining trends at the national level for stunting (F (1, 7204) = 7.89, p ≤ .005), underweight (F (1, 7441) = 44.87, p ≤ .001) and wasting (F (1, 7130) = 6.19, p ≤ .013). However, analyses of the sex-specific trends revealed that the declining trends in stunting and wasting were significant among males but not among females. In contrast to the national trend, there were significantly increasing trends in stunting for males (F (1, 2004) = 3.92, p ≤ .048) and females (F (1, 2004) = 4.34, p ≤ .037) whose mothers had higher than primary education, while the trends decreased significantly for males and females whose mothers had no education. At the national level in Ghana, child malnutrition is significantly declining. However, the aggregate national trend masks important deviations in certain socio-demographic segments, including worsening levels of malnutrition. This paper shows the importance of disaggregated analyses of national child malnutrition data, to unmask underlying geographic and socio-demographic differences.

Ehrlichia ruminantium seroprevalence in domestic ruminants in Ghana. II. Point prevalence survey.

PubMed

Koney, E B M; Dogbey, O; Walker, A R; Bell-Sakyi, L

2004-11-15

Serum samples collected on a single occasion from cattle, sheep and goats at sites in all 10 regions of Ghana were tested for antibodies to Ehrlichia (previously Cowdria) ruminantium, the causative agent of heartwater, by polyclonal competitive ELISA (PC-ELISA). The survey revealed the presence of heartwater-exposed ruminants throughout the country, with local seroprevalence up to 100%. Seronegative, and therefore presumably susceptible, animals were also present in all regions, in some areas in numbers high enough to indicate local endemic instability. Overall seroprevalences in cattle, sheep and goats were 61, 51 and 28% respectively, and were generally higher in the northern part of the country and lower in the forest zone. Amongst animals over 1 year old, two thirds of cattle and sheep, and around one third of goats throughout the country had been exposed to E. ruminantium. In the north, seroprevalence in sheep sampled with and without cattle was similar, whereas in the south seroconversion rates in sheep were significantly higher in areas where cattle were present.

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

PubMed

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

2016-09-06

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

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 improve the health innovation environment through increasing support for its small firms; coordinating policies; and beginning a dialogue with donors on how health research can create locally-owned knowledge and be more demand-driven. Mobilizing stakeholders around health product development areas, such as traditional medicines and diagnostics, would help to create trust between groups and build a stronger health innovation system. PMID:21144073

Measles immunity gaps and the progress towards elimination: a multi-country modelling analysis.

PubMed

Trentini, Filippo; Poletti, Piero; Merler, Stefano; Melegaro, Alessia

2017-10-01

The persistent circulation of measles in both low-income and high-income countries requires a better characterisation of present epidemiological trends and existing immunity gaps across different sociodemographic settings. Serological surveys, which provide direct measures of population protection against the infection, are underexploited and often supply fragmentary estimates of population immunity. This study aims to investigate how measles immunity has changed over time across different socioeconomic settings, as a result of demographic changes and past immunisation policies. For this multi-country modelling analysis, we developed a transmission model to simulate measles circulation during the past 65 years in nine countries with distinct demographic and vaccination histories. The model was calibrated on historical serological data and used to estimate the reduction of disease burden as a result of vaccination and present age-specific residual susceptibility. Our model shows that estimated residual susceptibility to measles ranges from 3% in the UK to more than 10% in Kenya and Ethiopia. In high-income countries, such as Italy, Singapore, and South Korea, where routine first-dose administration produced more than 90% of immunised individuals, only about 20% of susceptible individuals are younger than 5 years. We also observed that the reduction in fertility that has occurred during the past decades in high-income countries has contributed to almost half of the reduction in measles incidence. In low-income countries, where fertility is high, the population is younger and routine vaccination has been suboptimum. Susceptible individuals are concentrated in early childhood, with about 60% of susceptible individuals in Ethiopia younger than 10 years. In these countries, Supplementary Immunization Activities (SIAs) were responsible for more than 25% of immunised individuals (up to 45% in Ethiopia), mitigating the consequences of suboptimum routine vaccination coverage. Future vaccination strategies in high-fertility countries should focus on increasing childhood immunisation rates, either by raising first-dose coverage or by making erratic SIAs more frequent and regular. Immunisation campaigns targeting adolescents and adults are required in low-fertility countries, where the susceptibility in these age groups will otherwise sustain measles circulation. European Research Council. Copyright © 2017 Elsevier Ltd. All rights reserved.

Impacts of maternal mortality on living children and families: A qualitative study from Butajira, Ethiopia.

PubMed

Molla, Mitike; Mitiku, Israel; Worku, Alemayehu; Yamin, Alicia

2015-05-06

The consequences of maternal mortality on orphaned children and the family members who support them are dramatic, especially in countries that have high maternal mortality like Ethiopia. As part of a four country, mixed-methods study (Ethiopia, Malawi, South Africa, and Tanzania) qualitative data were collected in Butajira, Ethiopia with the aim of exploring the far reaching consequences of maternal deaths on families and children. We conducted interviews with 28 adult family members of women who died from maternal causes, as well as 13 stakeholders (government officials, civil society, and a UN agency); and held 10 focus group discussions with 87 community members. Data were analyzed using NVivo10 software for qualitative analysis. We found that newborns and children whose mothers died from maternal causes face nutrition deficits, and are less likely to access needed health care than children with living mothers. Older children drop out of school to care for younger siblings and contribute to household and farm labor which may be beyond their capacity and age, and often choose migration in search of better opportunities. Family fragmentation is common following maternal death, leading to tenuous relationships within a household with the births and prioritization of additional children further stretching limited financial resources. Currently, there is no formal standardized support system for families caring for vulnerable children in Ethiopia. Impacts of maternal mortality on children are far-reaching and have the potential to last into adulthood. Coordinated, multi-sectorial efforts towards mitigating the impacts on children and families following a maternal death are lacking. In order to prevent impacts on children and families, efforts targeting maternal mortality must address inequalities in access to care at the community, facility, and policy levels.

A comparative analysis of avoidable causes of childhood blindness in Malaysia with low income, middle income and high income countries.

PubMed

Koay, C L; Patel, D K; Tajunisah, I; Subrayan, V; Lansingh, V C

2015-04-01

To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

A multi-scalar investigation of development and health in Ethiopia: household electrification in a agriculturally dependent and climate sensitive country

NASA Astrophysics Data System (ADS)

Grace, K.; Brown, M. E.; Bakhtsiyarava, M.

2017-12-01

In poor countries, household electricity status is often used as a measure of household resources. Often, the primary use of the variable is to sort the poorest households - those without electricity - from the better-off households - those with electricity. Expanding electrification is also part of a suite of goals developed by health and development and reflected in the Millennium Development Goals (MDG) and now the UN's Sustainable Development Goals. Therefore, this measure is also used in a macro-level description of a country to describe a country's process of urbanization or development. As countries, electrify and expand access to electrification to the poorest households and communities, understanding the role and impact of electrification on the health and development of these communities is necessary. In other words, moving beyond the binomial categorization of a household as electrified or not electrified and instead investigating the ways that electrification impacts communities, households and individuals is a necessary component of understanding contemporary patterns of health and development in the world's poorest countries. The goal of this research is to examine the linkages between health and development using multi-scalar, remotely-sensed measures of electrification in Ethiopia, one of the poorest countries in the world. For this study we use spatially referenced Demographic and Health Survey (DHS) data for Ethiopia from 2000 and 2005. In addition to measures of electrification gathered from the DHS, we also use time-varying satellite based measure of electrification collected by the US Department of Defense. Also, because many rural Ethiopians are dependent on small-scale, rainfed agriculture and therefore highly vulnerable to climate shocks and food insecurity, any investigation of health and development must also consider the local food production context. To support the analysis and provide information on broader measures of food insecurity and wellbeing, we also use livelihood zone data from the Famine Early Warning Systems (FEWS NET), as well as remotely sensed based estimates of rainfall and temperature.

FIFA 11 for Health Programme: Implementation in Five Countries in Sub-Saharan Africa

ERIC Educational Resources Information Center

Fuller, Colin W.; Junge, Astrid; Amaning, Jacob; Kaijage, Rogasian R.; Kaputa, John; Magwende, George; Pambo, Prince; Dvorak, Jiri

2015-01-01

Objective: To assess the effectiveness of the FIFA 11 for Health programme in increasing children's knowledge about communicable and non-communicable diseases in five countries of Sub-Saharan Africa. Method: A prospective five-cohort study was implemented in schools in Ghana (17), Malawi (12), Namibia (11), Tanzania (18) and Zambia (11). The…

Benefits, Challenges, and Dynamism of Positionalities Associated with Mixed Methods Research in Developing Countries: Evidence from Ghana

ERIC Educational Resources Information Center

Teye, Joseph Kofi

2012-01-01

Although mixed methods designs have gained visibility in recent years, most of the publications on this methodological strategy have been written by scholars in the developed world. Consequently, the practical challenges associated with mixed methods research in developing countries have not been adequately discussed in the literature. Relying on…

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

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.

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 phones offers promise for future data collection in Ghana and may be suitable for other developing countries.

Recommendations for fluoride limits in drinking water based on estimated daily fluoride intake in the Upper East Region, Ghana.

PubMed

Craig, Laura; Lutz, Alexandra; Berry, Kate A; Yang, Wei

2015-11-01

Both dental and skeletal fluorosis caused by high fluoride intake are serious public health concerns around the world. Fluorosis is particularly pronounced in developing countries where elevated concentrations of naturally occurring fluoride are present in the drinking water, which is the primary route of exposure. The World Health Organization recommended limit of fluoride in drinking water is 1.5 mg F(-) L(-1), which is also the upper limit for fluoride in drinking water for several other countries such as Canada, China, India, Australia, and the European Union. In the United States the enforceable limit is much higher at 4 mg F(-) L(-1), which is intended to prevent severe skeletal fluorosis but does not protect against dental fluorosis. Many countries, including the United States, also have notably lower unenforced recommended limits to protect against dental fluorosis. One consideration in determining the optimum fluoride concentration in drinking water is daily water intake, which can be high in hot climates such as in northern Ghana. The results of this study show that average water intake is about two times higher in Ghana than in more temperate climates and, as a result, the fluoride intake is higher. The results also indicate that to protect the Ghanaian population against dental fluorosis, the maximum concentration of fluoride in drinking water for children under 6-8 years should be 0.6 mg F(-) L(-1) (and lower in the first two years of life), and the limit for older children and adults should be 1.0 mg F(-) L(-1). However, when considering that water treatment is not cost-free, the most widely recommended limit of 1.5 mg F(-) L(-1) - which is currently the limit in Ghana--may be appropriate for older children and adults since they are not vulnerable to dental fluorosis once the tooth enamel is formed. Copyright © 2015 Elsevier B.V. All rights reserved.

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 comparison to household surveys. Random digit dialing of mobile phones offers promise for future data collection in Ghana and may be suitable for other developing countries. PMID:29351349

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

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.

Water, sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia.

PubMed

Morgan, Camille; Bowling, Michael; Bartram, Jamie; Lyn Kayser, Georgia

2017-08-01

Adequate access to water, sanitation, and hygiene (WaSH) in schools impacts health, educational outcomes, and gender disparities. Little multi-country research has been published on WaSH in rural schools in Sub-Saharan Africa. In this multi-national cross-sectional WaSH study, we document WaSH access, continuity, quality, quantity, and reliability in 2270 schools that were randomly sampled in rural regions of six Sub-Saharan African countries: Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Data collection included: school WaSH surveys containing internationally established WaSH indicators, direct observation, and field- and laboratory-based microbiological water quality testing. We found 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda had improved water sources on premises, improved sanitation, and water and soap for handwashing. Fewer than 23% of rural schools in the six countries studied met the World Health Organization's recommended student-to-latrine ratios for boys and for girls. Fewer than 20% were observed to have at least four of five recommended menstrual hygiene services (separate-sex latrines with doors and locks, water for use, waste bin). The low access to safe and adequate WaSH services in rural schools suggest opportunities for WaSH interventions that could have substantive impact on health, education, and gender disparities. Copyright © 2017 Elsevier GmbH. All rights reserved.

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

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

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.

Barriers to evidence-based acute stroke care in Ghana: a qualitative study on the perspectives of stroke care professionals

PubMed Central

Baatiema, Leonard; de-Graft Aikins, Ama; Sav, Adem; Mnatzaganian, George; Chan, Carina K Y; Somerset, Shawn

2017-01-01

Objective Despite major advances in research on acute stroke care interventions, relatively few stroke patients benefit from evidence-based care due to multiple barriers. Yet current evidence of such barriers is predominantly from high-income countries. This study seeks to understand stroke care professionals’ views on the barriers which hinder the provision of optimal acute stroke care in Ghanaian hospital settings. Design A qualitative approach using semistructured interviews. Both thematic and grounded theory approaches were used to analyse and interpret the data through a synthesis of preidentified and emergent themes. Setting A multisite study, conducted in six major referral acute hospital settings (three teaching and three non-teaching regional hospitals) in Ghana. Participants A total of 40 participants comprising neurologists, emergency physician specialists, non-specialist medical doctors, nurses, physiotherapists, clinical psychologists and a dietitian. Results Four key barriers and 12 subthemes of barriers were identified. These include barriers at the patient (financial constraints, delays, sociocultural or religious practices, discharge against medical advice, denial of stroke), health system (inadequate medical facilities, lack of stroke care protocol, limited staff numbers, inadequate staff development opportunities), health professionals (poor collaboration, limited knowledge of stroke care interventions) and broader national health policy (lack of political will) levels. Perceived barriers varied across health professional disciplines and hospitals. Conclusion Barriers from low/middle-income countries differ substantially from those in high-income countries. For evidence-based acute stroke care in low/middle-income countries such as Ghana, health policy-makers and hospital managers need to consider the contrasts and uniqueness in these barriers in designing quality improvement interventions to optimise patient outcomes. PMID:28450468

Assessment of risk of peripheral vascular disease and vascular care capacity in low- and middle-income countries.

PubMed

Gyedu, A; Stewart, B T; Nakua, E; Quansah, R; Donkor, P; Mock, C; Hardy, M; Yangni-Angate, K H

2016-01-01

This study aimed to describe national peripheral vascular disease (PVD) risk and health burden, and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in low- and middle-income countries was defined, and capacity improvement priorities were identified. Data to estimate PVD risk factor burden were obtained from the World Health Organization Study on Global Ageing and Adult Health (SAGE), Ghana, and the Institute of Health Metrics and Evaluation Global Burden of Disease (IHME GBD) database. In addition, a novel nationwide assessment of vascular care capacity was performed, with 20 vascular care items assessed at 40 hospitals in Ghana. Factors contributing to specific item deficiency were described. From the SAGE database, there were 4305 respondents aged at least 50 years with data to estimate PVD risk. Of these, 57·4 per cent were at moderate to risk high of PVD with at least three risk factors; extrapolating nationally, the estimate was 1 654 557 people. Based on IHME GBD data, the estimated disability-adjusted life-years incurred from PVD increased fivefold from 1990 to 2010 (from 6·3 to 31·7 per 100 000 persons respectively). Vascular care capacity assessment demonstrated marked deficiencies in items for diagnosis, and in perioperative and vascular surgical care. Deficiencies were most often due to absence of equipment, lack of training and technology breakage. Risk factor reduction and management as well as optimization of current resources are paramount to avoid the large burden of PVD falling on healthcare systems in low- and middle-income countries. These countries are not well equipped to handle vascular surgical care, and rapid development of such capacity would be difficult and expensive. © 2015 BJS Society Ltd Published by John Wiley & Sons Ltd.

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 within the geosciences community.

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.

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.

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 in both countries. Developing mechanisms to engage private providers as stakeholders in social health insurance schemes is important to incentivizing their participation and addressing their concerns.

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

PubMed

Hörbst, Viola; Gerrits, Trudie

2016-08-01

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

Review of the genus Lanchnophorus (Hemiptera: Heteroptera: Rhyparochromidae) with description of three new species and other nomenclatural changes.

PubMed

Kment, Petr; Carapezza, Attilio; Jindra, Zdeněk; Kondorosy, Előd

2017-01-25

The generic name Lanchnophorus Reuter, 1887, deemed for a long time to be unavailable as incorrect original spelling of Lachnophorus (in fact Lachnophorus Distant, 1903 is an unjustified emendation of the former), is restored as a valid name of the genus. Lachnesthus Bergroth, 1915, syn. nov. (new name for the preoccupied Lachnophorus Distant, 1903) is considered junior synonym of Lanchnophorus. The following nomenclatural changes are proposed: Lanchnophorus flavus (Scudder, 1971) comb. nov. = Lachnesthus chinai Scudder, nomen nudum; Lanchnophorus guttulatus Reuter, 1887, comb. restit. = Lachnophorus albidomaculatus Distant, 1913, syn. nov. = Lachnesthus rodriguezensis China, 1925, syn. nov.; Lanchnophorus leucospilus (Walker, 1872) comb. nov.; Lanchnophorus merula (Distant, 1903) comb. nov.; and Lanchnophorus singalensis (Dohrn, 1860) comb. nov. Three new species are described: Lanchnophorus gaoqingae Kment & Jindra sp. nov. from China (Yunnan), Lanchnophorus seminitens Kment & Carapezza sp. nov. from Socotra Island (Yemen), and Lanchnophorus webbi Kondorosy sp. nov. from India: Tamil Nadu. Bibliographies and known distribution of all the included species are reviewed. The following new country and state records are provided: L. flavus from Central African Republic, Ethiopia, Ghana, Mali, Malawi, Niger, Zambia and Zimbabwe; L. leucospilus from China (Yunnan) and Laos, L. merula from India (Kerala/Tamil Nadu) and Thailand; L. singalensis from Angola, Benin, Mozambique, Namibia, Senegal, Sierra Leone, Tanzania, Togo, Uganda, Zambia, Zimbabwe, China (Hainan), Iran (Sistan and Ba-luchestan), Oman, Pakistan, India (Himachal Pradesh, Karnataka, Kerala, Rajasthan), Malaysia, Philippines, and Thailand.

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.

"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

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.

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

PubMed

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

2016-01-01

The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Electronic search was done for literature published between 2003-2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients' trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors.

A Review of the National Health Insurance Scheme in Ghana: What Are the Sustainability Threats and Prospects?

PubMed Central

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

2016-01-01

Background The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. However, stagnating active membership, reports of poor quality health care rendered to NHIS-insured clients and cost escalations have raised concerns on the operational and financial sustainability of the scheme. This paper reviewed peer reviewed articles and grey literature on the sustainability challenges and prospects of the NHIS in Ghana. Methods Electronic search was done for literature published between 2003–2016 on the NHIS and its sustainability in Ghana. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. Out of this number, 31 eligible peer reviewed articles were selected for final review based on specific relevance to the Ghanaian context. Results Ability of the NHIS to continue its operations in Ghana is threatened financially and operationally by factors such as: cost escalation, possible political interference, inadequate technical capacity, spatial distribution of health facilities and health workers, inadequate monitoring mechanisms, broad benefits package, large exemption groups, inadequate client education, and limited community engagement. Moreover, poor quality care in NHIS-accredited health facilities potentially reduces clients’ trust in the scheme and consequently decreases (re)enrolment rates. These sustainability challenges were reviewed and discussed in this paper. Conclusions The NHIS continues to play a critical role towards attaining universal health coverage in Ghana albeit confronted by challenges that could potentially collapse the scheme. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors. PMID:27832082

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

PubMed Central

Dapaah, Jonathan Mensah; Spronk, Rachel

2016-01-01

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

The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia.

PubMed

Shiferaw, Fassil; Zolfo, Maria

2012-01-01

Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes. This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources. Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites. Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect 'one size fits all' technology and the use of combined interoperable applications, according to the local context, is highly recommended. Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts.

Toward a workable biosafety system for regulating genetically modified organisms in Ethiopia: balancing conservation and competitiveness.

PubMed

Abraham, Adane

2013-01-01

On September 9, 2009, Ethiopia enacted a highly restrictive biosafety law firmly based on precautionary principles as a foundation for its GMO regulation system. Its drafting process, led by the country's Environmental Protection Authority, was judged as biased, focusing only on protecting the environment from perceived risks, giving little attention to potential benefits of GMOs. Many of its provisions are very stringent, exceeding those of Cartagena Protocol on Biosafety, while others cannot be fulfilled by applicants, collectively rendering the emerged biosafety system unworkable. These provisions include requirements for advance informed agreement and rigorous socioeconomic assessment in risk evaluation for all GMO transactions, including contained research use-which requires the head of the competent national authority of the exporting country to take full responsibility for GMO-related information provided-and stringent labeling, insurance and monitoring requirements for all GMO activities. Furthermore, there is no provision to establish an independent national biosafety decision-making body(ies). As a result, foreign technology owners that provide highly demanded technologies like Bt cotton declined to work with Ethiopia. There is a fear that the emerged biosafety system might also continue to suppress domestic genetic engineering research and development. Thus, to benefit from GMOs, Ethiopia has to revise its biosafety system, primarily by making changes to some provisions of the law in a way that balances its diverse interests of conserving biodiversity, protecting the environment and enhancing competition in agricultural and other economic sectors.

Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals.

PubMed

Assefa, Yibeltal; Damme, Wim Van; Williams, Owain D; Hill, Peter S

2017-01-01

We analysed the performance of Ethiopia in achieving the health-related millennium development goals (MDGs) with the aim of acquiring lessons for the sustainable development goals (SDGs). Ethiopia achieved most of the health MDGs: a 67% reduction in under-five mortality, a 71% decline in maternal mortality ratio, a 90% decline in new HIV infections, a decrease in malaria-related deaths by 73% and a more than 50% decline in mortality due to tuberculosis. We argue that these achievements are due to implementation of a mix of comprehensive strategies within the health system and across other sectors of the government. Scaling up of interventions by disease control programmes (including the health extension programme) and strengthening of the health system have played important roles towards the achievements. These health gains could not have been realised without progress in the other MDGs: poverty reduction, education, access to safe drinking-water and peace and stability of the country. However, the gains were not equitable, with differences between urban and rural areas, among regions and socioeconomic strata. Ethiopia's remarkable success in meeting most of the targets of the health-related MDGs could be explained by its comprehensive and multisectoral approach for health development. The inequity gap remains a challenge that achieving the health-related SDGs requires the country to implement strategies, which specifically target more marginal populations and geographic areas. This also needs peace and stability, without which it is almost impossible to improve health.

‘We identify, discuss, act and promise to prevent similar deaths’: a qualitative study of Ethiopia's Maternal Death Surveillance and Response system

PubMed Central

Abebe, Berhanu; Busza, Joanna; Hadush, Azmach; Usmael, Abdurehman; Zeleke, Amsalu Belew; Sita, Sahle; Hailu, Solomon; Graham, Wendy J

2017-01-01

Introduction Ethiopia introduced national Maternal Death Surveillance and Response (MDSR) in 2013 and is among the first sub-Saharan African countries to capture data on facility-based and community-based maternal deaths. We interviewed frontline MDSR implementers about their experiences of the first 2 years of MDSR, including perceptions of its introduction and outcomes for health services. Methods We conducted a qualitative case study in 4 zones in the largest regions, interviewing 69 key informants from regional, zonal, district and facility levels. Results A defining feature of Ethiopia's MDSR system is its integration within existing disease surveillance, with both benefits and challenges. Facilitators of the system's introduction were strong political support, alignment with broader health strategies and strong links across health system departments. Barriers included confusion around new responsibilities, high staff turnover and fear of legal repercussions. Stakeholders believed MDSR increased confidence in using local data to improve maternal health services and enhanced communication across the health system. Conclusions MDSR systems take time to establish, encountering challenges in early implementation. Ensuring MDSR has a clear purpose, explicitly defined roles and responsibilities, and adequate supervisory support from the start will ensure it becomes embedded within the health system as routine practice rather than perceived as a stand-alone system. Countries planning to adopt or extend MDSR can learn from Ethiopia's experience, particularly the decision to make maternal mortality a weekly reportable condition within Public Health Emergency Management. PMID:28589016

Systematics and Taxonomy of the Long-horned Caddisfly Genus Tagalopsyche (Trichoptera: Leptoceridae)

NASA Astrophysics Data System (ADS)

Andersen, T.; Holzenthal, R. W.

2005-05-01

The long-horned caddisfly genus Tagalopsyche Banks 1913 contains 4 described species from the Oriental and Afrotropical regions: T. aethiopica Kimmins (Ethiopia), T. brunnea (Ulmer) (Indonesia), T. fletcheri Kimmins (India), and T. sisyroides Banks (Philippines), the type species. In addition, at least 6 new species are known from Ghana, India, Sri Lanka, and Malaysia, more than doubling the known species diversity. Diagnoses, descriptions, and illustrations of males and known females are provided for all species as well as a re-diagnosis of generic characters and a key to species. The genus is most closely related to Mystacides, with 19 species in the Nearctic, Palearctic and Oriental regions, with which is shares the synapomorpy: abdominal sternum IX of the male genitalia produced posteriorly. Little is known of the biology or ecology of the species.

Dairy intensification in developing countries: effects of market quality on farm-level feeding and breeding practices.

PubMed

Duncan, A J; Teufel, N; Mekonnen, K; Singh, V K; Bitew, A; Gebremedhin, B

2013-12-01

Smallholder dairy production represents a promising income generating activity for poor farmers in the developing world. Because of the perishable nature of milk, marketing arrangements for collection, distribution and sale are important for enhanced livelihoods in the smallholder dairy sector. In this study we examined the relationship between market quality and basic feeding and breeding practices at farm level. We define market quality as the attractiveness and reliability of procurement channels and associated input supply arrangements. We took as our study countries, India with its well-developed smallholder dairy sector, and Ethiopia where the smallholder dairy industry has remained relatively undeveloped despite decades of development effort. We conducted village surveys among producer groups in 90 villages across three States in India and two Regions in Ethiopia. Producer groups were stratified according to three levels of market quality - high, medium and low. Data showed that diet composition was relatively similar in India and Ethiopia with crop residues forming the major share of the diet. Concentrate feeding tended to be more prominent in high market quality sites. Herd composition changed with market quality with more dairy (exotic) cross-bred animals in high market quality sites in both India and Ethiopia. Cross-bred animals were generally more prominent in India than Ethiopia. Herd performance within breed did not change a great deal along the market quality gradient. Parameters such as calving interval and milk yield were relatively insensitive to market quality. Insemination of cross-bred cows was predominantly by artificial insemination (AI) in India and accounted for around half of cross-bred cow inseminations in Ethiopia. Data on perceptions of change over the last decade indicated that per herd and per cow productivity are both increasing in high market quality sites with a more mixed picture in medium and low-quality sites. Similarly dairy-derived income is on the increase in high market quality sites. This is accompanied by a strong increase in stall feeding at the expense of grazing. The study indicates that the first constraint to intensification of dairy production in Ethiopia is the genetic quality of the herd. There is less scope for improved AI provision in India since the cross-bred herd is mainly serviced by AI already. However, as for Ethiopia, there is considerable scope for closing yield gaps in India through improved feed use and supply. Results strongly show that well-developed markets with good procurement arrangements are key for sustainable dairy intensification.

Spatio-temporal variability and trends of precipitation and extreme rainfall events in Ethiopia in 1980-2010

NASA Astrophysics Data System (ADS)

Gummadi, Sridhar; Rao, K. P. C.; Seid, Jemal; Legesse, Gizachew; Kadiyala, M. D. M.; Takele, Robel; Amede, Tilahun; Whitbread, Anthony

2017-12-01

This article summarizes the results from an analysis conducted to investigate the spatio-temporal variability and trends in the rainfall over Ethiopia over a period of 31 years from 1980 to 2010. The data is mostly observed station data supplemented by bias-corrected AgMERRA climate data. Changes in annual and Belg (March-May) and Kiremt (June to September) season rainfalls and rainy days have been analysed over the entire Ethiopia. Rainfall is characterized by high temporal variability with coefficient of variation (CV, %) varying from 9 to 30% in the annual, 9 to 69% during the Kiremt season and 15-55% during the Belg season rainfall amounts. Rainfall variability increased disproportionately as the amount of rainfall declined from 700 to 100 mm or less. No significant trend was observed in the annual rainfall amounts over the country, but increasing and decreasing trends were observed in the seasonal rainfall amounts in some areas. A declining trend is also observed in the number of rainy days especially in Oromia, Benishangul-Gumuz and Gambella regions. Trends in seasonal rainfall indicated a general decline in the Belg season and an increase in the Kiremt season rainfall amounts. The increase in rainfall during the main Kiremt season along with the decrease in the number of rainy days leads to an increase in extreme rainfall events over Ethiopia. The trends in the 95th-percentile rainfall events illustrate that the annual extreme rainfall events are increasing over the eastern and south-western parts of Ethiopia covering Oromia and Benishangul-Gumuz regions. During the Belg season, extreme rainfall events are mostly observed over central Ethiopia extending towards the southern part of the country while during the Kiremt season, they are observed over parts of Oromia, (covering Borena, Guji, Bali, west Harerge and east Harerge), Somali, Gambella, southern Tigray and Afar regions. Changes in the intensity of extreme rainfall events are mostly observed over south-eastern parts of Ethiopia extending to the south-west covering Somali and Oromia regions. Similar trends are also observed in the greatest 3-, 5- and 10-day rainfall amounts. Changes in the consecutive dry and wet days showed that consecutive wet days during Belg and Kiremt seasons decreased significantly in many areas in Ethiopia while consecutive dry days increased. The consistency in the trends over large spatial areas confirms the robustness of the trends and serves as a basis for understanding the projected changes in the climate. These results were discussed in relation to their significance to agriculture.

Multisectoral Approaches in Advancing Girls' Education: Lessons Learned in Five SAGE Countries. SAGE Technical Report.

ERIC Educational Resources Information Center

Rugh, Andrea

Strategies for Advancing Girls' Education (SAGE) is a project of the U.S. Agency for International Development (USAID), Bureau for Economic Growth, Agriculture and Trade/Office of Women in Development (EGAT/WID). Five countries participated in SAGE: Guinea, Mali, Ghana, El Salvador; and the Democratic Republic of the Congo. The project started in…

Competency-Based Training in International Perspective: Comparing the Implementation Processes Towards the Achievement of Employability

ERIC Educational Resources Information Center

Boahin, Peter; Eggink, Jose; Hofman, Adriaan

2014-01-01

This article undertakes a comparison of competency-based training (CBT) systems in a number of countries with the purpose of drawing lessons to support Ghana and other countries in the process of CBT implementation. The study focuses on recognition of prior learning and involvement of industry since these features seem crucial in achieving…

Institutional Governance and Management Systems in Sub-Saharan Africa Higher Education: Developments and Challenges in a Ghanaian Research University

ERIC Educational Resources Information Center

Abugre, James B.

2018-01-01

This article examines the developments and challenges of higher education in developing countries. Using a thorough qualitative interview of deans, directors and heads of Department of the University of Ghana, this paper draws on their analysis to discover unexplored issues that affect the universities in developing countries. The study identifies…

Cross-Cultural Adaptation and Validation of the Commitment-to-School Scale Using a Sample of Junior High School Youth in Ghana

ERIC Educational Resources Information Center

Ansong, David; Chowa, Gina A.; Masa, Rainier D.

2016-01-01

Empirical evidence from developed countries suggests that students' commitment to school is fundamental to their academic success. However, in developing countries, validated measures of student commitment to school do not exist. The current study helps fill this research gap by examining the validity and reliability of a commitment-to-school…

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.

Social solidarity and willingness to tolerate risk- and income-related cross-subsidies within health insurance: experiences from Ghana, Tanzania and South Africa.

PubMed

Goudge, Jane; Akazili, James; Ataguba, John; Kuwawenaruwa, August; Borghi, Josephine; Harris, Bronwyn; Mills, Anne

2012-03-01

The importance of ill-health in perpetuating poverty is well recognized. In order to prevent the damaging downward spiral of poverty and illness, there is a need for a greater level of social protection, with greater cross-subsidization between the poor and wealthy, and the healthy and those with ill-health. The aim of this paper is to examine individual preferences for willingness to pre-pay for health care and willingness to cross-subsidize the sick and the poor in Ghana, South Africa and Tanzania. Household surveys in the three countries elicited views on cross-subsidization within health care financing. The paper examines how these preferences varied by socio-economic status, other respondent characteristics, and the extent and type of experience of health insurance in the light of country context. In South Africa and Ghana, 62% and 55% of total respondents, respectively, were in favour of a progressive financing system in which richer groups would pay a higher proportion of income than poorer groups, rather than a system where individuals pay the same proportion of income irrespective of their wealth (proportional). In Tanzania, 45% of the total sample were willing to pay for the health care of the poor. However, in all three countries, a progressive system was favoured by a smaller proportion of the most well off than of less well off groups. Solidarity has been considered to be a collective property of a specific socio-political culture, based on shared expectations and developed as part of a communal, historical learning process. The three countries had different experiences of health insurance and this may have contributed to the above differences in expressed willingness to pay between countries. Building and 'living with' institutions that provide affordable universal coverage is likely to be an essential part of the learning process which supports the development of social solidarity.

Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control.

PubMed

Lloyd-Sherlock, Peter; Beard, John; Minicuci, Nadia; Ebrahim, Shah; Chatterji, Somnath

2014-02-01

This study uses data from the World Health Organization's Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor.

Magnitude of institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district Afar Regional State, Ethiopia.

PubMed

Assefa, Luelseged; Alemayehu, Mussie; Debie, Ayal

2018-03-02

Reduction of maternal mortality is a global priority particularly in developing countries like Ethiopia where maternal mortality ratio is one of the highest in the world. Most deliveries in developing countries occur at home without skilled birth attendants. Therefore, the objective of this study was to assess institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district, Ethiopia. Overall, 35.2% of women delivered at health facilities. Women who had good knowledge AOR = 2.1, 95% CI 1.32, 4.87), Ante Natal Care (ANC) follow up (AOR = 3.2, 95% CI 1.55, 6.63), resided in a place where distance to reach at the nearby health facilities takes < 30 min (AOR = 3.1; 95% CI 2.57, 66.33) and women whose husband involved in decision regarding delivery place (AOR = 1.9; 95% CI 1.49, 5.07) were more likely to deliver at health facility. Therefore, strengthening ANC services, improving maternal knowledge, involving husbands in decision of delivery place and expanding health facilities in the community would enhance institutional delivery.

Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability

PubMed Central

Daviaud, Emmanuelle; Besada, Donnela; Leon, Natalie; Rohde, Sarah; Sanders, David; Oliphant, Nicholas; Doherty, Tanya

2017-01-01

Background Sub–Saharan Africa still reports the highest rates of under–five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduced to improve access to essential services for children 2–59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country–level scale–up implications. The paper focuses on costs to provider (health system and donors) to inform planning and budgeting, and does not cover cost–effectiveness. Methods The analysis combines annualised set–up costs and 1 year implementation costs to calculate incremental economic and financial costs per treatment from a provider perspective. Affordability is assessed by calculating the per capita financial cost of the program as a percentage of the public health expenditure per capita. Time and financial implications of a 30% increase in utilization were modeled. Country scale–up is modeled for all children under 5 in rural areas. Results Utilization of iCCM services varied from 0.05 treatment/y/under–five in Ethiopia to over 1 in Niger. There were between 10 and 603 treatments/community health worker (CHW)/y. Consultation cost represented between 93% and 22% of economic costs per treatment influenced by the level of utilization. Weighted economic cost per treatment ranged from US$ 13 (2015 USD) in Ghana to US$ 2 in Malawi. CHWs spent from 1 to 9 hours a week on iCCM. A 30% increase in utilization would add up to 2 hours a week, but reduce cost per treatment (by 20% in countries with low utilization). Country scale up would amount to under US$ 0.8 per capita total population (US$ 0.06–US$0.74), between 0.5% and 2% of public health expenditure per capita but 8% in Niger. Conclusions iCCM addresses unmet needs and impacts on under 5 mortality. An economic cost of under US$ 1/capita/y represents a sound investment. Utilization remains low however, and strategies must be developed as a priority to improve demand. Continued donor support is required to sustain iCCM services and strengthen its integration within national health systems. PMID:28702174

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.

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

From condemnation to understanding: Views on suicidal behavior in Ghana in transition.

PubMed

Osafo, Joseph; Akotia, Charity S; Hjelmeland, Heidi; Knizek, Birthe L

2017-09-01

The cultural context in which suicide occurs has been emphasized as critical in understanding the act and informing prevention. Yet the penchant of psychiatrizing suicidality in mainstream suicidology relegates cultural issues to the background. Through the lenses of critical cultural suicidology, the authors have re-emphasized the importance of culture by reviewing the two major meanings of suicide as observed in our 8-year study in Ghana: moral transgression and life crisis. They have also showed the usefulness of the life crisis perspective of suicidality in reducing stigma and sustaining advocacy in decriminalizing attempted suicide in the country.

Variations in first-time caesarean birth between Eastern African immigrants and Australian-born women in public care: A population-based investigation in Victoria.

PubMed

Belihu, Fetene B; Small, Rhonda; Davey, Mary-Ann

2017-06-01

Caesarean section (CS) rates are known to vary by country, migration status and social group. However, little population-based, confounder adjusted evidence exists on caesarean rate for African immigrants in Australia. To investigate disparities in first-time caesarean, mainly unplanned caesarean in labour for women born in Eritrea, Ethiopia, Somalia and Sudan relative to Australian-born women in public care. A population-based study of 237 943 Australian and 4057 Eastern African singleton births between 1999 and 2007, was conducted using Victorian Perinatal Data Collection. Descriptive and multivariable logistic regression analysis by parity, adjusting for confounders selected a priori, was performed for first-time unplanned caesarean in labour and overall caesarean. Primiparae born in each of the Eastern African countries had elevated odds of unplanned caesarean in labour: Eritrea adjusted odds ratio (OR adj ) 2.04 95% CI (1.41, 2.97), Ethiopia OR adj 2.08 95% CI (1.62, 2.68), Somalia OR adj 1.62 95% CI (1.25, 2.10) and Sudan OR adj 1.39 95% CI (1.03, 1.87). Similarly, multiparae from Eastern African countries had elevated odds of unplanned caesarean in labour: Eritrea OR adj 2.13 95%CI(1.15, 3.97), Ethiopia OR adj 2.05 95% CI (1.38, 3.03), Somalia OR adj 2.16 95% CI (1.69, 2.77) and Sudan OR adj 1.81 95% CI (1.32, 2.49). The odds of any first-time caesarean (planned or unplanned) were elevated for primiparae born in all countries except Sudan and for multiparae born in Ethiopia and Somalia. We observed substantial variations in a first-time CS between Eastern African and Australian-born women in Victoria, Australia. However, these disparities were unexplained by socio-demographic and clinical risks, suggesting the potential importance of other factors such as communication difficulties, support systems for immigrant pregnant women and possible differences in care. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

District decision-making for health in low-income settings: a case study of the potential of public and private sector data in India and Ethiopia.

PubMed

Bhattacharyya, Sanghita; Berhanu, Della; Taddesse, Nolawi; Srivastava, Aradhana; Wickremasinghe, Deepthi; Schellenberg, Joanna; Iqbal Avan, Bilal

2016-09-01

Many low- and middle-income countries have pluralistic health systems where private for-profit and not-for-profit sectors complement the public sector: data shared across sectors can provide information for local decision-making. The third article in a series of four on district decision-making for health in low-income settings, this study shows the untapped potential of existing data through documenting the nature and type of data collected by the public and private health systems, data flow and sharing, use and inter-sectoral linkages in India and Ethiopia. In two districts in each country, semi-structured interviews were conducted with administrators and data managers to understand the type of data maintained and linkages with other sectors in terms of data sharing, flow and use. We created a database of all data elements maintained at district level, categorized by form and according to the six World Health Organization health system blocks. We used content analysis to capture the type of data available for different health system levels. Data flow in the public health sectors of both counties is sequential, formal and systematic. Although multiple sources of data exist outside the public health system, there is little formal sharing of data between sectors. Though not fully operational, Ethiopia has better developed formal structures for data sharing than India. In the private and public sectors, health data in both countries are collected in all six health system categories, with greatest focus on service delivery data and limited focus on supplies, health workforce, governance and contextual information. In the Indian private sector, there is a better balance than in the public sector of data across the six categories. In both India and Ethiopia the majority of data collected relate to maternal and child health. Both countries have huge potential for increased use of health data to guide district decision-making. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Molecular characterization of Echinococcus granulosus s.l. cysts from cattle, camels, goats and pigs in Ethiopia.

PubMed

Tigre, Worku; Deresa, Benti; Haile, Adane; Gabriël, Sarah; Victor, Bjorn; Pelt, Jani Van; Devleesschauwer, Brecht; Vercruysse, Jozef; Dorny, Pierre

2016-01-15

Cystic Echinococcosis (CE) caused by Echinococcus granulosus sensu lato (s.l.) is a neglected helminth zoonosis affecting humans and various animal species. Human CE has been reported in almost all countries of sub-Saharan Africa but its prevalence and public health impact are subject to large geographical variations. The reasons for these differences are not well understood; among other factors, occurrence of different species/genotypes of E. granulosus s.l. has been suggested. CE is very common in all livestock species in Ethiopia; human CE is poorly documented in the country. The aim of this study was to assess the fertility and molecularly characterize hydatid cysts collected from cattle, camels, goats and pigs from different parts of the country. From the 137 samples characterized by PCR-RFLP and sequencing, 115 (83.9%) were identified as E. granulosus s.s. (G1, common sheep strain), 6 (4.4%) as Echinococcus ortleppi (G5, cattle strain) and 16 (11.7%) as Echinococcus intermedius (G6/7, camel strain). In cattle, E. granulosus s.s. and E. ortleppi were found; in camels and goats, E. granulosus s.s. and E. intermedius; two cysts found in pigs were identified as E. granulosus s.s. and E. ortleppi, respectively. All cysts recovered from goats and pigs were sterile, while fertility was 34% and 50% in cysts from cattle and camels, respectively. In cattle, 31% of E. granulosus s.s. cysts were fertile, showing the importance of cattle in the transmission of the "sheep strain". Next to E. granulosus s.s., E. intermedius (camel strain) was the predominant species: 34.4% of the cysts collected from camels and 62.5% from goats were identified as E. intermedius. These animals originated from the drier Central, Eastern and Southern parts of the country. For the first time, we showed the presence of CE in pigs in Ethiopia. The presence of these strains and especially the fact that the zoonotic E. granulosus s.s. and E. intermedius are dominant, make CE an important public health concern in Ethiopia. Copyright © 2015 Elsevier B.V. All rights reserved.

Review paper on research ethics in Ethiopia: experiences and lessons learnt from Addis Ababa University College of Health Sciences 2007-2012.

PubMed

Feleke, Yeweyenhareg; Addissie, Adamu; Wamisho, Biruk L; Davey, Gail

2015-01-01

Health research in Ethiopia is increasing both in volume and type, accompanied with expansion of higher education and research since the past few years. This calls for a proportional competence in the governance of medical research ethics in Ethiopia in the respective research and higher learning institutes. The paper highlights the evolution and progress ofthe ethics review at Addis Ababa University - College of Health Sciences (AAU-CHS) in the given context of health research review system in Ethiopia. Reflections are made on the key lessons to be drawnfrom the formative experiences of the Institutional Review Board (IRB) and their implications to the Ethiopian health research review system. This article is a review paper based on review of published and un published documents on research ethics in Ethiopia and the AAU-CHS (2007-2012). Thematic summaries of review findings are presented in thematic areas - formation of ethics review and key factors in the evolution of ethics review and implications. The IRB at AAU-CHS has been pivotal in providing review and follow-up for important clinical studies in Ethiopia. It has been one of the first IRBs to get WHO/SIDCER recognition from Africa and Ethiopia. Important factors in the successes of the IRB among others included leadership commitment, its placement in institutional structure, and continued capacity building. Financial challenges and sustainability issues need to be addressed for the sustained gains registered so far. Similar factors are considered important for the new and younger IRBs within the emergent Universities and research centers in the country.

The burden of neglected tropical diseases in Ethiopia, and opportunities for integrated control and elimination

PubMed Central

2012-01-01

Background Neglected tropical diseases (NTDs) are a group of chronic parasitic diseases and related conditions that are the most common diseases among the 2·7 billion people globally living on less than US$2 per day. In response to the growing challenge of NTDs, Ethiopia is preparing to launch a NTD Master Plan. The purpose of this review is to underscore the burden of NTDs in Ethiopia, highlight the state of current interventions, and suggest ways forward. Results This review indicates that NTDs are significant public health problems in Ethiopia. From the analysis reported here, Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo. Ethiopia is estimated to have the highest burden of trachoma, podoconiosis and cutaneous leishmaniasis in sub-Saharan Africa (SSA), the second highest burden in terms of ascariasis, leprosy and visceral leishmaniasis, and the third highest burden of hookworm. Infections such as schistosomiasis, trichuriasis, lymphatic filariasis and rabies are also common. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. However, despite these high burdens of infection, the control of most NTDs in Ethiopia is in its infancy. In terms of NTD control achievements, Ethiopia reached the leprosy elimination target of 1 case/10,000 population in 1999. No cases of human African trypanosomiasis have been reported since 1984. Guinea worm eradication is in its final phase. The Onchocerciasis Control Program has been making steady progress since 2001. A national blindness survey was conducted in 2006 and the trachoma program has kicked off in some regions. Lymphatic Filariasis, podoconiosis and rabies mapping are underway. Conclusion Ethiopia bears a significant burden of NTDs compared to other SSA countries. To achieve success in integrated control of NTDs, integrated mapping, rapid scale up of interventions and operational research into co implementation of intervention packages will be crucial. PMID:23095679

The U.S. military's Neisseria gonorrhoeae resistance surveillance initiatives in selected populations of five countries.

PubMed

Tsai, Alice Y; Dueger, Erica; Macalino, Grace E; Montano, Silvia M; Tilley, Drake H; Mbuchi, Margaret; Wurapa, Eyako K; Saylors, Karen; Duplessis, Christopher C; Puplampu, Naiki; Garges, Eric C; McClelland, R Scott; Sanchez, Jose L

2013-02-01

Multi-drug resistant Neisseria gonorrhoeae (GC) threatens the successful treatment of gonorrhea. This report presents preliminary findings with regard to the prevalence of laboratory-confirmed GC and the extent of drug-resistance among sample populations in five countries. Between October 2010 and January 2013, 1,694 subjects (54% male; 45% female; 1% unknown) were enrolled and screened for the presence of laboratory-confirmed GC in the United States, Djibouti, Ghana, Kenya, and Peru. Overall, 108 (6%) of enrolled subjects tested positive for GC. Antimicrobial susceptibility testing results were available for 66 GC isolates. Resistance to at least three antibiotics was observed at each overseas site. All isolates tested in Ghana (n=6) were resistant to ciprofloxacin, penicillin, and tetracycline. In Djibouti, preliminary results suggested resistance to penicillin, tetracycline, ciprofloxacin, cefepime, and ceftriaxone. The small sample size and missing data prevent comparative analysis and limit the generalizability of these preliminary findings.

The position of Ghana on the progressive map of positive mental health: A critical perspective.

PubMed

Wilson, Angelina; Somhlaba, Nceba Z

2017-05-01

According to the World Health Organisation (WHO), mental health is a state of well-being and not just the absence of diseases. With this definition, there has been a surge of mental health research, albeit still predominantly in Western countries, which is reflected in contemporary theories on positive mental health that include 'flourishing mental health', 'salutogenesis', and 'fortigenesis'. However, in low- and middle-income countries (LMICs), mental health research is slowly receiving scholarly attention. The aim of this paper was twofold: Firstly, to highlight progress that had been made in some LMICs, giving consideration to research across different settings and populations as a basis to argue for more research on positive mental health in the Ghanaian context. Secondly, to present a critical perspective on the current mental health research trends in Ghana, thus discussing important recommendations for future research.

Orthoptera (Insecta: Tettigonioidea, Pyrgomorphoidea, Acridoidea) of Kafa Biosphere Reserve, Bale Mountains National Park and other areas of conservation interest in Ethiopia.

PubMed

Felix, Rob P W H; Massa, Bruno

2016-11-09

An annotated checklist of 51 Orthoptera taxa (Tettigonioidea, Pyrgomorphoidea and Acridoidea) of Kafa Biosphere Reserve, Bale Mountains National Park and some additional sites in Ethiopia is presented. Ten species are newly recorded for the country. Four species are new to science: Peropyrrhicia attilioi n. sp., P. keffensis n. sp., P. semiensis n. sp. and Coryphosima danieli n. sp. The status of Peropyrrhicia cooperi Uvarov, 1934 and P. scotti Uvarov, 1934 is revised: both are considered valid species.

Smoking prevalence differs by location of residence among Ghanaians in Africa and Europe: The RODAM study

PubMed Central

Brathwaite, Rachel; Addo, Juliet; Kunst, Anton E.; Agyemang, Charles; Owusu-Dabo, Ellis; de-Graft Aikins, Ama; Beune, Erik; Meeks, Karlijn; Klipstein-Grobusch, Kerstin; Bahendeka, Silver; Mockenhaupt, Frank P.; Amoah, Stephen; Galbete, Cecilia; Schulze, Matthias B.; Danquah, Ina; Smeeth, Liam

2017-01-01

Background Although the prevalence of smoking is low in Ghana, little is known about the effect of migration on smoking. Comparing Ghanaians living in their country of origin to those living in Europe offers an opportunity to investigate smoking by location of residence and the associations between smoking behaviours and migration-related factors. Methods Data on a relatively homogenous group of Ghanaians living in London (n = 949), Amsterdam (n = 1400), Berlin (n = 543), rural Ghana (n = 973) and urban Ghana (n = 1400) from the cross-sectional RODAM (Research on Obesity & Diabetes in African Migrants) study were used. Age-standardized prevalence rates of smoking by location of residence and factors associated with smoking among Ghanaian men were estimated using prevalence ratios (PR: 95% CIs). Results Current smoking was non-existent among women in rural and urban Ghana and London but was 3.2% and 3.3% in women in Amsterdam and Berlin, respectively. Smoking prevalence was higher in men in Europe (7.8%) than in both rural and urban Ghana (4.8%): PR 1.91: 95% CI 1.27, 2.88, adjusted for age, marital status, education and employment. Factors associated with a higher prevalence of smoking among Ghanaian men included European residence, being divorced or widowed, living alone, Islam religion, infrequent attendance at religious services, assimilation (cultural orientation), and low education. Conclusion Ghanaians living in Europe are more likely to smoke than their counterparts in Ghana, suggesting convergence to European populations, although prevalence rates are still far below those in the host populations. PMID:28475620

Cost-effectiveness analysis and mortality impact estimation of scaling-up pregnancy test kits in Madagascar, Ethiopia and Malawi.

PubMed

Kolesar, Robert J; Audibert, Martine; Comfort, Alison B

2017-07-01

Cost-effective, innovative approaches are needed to accelerate progress towards ending preventable infant, child and maternal mortality. To inform policy decisions, we conducted a cost-effectiveness analysis of adding urine pregnancy test kits to the maternal and reproductive services package offered at the community level in Madagascar, Ethiopia and Malawi. We used a decision tree model to compare the intervention with the status quo for each country. We also completed single factor sensitivity analyses and Monte Carlo simulations with 10 000 iterations to generate the probability distribution of the estimates and uncertainty limits. Among a hypothetical cohort of 100 000 women of reproductive age, we estimate that over a 1-year period, the intervention would save 26, 35 and 48 lives in Madagascar, Ethiopia, and Malawi, respectively. The Incremental Cost Effectiveness Ratio (ICER) for the cost per life saved varies by country: $2311 [95% Uncertainty Interval (UI): $1699; $3454] in Madagascar; $2969 [UI: $2260; $5041] in Ethiopia and $1228 [UI: $918; $1777] in Malawi. This equates to an average cost per Disability Adjusted Life Year (DALY) averted of $36.28, $47.95 and $21.92, respectively. Based on WHO criteria and a comparison with other maternal, newborn, and child health interventions, we conclude that the addition of urine pregnancy tests to an existing community health worker maternal and reproductive services package is highly cost-effective in all three countries. To optimize uptake of family planning and antenatal care services and, in turn, accelerate the reduction of mortality and DALYs, decision makers and program planners should consider adding urine pregnancy tests to the community-level package of services. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Vitamin D Deficiency and Its Predictors in a Country with Thirteen Months of Sunshine: The Case of School Children in Central Ethiopia

PubMed Central

Wakayo, Tolassa; Belachew, Tefera; Vatanparast, Hassan; Whiting, Susan J.

2015-01-01

Studies examining vitamin D status among children living in sunny climates indicated that children did not receive adequate vitamin D, however, this has not been looked at among children living in Ethiopia. In this study, we determined vitamin D deficiency and its predictors among school children aged 11–18 years, examining circulating 25-hydroxy vitamin D [25(OH)D]. The school-based cross-sectional study was conducted in schools in Adama Town (n = 89) and in rural Adama (n = 85) for a total sample of 174. Students were randomly selected using multi-stage stratified sampling method from both settings. Socioeconomic status of parents and demographic, anthropometric, sun exposure status and blood 25(OH)D levels were obtained. Vitamin D deficiency, defined as circulating levels of 25(OH)D <50 nmol/L, was found in 42% of the entire study participants. Prevalence of deficiency was significantly higher among students in urban setting compared to rural (61.8% vs 21.2%, respectively, p<0.001). After controlling for potential confounders using multivariable logistic regression model, duration of exposure to sunlight, amount of body part exposed to sunlight, place of residence, maternal education, body fatness, having TV/computer at home and socioeconomic status were significant predictors of vitamin D deficiency. The findings suggest that Vitamin D deficiency was prevalent in healthy school children living both in urban and rural areas of a country with abundant year round sunshine providing UVB, with the prevalence of deficiency being significantly higher among urban school children who were less exposed to sunlight. Behaviour change communication to enhance exposure to ultraviolet light is critical to prevent vitamin D deficiency in tropical country like Ethiopia. Further study is required to assess the deleterious effect of its deficiency on bone mineral homeostasis of growing children in Ethiopia during their most critical period of bone development. PMID:25822900

Examining the changing profile of undernutrition in the context of food price rises and greater inequality.

PubMed

Nandy, Shailen; Daoud, Adel; Gordon, David

2016-01-01

This paper examines how the profile of undernutrition among children in two African countries (Ethiopia and Nigeria) changed over the period of the 2007/08 food, fuel and financial crisis. Using the Composite Index of Anthropometric Failure (CIAF), an indicator which allows for a comprehensive assessment of undernutrition in young children, we examine what changes occurred in the composition of undernutrition, and how these changes were distributed amongst children in different socio-economic groups. This is important as certain combinations of anthropometric failure (AF), especially the experience of multiple failures (dual and triple combinations of AF) are associated with higher morbidity and mortality risks, and are also related to poverty. Our hypothesis is that increases in food prices during the crisis contributed to an increase in inequality, which may have resulted in concurrent increases in the prevalence of more damaging forms of undernutrition amongst poorer children. While both countries witnessed large increases in food prices, the effects were quite different. Ethiopia managed reduce the prevalence of multiple anthropometric failure between 2005 and 2011 across most groups and regions. By contrast, in Nigeria prevalence increased between 2008 and 2013, and particularly so in the poorer, northern states. The countries studied applied quite different policies in response to food price increases, with the results from Ethiopia demonstrating that protectionist public health and nutrition interventions can mitigate the impacts of price increases on poor children. Copyright © 2016. Published by Elsevier Ltd.

Comparative Hydrology in Ethiopia: a learning experience

NASA Astrophysics Data System (ADS)

Berhanu, B.; Terefe, M.; Viglione, A.; Fant, C.; Gebretsadik, Y.; Cullis, J.; Mekonnen, G.; Alamirew, T.; Sivapalan, M.

2012-04-01

Ethiopia is climatically and environmentally extremely heterogeneous. The highlands receive a lot of rainfall (more than 2000 mm/year) concentrated in only three months. Most of Ethiopian runoff is produced in these highlands (part of this water reaches the Mediterranean sea through the Nile river). Lowlands vary from forests to deserts. The hottest place on earth is there (the Danakil depression, more than 150 meters below see level). This makes the spatial and temporal variability of hydrologic signatures very strong in the country. We present the results of a comparative hydrology exercise performed during a three-week Winter Research Workshop held in Addis Ababa during Christmas time this year. There, a new institution, the Ethiopian Institute of Water Resources (EIWR), and a new education program (18 PhD + 24 MSc) has been started less than one year ago. Instead of the traditional approach of education, based on lectures, reading and exercises, a learner-centered approach has been used: the students have been asked to collect available rainfall and runoff data, to interpret them by comparing and contrasting different catchments in the country, to develop conceptual models and use them to critically test ideas. The R software has been used in the workshop for two reason: (1) its flexibility makes it an ideal language for learner-centered education, since students can easily define new functions and extensions and can autonomously develop and test their hypothesis; (2) it is open source, light and free of charge, which makes it particularly appealing in developing countries like Ethiopia.

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 treatment costs per case of US$ 11.99, US$ 6.79 and US$ 20.54, respectively. Conclusion This study provides important insight into the economic burden of malaria in SSA that may assist policy makers when designing future malaria control interventions. PMID:24004482

Multi-country analysis of treatment costs for HIV/AIDS (MATCH): facility-level ART unit cost analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia.

PubMed

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. In 2010-2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2-8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77-95% alive and on treatment). This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation.

The Performance of a Rapid Diagnostic Test in Detecting Malaria Infection in Pregnant Women and the Impact of Missed Infections.

PubMed

Williams, John E; Cairns, Matthew; Njie, Fanta; Laryea Quaye, Stephen; Awine, Timothy; Oduro, Abraham; Tagbor, Harry; Bojang, Kalifa; Magnussen, Pascal; Ter Kuile, Feiko O; Woukeu, Arouna; Milligan, Paul; Chandramohan, Daniel; Greenwood, Brian

2016-04-01

Intermittent screening and treatment in pregnancy (ISTp) is a potential strategy for the control of malaria during pregnancy. However, the frequency and consequences of malaria infections missed by a rapid diagnostic test (RDT) for malaria are a concern. Primigravidae and secundigravidae who participated in the ISTp arm of a noninferiority trial in 4 West African countries were screened with an HRP2/pLDH RDT on enrollment and, in Ghana, at subsequent antenatal clinic (ANC) visits. Blood samples were examined subsequently by microscopy and by a polymerase chain reaction (PCR) assay. The sensitivity of the RDT to detect peripheral blood infections confirmed by microscopy and/or PCR at enrollment ranged from 91% (95% confidence interval [CI], 88%, 94%) in Burkina Faso to 59% (95% CI, 48%, 70% in The Gambia. In Ghana, RDT sensitivity was 89% (95% CI, 85%, 92%), 83% (95% CI, 76%, 90%) and 77% (95% CI, 67%, 86%) at enrollment, second and third ANC visits respectively but only 49% (95% CI, 31%, 66%) at delivery. Screening at enrollment detected 56% of all infections detected throughout pregnancy. Seventy-five RDT negative PCR or microscopy positive infections were detected in 540 women; these were not associated with maternal anemia, placental malaria, or low birth weight. The sensitivity of an RDT to detect malaria in primigravidae and secundigravidae was high at enrollment in 3 of 4 countries and, in Ghana, at subsequent ANC visits. In Ghana, RDT negative malaria infections were not associated with adverse birth outcomes but missed infections were uncommon. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

The Performance of a Rapid Diagnostic Test in Detecting Malaria Infection in Pregnant Women and the Impact of Missed Infections

PubMed Central

Williams, John E.; Cairns, Matthew; Njie, Fanta; Laryea Quaye, Stephen; Awine, Timothy; Oduro, Abraham; Tagbor, Harry; Bojang, Kalifa; Magnussen, Pascal; ter Kuile, Feiko O.; Woukeu, Arouna; Milligan, Paul; Chandramohan, Daniel; Greenwood, Brian

2016-01-01

Background. Intermittent screening and treatment in pregnancy (ISTp) is a potential strategy for the control of malaria during pregnancy. However, the frequency and consequences of malaria infections missed by a rapid diagnostic test (RDT) for malaria are a concern. Methods. Primigravidae and secundigravidae who participated in the ISTp arm of a noninferiority trial in 4 West African countries were screened with an HRP2/pLDH RDT on enrollment and, in Ghana, at subsequent antenatal clinic (ANC) visits. Blood samples were examined subsequently by microscopy and by a polymerase chain reaction (PCR) assay. Results. The sensitivity of the RDT to detect peripheral blood infections confirmed by microscopy and/or PCR at enrollment ranged from 91% (95% confidence interval [CI], 88%, 94%) in Burkina Faso to 59% (95% CI, 48%, 70% in The Gambia. In Ghana, RDT sensitivity was 89% (95% CI, 85%, 92%), 83% (95% CI, 76%, 90%) and 77% (95% CI, 67%, 86%) at enrollment, second and third ANC visits respectively but only 49% (95% CI, 31%, 66%) at delivery. Screening at enrollment detected 56% of all infections detected throughout pregnancy. Seventy-five RDT negative PCR or microscopy positive infections were detected in 540 women; these were not associated with maternal anemia, placental malaria, or low birth weight. Conclusions. The sensitivity of an RDT to detect malaria in primigravidae and secundigravidae was high at enrollment in 3 of 4 countries and, in Ghana, at subsequent ANC visits. In Ghana, RDT negative malaria infections were not associated with adverse birth outcomes but missed infections were uncommon. PMID:26721833

Do biomass fuel use and consumption of unsafe water mediate educational inequalities in stillbirth risk? An analysis of the 2007 Ghana Maternal Health Survey

PubMed Central

Näyhä, Simo; Jaakkola, Jouni J K

2017-01-01

Background Numerous studies have explored the association between educational inequalities and stillbirth but most have failed to elaborate how low educational attainment leads to an increased risk of stillbirth. We hypothesised that use of biomass fuels and consumption of unsafe water related to low educational attainment could explain the stillbirth burden in Ghana attributable to socioeconomic disadvantage. Methods Data from the 2007 Ghana Maternal Health Survey, a nationally representative population-based survey were analysed for this study. Of the10 370 women aged 15–49 years interviewed via structured questionnaires for the survey, 7183 primiparous and multiparous women qualified for inclusion in the present study. Results In a logistic regression analysis that adjusted for age, area of residence, marital status and ethnicity of women, lower maternal primary education was associated with a 62% (OR=1.62; 95% CI 1.04 to 2.52) increased lifetime risk of stillbirth. Biomass fuel use and consumption of unsafe water mediated 18% and 8% of the observed effects, respectively. Jointly these two exposures explained 24% of the observed effects. The generalised additive modelling revealed a very flat inverted spoon-shaped smoothed curve which peaked at low levels of schooling (2–3 years) and confirms the findings from the logistic regression analysis. Conclusions Our results show that biomass fuel use and unsafe water consumption could be important pathways through which low maternal educational attainment leads to stillbirths in Ghana and similar developing countries. Addressing educational inequalities in developing countries is thus essential for ensuring household choices that curtail environmental exposures and help improve pregnancy outcomes. PMID:28174221

Lesson and Impressions of the Ghanaian Capital Markets

DTIC Science & Technology

2011-07-31

with natural resources, Ghana has roughly twice the per capita output of the poorest countries in West Africa. Gold and cocoa production are major...sources of foreign exchange. Interestingly, the country’s largest source of foreign exchange is remittances from workers abroad. Oil production has...prominent industries include textiles, apparel, steel, tires, flour milling, cocoa processing, beverages, tobacco, simple consumer goods, and car, truck

Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania.

PubMed

Prytherch, Helen; Kagoné, Moubassira; Aninanya, Gifty A; Williams, John E; Kakoko, Deodatus C V; Leshabari, Melkidezek T; Yé, Maurice; Marx, Michael; Sauerborn, Rainer

2013-04-25

In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term 'motivation' was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in professional ethics, and the way this is reinforced in practice require closer attention. The differences in the findings across the three settings underscore the importance of in-depth country-level research to tailor the development of incentives schemes.

Prospects for the use of larvivorous fish for malaria control in Ethiopia: search for indigenous species and evaluation of their feeding capacity for mosquito larvae.

PubMed

Fletcher, M; Teklehaimanot, A; Yemane, G; Kassahun, A; Kidane, G; Beyene, Y

1993-02-01

Because of problems with drug and insecticide resistance, the National Organization for the Control of Malaria and other Vectorborne Diseases, Ethiopia, has embarked on a programme of research on alternative malaria control methods, including the use of biological control agents, such as larvivorous fish. The objectives of the study were to identify indigenous larvivorous fish species which could be potential candidates for use as biological control agents; to extend knowledge of their distribution in Ethiopia; and to conduct laboratory tests to determine their feeding capacity. An extensive search resulted in the identification of 11 larvivorous fish species indigenous to Ethiopia, including five species previously unrecorded in the country. Seven species were assessed under standard laboratory conditions for their feeding capacity on larvae of Anopheles gambiae s.l. and Culex andersoni. All species tested were efficient larvivores in the laboratory. However, their larvivorous capacity should be tested further in field trials. Based on the findings of this study, two priority areas for the assessment of biological control using larvivorous fish were identified, the port city of Assab, using the local species Aphanius dispar, and the Ogaden, south-eastern Ethiopia, using the local species Oreochromis spilurus spilurus.

Most common causes of natural and injury-related deaths in Addis Ababa, Ethiopia.

PubMed

Gemechu, Tufa; Tinsae, Mihrete; Ashenafi, Senait; Rodriguez, Victor Manuel; Lori, Alfredo; Collins, Michelle; Hurford, Rosemary; Haimanot, Rahel; Sandoval, Melissa; Mehari, Enawgaw; Langford, T Dianne

2009-01-01

In Ethiopia, like many developing countries, autopsy is rare unless conducted in the medico-legal arena, making vital statistics that include pathological diagnoses sparse. To determine the most common factors contributing to death among individuals who died from natural or injury-related events in Ethiopia 200 consecutive autopsies were conducted in 2006 at the Forensic Medico-legal Pathology Department, Menelik II Hospital, Addis Ababa, Ethiopia. The results describe significant pathological observations, putative cause of death, age distribution, and gender ratios. Eighty-one percent of the cases were male, and the mean age was 38.9 (+/-15.5 years). Fifty-two percent of the individuals died from natural causes, including infections, and 48% died from injury-related events. In the natural deaths group, as determined by gross examination at autopsy pulmonary complications were the most commonly reported cause of death, with suspected tuberculosis accounting for 12%. Tuberculosis (21, 8%) and liver disease (14, 5%) were the most common histopathological findings in the natural and injury-related causes groups, respectively. In the injury-related group, automobile accident was the most common cause of accidental death (80%), and homicide by beating was the most common cause of death in the intentional injury group (31%). These data provide valuable unbiased analyses of causes of death among individuals in Addis Ababa, Ethiopia.

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.

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.

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

Tetanus in Ethiopia: unveiling the blight of an entirely vaccine-preventable disease.

PubMed

Woldeamanuel, Yohannes Woubishet

2012-12-01

Today, tetanus exacts its toll only in resource-poor countries like Ethiopia. Agrarian rural life with limited vaccine typifies tetanus risk in Ethiopia where current tetanus control trends on expanding infant immunization and eliminating highly prevalent maternal and neonatal tetanus (MNT). Protection by infant tetanus immunization primers disappears within an average of 3 years, if not followed by boosters. Second-year of life, school-based, and universal 10-yearly tetanus immunizations need to be supplemented. Facility-based reviews in Ethiopia reveal a continued burden of tetanus at tertiary-level hospitals where ICU care is suboptimal. Quality of medical care for tetanus is low - reflected by high case-fatality-rates. Opportunities at primary-health-care-units (antenatal-care, family planning, abortion, wound-care, tetanus-survivors) need to be fully-utilized to expand tetanus immunization. Prompt wound-care with post-exposure prophylaxis and proper footwear must be promoted. Standard ICU care needs to exist. Realization of cold-chain-flexible, needle-less and mono-dose vaccine programs allow avoiding boosters, vaccine-refrigeration, and improve compliance.

The role of information communication technology (ICT) towards universal health coverage: the first steps of a telemedicine project in Ethiopia

PubMed Central

Shiferaw, Fassil; Zolfo, Maria

2012-01-01

Background Eighty-five per cent of the Ethiopian population lives in remote areas, without access to modern health services. The limited health care budget, chronic shortage of health care workers and lack of incentives to retain those in remote areas further jeopardize the national health care delivery system. Recently, the application of information communication technology (ICT) to health care delivery and the use of telemedicine have raised hopes. Objective This paper analyzes the challenges, failures and successes encountered in setting-up and implementing a telemedicine program in Ethiopia and provides possible recommendations for developing telemedicine strategies in countries with limited resources. Design Ten sites in Ethiopia were selected to participate in this pilot between 2004 and 2006 and twenty physicians, two per site, were trained in the use of a store and forward telemedicine system, using a dial-up internet connection. Teledermatology, teleradiology and telepathology were the chosen disciplines for the electronic referrals, across the selected ten sites. Results Telemedicine implementation does not depend only on technological factors, rather on e-government readiness, enabling policies, multisectoral involvement and capacity building processes. There is no perfect ‘one size fits all’ technology and the use of combined interoperable applications, according to the local context, is highly recommended. Conclusions Telemedicine is still in a premature phase of development in Ethiopia and other sub-Saharan African countries, and it remains difficult to talk objectively about measurable impact of its use, even though it has demonstrated practical applicability beyond reasonable doubts. PMID:22479235

Public finance of rotavirus vaccination in India and Ethiopia: an extended cost-effectiveness analysis.

PubMed

Verguet, Stéphane; Murphy, Shane; Anderson, Benjamin; Johansson, Kjell Arne; Glass, Roger; Rheingans, Richard

2013-10-01

An estimated 4% of global child deaths (approximately 300,000 deaths) were attributed to rotavirus in 2010. About a third of these deaths occurred in India and Ethiopia. Public finance of rotavirus vaccination in these two countries could substantially decrease child mortality and also reduce rotavirus-related hospitalizations, prevent health-related impoverishment and bring significant cost savings to households. We use a methodology of 'extended cost-effectiveness analysis' (ECEA) to evaluate a hypothetical publicly financed program for rotavirus vaccination in India and Ethiopia. We measure program impact along four dimensions: 1) rotavirus deaths averted; 2) household expenditures averted; 3) financial risk protection afforded; 4) distributional consequences across the wealth strata of the country populations. In India and Ethiopia, the program would lead to a substantial decrease in rotavirus deaths, mainly among the poorer; it would reduce household expenditures across all income groups and it would effectively provide financial risk protection, mostly concentrated among the poorest. Potential indirect benefits of vaccination (herd immunity) would increase program benefits among all income groups, whereas potentially decreased vaccine efficacy among poorer households would reduce the equity benefits of the program. Our approach incorporates financial risk protection and distributional consequences into the systematic economic evaluation of vaccine policy, illustrated here with the case study of public finance for rotavirus vaccination. This enables selection of vaccine packages based on the quantitative inclusion of information on equity and on how much financial risk protection is being bought per dollar expenditure on vaccine policy, in addition to how much health is being bought. Copyright © 2013 Elsevier Ltd. All rights reserved.

Distributional cost-effectiveness analysis in low- and middle-income countries: illustrative example of rotavirus vaccination in Ethiopia.

PubMed

Dawkins, Bryony R; Mirelman, Andrew J; Asaria, Miqdad; Johansson, Kjell Arne; Cookson, Richard A

2018-04-01

Reducing health inequality is a major policy concern for low- and middle-income countries (LMICs) on the path to universal health coverage. However, health inequality impacts are rarely quantified in cost-effectiveness analyses of health programmes. Distributional cost-effectiveness analysis (DCEA) is a method developed to analyse the expected social distributions of costs and health benefits, and the potential trade-offs that may exist between maximising total health and reducing health inequality. This is the first paper to show how DCEA can be applied in LMICs. Using the introduction of rotavirus vaccination in Ethiopia as an illustrative example, we analyse a hypothetical re-designed vaccination programme, which invests additional resources into vaccine delivery in rural areas, and compare this with the standard programme currently implemented in Ethiopia. We show that the re-designed programme has an incremental cost-effectiveness ratio of US$69 per health-adjusted life year (HALY) compared with the standard programme. This is potentially cost-ineffective when compared with current estimates of health opportunity cost in Ethiopia. However, rural populations are typically less wealthy than urban populations and experience poorer lifetime health. Prioritising such populations can thus be seen as being equitable. We analyse the trade-off between cost-effectiveness and equity using the Atkinson inequality aversion parameter, ε, representing the decision maker's strength of concern for reducing health inequality. We find that the more equitable programme would be considered worthwhile by a decision maker whose inequality concern is greater than ε = 5.66, which at current levels of health inequality in Ethiopia implies that health gains are weighted at least 3.86 times more highly in the poorest compared with the richest wealth quintile group. We explore the sensitivity of this conclusion to a range of assumptions and cost-per-HALY threshold values, to illustrate how DCEA can inform the thinking of decision makers and stakeholders about health equity trade-offs.

Co-creating a psychiatric resident program with Ethiopians, for Ethiopians, in Ethiopia: the Toronto Addis Ababa Psychiatry Project (TAAPP).

PubMed

Alem, Atalay; Pain, Clare; Araya, Mesfin; Hodges, Brian D

2010-01-01

Globalization in medical education often means a "brain drain" of desperately needed health professionals from low- to high-income countries. Despite the best intentions, partnerships that simply transport students to Western medical schools for training have shockingly low return rates. Ethiopia, for example, has sent hundreds of physicians abroad for specialty training over the past 30 years, the vast majority of whom have not returned. This represents a highly problematic net transfer of financial and human resources from the Ethiopian people to Western countries that have failed to develop their own adequate health human resource plans. With this background in mind, in 2003 Addis Ababa University invited the University of Toronto to collaborate on the first Ethiopian psychiatric residency program to be run entirely in Ethiopia. Called the Toronto Addis Ababa Psychiatry Project (TAAPP), it was established on the principle of supplementing the ability of the small Addis Ababa University Department of Psychiatry to teach, provide clinical supervision, and to help develop educational capacity. Over the last 6 years the model has involved a large number of University of Toronto faculty and residents who have spent blocks of 1 month each in Addis Ababa. This article describes the first three phases of TAAPP (I) Development of a model residency program; (II) Enhancing clinical, educational and leadership capacity; and (III) Sustainability, faculty development, and continuing education. Between 2003 and 2009, the number of psychiatrists in Ethiopia increased from 11 to 34; the Addis Ababa University Department of Psychiatry faculty increased members from three to nine. There are new departments of psychiatry established in four other university hospitals in Ethiopia outside the capital city. Mental health services are now being integrated within the national system of primary care. An important issue that underscores such a partnership is the risk of simply exporting Western, America-centric psychiatric training versus creating culturally appropriate models of education.

Does Economic Growth Reduce Childhood Undernutrition in Ethiopia?

PubMed

Biadgilign, Sibhatu; Shumetie, Arega; Yesigat, Habtamu

2016-01-01

Policy discussions and debates in the last couple of decades emphasized efficiency of development policies for translating economic growth to development. One of the key aspects in this regard in the developing world is achieving improved nutrition through economic development. Nonetheless, there is a dearth of literature that empirically verifies the association between economic growth and reduction of childhood undernutrition in low- and middle-income countries. Thus, the aim of the study is to assess the interplay between economic growth and reduction of childhood undernutrition in Ethiopia. The study used pooled data of three rounds (2000, 2005 and 2010) from the Demographic and Health Surveys (DHS) of Ethiopia. A multilevel mixed logistic regression model with robust standard errors was utilized in order to account for the hierarchical nature of the data. The dependent variables were stunting, underweight, and wasting in children in the household. The main independent variable was real per capita income (PCI) that was adjusted for purchasing power parity. This information was obtained from World Bank. A total of 32,610 children were included in the pooled analysis. Overall, 11,296 (46.7%) [46.0%-47.3%], 8,197(33.8%) [33.2%-34.4%] and 3,175(13.1%) [12.7%-13.5%] were stunted, underweight, and wasted, respectively. We found a strong correlation between prevalence of early childhood undernutrition outcomes and real per capita income (PCI). The proportions of stunting (r = -0.1207, p<0.0001), wasting (r = -0.0338, p<0.0001) and underweight (r = -0.1035, p<0.0001) from the total children in the household were negatively correlated with the PCI. In the final model adjustment with all the covariates, economic growth substantially reduced stunting [β = -0.0016, SE = 0.00013, p<0.0001], underweight [β = -0.0014, SE = 0.0002, p<0.0001] and wasting [β = -0.0008, SE = 0.0002, p<0.0001] in Ethiopia over a decade. Economic growth reduces child undernutrition in Ethiopia. This verifies the fact that the economic growth of the country accompanied with socio-economic development and improvement of the livelihood of the poor. Direct nutrition specific and nutrition sensitive interventions could also be recommended in order to have an impact on the massive reduction of childhood undernutrition in the country.

Weighted log-linear models for service delivery points in Ethiopia: a case of modern contraceptive users at health facilities.

PubMed

Workie, Demeke Lakew; Zike, Dereje Tesfaye; Fenta, Haile Mekonnen; Mekonnen, Mulusew Admasu

2018-05-10

Ethiopia is among countries with low contraceptive usage prevalence rate and resulted in high total fertility rate and unwanted pregnancy which intern affects the maternal and child health status. This study aimed to investigate the major factors that affect the number of modern contraceptive users at service delivery point in Ethiopia. The Performance Monitoring and Accountability2020/Ethiopia data collected between March and April 2016 at round-4 from 461 eligible service delivery points were in this study. The weighted log-linear negative binomial model applied to analyze the service delivery point's data. Fifty percent of service delivery points in Ethiopia given service for 61 modern contraceptive users with the interquartile range of 0.62. The expected log number of modern contraceptive users at rural was 1.05 (95% Wald CI: - 1.42 to - 0.68) lower than the expected log number of modern contraceptive users at urban. In addition, the expected log count of modern contraceptive users at others facility type was 0.58 lower than the expected log count of modern contraceptive users at the health center. The numbers of nurses/midwives were affecting the number of modern contraceptive users. Since, the incidence rate of modern contraceptive users increased by one due to an additional nurse in the delivery point. Among different factors considered in this study, residence, region, facility type, the number of days per week family planning offered, the number of nurses/midwives and number of medical assistants were to be associated with the number of modern contraceptive users. Thus, the Government of Ethiopia would take immediate steps to address causes of the number of modern contraceptive users in Ethiopia.

Care seeking behaviour for children with suspected pneumonia in countries in sub-Saharan Africa with high pneumonia mortality.

PubMed

Noordam, Aaltje Camielle; Carvajal-Velez, Liliana; Sharkey, Alyssa B; Young, Mark; Cals, Jochen W L

2015-01-01

Pneumonia is the leading cause of childhood mortality in sub-Saharan Africa (SSA). Because effective antibiotic treatment exists, timely recognition of pneumonia and subsequent care seeking for treatment can prevent deaths. For six high pneumonia mortality countries in SSA we examined if children with suspected pneumonia were taken for care, and if so, from which type of care providers, using national survey data of 76530 children. We also assessed factors independently associated with care seeking from health providers, also known as 'appropriate' providers. We report important differences in care seeking patterns across these countries. In Tanzania 85% of children with suspected pneumonia were taken for care, whereas this was only 30% in Ethiopia. Most of the children living in these six countries were taken to a primary health care facility; 86, 68 and 59% in Ethiopia, Tanzania and Burkina Faso respectively. In Uganda, hospital care was sought for 60% of children. 16-18% of children were taken to a private pharmacy in Democratic Republic of Congo (DRC), Tanzania and Nigeria. In Tanzania, children from the richest households were 9.5 times (CI 2.3-39.3) more likely to be brought for care than children from the poorest households, after controlling for the child's age, sex, caregiver's education and urban-rural residence. The influence of the age of a child, when controlling for sex, urban-rural residence, education and wealth, shows that the youngest children (<2 years) were more likely to be brought to a care provider in Nigeria, Ethiopia and DRC. Urban-rural residence was not significantly associated with care seeking, after controlling for the age and sex of the child, caregivers education and wealth. The study suggests that it is crucial to understand country-specific care seeking patterns for children with suspected pneumonia and related determinants using available data prior to planning programmatic responses.

Dark Skies Africa: a Prototype Project with the IAU Office of Astronomy for Development

NASA Astrophysics Data System (ADS)

Walker, Constance Elaine; Tellez, Daniel; Pompea, Stephen M.

2015-08-01

The IAU’s Office of Astronomy for Development (OAD) awarded the National Optical Astronomy Observatory (NOAO) with a grant to deliver a “Dark Skies Outreach to Sub-Saharan Africa” program to institutions in 12 African countries during 2013: Algeria, Nigeria, Rwanda, Tanzania, Ghana, Zambia, South Africa, Ethiopia, Gabon, Kenya, Namibia and Senegal. The program helped students identify wasteful and inefficient lighting and provided ways to reduce consumption and to keep energy costs in check. The goal was to inspire students to be responsible stewards in helping their community safeguard one of Africa’s natural resources - a dark night sky.Thirteen kits made by the NOAO Education and Public Outreach group were sent to coordinators at university, science center and planetarium-type institutions in the 12 countries and to the IAU OAD. The program’s kit included complete instructional guides and supplies for six hands-on activities (e.g., on the importance of shielding lights and using energy efficient bulbs) and a project on energy conservation and responsible lighting (through energy audits). The activities were taught to the coordinators in a series of six Google+ Hangout sessions scheduled from June to mid-November. The coordinators at the institutions in turn trained local teachers in junior and senior high schools. The Google+ Hangout sessions also included instruction on carrying out evaluations. From the end of November until mid-December students from the different African countries shared final class projects (such as posters or powerpoints) on the program’s website.The entire program was designed to help coordinators and educators work with students, parents and the community to identify dark sky resource, lighting and energy issues and to assess their status, efficiency and effectiveness. The audience will take away from the presentation lessons learned on how well the techniques succeeded in using Google+ Hangout sessions to instruct and sustain a community of coordinators and educators through distance learning, as well as immersing them (and their students) in projects after a scaffolded sequence of activities.

How a geomorphosite inventory can contribute to regional sustainable development? The case of the Simen Mountains National Park, Ethiopia

NASA Astrophysics Data System (ADS)

Mauerhofer, Lukas; Reynard, Emmanuel; Asrat, Asfawossen; Hurni, Hans; Wildlife Conservation Authority, Ethiopian

2016-04-01

This research aimed at investigating how an inventory of geomorphosites can foster or improve the knowledge and management of geomorphological heritages in the context of developing countries. Accordingly, a geomorphosite inventory in the Simen Mountains National Park (SMNP), Ethiopia was conducted following the method of Reynard et al. (2015). The national context of geoheritage and geoconservation in Ethiopia was appraised and a road map for the management of the inventoried sites in the SMNP was elaborated. Ethiopia hosts numerous geoheritage sites, some of which of highest international significance. Therefore, geotourism has recently been promoted throughout the country (Asrat et al., 2008). Despite numerous trials of the scientific community, there is not yet a national policy for geoconservation in the country. Many parts of Ethiopia are underdeveloped in terms of economic subsistence and infrastructure, making these immediate priorities over conservation efforts. Nevertheless, this study showed that the Simen Mountains have the potential to become a UNESCO Global Geopark and that geosites could be used to develop geotourism within SMNP, and that development and conservation are not contradictory. Twenty-one geomorphosites were identified and assessed. Diverse geomorphological contexts including fluvial, structural, glacial, periglacial, anthropic and organic characterize the SMNP. The temporal stages, which allow the reconstitution of the morphogenesis of the Simen Mountains, are the Cenozoic volcanism, Last Glacial Maximum, Holocene as well as historic/modern landscape modification. Four synthesis maps were elaborated to present the results of the assessment. The average scientific value of the inventoried geomorphosites is very high compared to other inventories realized using the same method. This is particularly due to the extremely high integrity of the sites. Almost all geomorphosites are in a good state of conservation and only few sites are vulnerable to human encroachment. The educational interest of most sites is high but interpretation facilities are absent. With some minor adjustments, the application of the inventory method (Reynard et al., 2015) to the SMNP has proven successful and can be recommended for application to other areas in developing countries of similar well-documented geomorphology. However, the method could prove too complex for areas where basic knowledge on geomorphology is poor, as is often the case in developing countries. Based on previous studies (in particular Asrat et al. 2012) and results of the current inventory, a road map for SMNP geomorphosite management was proposed. Eight strategic objectives and working tasks were considered, which include the development of geotourism products such as geotourist maps, geo-trails and guidebooks, geo-trekking, geo-sightseeing tours, and interpretive panels as well as the training of geo-guides and capacity building of the park staff and specific management of the Lemalemo site, one of the most accessible geosites in the park. The overall goal is to raise awareness on the rich geomorphological heritage through geotourism development and empowerment of locals and thus to contribute to long-term protection of the geomorphosites. In conclusion the study revealed important potential for sustainable rural development in the Simen. Applied research will be necessary on how exactly the promotion products should be developed. References Asrat, A., Demissie, M., Mogessie, A. (2008). Geotourism in Ethiopia: archaelogical and ancient cities, religious and cultural centres: Yeha, Axum, Wukro, and Lalibela. Addis Ababa: Shama Books. Asrat, A., Demissie, M., Mogessie, A. (2012). Geoheritage conservation in Ethiopia: the case of the Simien Mountains. Quaestiones Geographicae, 31(1), 7-23. doi:10.2478/v10117-012-0001-0. Reynard E., Perret A., Bussard J., Grangier L., Martin S. (2015). Integrated approach for the inventory and management of geomorphological heritage at the regional scale. Geoheritage, doi: 10.1007/s12371-015-0153-0

Liftoff: The Blossoming of Contraceptive Implant Use in Africa.

PubMed

Jacobstein, Roy

2018-03-21

This article draws from national surveys of every sub-Saharan African country with at least 1 recent survey published between 2015 and 2017 and 2 prior surveys from 2003 to 2014. Twelve countries comprising over 60% of the region's population met these inclusion criteria. The analysis considers recent and longer-term changes in 3 key variables: modern contraceptive prevalence rate (mCPR), method-specific prevalence, and a method's share of the current modern method mix. As recently as 2011, implant CPR in sub-Saharan Africa was only 1.1%. Since then, sizeable price reductions, much-increased commodity supply, greater government commitment to rights-based family planning, broader WHO eligibility guidance, and wider adoption of high-impact service delivery practices have resulted in expanded client access and marked increases in implant prevalence and share of the method mix. Ten of the 12 countries now have an implant CPR around 6% or higher, with 3 countries above 11%. Increased implant use has been the main driver of the increased mCPR attained by 11 countries, with gains in implant use alone exceeding combined gains in use of injectables, pills, and intrauterine devices. In countries as diverse as Burkina Faso and Ethiopia, Democratic Republic of the Congo and Ghana, Kenya and Senegal, implant use now accounts for one-fourth to one-half of all modern method use. Implants have become the first or second most widely used method in 10 countries. In the 7 countries with multiple surveys conducted over a 2- to 3-year span between 2013-14 and 2016-17, average annual gains in implant prevalence range from 0.97 to 4.15 percentage points; this contrasts to historical annual gains in use of all modern methods of 0.70 percentage points in 42 sub-Saharan African countries from 1986 to 2008. Implant use has risen substantially and fairly equitably across almost all sociodemographic categories, including unmarried women, women of lower and higher parity, women in all 5 wealth quintiles, younger and older women, and women residing in rural areas. A notable exception is the category of nulliparous married women, whose implant use is mostly below 1%. These attainments represent a major success story not often seen in family planning programming. With continued program commitment and donor support, these trends in implant uptake and popularity are likely to continue for the next few years. This implies even greater need for the international family planning community to maintain its focus on rights-based programming, ensuring reliable access to implant removal as well as insertion services, and addressing issues of financing and sustainability. © Jacobstein.

Liftoff: The Blossoming of Contraceptive Implant Use in Africa

PubMed Central

Jacobstein, Roy

2018-01-01

This article draws from national surveys of every sub-Saharan African country with at least 1 recent survey published between 2015 and 2017 and 2 prior surveys from 2003 to 2014. Twelve countries comprising over 60% of the region's population met these inclusion criteria. The analysis considers recent and longer-term changes in 3 key variables: modern contraceptive prevalence rate (mCPR), method-specific prevalence, and a method's share of the current modern method mix. As recently as 2011, implant CPR in sub-Saharan Africa was only 1.1%. Since then, sizeable price reductions, much-increased commodity supply, greater government commitment to rights-based family planning, broader WHO eligibility guidance, and wider adoption of high-impact service delivery practices have resulted in expanded client access and marked increases in implant prevalence and share of the method mix. Ten of the 12 countries now have an implant CPR around 6% or higher, with 3 countries above 11%. Increased implant use has been the main driver of the increased mCPR attained by 11 countries, with gains in implant use alone exceeding combined gains in use of injectables, pills, and intrauterine devices. In countries as diverse as Burkina Faso and Ethiopia, Democratic Republic of the Congo and Ghana, Kenya and Senegal, implant use now accounts for one-fourth to one-half of all modern method use. Implants have become the first or second most widely used method in 10 countries. In the 7 countries with multiple surveys conducted over a 2- to 3-year span between 2013–14 and 2016–17, average annual gains in implant prevalence range from 0.97 to 4.15 percentage points; this contrasts to historical annual gains in use of all modern methods of 0.70 percentage points in 42 sub-Saharan African countries from 1986 to 2008. Implant use has risen substantially and fairly equitably across almost all sociodemographic categories, including unmarried women, women of lower and higher parity, women in all 5 wealth quintiles, younger and older women, and women residing in rural areas. A notable exception is the category of nulliparous married women, whose implant use is mostly below 1%. These attainments represent a major success story not often seen in family planning programming. With continued program commitment and donor support, these trends in implant uptake and popularity are likely to continue for the next few years. This implies even greater need for the international family planning community to maintain its focus on rights-based programming, ensuring reliable access to implant removal as well as insertion services, and addressing issues of financing and sustainability. PMID:29559495

A qualitative study of health system barriers to accessibility and utilization of maternal and newborn healthcare services in Ghana after user-fee abolition.

PubMed

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

2014-12-21

To reduce financial barriers to access, and improve access to and use of skilled maternal and newborn healthcare services, the government of Ghana, in 2003, implemented a new maternal healthcare policy that provided free maternity care services in all public and mission healthcare facilities. Although supervised delivery in Ghana has increased from 47% in 2003 to 55% in 2010, strikingly high maternal mortality ratio and low percentage of skilled attendance are still recorded in many parts of the country. To explore health system factors that inhibit women's access to and use of skilled maternal and newborn healthcare services in Ghana despite these services being provided free. We conducted qualitative research with 185 expectant and lactating mothers and 20 healthcare providers in six communities in Ghana between November 2011 and May 2012. We used Attride-Stirling's thematic network analysis framework to analyze and present our data. We found that in addition to limited and unequal distribution of skilled maternity care services, women's experiences of intimidation in healthcare facilities, unfriendly healthcare providers, cultural insensitivity, long waiting time before care is received, limited birthing choices, poor care quality, lack of privacy at healthcare facilities, and difficulties relating to arranging suitable transportation were important health system barriers to increased and equitable access and use of services in Ghana. Our findings highlight how a focus on patient-side factors can conceal the fact that many health systems and maternity healthcare facilities in low-income settings such as Ghana are still chronically under-resourced and incapable of effectively providing an acceptable minimum quality of care in the event of serious obstetric complications. Efforts to encourage continued use of maternity care services, especially skilled assistance at delivery, should focus on addressing those negative attributes of the healthcare system that discourage access and use.

Community-based distribution of misoprostol to prevent postpartum haemorrhage at home births: results from operations research in rural Ghana.

PubMed

Geller, S; Carnahan, L; Akosah, E; Asare, G; Agyemang, R; Dickson, R; Kapungu, C; Owusu-Ansah, L; Robinson, N; Mensah-Homiah, J

2014-02-01

To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana. Operations research. Rural Ghana. Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC). Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women. Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality. Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly. This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios. © 2013 Royal College of Obstetricians and Gynaecologists.

Assessment of formaldehyde levels in local and imported fresh fish in Ghana: a case study in the Tamale Metropolis of Ghana.

PubMed

Saba, Courage Kosi Setsoafia; Atayure, Seidu Isaac; Adzitey, Frederick

2015-03-01

Fish is an important source of protein all over the world, including in Ghana. The fishery sector plays a major role in meeting the domestic need of animal protein and also contributes greatly in foreign exchange earnings. The domestic supply of fish does not meet the demand, so Ghana imports fish and fish products from other countries. Media reports in Ghana have alleged the use of formaldehyde to preserve fish for increased shelf life and to maintain freshness. This research, therefore, sought to establish the levels of formaldehyde in imported and local fresh fish in the Tamale Metropolis by using a ChemSee formaldehyde and formalin detection test kit. Positive and negative controls were performed by using various concentrations of formalin (1, 10, 30, 50, 100, and 300 ppm) and sterile distilled water, respectively. Three times over a 6-month period, different fish species were obtained from five wholesale cold stores (where fish are sold in cartons) and some local sales points (where locally caught fish are sold). A total of 32 samples were taken during three different sampling sessions: 23 imported fish (mackerel, herring, horse mackerel, salmon, and redfish) and 9 local tilapia. The fish were cut, and 50 g was weighed and blended with an equal volume (50 ml) of sterile distilled water. Samples were transferred to test tubes and centrifuged. A test strip was dipped into the supernatant and observed for a color change. A change in color from white to pink or purple indicated the presence of formaldehyde in fish. The study showed that no formaldehyde was present in the imported and local fish obtained. The appropriate regulatory agencies should carry out this study regularly to ensure that fish consumed in Ghana is safe for consumption.

Regression Analysis to Identify Factors Associated with Urinary Iodine Concentration at the Sub-National Level in India, Ghana, and Senegal

PubMed Central

Knowles, Jacky; Kupka, Roland; Dumble, Sam; Garrett, Greg S.; Pandav, Chandrakant S.; Yadav, Kapil; Touré, Ndeye Khady; Foriwa Amoaful, Esi; Gorstein, Jonathan

2018-01-01

Single and multiple variable regression analyses were conducted using data from stratified, cluster sample design, iodine surveys in India, Ghana, and Senegal to identify factors associated with urinary iodine concentration (UIC) among women of reproductive age (WRA) at the national and sub-national level. Subjects were survey household respondents, typically WRA. For all three countries, UIC was significantly different (p < 0.05) by household salt iodine category. Other significant differences were by strata and by household vulnerability to poverty in India and Ghana. In multiple variable regression analysis, UIC was significantly associated with strata and household salt iodine category in India and Ghana (p < 0.001). Estimated UIC was 1.6 (95% confidence intervals (CI) 1.3, 2.0) times higher (India) and 1.4 (95% CI 1.2, 1.6) times higher (Ghana) among WRA from households using adequately iodised salt than among WRA from households using non-iodised salt. Other significant associations with UIC were found in India, with having heard of iodine deficiency (1.2 times higher; CI 1.1, 1.3; p < 0.001) and having improved dietary diversity (1.1 times higher, CI 1.0, 1.2; p = 0.015); and in Ghana, with the level of tomato paste consumption the previous week (p = 0.029) (UIC for highest consumption level was 1.2 times lowest level; CI 1.1, 1.4). No significant associations were found in Senegal. Sub-national data on iodine status are required to assess equity of access to optimal iodine intake and to develop strategic responses as needed. PMID:29690505

Determinants of routine immunization costing in Benin and Ghana in 2011.

PubMed

Ahanhanzo, Césaire Damien; Huang, Xiao Xian; Le Gargasson, Jean-Bernard; Sossou, Justin; Nyonator, Frank; Colombini, Anais; Gessner, Bradford D

2015-05-07

Existing tools to evaluate costs do not always capture the heterogeneity of costs at the facility level. This study seeks to address this issue through an analysis of determinants of health facility immunization costs. A statistical analysis on facility routine delivery and vaccine costs was conducted using ordinary least squares regression. Explanatory variables included the number of doses administered; proportion of time spent by facility staff on immunization; average staff wage; whether the health facility had enough staff; presence of cold chain equipment; distance to a vaccine collection point; and, facility ownership. Data were drawn from representative samples of primary care facilities in Benin and Ghana (46 and 50 facilities, respectively) collected as part of the EPIC studies. Weighted average RI immunization facility cost was US$ 16,459 in Ghana and US$ 14,994 in Benin. The regression found total doses administered to be positively and significantly associated with facility cost in both countries. A 10% increase in doses resulted in a 4% increase in cost in Ghana, and a 7.5% increase in Benin. In Ghana, the proportion of immunization time, presence of cold chain, and sufficiency of staff were positively and significantly associated with total cost. In Benin, facility cost was negatively and significantly related to distance to the vaccine collection point. In the pooled sample, facilities in capital cities were associated with significantly higher costs. This study provides evidence on the importance of the level of scale in determining facility immunization cost, as well as the role of availability of health workers and time they spend on immunization in Ghana and Benin. This type of analysis can provide insights into the costs of scaling up immunization services, and can assist with development of more efficient immunization strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Experiences of leadership in health care in sub-Saharan Africa

PubMed Central

2012-01-01

Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. Methods We conducted a qualitative study using in-person interviews with individuals (n = 17) in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their country’s minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Interviews were audio recorded and professionally transcribed. Data analysis was performed by a five-person multidisciplinary team using the constant comparative method, facilitated by ATLAS.ti 5.0 software. Results Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Conclusions Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context. Developing such skills may require more time and a deeper level of engagement and collaboration than is typically invested in efforts to strengthen health systems. PMID:22974417

Quality considerations in midwifery pre-service education: exemplars from Africa.

PubMed

Fullerton, Judith T; Johnson, Peter G; Thompson, Joyce B; Vivio, Donna

2011-06-01

This paper uses comparisons and contrasts identified during an assessment of pre-service education for midwives in three countries in sub-Saharan Africa. The purpose of the paper is to stimulate discussion about issues that must be carefully considered in the context of midwifery educational programming and the expansion of the midwifery workforce. A mixed qualitative and quantitative participatory assessment was conducted in Ethiopia, Ghana and Malawi, in the context of a final review of outcomes of a USAID-funded global project (ACCESS). Quantitative surveys were distributed. Individual and focus group interviews were conducted. Participants included key informants at donor, government and policy-making levels, representatives of collaborating and supporting agencies, midwives and students in education programmes, and midwives in clinical practice. Information is presented concerning the challenges encountered by those responsible for midwifery pre-service education related to issues in programming including: pathways to midwifery, student recruitment and admission, midwifery curricula, preparation of faculty to engage in academic teaching and clinical mentorship, modes of curriculum dissemination and teaching/learning strategies, programme accreditation, qualifications for entry-into practice and the assessment of continued competence. Quality issues must be carefully considered when designing and implementing midwifery pre-service education programmes, and planning for the integration of new graduates into the health workforce. These issues, such as the availability of qualified tutors and clinical teachers, and measures for the implementation of competency-based teaching and learner-assessment strategies, are particularly relevant in countries that experience health manpower shortages. This review highlights important strategic choices that can be made to enhance the quality of pre-service midwifery education. The deployment, appropriate utilisation and increased number of highly qualified midwifery graduates can improve the quality of maternal and newborn health-care service, and reduce maternal and newborn mortality. Copyright © 2010 Elsevier Ltd. All rights reserved.

Yield gap analyses to estimate attainable bovine milk yields and evaluate options to increase production in Ethiopia and India.

PubMed

Mayberry, Dianne; Ash, Andrew; Prestwidge, Di; Godde, Cécile M; Henderson, Ben; Duncan, Alan; Blummel, Michael; Ramana Reddy, Y; Herrero, Mario

2017-07-01

Livestock provides an important source of income and nourishment for around one billion rural households worldwide. Demand for livestock food products is increasing, especially in developing countries, and there are opportunities to increase production to meet local demand and increase farm incomes. Estimating the scale of livestock yield gaps and better understanding factors limiting current production will help to define the technological and investment needs in each livestock sector. The aim of this paper is to quantify livestock yield gaps and evaluate opportunities to increase dairy production in Sub-Saharan Africa and South Asia, using case studies from Ethiopia and India. We combined three different methods in our approach. Benchmarking and a frontier analysis were used to estimate attainable milk yields based on survey data. Household modelling was then used to simulate the effects of various interventions on dairy production and income. We tested interventions based on improved livestock nutrition and genetics in the extensive lowland grazing zone and highland mixed crop-livestock zones of Ethiopia, and the intensive irrigated and rainfed zones of India. Our analyses indicate that there are considerable yield gaps for dairy production in both countries, and opportunities to increase production using the interventions tested. In some cases, combined interventions could increase production past currently attainable livestock yields.

Identification of a New Genotype of African Swine Fever Virus in Domestic Pigs from Ethiopia.

PubMed

Achenbach, J E; Gallardo, C; Nieto-Pelegrín, E; Rivera-Arroyo, B; Degefa-Negi, T; Arias, M; Jenberie, S; Mulisa, D D; Gizaw, D; Gelaye, E; Chibssa, T R; Belaye, A; Loitsch, A; Forsa, M; Yami, M; Diallo, A; Soler, A; Lamien, C E; Sánchez-Vizcaíno, J M

2017-10-01

African swine fever (ASF) is an important emerging transboundary animal disease (TAD), which currently has an impact on many countries in Africa, Eastern Europe, the Caucasus and the Russian Federation. The current situation in Europe shows the ability of the virus to rapidly spread, which stands to threaten the global swine industry. At present, there is no viable vaccine to minimize spread of the disease and stamping out is the main source of control. In February 2011, Ethiopia had reported its first suspected outbreaks of ASF. Genomic analyses of the collected ASF virus (ASFV) strains were undertaken using 23 tissue samples collected from domestic swine in Ethiopia from 2011 to 2014. The analysis of Ethiopian ASFVs partial p72 gene sequence showed the identification of a new genotype, genotype XXIII, that shares a common ancestor with genotypes IX and X, which comprise isolates circulating in Eastern African countries and the Republic of Congo. Analysis of the p54 gene also followed the p72 pattern and the deduced amino acid sequence of the central variable region (CVR) of the B602L gene showed novel tetramer repeats not previously characterized. © 2016 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.

Causes of sudden death in Addis Ababa, Ethiopia.

PubMed

Schneider, J; Bezabih, K

2001-10-01

The aim of this study was to evaluate the causes of death in individuals who died suddenly in Addis Ababa, Ethiopia. The selection of the cases was based on police reports, which contained a description of sudden unexpected or instantaneous death. The study was performed on necropsies of the Medico legal Department of Menelik II Hospital, in Addis Ababa during the years 1998 and 1999. According to the pathological features of the heart, we classified 92 dead bodies in 3 groups: Group A: Hearts showing adequate morphological changes to explain sudden death (n = 63). Group B: Hearts showing some structural changes, but inadequate to explain sudden death (n = 20). Group C: Normal hearts (n = 7). In two bodies the general autopsy revealed an extra cardiac cause of death. The single most relevant cause of death in group A was coronary artery disease (44 cases) followed by excessive myocardial hypertrophy due to post-rheumatic valvular lesions (7 cases). While the high prevalence of rheumatic heart disease in Ethiopia is well known, the proportion of cases who died due to coronary heart disease is surprising. Though during the last years some African authors assumed that coronary atherosclerosis is on the increase in developing countries the percentage is higher than expected and higher than in other countries where similar studies exist.

Ghana's experience in the establishment of a national digital seismic network observatory

NASA Astrophysics Data System (ADS)

Ahulu, Sylvanus; Danuor, Sylvester Kojo

2015-07-01

The Government of Ghana has established a National Digital Seismic Network Observatory in Ghana with the aim of monitoring events such as earthquakes, blasts from mining and quarrying, nuclear tests, etc. The Digital Observatory was commissioned on 19 December 2012, and was dedicated to Geosciences in Ghana. Previously Ghana did not have any operational, digital seismic network acquisition system with the capability of monitoring and analysing data for planning and research purposes. The Ghana Geological Survey has been monitoring seismic events with an analogue system which was not efficient and does not deliver real-time data. Hence, the importance of setting up the National Digital Seismic Network System which would enable the Geological Survey to constantly monitor, manage and coordinate both natural and man-made seismic activities in the country and around the globe, to some extent on real-time basis. The Network System is made up of six remote digital stations that transmit data via satellite to the central observatory. Sensors used are 3× Trillium Compact and 3× Trillium 120PA with Trident digitizers. The department has also acquired strong motion equipment: Titan accelerometers with Taurus digitizers from Nanometrics. Three of each of these instruments have been installed at the Akosombo and Kpong hydrodams, and also at the Weija water supply dam. These instruments are used to monitor dams. The peak ground acceleration (PGA) values established from the analysed data from the accelerometers will be used to retrofit or carry out maintenance work of the dam structures to avoid collapse. Apart from these, the observatory also assesses and analyses seismic waveforms relevant to its needs from the Global Seismographic Network (GSN) system operated by the US Geological Survey. The Ghana Geological Survey, through its Seismic Network Observatory makes data available to its stakeholder institutions for earthquake disaster mitigation; reports on all aspects of seismic-related disasters to the relevant government agencies that deal with disasters; makes recommendations to the government of Ghana on earthquake safety measures; and provides information to assist government institutions develop appropriate land and building policies. The Geological Survey Department, in collaboration with stakeholder agencies, periodically organises public lectures on earthquake disaster risk mitigation.

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 driving providers to gain and maintain accreditation in both countries. Developing mechanisms to engage private providers as stakeholders in social health insurance schemes is important to incentivizing their participation and addressing their concerns. PMID:29470545

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

PubMed Central

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

2013-01-01

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

Secondhand tobacco smoke exposure in selected public places (PM2.5 and air nicotine) and non-smoking employees (hair nicotine) in Ghana

PubMed Central

Agbenyikey, Wilfred; Wellington, Edith; Gyapong, John; Travers, Mark J; Breysse, Patrick N; McCarty, Kathleen M

2010-01-01

Background 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 (PM2.5) and nicotine concentrations and (2) hair nicotine concentrations in non-smoking employees. Quantifying SHS exposure will provide evidence needed to develop tobacco control legislation. Method PM2.5 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. Result Compared to non-smoking venues, smoking venues had markedly elevated PM2.5 (median 553 [IQR 259–1038] vs 16.0 [14.0–17.0] μg/m3) and air nicotine (1.83 [0.91–4.25] vs 0.03 [0.02–0.04] μg/m3) 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 PM2.5 concentrations (r=0.47) and air nicotine concentrations (r=0.63). Conclusion 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. PMID:20930057

Seeking greener pastures? The relationship between career satisfaction and the intention to emigrate: a survey of Ghanaian physicians.

PubMed

Opoku, Samuel T; Apenteng, Bettye A

2014-09-01

A significant number of physicians from developing nations emigrate to developed nations in search of better career opportunities. In addition to crippling the health systems of developing nations, the emigration of physicians from sub-Saharan African (SSA) countries results in a loss of return on investment to these nations. The purpose of this study was to identify the relationship between career satisfaction and the intention of active Ghanaian physicians to leave the country within the next 5 years. This study was a cross-sectional correlational study using data from a survey of practicing physicians in Ghana. The primary independent variables examined were dimensions of career satisfaction, assessed using an abridged form of the Physician Work Life Survey. Data from the multivariate ordered logistic regression model indicated that physicians who were house officers or medical officers and those who reported dissatisfaction with their compensation were more likely to report that they were thinking about leaving Ghana within the next 5 years. Health policies aimed at increasing monetary compensation and providing junior physicians with the resources needed to excel in their careers may improve the retention of physicians in Ghana. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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.

State-civil society partnerships for HIV/AIDS treatment and prevention in Ghana: exploring factors associated with successes and challenges.

PubMed

Hushie, Martin; Omenyo, Cephas N; van den Berg, Jacob J; Lally, Michelle A

2016-08-02

The past decade has seen an increased number of state-civil society partnerships in the global Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) response of many countries. However, there has been limited research carried out concerning the successes and challenges of these partnerships. In-depth qualitative interviews were conducted with 23 participants from 21 different state-civil society partnerships throughout Ghana including all three major geographical zones (Northern, Middle, and Southern zones) to examine the nature of these partnerships and their positive and negative effects in responding to the national HIV/AIDS epidemic. Major themes included: 1) commitment by the government and civil society organizations to work cooperatively in order to support the development and implementation of HIV/AIDS interventions in Ghana; 2) the role of civil society organizations in facilitating community mobilization; capacity building; and information, resources and skills exchange to increase the efficiency and effectiveness of these partnerships for HIV prevention and treatment; and 3) significant challenges including funding issues and other structural barriers for these partnerships that need to be addressed moving forward. Future research should focus on examining the impact of recommended changes on state-civil partnerships and studying the extent and nature of these partnerships in other countries in order to establish the generalizability of the findings from this study.

Quadruple Burden of HIV/AIDS, Tuberculosis, Chronic Intestinal Parasitoses, and Multiple Micronutrient Deficiency in Ethiopia: A Summary of Available Findings

PubMed Central

Amare, Bemnet; Moges, Beyene; Mulu, Andargachew; Yifru, Sisay; Kassu, Afework

2015-01-01

Human immunodeficiency virus (HIV), tuberculosis (TB), and helminthic infections are among the commonest public health problems in the sub-Saharan African countries like Ethiopia. Multiple micronutrient deficiencies also known as the “hidden hunger” are common in people living in these countries either playing a role in their pathogenesis or as consequences. This results in a vicious cycle of multiple micronutrient deficiencies and infection/disease progression. As infection is profoundly associated with nutritional status resulting from decreased nutrient intake, decreased nutrient absorption, and nutrient losses, micronutrient deficiencies affect immune system and impact infection and diseases progression. As a result, micronutrients, immunity, and infection are interrelated. The goal of this review is therefore to provide a summary of available findings regarding the “quadruple burden trouble” of HIV, TB, intestinal parasitic infections, and multiple micronutrient deficiencies to describe immune-modulating effects related to disorders. PMID:25767808

Quadruple burden of HIV/AIDS, tuberculosis, chronic intestinal parasitoses, and multiple micronutrient deficiency in ethiopia: a summary of available findings.

PubMed

Amare, Bemnet; Moges, Beyene; Mulu, Andargachew; Yifru, Sisay; Kassu, Afework

2015-01-01

Human immunodeficiency virus (HIV), tuberculosis (TB), and helminthic infections are among the commonest public health problems in the sub-Saharan African countries like Ethiopia. Multiple micronutrient deficiencies also known as the "hidden hunger" are common in people living in these countries either playing a role in their pathogenesis or as consequences. This results in a vicious cycle of multiple micronutrient deficiencies and infection/disease progression. As infection is profoundly associated with nutritional status resulting from decreased nutrient intake, decreased nutrient absorption, and nutrient losses, micronutrient deficiencies affect immune system and impact infection and diseases progression. As a result, micronutrients, immunity, and infection are interrelated. The goal of this review is therefore to provide a summary of available findings regarding the "quadruple burden trouble" of HIV, TB, intestinal parasitic infections, and multiple micronutrient deficiencies to describe immune-modulating effects related to disorders.

Linking population, fertility, and family planning with adaptation to climate change: perspectives from Ethiopia.

PubMed

Rovin, Kimberly; Hardee, Karen; Kidanu, Aklilu

2013-09-01

Global climate change is felt disproportionately in the world's most economically disadvantaged countries. As adaption to an evolving climate becomes increasingly salient on national and global scales, it is important to assess how people at the local-level are already coping with changes. Understanding local responses to climate change is essential for helping countries to construct strategies to bolster resilience to current and future effects. This qualitative research investigated responses to climate change in Ethiopia; specifically, how communities react to and cope with climate variation, which groups are most vulnerable, and the role of family planning in increasing resilience. Participants were highly aware of changing climate effects, impacts of rapid population growth, and the need for increased access to voluntary family planning. Identification of family planning as an important adaptation strategy supports the inclusion of rights-based voluntary family planning and reproductive health into local and national climate change adaptation plans.

Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study.

PubMed

Marks, Florian; von Kalckreuth, Vera; Aaby, Peter; Adu-Sarkodie, Yaw; El Tayeb, Muna Ahmed; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Biggs, Holly M; Bjerregaard-Andersen, Morten; Breiman, Robert F; Campbell, James I; Cosmas, Leonard; Crump, John A; Espinoza, Ligia Maria Cruz; Deerin, Jessica Fung; Dekker, Denise Myriam; Fields, Barry S; Gasmelseed, Nagla; Hertz, Julian T; Van Minh Hoang, Nguyen; Im, Justin; Jaeger, Anna; Jeon, Hyon Jin; Kabore, Leon Parfait; Keddy, Karen H; Konings, Frank; Krumkamp, Ralf; Ley, Benedikt; Løfberg, Sandra Valborg; May, Jürgen; Meyer, Christian G; Mintz, Eric D; Montgomery, Joel M; Niang, Aissatou Ahmet; Nichols, Chelsea; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Jin Kyung; Park, Se Eun; Rabezanahary, Henintsoa; Rakotozandrindrainy, Raphaël; Raminosoa, Tiana Mirana; Razafindrabe, Tsiriniaina Jean Luco; Sampo, Emmanuel; Schütt-Gerowitt, Heidi; Sow, Amy Gassama; Sarpong, Nimako; Seo, Hye Jin; Sooka, Arvinda; Soura, Abdramane Bassiahi; Tall, Adama; Teferi, Mekonnen; Thriemer, Kamala; Warren, Michelle R; Yeshitela, Biruk; Clemens, John D; Wierzba, Thomas F

2017-03-01

Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence estimates of typhoid fever and invasive non-typhoidal salmonella (iNTS) disease in sub-Saharan Africa, and the antimicrobial susceptibility profiles of the causative agents. We established a systematic, standardised surveillance of blood culture-based febrile illness in 13 African sentinel sites with previous reports of typhoid fever: Burkina Faso (two sites), Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar (two sites), Senegal, South Africa, Sudan, and Tanzania (two sites). We used census data and health-care records to define study catchment areas and populations. Eligible participants were either inpatients or outpatients who resided within the catchment area and presented with tympanic (≥38·0°C) or axillary temperature (≥37·5°C). Inpatients with a reported history of fever for 72 h or longer were excluded. We also implemented a health-care utilisation survey in a sample of households randomly selected from each study area to investigate health-seeking behaviour in cases of self-reported fever lasting less than 3 days. Typhoid fever and iNTS disease incidences were corrected for health-care-seeking behaviour and recruitment. Between March 1, 2010, and Jan 31, 2014, 135 Salmonella enterica serotype Typhi (S Typhi) and 94 iNTS isolates were cultured from the blood of 13 431 febrile patients. Salmonella spp accounted for 33% or more of all bacterial pathogens at nine sites. The adjusted incidence rate (AIR) of S Typhi per 100 000 person-years of observation ranged from 0 (95% CI 0-0) in Sudan to 383 (274-535) at one site in Burkina Faso; the AIR of iNTS ranged from 0 in Sudan, Ethiopia, Madagascar (Isotry site), and South Africa to 237 (178-316) at the second site in Burkina Faso. The AIR of iNTS and typhoid fever in individuals younger than 15 years old was typically higher than in those aged 15 years or older. Multidrug-resistant S Typhi was isolated in Ghana, Kenya, and Tanzania (both sites combined), and multidrug-resistant iNTS was isolated in Burkina Faso (both sites combined), Ghana, Kenya, and Guinea-Bissau. Typhoid fever and iNTS disease are major causes of invasive bacterial febrile illness in the sampled locations, most commonly affecting children in both low and high population density settings. The development of iNTS vaccines and the introduction of S Typhi conjugate vaccines should be considered for high-incidence settings, such as those identified in this study. Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Ethiopia's Grand Renaissance Dam: Implications for Downstream Riparian Countries

NASA Astrophysics Data System (ADS)

Zhang, Y.; Block, P. J.; Hammond, M.; King, A.

2013-12-01

Ethiopia has begun seriously developing their significant hydropower potential by launching construction of the Grand Ethiopian Renaissance Dam (GERD) on the Blue Nile River to facilitate local and regional growth. Although this has required substantial planning on Ethiopia's part, no policy dictating the reservoir filling rate strategy has been publicly issued. This filling stage will have clear implications on downstream flows in Sudan and Egypt, complicated by evaporative losses, climate variability, and climate change. In this study, various filling policies and future climate states are simultaneously explored to infer potential streamflow reductions at Lake Nasser, providing regional decision-makers with a set of plausible, justifiable, and comparable outcomes. Schematic of the model framework Box plots of 2017-2032 percent change in annual average streamflow at Lake Nasser for each filling policy constructed from the 100 time-series and weighted precipitation changes. All values are relative to the no dam policy and no changes to future precipitation.

Development of a scalable mental healthcare plan for a rural district in Ethiopia

PubMed Central

Fekadu, Abebaw; Hanlon, Charlotte; Medhin, Girmay; Alem, Atalay; Selamu, Medhin; Giorgis, Tedla W.; Shibre, Teshome; Teferra, Solomon; Tegegn, Teketel; Breuer, Erica; Patel, Vikram; Tomlinson, Mark; Thornicroft, Graham; Prince, Martin; Lund, Crick

2016-01-01

Background Developing evidence for the implementation and scaling up of mental healthcare in low- and middle-income countries (LMIC) like Ethiopia is an urgent priority. Aims To outline a mental healthcare plan (MHCP), as a scalable template for the implementation of mental healthcare in rural Ethiopia. Method A mixed methods approach was used to develop the MHCP for the three levels of the district health system (community, health facility and healthcare organisation). Results The community packages were community case detection, community reintegration and community inclusion. The facility packages included capacity building, decision support and staff well-being. Organisational packages were programme management, supervision and sustainability. Conclusions The MHCP focused on improving demand and access at the community level, inclusive care at the facility level and sustainability at the organisation level. The MHCP represented an essential framework for the provision of integrated care and may be a useful template for similar LMIC. PMID:26447174

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 procedure-capable first-level referral hospitals than in noncapable hospitals (median, 638; interquartile range, 440-1418 vs 360; interquartile range, 0-896 procedures per 100 000 population; P = .03). Population-level spatial access within 2 hours to a hospital that performed 1 to 11 and at least 12 of each bellwether procedure was 83.2% (uncertainty interval [UI], 82.2%-83.4%) and 71.4% (UI, 64.4%-75.0%), respectively. Five hospitals were identified for targeted capability improvement. Almost 30% of Ghanaians cannot access essential surgery within 2 hours. Bellwether capability is a useful metric for essential surgery more broadly. Similar strategic planning exercises might be useful for other low-income and middle-income countries aiming to improve access to essential surgery.

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

Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18-49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of 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. 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

Background Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. Methods The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18–49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. Results The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of 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

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 facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

Cardiovascular risk status of Afro-origin populations across the spectrum of economic development: findings from the Modeling the Epidemiologic Transition Study.

PubMed

Dugas, Lara R; Forrester, Terrence E; Plange-Rhule, Jacob; Bovet, Pascal; Lambert, Estelle V; Durazo-Arvizu, Ramon A; Cao, Guichan; Cooper, Richard S; Khatib, Rasha; Tonino, Laura; Riesen, Walter; Korte, Wolfgang; Kliethermes, Stephanie; Luke, Amy

2017-05-12

Cardiovascular risk factors are increasing in most developing countries. To date, however, very little standardized data has been collected on the primary risk factors across the spectrum of economic development. Data are particularly sparse from Africa. In the Modeling the Epidemiologic Transition Study (METS) we examined population-based samples of men and women, ages 25-45 of African ancestry in metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles. Key measures of cardiovascular disease risk are described. The risk factor profile varied widely in both total summary estimates of cardiovascular risk and in the magnitude of component factors. Hypertension ranged from 7% in women from Ghana to 35% in US men. Total cholesterol was well under 200 mg/dl for all groups, with a mean of 155 mg/dl among men in Ghana, South Africa and Jamaica. Among women total cholesterol values varied relatively little by country, following between 160 and 178 mg/dl for all 5 groups. Levels of HDL-C were virtually identical in men and women from all study sites. Obesity ranged from 64% among women in the US to 2% among Ghanaian men, with a roughly corresponding trend in diabetes. Based on the Framingham risk score a clear trend toward higher total risk in association with socioeconomic development was observed among men, while among women there was considerable overlap, with the US participants having only a modestly higher risk score. These data provide a comprehensive estimate of cardiovascular risk across a range of countries at differing stages of social and economic development and demonstrate the heterogeneity in the character and degree of emerging cardiovascular risk. Severe hypercholesterolemia, as characteristic in the US and much of Western Europe at the onset of the coronary epidemic, is unlikely to be a feature of the cardiovascular risk profile in these countries in the foreseeable future, suggesting that stroke may remain the dominant cardiovascular event.

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 and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries.

Building Sustainable Local Capacity for Global Health Research in West Africa.

PubMed

Sam-Agudu, Nadia A; Paintsil, Elijah; Aliyu, Muktar H; Kwara, Awewura; Ogunsola, Folasade; Afrane, Yaw A; Onoka, Chima; Awandare, Gordon A; Amponsah, Gladys; Cornelius, Llewellyn J; Mendy, Gabou; Sturke, Rachel; Ghansah, Anita; Siberry, George K; Ezeanolue, Echezona E

Global health research in resource-limited countries has been largely sponsored and led by foreign institutions. Thus, these countries' training capacity and productivity in global health research is limited. Local participation at all levels of global health knowledge generation promotes equitable access to evidence-based solutions. Additionally, leadership inclusive of competent local professionals promotes best outcomes for local contextualization and implementation of successful global health solutions. Among the sub-Saharan African regions, West Africa in particular lags in research infrastructure, productivity, and impact in global health research. In this paper, experts discuss strategies for scaling up West Africa's participation in global health evidence generation using examples from Ghana and Nigeria. We conducted an online and professional network search to identify grants awarded for global health research and research education in Ghana and Nigeria. Principal investigators, global health educators, and representatives of funding institutions were invited to add their knowledge and expertise with regard to strengthening research capacity in West Africa. While there has been some progress in obtaining foreign funding, foreign institutions still dominate local research. Local research funding opportunities in the 2 countries were found to be insufficient, disjointed, poorly sustained, and inadequately publicized, indicating weak infrastructure. As a result, research training programs produce graduates who ultimately fail to launch independent investigator careers because of lack of mentoring and poor infrastructural support. Research funding and training opportunities in Ghana and Nigeria remain inadequate. We recommend systems-level changes in mentoring, collaboration, and funding to drive the global health research agenda in these countries. Additionally, research training programs should be evaluated not only by numbers of individuals graduated but also by numbers of independent investigators and grants funded. Through equitable collaborations, infrastructure, and mentoring, West Africa can match the rest of Africa in impactful global health research. Copyright © 2016 Icahn School of Medicine at Mount Sinai. All rights reserved.

Implementing Multisector Nutrition Programs in Ethiopia and Nepal: Challenges and Opportunities From a Stakeholder Perspective.

PubMed

Kennedy, Eileen; Fekadu, Habtamu; Ghosh, Shibani; Baral, Kedar; Davis, Dale; Sapkota, Diplav; Webb, Patrick

2016-12-01

Effective governance is essential for effective nutrition program implementation. There are additional challenges in launching multisector plans to enhance nutritional status. The present study compares the challenges and opportunities in Ethiopia and Nepal in designing and implementing a multisector plan for nutrition. A semi-quantitative questionnaire with open-ended questions was used to solicit information from senior national-level policy officials and other key stakeholders. The nature of the major nutrition problems in each country was similar; these include malnutrition (particularly stunting), food insecurity, and micronutrient malnutrition. The main challenges identified included the need for more specificity in the roles of agencies/individuals in program implementation, more effective mechanisms for linking national to subnational officials, methods for creating awareness of the plans, and a dedicated line item in the budgets of each agency. The level of enthusiasm was high in both countries. Respondents in both countries highlighted the need to identify a "champion" at the highest level who would keep the momentum for the respective plans alive. © The Author(s) 2016.

Women, work and pregnancy outcome.

PubMed

Huffman, S

1988-01-01

In developing countries, 1/3 of infants are born weighing less than 2500 grams. A study conducted in Ethiopia among women consuming about 1600 kcal/day, those who were very physically active during pregnancy bore smaller babies, and gained less weight during pregnancy, than those who were not so active. Average birth weight was 3068 grams for the 1st group, 3270 grams for the less active. The active group of women gained an average of 6.5 kilograms, and the less active 9.2 kilograms. Women who did not engage in heavy work during pregnancy, although they were undernourished, apparently did not bear growth-retarded babies. Indirect evidence for the effect of physical activity on pregnancy outcome comes from studies conducted in Taiwan, and the Gambia. These studies, and others from Malawi, Burkina Faso, and Kenya have shown that women's energy expenditures vary greatly with the agricultural season. Daily housekeeping tasks, however, also consume a lot of women's energy. Technologies that allow women to reduce energy expenditure can have beneficial effects, if they do not simultaneously reduce their incomes. For instance, programs improving water or fuel availability, or reducing fuel needs, reduce women's energy expenditures. Food processing mills can help too if women have access to them, and are thus not in danger of being displaced from their jobs and losing necessary income. Examples of technology improving women's tasks are pedal drying machines for nice in Bangladesh, using a greater and pressing machine to prepare gari in Ghana; but growing thicker rice stalks in Indonesia displaced women workers and reduced income.

Factors influencing the burden of health care financing and the distribution of health care benefits in Ghana, Tanzania and South Africa.

PubMed

Macha, Jane; Harris, Bronwyn; Garshong, Bertha; Ataguba, John E; Akazili, James; Kuwawenaruwa, August; Borghi, Josephine

2012-03-01

In Ghana, Tanzania and South Africa, health care financing is progressive overall. However, out-of-pocket payments and health insurance for the informal sector are regressive. The distribution of health care benefits is generally pro-rich. This paper explores the factors influencing these distributions in the three countries. Qualitative data were collected through focus group discussions and in-depth interviews with insurance scheme members, the uninsured, health care providers and managers. Household surveys were also conducted in all countries. Flat-rate contributions contributed to the regressivity of informal sector voluntary schemes, either by design (in Tanzania) or due to difficulties in identifying household income levels (in Ghana). In all three countries, the regressivity of out-of-pocket payments is due to the incomplete enforcement of exemption and waiver policies, partial or no insurance cover among poorer segments of the population and limited understanding of entitlements among these groups. Generally, the pro-rich distribution of benefits is due to limited access to higher level facilities among poor and rural populations, who rely on public primary care facilities and private pharmacies. Barriers to accessing health care include medical and transport costs, exacerbated by the lack of comprehensive insurance coverage among poorer groups. Service availability problems, including frequent drug stock-outs, limited or no diagnostic equipment, unpredictable opening hours and insufficient skilled staff also limit service access. Poor staff attitudes and lack of confidence in the skills of health workers were found to be important barriers to access. Financing reforms should therefore not only consider how to generate funds for health care, but also explicitly address the full range of affordability, availability and acceptability barriers to access in order to achieve equitable financing and benefit incidence patterns.

The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda

PubMed Central

Temsah, Gheda; Mallick, Lindsay

2017-01-01

Abstract While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage—Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility. Although health insurance schemes in these three countries are mostly designed to focus on the poor, coverage has been highly skewed toward the rich, especially in Ghana and Rwanda. Indonesia shows less variation in coverage by wealth status. The analysis found significant positive effects of health insurance coverage on at least two of the four measures of maternal health care utilization in each of the three countries. Indonesia stands out for the most systematic effect of health insurance across all four measures. The positive impact of health insurance appears more consistent on use of facility-based delivery than use of antenatal care. The analysis suggests that broadening health insurance to include income-sensitive premiums or exemptions for the poor and low or no copayments can increase use of maternal health care. PMID:28365754

The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda.

PubMed

Wang, Wenjuan; Temsah, Gheda; Mallick, Lindsay

2017-04-01

While research has assessed the impact of health insurance on health care utilization, few studies have focused on the effects of health insurance on use of maternal health care. Analyzing nationally representative data from the Demographic and Health Surveys (DHS), this study estimates the impact of health insurance status on the use of maternal health services in three countries with relatively high levels of health insurance coverage-Ghana, Indonesia and Rwanda. The analysis uses propensity score matching to adjust for selection bias in health insurance uptake and to assess the effect of health insurance on four measurements of maternal health care utilization: making at least one antenatal care visit; making four or more antenatal care visits; initiating antenatal care within the first trimester and giving birth in a health facility. Although health insurance schemes in these three countries are mostly designed to focus on the poor, coverage has been highly skewed toward the rich, especially in Ghana and Rwanda. Indonesia shows less variation in coverage by wealth status. The analysis found significant positive effects of health insurance coverage on at least two of the four measures of maternal health care utilization in each of the three countries. Indonesia stands out for the most systematic effect of health insurance across all four measures. The positive impact of health insurance appears more consistent on use of facility-based delivery than use of antenatal care. The analysis suggests that broadening health insurance to include income-sensitive premiums or exemptions for the poor and low or no copayments can increase use of maternal health care. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

A Global Assessment of Access to and Use of Medical Information: The State of Evidence-Based Surgery.

PubMed

LaGrone, Lacey N; Fuhs, Amy K; Egoavil, Eduardo Huaman; Langdale, Lorrie A; Fuangworawong, Phupit; Hamasaki, Jose Luis; Gyedu, Adam; Mock, Charles N

2018-02-01

We aimed to assess surgeons' access to and use of medical information, as well as their training and perceptions about evidence-based medicine (EBM), in order to identify priority areas for improvement. An anonymous survey conducted among surgeons from the USA, Ghana, Peru, and Thailand examined access to, and use and perception of, medical literature. Of 307 participants, 98% reported access to "OK" or "good" internet. Fifty-one percent reported that language was a barrier to accessing needed medical information; most frequently in Peru (73%) and Thailand (64%). Access to priced full-text journals was poorest in Peru, where 54% lacked access, followed by Ghana (42%) and Thailand (32%). US respondents scored highest on the EBM knowledge test (1.4, SD 0.8), followed by Thailand (1.3, SD 0.9), Ghana (1.1, SD 0.8), and Peru (0.9, SD 0.8) (p < 0.001). Adjusted analysis revealed Ghanaians and Peruvians spent 5% and 1% more on medical information, respectively, relative to country income, than persons from other countries (p < 0.01). After adjustment, employment in a large and/or urban hospital and history of EBM training were associated with better EBM test scores, while middle-income origin and public hospital employment were associated with worse scores (p < 0.05). Language, access to priced full-text journals, and training are significant barriers to surgeons' practice of EBM globally. The way forward involves collaboration among surgical societies, publishers, hospital employers, and international policymakers in providing surgeons from all country income levels with the access and training necessary to interpret and apply medical information.

Pediatric burns mortality risk factors in a developing country’s tertiary burns intensive care unit

PubMed Central

Agbenorku, Pius; Agbenorku, Manolo; Fiifi-Yankson, Papa Kwesi

2013-01-01

Aim: This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. Methods: The data for the three years retrospective study (May 2009 – April 2012) was obtained from the pediatric burn admissions records and patients’ folders of the Reconstructive Plastic Surgery & Burns Unit (RPSBU), Komfo Anokye Teaching Hospital (KATH), Ghana. Data retrieved included: Demographic features, Total Burned Surface Area (TBSA) incurred; Aetiology of burns; Duration of the admission; Outcome of admission; Part of the body affected and Cost incurred. Ethical approval for this study was obtained from the KNUST-SMS/KATH Committee on Human Research, Publications and Ethics. Data analyses were performed with SPSS 17.0 version. Results: Information on 197 patients was completely retrieved for the study. Burns mortality rate for the study was identified to be 21.3% (N=42). The mean age of the 42 dead patients was 3.7±0.3 years, ranging from 0-13 years, while, males (54.8%, N= 23) outnumbered females (45.2%, N=19). The TBSA burned interquartile range was 48%. In terms of etiology of burns Scald (73.8%, N=31) was the commonest cause of injury. Mortality risk factors identified were Age <6 years (P=0.028); Scald especially hot water and soup (P=0.016); TBSA >36% (P=0.028) and Inhalation injury (P=0.040). Conclusion: Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana’s RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana. PMID:23875121

Universal health coverage in the context of population ageing: What determines health insurance enrolment in rural Ghana?

PubMed

Van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane

2018-05-24

Population ageing presents considerable challenges for the attainment of universal health coverage (UHC), especially in countries where such coverage is still in its infancy. Ghana presents an important case study on the effectiveness of policies aimed at achieving UHC in the context of population ageing in low and middle-income countries. It has witnessed a profound recent demographic transition, including a large increase in the number of older adults, which coincided with the development and implementation of a National Health Insurance Scheme (NHIS), designed to help achieve UHC. The objective of this paper is to examine the community, household and individual level determinants of NHIS enrolment among older adults aged 50-69 and 70 plus. The latter are exempt from NHIS premium payments. Using the Ghanaian Living Standards Survey from 2012 to 2013, determinants of NHIS enrolment for individuals aged 50-69 and 70 plus living in rural Ghana are examined through the application of multilevel regression analysis. Previous studies have mainly focused on the enrolment of young and middle aged adults and considered mainly demographic and socio-economic factors. The novel inclusion of spatial barriers within this analysis demonstrates that levels of NHIS enrolment are determined in part by the community provision of healthcare facilities. In addition, the findings imply that insurance enrolment increases with household expenditure even for those aged 70 plus who are exempt from the NHIS premium payment. Adequate and appropriate infrastructure as well as health insurance is vital to ensure movement to UHC in low and middle income countries. Overall, the results confirm that there remain significant inequalities in enrolment by expenditure quintile that future policy reform will need to address.

Identifying potential recommendation domains for conservation agriculture in Ethiopia, Kenya, and Malawi.

PubMed

Tesfaye, Kindie; Jaleta, Moti; Jena, Pradyot; Mutenje, Munyaradzi

2015-02-01

Conservation agriculture (CA) is being promoted as an option for reducing soil degradation, conserving water, enhancing crop productivity, and maintaining yield stability. However, CA is a knowledge- and technology-intensive practice, and may not be feasible or may not perform better than conventional agriculture under all conditions and farming systems. Using high resolution (≈1 km(2)) biophysical and socioeconomic geospatial data, this study identified potential recommendation domains (RDs) for CA in Ethiopia, Kenya, and Malawi. The biophysical variables used were soil texture, surface slope, and rainfall while the socioeconomic variables were market access and human and livestock population densities. Based on feasibility and comparative performance of CA over conventional agriculture, the biophysical and socioeconomic factors were first used to classify cultivated areas into three biophysical and three socioeconomic potential domains, respectively. Combinations of biophysical and socioeconomic domains were then used to develop potential RDs for CA based on adoption potential within the cultivated areas. About 39, 12, and 5% of the cultivated areas showed high biophysical and socioeconomic potential while 50, 39, and 21% of the cultivated areas showed high biophysical and medium socioeconomic potential for CA in Malawi, Kenya, and Ethiopia, respectively. The results indicate considerable acreages of land with high CA adoption potential in the mixed crop-livestock systems of the studied countries. However, there are large differences among countries depending on biophysical and socio-economic conditions. The information generated in this study could be used for targeting CA and prioritizing CA-related agricultural research and investment priorities in the three countries.

A political economy analysis of human resources for health (HRH) in Africa.

PubMed

Fieno, John Vincent; Dambisya, Yoswa M; George, Gavin; Benson, Kent

2016-07-22

Despite a global recognition from all stakeholders of the gravity and urgency of health worker shortage in Africa, little progress has been achieved to improve health worker coverage in many of the African human resources for health (HRH) crisis countries. The problem consists in how policy is made, how leaders are accountable, how the World Health Organization (WHO) and foreign donors encourage (or distort) health policy, and how development objectives are prioritized in these countries. This paper uses political economy analysis, which stems from a recognition that the solution to the shortage of health workers across Africa involves more than a technical response. A number of institutional arrangements dampen investments in HRH, including a mismatch between officials' tenure in office and program results, the vertical nature of health programming, the modalities of Overseas Development Assistance (ODA) in health, the structures of the global health community, and the weak capacity in HRH units within Ministries of Health. A major change in policymaking would only occur with a disruption to the political or institutional order. The case study of Ethiopia, who has increased its health workforce dramatically over the last 20 years, disrupted previous institutional arrangements through the power of ideas-HRH as a key intermediate development objective. The framing of HRH created the rationale for the political commitment to HRH investment. Ethiopia demonstrates that political will coupled with strong state capacity and adequate resource mobilization can overcome the institutional hurdles above. Donors will follow the lead of a country with long-term political commitment to HRH, as they did in Ethiopia.

Identifying Potential Recommendation Domains for Conservation Agriculture in Ethiopia, Kenya, and Malawi

NASA Astrophysics Data System (ADS)

Tesfaye, Kindie; Jaleta, Moti; Jena, Pradyot; Mutenje, Munyaradzi

2015-02-01

Conservation agriculture (CA) is being promoted as an option for reducing soil degradation, conserving water, enhancing crop productivity, and maintaining yield stability. However, CA is a knowledge- and technology-intensive practice, and may not be feasible or may not perform better than conventional agriculture under all conditions and farming systems. Using high resolution (≈1 km2) biophysical and socioeconomic geospatial data, this study identified potential recommendation domains (RDs) for CA in Ethiopia, Kenya, and Malawi. The biophysical variables used were soil texture, surface slope, and rainfall while the socioeconomic variables were market access and human and livestock population densities. Based on feasibility and comparative performance of CA over conventional agriculture, the biophysical and socioeconomic factors were first used to classify cultivated areas into three biophysical and three socioeconomic potential domains, respectively. Combinations of biophysical and socioeconomic domains were then used to develop potential RDs for CA based on adoption potential within the cultivated areas. About 39, 12, and 5 % of the cultivated areas showed high biophysical and socioeconomic potential while 50, 39, and 21 % of the cultivated areas showed high biophysical and medium socioeconomic potential for CA in Malawi, Kenya, and Ethiopia, respectively. The results indicate considerable acreages of land with high CA adoption potential in the mixed crop-livestock systems of the studied countries. However, there are large differences among countries depending on biophysical and socio-economic conditions. The information generated in this study could be used for targeting CA and prioritizing CA-related agricultural research and investment priorities in the three countries.

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

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.

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.

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

PubMed

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

2018-05-26

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

Radio and Television in Literacy. A Survey of the Use of the Broadcasting Media in Combating Illiteracy among Adults.

ERIC Educational Resources Information Center

Maddison, John

Information obtained in a survey of the uses of radio and television in connection with literacy work in 40 countries of the world is presented. Much of the information consists of replies to Unesco questionnaires on the subject. The countries surveyed were: Algeria, Cameroon, Central African Republic, Chad, Congo (Brazzaville), Ethiopia, Gabon,…

Knowledge Aid as Instrument of Regulation: World Bank's Non-Lending Higher Education Support for Ethiopia

ERIC Educational Resources Information Center

Molla, Tebeje

2014-01-01

In the context of low-income countries, the role of donors in public policymaking is of great importance. Donors use a combination of lending and non-lending instruments as pathways of influence to shape policy directions in aid-recipient countries. This paper reports some findings from a doctoral study on the role of the World Bank in the recent…

Inequities in utilization of reproductive and maternal health services in Ethiopia.

PubMed

Bobo, Firew Tekle; Yesuf, Elias Ali; Woldie, Mirkuzie

2017-06-19

Disparities in health services utilization within and between regional states of countries with diverse socio-cultural and economic conditions such as Ethiopia is a frequent encounter. Understanding and taking measures to address unnecessary and avoidable differences in the use of reproductive and maternal health services is a key concern in Ethiopia. The aim of the study was to examine degree of equity in reproductive and maternal health services utilization in Ethiopia. Data from Ethiopia demographic health survey 2014 was analyzed. We assessed inequities in utilization of modern contraceptive methods, antenatal care, facility based delivery and postnatal checkup. Four standard equity measurement methods were used; equity gaps, rate-ratios, concertation curve and concentration index. Inequities in service utilization were exhibited favoring women in developed regions, urban residents, most educated and the wealthy. Antenatal care by skilled provider was three times higher among women with post-secondary education than mothers with no education. Women in the highest wealth quantile had about 12 times higher skilled birth attendance than those in lowest wealth quantile. The rate of postnatal care use among urban resident was about 6 times that of women in rural area. Use of modern contraceptive methods was more equitably utilized service while, birth at health facility was less equitable across all economic levels, favoring the wealthy. Considerable inequity between and within regions of Ethiopia in the use of maternal health services was demonstrated. Strategically targeting social determinants of health with special emphasis to women education and economic empowerment will substantially contribute for altering the current situation favorably.

Adapting HIV patient and program monitoring tools for chronic non-communicable diseases in Ethiopia.

PubMed

Letebo, Mekitew; Shiferaw, Fassil

2016-06-02

Chronic non-communicable diseases (NCDs) have become a huge public health concern in developing countries. Many resource-poor countries facing this growing epidemic, however, lack systems for an organized and comprehensive response to NCDs. Lack of NCD national policy, strategies, treatment guidelines and surveillance and monitoring systems are features of health systems in many developing countries. Successfully responding to the problem requires a number of actions by the countries, including developing context-appropriate chronic care models and programs and standardization of patient and program monitoring tools. In this cross-sectional qualitative study we assessed existing monitoring and evaluation (M&E) tools used for NCD services in Ethiopia. Since HIV care and treatment program is the only large-scale chronic care program in the country, we explored the M&E tools being used in the program and analyzed how these tools might be adapted to support NCD services in the country. Document review and in-depth interviews were the main data collection methods used. The interviews were held with health workers and staff involved in data management purposively selected from four health facilities with high HIV and NCD patient load. Thematic analysis was employed to make sense of the data. Our findings indicate the apparent lack of information systems for NCD services, including the absence of standardized patient and program monitoring tools to support the services. We identified several HIV care and treatment patient and program monitoring tools currently being used to facilitate intake process, enrolment, follow up, cohort monitoring, appointment keeping, analysis and reporting. Analysis of how each tool being used for HIV patient and program monitoring can be adapted for supporting NCD services is presented. Given the similarity between HIV care and treatment and NCD services and the huge investment already made to implement standardized tools for HIV care and treatment program, adaptation and use of HIV patient and program monitoring tools for NCD services can improve NCD response in Ethiopia through structuring services, standardizing patient care and treatment, supporting evidence-based planning and providing information on effectiveness of interventions.

Experiences with dissection courses in human anatomy: a comparison between Germany and Ethiopia.

PubMed

Bekele, Assegedech; Reissig, Dieter; Löffler, Sabine; Hinz, Andreas

2011-03-01

Dissection courses in human anatomy are laborious, and new teaching tools have become available. Therefore, some universities intend to reduce the dissection course. Furthermore, little is known about dissection courses in African universities. The aim of this study is to compare the students' experiences with and evaluations of the dissection courses in two universities: Leipzig (Germany) and Gondar (Ethiopia). Since the Gondar Medical College was founded in cooperation with the Leipzig University in 1978, the anatomy courses in both universities follow roughly the same rules. A structured questionnaire was used to assess the dissection courses from the students' point of view. The sample of students consisted of 109 German and 124 Ethiopian first year undergraduate medical students. Most students in both countries (94% in Germany and 82% in Ethiopia) judge the dissection course to be highly relevant compared to other courses. Perceived health hazards associated with dissection of the cadaver show significant differences between Germany (14%) and Ethiopia (44%). Most students had normal feelings again at the end of the dissection course. Further similarities and differences between the courses in Germany and Ethiopia are described. Dissection courses are highly appreciated also in Africa. The high degree of affirmation of the dissection courses should be taken into consideration when discussing modifications of gross anatomy curriculum or changes in the teacher to student ratio. Copyright © 2010 Elsevier GmbH. All rights reserved.

Analysis of environmental communication and its implication for sustainable development in Ethiopia.

PubMed

Zikargae, Mekonnen Hailemariam

2018-09-01

Environmental issues have been causing debates around the globe. These issues have also got much attention in Ethiopia. Ethiopia has been adversely affected by the environmental crisis. Developing countries and the poor were depicted as unfortunate victims of climate change. The causes of climate change include deforestation, industries, mismanagement of the environment, and utilization of natural resources. One of the effects of climate change brought natural disaster what we call a drought. Drought affected many people, even recently, in Ethiopia. Concerning the environmental problems and issues in Ethiopia, there are beginnings at the policy level. However, the practical aspects of communicating and addressing these issues could not get much attention from the authority. The aim of the research is to analyze environmental communication of Amhara National Regional State-Environmental Protection Authority. Case study as a qualitative research method is used. The case design type is descriptive. The researcher selected two techniques of collecting data: in-depth interview and documents. The results show that the authority is unable to communicate environmental issues which were stated in the different conventions and policies. There are gaps that could be considered from the outcome of the research. The major gaps and challenges in addressing practical issues of environment are identified namely poor environmental information systems, lack of awareness creation through communications, and weak public dialogue and genuine participation consideration. Copyright © 2018 Elsevier B.V. All rights reserved.

Molecular characterization of Theileria orientalis from cattle in Ethiopia.

PubMed

Gebrekidan, Hagos; Gasser, Robin B; Baneth, Gad; Yasur-Landau, Daniel; Nachum-Biala, Yaarit; Hailu, Asrat; Jabbar, Abdul

2016-07-01

This study reports the first molecular characterization of Theileria orientalis in local breeds of cattle in Ethiopia. A conventional PCR utilizing major piroplasm surface protein (MPSP) gene and an established multiplexed tandem PCR (MT-PCR) were used to characterize T. orientalis and to assess the infection intensity, respectively. Of 232 blood samples tested, T. orientalis DNA was detected in only 2.2% of samples using conventional PCR; two genotypes buffeli (1.3%; 3/232) and type 5 (0.9%; 2/232) of T. orientalis were detected. Phylogenetic analysis revealed that the buffeli MPSP sequences from Ethiopia were closely related to those reported from Kenya, Sri Lanka and Myanmar, and type 5 sequences from Ethiopia grouped with those from Korea, Japan, Vietnam and Thailand. A higher number of samples (3.9%; 9/232) were test-positive by MT-PCR and four genotypes (buffeli, chitose, ikeda and type 5) of T. orientalis were detected. The average intensity of infections with genotypes buffeli (DNA copy numbers 11,056) and type 5 (7508) were significantly higher (P<0.0001) than the pathogenic genotype ikeda (61 DNA copies). This first insight into T. orientalis from cattle in Ethiopia using MPSP gene provides a basis for future studies of T. orientalis in various agroclimatic zones and of the impact of oriental theilerosis on cattle in this and other countries of Africa. Copyright © 2016 Elsevier GmbH. All rights reserved.

75 FR 61239 - Request for Public Comments on Annual Review of Country Eligibility for Benefits Under the...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... Verde, Republic of Cameroon, Republic of Chad, Federal Islamic Republic of Comoros, Republic of Congo, Democratic Republic of Congo, Republic of Djibouti, Ethiopia, Gabonese Republic, The Gambia, Republic of...

Quality of medicines commonly used in the treatment of soil transmitted helminths and giardia in ethiopia: a nationwide survey.

PubMed

Suleman, Sultan; Zeleke, Gemechu; Deti, Habtewold; Mekonnen, Zeleke; Duchateau, Luc; Levecke, Bruno; Vercruysse, Jozef; D'Hondt, Matthias; Wynendaele, Evelien; De Spiegeleer, Bart

2014-12-01

The presence of poor quality medicines in the market is a global threat on public health, especially in developing countries. Therefore, we assessed the quality of two commonly used anthelminthic drugs [mebendazole (MEB) and albendazole (ALB)] and one antiprotozoal drug [tinidazole (TNZ)] in Ethiopia. A multilevel stratified random sampling, with as strata the different levels of supply chain system in Ethiopia, geographic areas and government/privately owned medicines outlets, was used to collect the drug samples using mystery shoppers. The three drugs (106 samples) were collected from 38 drug outlets (government/privately owned) in 7 major cities in Ethiopia between January and March 2012. All samples underwent visual and physical inspection for labeling and packaging before physico-chemical quality testing and evaluated based on individual monographs in Pharmacopoeias for identification, assay/content, dosage uniformity, dissolution, disintegration and friability. In addition, quality risk was analyzed using failure mode effect analysis (FMEA) and a risk priority number (RPN) was assigned to each quality attribute. A clinically rationalized desirability function was applied in quantification of the overall quality of each medicine. Overall, 45.3% (48/106) of the tested samples were substandard, i.e. not meeting the pharmacopoeial quality specifications claimed by their manufacturers. Assay was the quality attribute most often out-of-specification, with 29.2% (31/106) failure of the total samples. The highest failure was observed for MEB (19/42, 45.2%), followed by TNZ (10/39, 25.6%) and ALB (2/25, 8.0%). The risk analysis showed that assay (RPN = 512) is the most critical quality attribute, followed by dissolution (RPN = 336). Based on Derringer's desirability function, samples were classified into excellent (14/106,13%), good (24/106, 23%), acceptable (38/106, 36%%), low (29/106, 27%) and bad (1/106,1%) quality. This study evidenced that there is a relatively high prevalence of poor quality MEB, ALB and TNZ in Ethiopia: up to 45% if pharmacopoeial acceptance criteria are used in the traditional, dichotomous approach, and 28% if the new risk-based desirability approach was applied. The study identified assay as the most critical quality attributes. The country of origin was the most significant factor determining poor quality status of the investigated medicines in Ethiopia.

Prevalence and determinants of anemia among pregnant women in Ethiopia; a systematic review and meta-analysis.

PubMed

Kassa, Getachew Mullu; Muche, Achenef Asmamaw; Berhe, Abadi Kidanemariam; Fekadu, Gedefaw Abeje

2017-01-01

Anemia during pregnancy is one of the most common indirect obstetric cause of maternal mortality in developing countries. It is responsible for poor maternal and fetal outcomes. A limited number of studies were conducted on anemia during pregnancy in Ethiopia, and they present inconsistent findings. Therefore, this review was undertaken to summarize the findings conducted in several parts of the country and present the national level of anemia among pregnant women in Ethiopia. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for this systematic review and meta-analysis. The databases used were; PUBMED, Cochrane Library, Google Scholar, CINAHL, and African Journals Online. Search terms used were; anemia, pregnancy related anemia and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for critical appraisal of studies. The meta-analysis was conducted using STATA 14 software. The pooled Meta logistic regression was computed to present the pooled prevalence and relative risks (RRs) of the determinate factors with 95% confidence interval (CI). Twenty studies were included in the meta-analysis with a total of 10, 281 pregnant women. The pooled prevalence of anemia among pregnant women in Ethiopia was 31.66% (95% CI (26.20, 37.11)). Based on the pooled prevalence of the subgroup analysis result, the lowest prevalence of anemia among pregnant women was observed in Amhara region, 15.89% (95% CI (8.82, 22.96)) and the highest prevalence was in Somali region, 56.80% (95% CI (52.76, 60.84)). Primigravid (RR: 0.61 (95% CI: 0.53, 0.71)) and urban women (RR: 0.73 (95% CI: 0.60, 0.88)) were less likely to develop anemia. On the other hand, mothers with short pregnancy interval (RR: 2.14 (95% CI: 1.67, 2.74)) and malaria infection during pregnancy (RR: 1.94 (95% CI: 1.33, 2.82)) had higher risk to develop anemia. Almost one-third of pregnant women in Ethiopia were anemic. Statistically significant association was observed between anemia during pregnancy and residence, gravidity, pregnancy interval, and malaria infection during pregnancy. Regions with higher anemia prevalence among pregnant women should be given due emphasis. The concerned body should intervene on the identified factors to reduce the high prevalence of anemia among pregnant women.

Quality of Medicines Commonly Used in the Treatment of Soil Transmitted Helminths and Giardia in Ethiopia: A Nationwide Survey

PubMed Central

Suleman, Sultan; Zeleke, Gemechu; Deti, Habtewold; Mekonnen, Zeleke; Duchateau, Luc; Levecke, Bruno; Vercruysse, Jozef; D'Hondt, Matthias; Wynendaele, Evelien; De Spiegeleer, Bart

2014-01-01

Background The presence of poor quality medicines in the market is a global threat on public health, especially in developing countries. Therefore, we assessed the quality of two commonly used anthelminthic drugs [mebendazole (MEB) and albendazole (ALB)] and one antiprotozoal drug [tinidazole (TNZ)] in Ethiopia. Methods/Principal Findings A multilevel stratified random sampling, with as strata the different levels of supply chain system in Ethiopia, geographic areas and government/privately owned medicines outlets, was used to collect the drug samples using mystery shoppers. The three drugs (106 samples) were collected from 38 drug outlets (government/privately owned) in 7 major cities in Ethiopia between January and March 2012. All samples underwent visual and physical inspection for labeling and packaging before physico-chemical quality testing and evaluated based on individual monographs in Pharmacopoeias for identification, assay/content, dosage uniformity, dissolution, disintegration and friability. In addition, quality risk was analyzed using failure mode effect analysis (FMEA) and a risk priority number (RPN) was assigned to each quality attribute. A clinically rationalized desirability function was applied in quantification of the overall quality of each medicine. Overall, 45.3% (48/106) of the tested samples were substandard, i.e. not meeting the pharmacopoeial quality specifications claimed by their manufacturers. Assay was the quality attribute most often out-of-specification, with 29.2% (31/106) failure of the total samples. The highest failure was observed for MEB (19/42, 45.2%), followed by TNZ (10/39, 25.6%) and ALB (2/25, 8.0%). The risk analysis showed that assay (RPN = 512) is the most critical quality attribute, followed by dissolution (RPN = 336). Based on Derringer's desirability function, samples were classified into excellent (14/106,13%), good (24/106, 23%), acceptable (38/106, 36%%), low (29/106, 27%) and bad (1/106,1%) quality. Conclusions/Significance This study evidenced that there is a relatively high prevalence of poor quality MEB, ALB and TNZ in Ethiopia: up to 45% if pharmacopoeial acceptance criteria are used in the traditional, dichotomous approach, and 28% if the new risk-based desirability approach was applied. The study identified assay as the most critical quality attributes. The country of origin was the most significant factor determining poor quality status of the investigated medicines in Ethiopia. PMID:25473966

Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control

PubMed Central

Lloyd-Sherlock, Peter; Beard, John; Minicuci, Nadia; Ebrahim, Shah; Chatterji, Somnath

2014-01-01

Background This study uses data from the World Health Organization’s Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. Results Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. Conclusions The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor. PMID:24505082

Implementing the World Report on Disability in West Africa: challenges and opportunities for Ghana.

PubMed

Tuakli-Wosornu, Yetsa A; Haig, Andrew J

2014-01-01

Disability issues have taken a prominent role on international stages in recent years. Beginning with the May 2005 World Health Assembly Resolution 58.23 and culminating in the June 2011 World Bank and World Health Organization World Report on Disability, comprehensive disability analyses from nations at various stages of development can now be accessed and used by relevant stakeholders in health, policy, and aide arenas. The implementation of this landmark report is critical for the advancement of social inclusion in diverse countries, including those with limited resources. However, activating the World Report on Disability in resource-limited countries remains a significant challenge because of threadbare data and cultural, institutional, and physical barriers to social inclusion. This review summarizes current national disability data and describes challenges and opportunities for the implementation of the World Report on Disability in Ghana. As a structural point of departure, the article uses the three broad categories of challenges outlined by the World Health Organization: attitudinal, physical, and institutional.

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

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

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

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.

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.

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 for the safety of VRUs in northern Ghana. Cycle paths and lanes (for cyclists) as well as sidewalks (for pedestrians) in particular will separate VRUs from motorists and improve their safety. Enforcement of traffic laws particularly regarding helmet use, speeding, and alcohol use will be beneficial. Introduction of the demerit points system in the enforcement of traffic regulations may have significant deterrent effects on road users who have the penchant for violating traffic regulations. Road safety education is also required to create responsible road users.

Zena's Hope.

ERIC Educational Resources Information Center

Hartrich, Catherine

2000-01-01

Describes Frontiers of Justice as a program that acquaints educators with third world countries. Narrates one educator's trip to Ghana, where ethnic conflict, lack of education, and AIDS are prevalent. States that food distribution has been linked with education especially for girls; asserts that if girls are educated they will educate their…

Quantitative risk assessment of entry of contagious bovine pleuropneumonia through live cattle imported from northwestern Ethiopia.

PubMed

Woube, Yilkal Asfaw; Dibaba, Asseged Bogale; Tameru, Berhanu; Fite, Richard; Nganwa, David; Robnett, Vinaida; Demisse, Amsalu; Habtemariam, Tsegaye

2015-11-01

Contagious bovine pleuropneumonia (CBPP) is a highly contagious bacterial disease of cattle caused by Mycoplasma mycoides subspecies mycoides small colony (SC) bovine biotype (MmmSC). It has been eradicated from many countries; however, the disease persists in many parts of Africa and Asia. CBPP is one of the major trade-restricting diseases of cattle in Ethiopia. In this quantitative risk assessment the OIE concept of zoning was adopted to assess the entry of CBPP into an importing country when up to 280,000 live cattle are exported every year from the northwestern proposed disease free zone (DFZ) of Ethiopia. To estimate the level of risk, a six-tiered risk pathway (scenario tree) was developed, evidences collected and equations generated. The probability of occurrence of the hazard at each node was modelled as a probability distribution using Monte Carlo simulation (@RISK software) at 10,000 iterations to account for uncertainty and variability. The uncertainty and variability of data points surrounding the risk estimate were further quantified by sensitivity analysis. In this study a single animal destined for export from the northwestern DFZ of Ethiopia has a CBPP infection probability of 4.76×10(-6) (95% CI=7.25×10(-8) 1.92×10(-5)). The probability that at least one infected animal enters an importing country in one year is 0.53 (90% CI=0.042-0.97). The expected number of CBPP infected animals exported any given year is 1.28 (95% CI=0.021-5.42). According to the risk estimate, an average of 2.73×10(6) animals (90% CI=10,674-5.9×10(6)) must be exported to get the first infected case. By this account it would, on average, take 10.15 years (90% CI=0.24-23.18) for the first infected animal to be included in the consignment. Sensitivity analysis revealed that prevalence and vaccination had the highest impact on the uncertainty and variability of the overall risk. Copyright © 2015 Elsevier B.V. All rights reserved.

The composition of demand for newly launched vaccines: results from the pneumococcal and rotavirus vaccine introductions in Ethiopia and Malawi

PubMed Central

Kidane, Teklay; Chirwa, Geoffrey; Tesfaye, Neghist; Prescott, Marta R; Scotney, Soleine T; Valle, Moussa; Abebe, Sintayehu; Tambuli, Adija; Malewezi, Bridget; Mohammed, Tahir; Kobayashi, Emily; Wootton, Emily; Wong, Renee; Dosani, Rahima; Subramaniam, Hamsa; Joseph, Jessica; Yavuz, Elif; Apple, Aliza; Le Tallec, Yann; Kang’ethe, Alice

2016-01-01

Understanding post-launch demand for new vaccines can help countries maximize the benefits of immunization programmes. In particular, low- and middle-income countries (LMICs) should ensure adequate resource planning with regards to stock consumption and service delivery for new vaccines, whereas global suppliers must produce enough vaccines to meet demand. If a country underestimates the number of children seeking vaccination, a stock-out of commodities will create missed opportunities for saving lives. We describe the post-launch demand for the first dose of pneumococcal conjugate vaccine (PCV1) in Ethiopia and Malawi and the first dose of rotavirus vaccine (Rota1) in Malawi, with focus on the new birth cohort and the ‘backlog cohort’, comprised of older children who are still eligible for vaccination at the time of launch. PCV1 and Rota1 uptake were compared with the demand for the first dose of pentavalent vaccine (Penta1), a routine immunization that targets the same age group and immunization schedule. In the first year, the total demand for PCV1 was 37% greater than that of Penta1 in Ethiopia and 59% greater in Malawi. In the first 6 months, the demand of Rota1 was only 5.9% greater than Penta1 demand in Malawi. Over the first three post-introduction months, 70.7% of PCV1 demand in Ethiopia and 71.5% of demand in Malawi came from children in the backlog cohort, whereas only 28.0% of Rota1 demand in Malawi was from the backlog cohort. The composition of demand was impacted by time elapsed since vaccine introduction and age restrictions. Evidence suggests that countries’ plans should account for the impact of backlog demand, especially in the first 3 months post-introduction. LMICs should request for higher stock volumes when compared with routine needs, plan social mobilization activities to reach the backlog cohort and allocate human resources and cold chain capacity to accommodate high demand following vaccine introduction. PMID:26856361

HUMAN CAPITAL GROWTH AND POVERTY: EVIDENCE FROM ETHIOPIA AND PERU

PubMed Central

ATTANASIO, ORAZIO; MEGHIR, COSTAS; NIX, EMILY; SALVATI, FRANCESCA

2017-01-01

In this paper we use high quality data from two developing countries, Ethiopia and Peru, to estimate the production functions of human capital from age 1 to age 15. We characterize the nature of persistence and dynamic complementarities between two components of human capital: health and cognition. We also explore the implications of different functional form assumptions for the production functions. We find that more able and higher income parents invest more, particularly at younger ages when investments have the greatest impacts. These differences in investments by parental income lead to large gaps in inequality by age 8 that persist through age 15. PMID:28579736

Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania

PubMed Central

2013-01-01

Background In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. Methods In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Results Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term ‘motivation’ was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Conclusions Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in professional ethics, and the way this is reinforced in practice require closer attention. The differences in the findings across the three settings underscore the importance of in-depth country-level research to tailor the development of incentives schemes. PMID:23617375

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 on countries' mental health systems were: lack of internal consistency of structure and content of policies, superficiality of key international concepts, lack of evidence on which to base policy directions, inadequate political support, poor integration of mental health policies within the overall national policy and legislative framework, and lack of financial specificity. Three strategies to address these concerns emerged, namely strengthening capacity of key stakeholders in public (mental) health and policy development, creation of a culture of inclusive and dynamic policy development, and coordinated action to optimize use of available resources. PMID:21477285

Does Multi-morbidity Mediate the Effect of Socioeconomics on Self-rated Health? Cross-country Differences

PubMed Central

Assari, Shervin; Lankarani, Maryam Moghani

2015-01-01

Background: This study explored cross-country differences in how multi-morbidity explains the effects of socioeconomic characteristics on self-rated health. Methods: The study borrowed data from the Research on Early Life and Aging Trends and Effects. Participants were 44,530 individuals (age > 65 years) who were sampled from 15 countries (i.e. United States, China, India, Russia, Costa Rica, Puerto Rico, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, Ghana and South Africa). Multi-morbidity was measured as number of chronic medical conditions. In Model I, main effects of socioeconomic factors on self-rated health were calculated using country-specific logistic regressions. In Model II, number of chronic conditions were also added to the models to find changes in coefficients for demographic and socioeconomic factors. Results: In the United States, number of chronic medical conditions explained the effect of income on subjective health. In Puerto Rico, number of chronic medical conditions explained the effect of marital status on subjective health. In Costa Rica, Argentina, Barbados, Cuba, and Uruguay, number of chronic medical conditions explained gender disparities in subjective health. In China, Mexico, Brazil, Russia, Chile, India, Ghana and South Africa, number of chronic medical conditions did not explain the effect of demographic or socioeconomic factors on subjective health. Conclusions: Multi-morbidity explains the effect of demographic and socioeconomic factors on subjective health in some but not other countries. Further research is needed. PMID:26445632

Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment

PubMed Central

Kumie, Abera; Amera, Tadesse; Berhane, Kiros; Samet, Jonathan; Hundal, Nuvjote; G/Michael, Fitsum; Gilliland, Frank

2017-01-01

Background The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers’ health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia. Objectives The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services. Methods Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review. Results Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international permissible limits. There is a high level of workplace injuries that often leads to an extended loss of productive working days. Occupational safety and health services were found to be inadequately organized. There is limited practice in exposure assessment and monitoring. This happens to be true despite the existing favorable environment in areas of policies and regulations. Conclusion and Recommendation There is a severe scarcity of peer-reviewed literature related to workplace exposures and their impact on workplace health and safety. Limited adequately skilled manpower is available. The internal infrastructural capacity is weak and cannot help to identify and assess hazards in the workplace. Monitoring system and laboratory investigation is limited despite the presence of favorable policy and regulatory frameworks. Addressing these gaps is of immediate concern. PMID:28867918

Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment.

PubMed

Kumie, Abera; Amera, Tadesse; Berhane, Kiros; Samet, Jonathan; Hundal, Nuvjote; G/Michael, Fitsum; Gilliland, Frank

2016-01-01

The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia. The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services. Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review. Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international permissible limits. There is a high level of workplace injuries that often leads to an extended loss of productive working days. Occupational safety and health services were found to be inadequately organized. There is limited practice in exposure assessment and monitoring. This happens to be true despite the existing favorable environment in areas of policies and regulations. There is a severe scarcity of peer-reviewed literature related to workplace exposures and their impact on workplace health and safety. Limited adequately skilled manpower is available. The internal infrastructural capacity is weak and cannot help to identify and assess hazards in the workplace. Monitoring system and laboratory investigation is limited despite the presence of favorable policy and regulatory frameworks. Addressing these gaps is of immediate concern.

A short history of HIV prevention programs for female sex workers in Ghana: lessons learned over 3 decades.

PubMed

Wondergem, Peter; Green, Kimberly; Wambugu, Samuel; Asamoah-Adu, Comfort; Clement, Nana Fosua; Amenyah, Richard; Atuahene, Kyeremeh; Szpir, Michael

2015-03-01

Female sex workers (FSWs) in Ghana have a 10-fold greater risk for acquiring HIV than the general adult population, and they contribute a substantial proportion of the new HIV infections in the country. Although researchers have conducted behavioral and biological surveys, there has been no review of the contextual, programmatic, and epidemiological changes over time. The authors conducted a historical review of HIV prevention programs in Ghana. We reviewed the use of different interventions for HIV prevention among FSWs and data from program monitoring and Integrated Biological and Behavioral Surveillance Surveys. In particular, we looked at changes in service access and coverage, the use of HIV testing and counseling services, and the changing prevalence of HIV and other sexually transmitted infections. HIV prevention interventions among FSWs increased greatly between 1987 and 2013. Only 72 FSWs were reached in a pilot program in 1987, whereas 40,508 FSWs were reached during a national program in 2013. Annual condom sales and the proportion of FSWs who used HIV testing and counseling services increased significantly, whereas the prevalence of gonorrhea and chlamydia decreased. The representation of FSWs in national HIV strategic plans and guidelines also improved. Ghana offers an important historical example of an evolving HIV prevention program that-despite periods of inactivity-grew in breadth and coverage over time. The prevention of HIV infections among sex workers has gained momentum in recent years through the efforts of the national government and its partners-a trend that is critically important to Ghana's future.

Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana's National Health Insurance Scheme.

PubMed

Aryeetey, Genevieve Cecilia; Westeneng, Judith; Spaan, Ernst; Jehu-Appiah, Caroline; Agyepong, Irene Akua; Baltussen, Rob

2016-07-22

Ghana since 2004, begun implementation of a National Health Insurance Scheme (NHIS) to minimize financial barriers to health care at point of use of service. Usually health insurance is expected to offer financial protection to households. This study aims to analyze the effect health insurance on household out-of-pocket expenditure (OOPE), catastrophic expenditure (CE) and poverty. We conducted two repeated household surveys in two regions of Ghana in 2009 and 2011. We first analyzed the effect of OOPE on poverty by estimating poverty headcount before and after OOPE were incurred. We also employed probit models and use of instrumental variables to analyze the effect of health insurance on OOPE, CE and poverty. Our findings showed that between 7-18 % of insured households incurred CE as a result of OOPE whereas this was between 29-36 % for uninsured households. In addition, between 3-5 % of both insured and uninsured households fell into poverty due to OOPE. Our regression analyses revealed that health insurance enrolment reduced OOPE by 86 % and protected households against CE and poverty by 3.0 % and 7.5 % respectively. This study provides evidence that high OOPE leads to CE and poverty in Ghana but enrolment into the NHIS reduces OOPE, provides financial protection against CE and reduces poverty. These findings support the pro-poor policy objective of Ghana's National Health Insurance Scheme and holds relevance to other low and middle income countries implementing or aiming to implement insurance schemes.

Enhancing Linkages Between Healthy Diets, Local Agriculture, and Sustainable Food Systems: The School Meals Planner Package in Ghana.

PubMed

Fernandes, Meenakshi; Galloway, Rae; Gelli, Aulo; Mumuni, Daniel; Hamdani, Salha; Kiamba, Josephine; Quarshie, Kate; Bhatia, Rita; Aurino, Elisabetta; Peel, Francis; Drake, Lesley

2016-12-01

Interventions that enhance linkages between healthy diets and local agriculture can promote sustainable food systems. Home-grown school feeding programs present a promising entry point for such interventions, through the delivery of nutritious menus and meals. To describe the adaptation of the School Meals Planner Package to the programmatic and environmental reality in Ghana during the 2014 to 2015 school year. Guided by a conceptual framework highlighting key considerations and trade-offs in menu design, an open-source software was developed that could be easily understood by program implementers. Readily available containers from markets were calibrated into "handy measures" to support the provision of adequate quantities of food indicated by menus. Schools and communities were sensitized to the benefits of locally sourced, nutrient-rich diets. A behavior change communication campaign including posters and songs promoting healthy diets was designed and disseminated in schools and communities. The School Meals Planner Package was introduced in 42 districts in Ghana, reaching more than 320 000 children. Monitoring reports and feedback on its use were positive, demonstrating how the tool can be used by planners and implementers alike to deliver nutritious, locally-sourced meals to schoolchildren. The value of the tool has been recognized at the highest levels by Ghana's government who have adopted it as official policy. The School Meals Planner Package supported the design of nutritious, locally sourced menus for the school feeding program in Ghana. The tool can be similarly adapted for other countries to meet context-specific needs. © The Author(s) 2016.

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.

Induced abortion and associated factors in health facilities of Guraghe zone, southern Ethiopia.

PubMed

Tesfaye, Gezahegn; Hambisa, Mitiku Teshome; Semahegn, Agumasie

2014-01-01

Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24-14.71)), age of 30-34 years (AOR = 0.15, CI: (0.04-0.55)), primary education (AOR = 0.26, CI: (0.13-0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14-0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care.

Induced Abortion and Associated Factors in Health Facilities of Guraghe Zone, Southern Ethiopia

PubMed Central

Hambisa, Mitiku Teshome; Semahegn, Agumasie

2014-01-01

Unsafe abortion is one of the major medical and public health problems in developing countries including Ethiopia. However, there is a lack of up-to-date and reliable information on induced abortion distribution and its determinant factors in the country. This study was intended to assess induced abortion and associated factors in health facilities of Guraghe zone, Southern Ethiopia. Institution based cross-sectional study was conducted in eight health facilities in Guraghe zone. Client exit interview was conducted on 400 patients using a structured questionnaire. Bivariate and multivariate logistic regression analysis was performed to identify factors associated with induced abortion. Out of 400 women, 75.5% responded that the current pregnancy that ended in abortion is unwanted. However, only 12.3% of the respondents have admitted interference to the current pregnancy. Having more than four pregnancies (AOR = 4.28, CI: (1.24–14.71)), age of 30–34 years (AOR = 0.15, CI: (0.04–0.55)), primary education (AOR = 0.26, CI: (0.13–0.88)), and wanted pregnancy (AOR = 0.44, CI: (0.14–0.65)) were found to have association with induced abortion. The study revealed high level of induced abortion which is underpinned by high magnitude of unwanted pregnancy. There is requirement for widespread expansion of increased access to high quality family planning service and post-abortion care. PMID:24800079

'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana.

PubMed

Koduah, Augustina; Agyepong, Irene Akua; van Dijk, Han

2016-10-01

This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC). Copyright © 2016 Elsevier Ltd. All rights reserved.

Insights into the Affordable Medicines Facility-malaria in Ghana: the role of caregivers and licensed chemical sellers in four regions.

PubMed

Adjei, Andrew A; Winch, Peter; Laar, Amos; Sullivan, David J; Sakyi, Kwame S; Stephens, Judith K; Adjei, George O; Boateng, Isaac A; Aubyn, Vivian N Ama; Kubio, Chrysantus; Tuakli, Julliette; Vanotoo, Linda; Bortei, Bernard B; Amo-Addae, Maame; Sorvor, Felix; Coleman, Nathaniel; Dalglish, Sarah; Owusu, Richmond; Gebreyesus, Tsega; Essuman, Edward; Greene, Rebecca; Ankomah, Ezekiel; Houston, Kiely; Bart-Plange, Constance; Salamat, Samuel; Addison, Ebenezer A; Quakyi, Isabella A

2016-05-10

The Affordable Medicine Facility-malaria (AMFm) was an innovative global financing mechanism for the provision of quality-assured artemisinin-based combination therapy (ACT) across both the private and public health sectors in eight countries in sub-Saharan Africa. This study evaluated the effectiveness of AMFm subsidies in increasing access to ACT in Ghana and documented malaria management practices at the household and community levels during the implementation of the AMFm. This study, conducted in four regions in Ghana between January, 2011 to December, 2012, employed cross-sectional mixed-methods design that included qualitative and quantitative elements, specifically household surveys, focus group discussions (FGD) and in-depth interviews. The study indicated high ACT availability, adequate provider knowledge and reasonably low quality-assured ACT use in the study areas, all of which are a reflection of a high market share of ACT in these hard-to-reach areas of the country. Adequate recognition of childhood malaria symptoms by licensed chemical seller (LCS) attendants was observed. A preference by caregivers for LCS over health facilities for seeking treatment solutions to childhood malaria was found. Artemisinin-based combination therapy with the AMFm logo was accessible and affordable for most people seeking treatment from health facilities and LCS shops in rural areas. Caregivers and LCS were seen to play key roles in the health of the community especially with children under 5 years of age.

Comparison of municipal solid waste management systems in Canada and Ghana: A case study of the cities of London, Ontario, and Kumasi, Ghana

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

Asase, Mizpah; Yanful, Ernest K.; Mensah, Moses

2009-10-15

Integrated waste management has been accepted as a sustainable approach to solid waste management in any region. It can be applied in both developed and developing countries. The difference is the approach taken to develop the integrated waste management system. This review looks at the integrated waste management system operating in the city of London, Ontario-Canada and how lessons can be drawn from the system's development and operation that will help implement a sustainable waste management system in the city of Kumasi, Ghana. The waste management system in London is designed such that all waste generated in the city ismore » handled and disposed of appropriately. The responsibility of each sector handling waste is clearly defined and monitored. All major services are provided and delivered by a combination of public and private sector forces. The sustainability of the waste management in the city of London is attributed to the continuous improvement strategy framework adopted by the city based on the principles of integrated waste management. It is perceived that adopting a strategic framework based on the principles of integrated waste management with a strong political and social will, can transform the current waste management in Kumasi and other cities in developing countries in the bid for finding lasting solutions to the problems that have plagued the waste management system in these cities.« less

Inequalities in Maternal Health Care Utilization in Sub-Saharan African Countries: A Multiyear and Multi-Country Analysis

PubMed Central

Alam, Nazmul; Hajizadeh, Mohammad; Dumont, Alexandre; Fournier, Pierre

2015-01-01

To assess social inequalities in the use of antenatal care (ANC), facility based delivery (FBD), and modern contraception (MC) in two contrasting groups of countries in sub-Saharan Africa divided based on their progress towards maternal mortality reduction. Six countries were included in this study. Three countries (Ethiopia, Madagascar, and Uganda) had <350 MMR in 2010 with >4.5% average annual reduction rate while another three (Cameroon, Zambia, and Zimbabwe) had >550 MMR in 2010 with only <1.5% average annual reduction rate. All of these countries had at least three rounds of Demographic and Health Surveys (DHS) before 2012. We measured rate ratios and differences, as well as relative and absolute concentration indices in order to examine within-country geographical and wealth-based inequalities in the utilization of ANC, FBD, and MC. In the countries which have made sufficient progress (i.e. Ethiopia, Madagascar, and Uganda), ANC use increased by 8.7, 9.3 and 5.7 percent, respectively, while the utilization of FBD increased by 4.7, 0.7 and 20.2 percent, respectively, over the last decade. By contrast, utilization of these services either plateaued or decreased in countries which did not make progress towards reducing maternal mortality, with the exception of Cameroon. Utilization of MC increased in all six countries but remained very low, with a high of 40.5% in Zimbabwe and low of 16.1% in Cameroon as of 2011. In general, relative measures of inequalities were found to have declined overtime in countries making progress towards reducing maternal mortality. In countries with insufficient progress towards maternal mortality reduction, these indicators remained stagnant or increased. Absolute measures for geographical and wealth-based inequalities remained high invariably in all six countries. The increasing trend in the utilization of maternal care services was found to concur with a steady decline in maternal mortality. Relative inequality declined overtime in countries which made progress towards reducing maternal mortality. PMID:25853423

Male and female Ethiopian and Kenyan runners are the fastest and the youngest in both half and full marathon.

PubMed

Knechtle, Beat; Nikolaidis, Pantelis T; Onywera, Vincent O; Zingg, Matthias A; Rosemann, Thomas; Rüst, Christoph A

2016-01-01

In major marathon races such as the 'World Marathon Majors', female and male East African runners particularly from Ethiopia and Kenya are the fastest. However, whether this trend appears for female and male Ethiopians and Kenyans at recreational level runners (i.e. races at national level) and in shorter road races (e.g. in half-marathon races) has not been studied yet. Thus, the aim of the present study was to examine differences in the performance and the age of female and male runners from East Africa (i.e. Ethiopians and Kenyans) between half- and full marathons. Data from 508,108 athletes (125,894 female and 328,430 male half-marathoners and 10,205 female and 43,489 male marathoners) originating from 126 countries and competing between 1999 and 2014 in all road-based half-marathons and marathons held in one country (Switzerland) were analysed using Chi square (χ(2)) tests, mixed-effects regression analyses and one-way analyses of variance. In half-marathons, 48 women (0.038 %) and 63 men (0.019 %) were from Ethiopia and 80 women (0.063 %) and 134 men (0.040 %) from Kenya. In marathons, three women (0.029 %) and 15 men (0.034 %) were from Ethiopia and two women (0.019 %) and 33 men (0.075 %) from Kenya. There was no statistically significant association between the nationality of East Africans and the format of a race. In both women and men, the fastest race times in half-marathons and marathons were achieved by East African runners (p < 0.001). Ethiopian and Kenyan runners were the youngest in both sexes and formats of race (p < 0.001). In summary, women and men from Ethiopia and Kenya, despite they accounted for <0.1 % in half-marathons and marathons, achieved the fastest race times and were the youngest in both half-marathons and marathons. These findings confirmed in the case of half-marathon the trend previously observed in marathon races for a better performance and a younger age in East African runners from Ethiopia and Kenya.

Does Measles Vaccination Reduce the Risk of Acute Respiratory Infection (ARI) and Diarrhea in Children: A Multi-Country Study?

PubMed

Bawankule, Rahul; Singh, Abhishek; Kumar, Kaushalendra; Shetye, Sadanand

2017-01-01

Pneumonia and diarrhea occur either as complications or secondary infections in measles affected children. So, the integrated Global Action Plan for Pneumonia and Diarrhea (GAPPD) by WHO and UNICEF includes measles vaccination as preventive measure in children. The objective of the study is to examine the effect of measles vaccination on Acute Respiratory Infection (ARI) and diarrhea in children in the Democratic Republic of Congo, Ethiopia, India, Nigeria, and Pakistan. We analyzed data from the most recent rounds of Demographic and Health Surveys (DHS) in the selected countries. We included children age 12-59 months in the analysis. We used multivariable binary logistic regression to examine the effect of measles vaccination on ARI and diarrhea in children. We also estimated Vaccination Effectiveness (VE). More than 60 percent of the children age 12-59 months were given measles vaccine before the survey in the Democratic Republic of Congo, Ethiopia, India and Pakistan. Children who were given the measles vaccine were less likely to suffer from ARI than unvaccinated children in India and Pakistan. Children who were given the measles vaccine had a lower risk of diarrhea than those who did not receive it in all the selected countries except Ethiopia. Measles vaccination was associated with reduction in ARI cases by 15-30 percent in India and Pakistan, and diarrhea cases by 12-22 percent in the Democratic Republic of Congo, India, Nigeria and Pakistan. The receipt of the measles vaccine was associated with decrease in ARI and diarrhea in children. The immunization program must ensure that each child gets the recommended doses of measles vaccine at the appropriate age. The measles vaccination should be given more attention as a preventive intervention under the Global Action Plan for Pneumonia and Diarrhea (GAPPD) in all low and middle-income countries.

Multi-Country Analysis of Treatment Costs for HIV/AIDS (MATCH): Facility-Level ART Unit Cost Analysis in Ethiopia, Malawi, Rwanda, South Africa and Zambia

PubMed Central

Tagar, Elya; Sundaram, Maaya; Condliffe, Kate; Matatiyo, Blackson; Chimbwandira, Frank; Chilima, Ben; Mwanamanga, Robert; Moyo, Crispin; Chitah, Bona Mukosha; Nyemazi, Jean Pierre; Assefa, Yibeltal; Pillay, Yogan; Mayer, Sam; Shear, Lauren; Dain, Mary; Hurley, Raphael; Kumar, Ritu; McCarthy, Thomas; Batra, Parul; Gwinnell, Dan; Diamond, Samantha; Over, Mead

2014-01-01

Background Today's uncertain HIV funding landscape threatens to slow progress towards treatment goals. Understanding the costs of antiretroviral therapy (ART) will be essential for governments to make informed policy decisions about the pace of scale-up under the 2013 WHO HIV Treatment Guidelines, which increase the number of people eligible for treatment from 17.6 million to 28.6 million. The study presented here is one of the largest of its kind and the first to describe the facility-level cost of ART in a random sample of facilities in Ethiopia, Malawi, Rwanda, South Africa and Zambia. Methods & Findings In 2010–2011, comprehensive data on one year of facility-level ART costs and patient outcomes were collected from 161 facilities, selected using stratified random sampling. Overall, facility-level ART costs were significantly lower than expected in four of the five countries, with a simple average of $208 per patient-year (ppy) across Ethiopia, Malawi, Rwanda and Zambia. Costs were higher in South Africa, at $682 ppy. This included medications, laboratory services, direct and indirect personnel, patient support, equipment and administrative services. Facilities demonstrated the ability to retain patients alive and on treatment at these costs, although outcomes for established patients (2–8% annual loss to follow-up or death) were better than outcomes for new patients in their first year of ART (77–95% alive and on treatment). Conclusions This study illustrated that the facility-level costs of ART are lower than previously understood in these five countries. While limitations must be considered, and costs will vary across countries, this suggests that expanded treatment coverage may be affordable. Further research is needed to understand investment costs of treatment scale-up, non-facility costs and opportunities for more efficient resource allocation. PMID:25389777

Investigation of the high rates of extrapulmonary tuberculosis in Ethiopia reveals no single driving factor and minimal evidence for zoonotic transmission of Mycobacterium bovis infection.

PubMed

Berg, Stefan; Schelling, Esther; Hailu, Elena; Firdessa, Rebuma; Gumi, Balako; Erenso, Girume; Gadisa, Endalamaw; Mengistu, Araya; Habtamu, Meseret; Hussein, Jemal; Kiros, Teklu; Bekele, Shiferaw; Mekonnen, Wondale; Derese, Yohannes; Zinsstag, Jakob; Ameni, Gobena; Gagneux, Sebastien; Robertson, Brian D; Tschopp, Rea; Hewinson, Glyn; Yamuah, Lawrence; Gordon, Stephen V; Aseffa, Abraham

2015-03-03

Ethiopia, a high tuberculosis (TB) burden country, reports one of the highest incidence rates of extra-pulmonary TB dominated by cervical lymphadenitis (TBLN). Infection with Mycobacterium bovis has previously been excluded as the main reason for the high rate of extrapulmonary TB in Ethiopia. Here we examined demographic and clinical characteristics of 953 pulmonary (PTB) and 1198 TBLN patients visiting 11 health facilities in distinct geographic areas of Ethiopia. Clinical characteristics were also correlated with genotypes of the causative agent, Mycobacterium tuberculosis. No major patient or bacterial strain factor could be identified as being responsible for the high rate of TBLN, and there was no association with HIV infection. However, analysis of the demographic data of involved patients showed that having regular and direct contact with live animals was more associated with TBLN than with PTB, although no M. bovis was isolated from patients with TBLN. Among PTB patients, those infected with Lineage 4 reported "contact with other TB patient" more often than patients infected with Lineage 3 did (OR = 1.6, CI 95% 1.0-2.7; p = 0.064). High fever, in contrast to low and moderate fever, was significantly associated with Lineage 4 (OR = 2.3; p = 0.024). On the other hand, TBLN cases infected with Lineage 4 tended to get milder symptoms overall for the constitutional symptoms than those infected with Lineage 3. The study suggests a complex role for multiple interacting factors in the epidemiology of extrapulmonary TB in Ethiopia, including factors that can only be derived from population-based studies, which may prove to be significant for TB control in Ethiopia.

Women's preferences for obstetric care in rural Ethiopia: a population-based discrete choice experiment in a region with low rates of facility delivery.

PubMed

Kruk, M E; Paczkowski, M M; Tegegn, A; Tessema, F; Hadley, C; Asefa, M; Galea, S

2010-11-01

Delivery attended by skilled professionals is essential to reducing maternal mortality. Although the facility delivery rate in Ethiopia's rural areas is extremely low, little is known about which health system characteristics most influence women's preferences for delivery services. In this study, women's preferences for attributes of health facilities for delivery in rural Ethiopia were investigated. A population-based discrete choice experiment (DCE) was fielded in Gilgel Gibe, in southwest Ethiopia, among women with a delivery in the past 5 years. Women were asked to select a hypothetical health facility for future delivery from two facilities on a picture card. A hierarchical Bayesian procedure was used to estimate utilities associated with facility attributes: distance, type of provider, provider attitude, drugs and medical equipment, transport and cost. 1006 women completed 8045 DCE choice tasks. Among them, 93.8% had delivered their last child at home. The attributes with the greatest influence on the overall utility of a health facility for delivery were availability of drugs and equipment (mean β=3.9, p<0.01), seeing a doctor versus a health extension worker (mean β=2.1, p<0.01) and a receptive provider attitude (mean β=1.4, p<0.01). Women in rural southwest Ethiopia who have limited personal experience with facility delivery nonetheless value health facility attributes that indicate high technical quality: availability of drugs and equipment and physician providers. Well-designed policy experiments that measure the contribution of quality improvements to facility delivery rates in Ethiopia and other countries with low health service utilisation and high maternal mortality may inform national efforts to reduce maternal mortality.

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.

Informal workers' access to health care services: findings from a qualitative study in the Kassena-Nankana districts of Northern Ghana.

PubMed

Akazili, James; Chatio, Samuel; Ataguba, John Ele-Ojo; Agorinya, Isaiah; Kanmiki, Edmund Wedam; Sankoh, Osman; Oduro, Abraham

2018-05-16

Over the past two decades, employment in the informal sector has grown rapidly in all regions including low and middle-income countries. In the developing countries, between 50 and 75% of workers are employed in the informal sector. In Ghana, more than 80% of the total working population is working in the informal sector. They are largely self-employed persons such as farmers, traders, food processors, artisans, craft-workers among others. The persistent problem in advancing efforts to address health vulnerabilities of informal workers is lack of systematic data. Therefore, this study explored factors affecting informal workers access to health care services in Northern Ghana. The study used qualitative methodology where focus group discussions and in-depth interviews were conducted. Purposive sampling technique was used to select participants for the interviews. The interviews were transcribed and coded into emergent themes using Nvivo 10 software before thematic content analysis. Study participants held the view that factors such as poverty, time spent at the health facility seeking for health care, unpleasant attitude of health providers towards clients affected their access to health care services. They perceived that poor organization and operations of the current health system and poor health care services provided under the national health insurance scheme affected access to health care services according to study participants. However, sale of assets, family support, borrowed money from friends and occasional employer support were the copying strategies used by informal workers to finance their health care needs. Most of the population in Ghana are engaged in informal employment hence their contribution to the economy is very important. Therefore, efforts needed to be made by all stakeholders to address these challenges in order to help improve on access to health care services to all patients particularly the most vulnerable groups in society.

Do biomass fuel use and consumption of unsafe water mediate educational inequalities in stillbirth risk? An analysis of the 2007 Ghana Maternal Health Survey.

PubMed

Amegah, A Kofi; Näyhä, Simo; Jaakkola, Jouni J K

2017-02-07

Numerous studies have explored the association between educational inequalities and stillbirth but most have failed to elaborate how low educational attainment leads to an increased risk of stillbirth. We hypothesised that use of biomass fuels and consumption of unsafe water related to low educational attainment could explain the stillbirth burden in Ghana attributable to socioeconomic disadvantage. Data from the 2007 Ghana Maternal Health Survey, a nationally representative population-based survey were analysed for this study. Of the10 370 women aged 15-49 years interviewed via structured questionnaires for the survey, 7183 primiparous and multiparous women qualified for inclusion in the present study. In a logistic regression analysis that adjusted for age, area of residence, marital status and ethnicity of women, lower maternal primary education was associated with a 62% (OR=1.62; 95% CI 1.04 to 2.52) increased lifetime risk of stillbirth. Biomass fuel use and consumption of unsafe water mediated 18% and 8% of the observed effects, respectively. Jointly these two exposures explained 24% of the observed effects. The generalised additive modelling revealed a very flat inverted spoon-shaped smoothed curve which peaked at low levels of schooling (2-3 years) and confirms the findings from the logistic regression analysis. Our results show that biomass fuel use and unsafe water consumption could be important pathways through which low maternal educational attainment leads to stillbirths in Ghana and similar developing countries. Addressing educational inequalities in developing countries is thus essential for ensuring household choices that curtail environmental exposures and help improve pregnancy outcomes. 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/.

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. Our study provides a model for delivering and evaluating innovative educational interventions in developing countries to assess whether they meet external quality criteria and achieve their objectives. PMID:17596260

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.

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

Maternal plasma cholesterol and duration of pregnancy: a prospective cohort study in Ghana

USDA-ARS?s Scientific Manuscript database

Low serum cholesterol may be associated with preterm birth, however results are mixed and limited primarily to high-income countries. Our objective was to determine whether maternal blood lipid concentrations are associated with duration of gestation. We performed a nested cohort (n=320) study of pr...

75 FR 21131 - Bureau of Educational and Cultural Affairs (ECA); Request for Grant Proposals: Kennedy-Lugar...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... countries at the time of publication of this RFGP are: Egypt, Ghana, India, Indonesia, Malaysia, Mali...), Jordan, Kenya, Kosovo, Kuwait, Lebanon, Liberia, Macedonia, Malaysia, Mali, Morocco, Mozambique, Nigeria... opportunities; (4) monitoring student health, safety and welfare, host family and coordinator performance and...

Education and Modernization: A Method for Establishing The Relationship.

ERIC Educational Resources Information Center

Schubert, Jane G.

The Agency for International Development (AID) participant training program was examined to determine its impact on developing countries. One hundred and thirty-four senior officials in Ghana and Thailand provided 492 reports on: (1) indicators of participant achievements; (2) impact-producing characteristics; and (3) contributions attributed to…

First report of Phakopsora pachyrhizi causing rust on soybean in Malawi

USDA-ARS?s Scientific Manuscript database

Soybean rust (SBR), caused by Phakopsora pachyrhizi, has rapidly become established in Africa since the first report in Uganda in 1996. The urediniospores, as windborne propagules, have infested new regions of Africa, initiating SBR in many countries, including Ghana and Democratic Republic of the C...

Population dynamics of stored maize insect pests in warehouses in two districts of Ghana

USDA-ARS?s Scientific Manuscript database

Understanding what insect species are present and their temporal and spatial patterns of distribution is important for developing a successful integrated pest management strategy for food storage in warehouses. Maize in many countries in Africa is stored in bags in warehouses, but little monitoring ...

Determinants of E-Learning Adoption in Universities: Evidence from a Developing Country

ERIC Educational Resources Information Center

Ansong, Eric; Lovia Boateng, Sheena; Boateng, Richard

2017-01-01

This study sought to explore the technological, organizational, and environmental determinants of e-learning adoption in University of Ghana using a multistakeholder approach. Another construct (nature of the course) was added to the traditional constructs of the technology-organization-environment framework. Using survey research, e-learning…

Old, Black and Poor: Reports from Five Countries.

ERIC Educational Resources Information Center

Chappell, Neena, Ed.; And Others

1995-01-01

This special issue provides international comparisons of black seniors in South Africa, Ghana, Jamaica, Bermuda, and the United States, focusing on policy and program issues. The challenge is to ensure true equality of opportunity so that black seniors in the future will not be in the disadvantaged position of today. (Author)

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

PubMed

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

2014-01-01

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

Prevention and management of malaria during pregnancy: findings from a comparative qualitative study in Ghana, Kenya and Malawi

PubMed Central

2013-01-01

Background In endemic regions of sub-Saharan Africa, malaria during pregnancy (MiP) is a major preventable cause of maternal and infant morbidity and mortality. Current recommended MiP prevention and control includes intermittent preventive treatment (IPTp), distribution of insecticide-treated bed nets (ITNs) and appropriate case management. This article explores the social and cultural context to the uptake of these interventions at four sites across Africa. Methods A comparative qualitative study was conducted at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. Observations, which focused on behaviours linked to MiP prevention and treatment, were also undertaken at health facilities and in local communities. Results ITNs were generally recognized as important for malaria prevention. However, their availability and use differed across the sites. In Malawi and Kenya, ITNs were sought-after items, but there were complaints about availability. In central Ghana, women saved ITNs until the birth of the child and they were used seasonally in northern Ghana. In Kenya and central Ghana, pregnant women did not associate IPTp with malaria, whereas, in Malawi and northern Ghana, IPTp was linked to malaria, but not always with prevention. Although IPTp adherence was common at all sites, whether delivered with directly observed treatment or not, a few women did not comply with IPTp often citing previous side effects. Although generally viewed as positive, experiences of malaria testing varied across the four sites: treatment was sometimes administered in spite of a negative diagnosis in Ghana (observed) and Malawi (reported). Despite generally following the advice of healthcare staff, particularly in Kenya, personal experience, and the availability and accessibility of medication – including anti-malarials – influenced MiP treatment. Conclusion Although ITNs were valued as malaria prevention, health messages could address issues that reduce their use during pregnancy in particular contexts. The impact of previous side effects on adherence to IPTp and anti-malarial treatment regimens during pregnancy also requires attention. Overtreatment of MiP highlights the need to monitor the implementation of MiP case management guidelines. PMID:24257105

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 (3.3%) performed at least 12. The essential surgical procedure rate was greater in bellwether procedure–capable first-level referral hospitals than in noncapable hospitals (median, 638; interquartile range, 440–1418 vs 360; interquartile range, 0–896 procedures per 100 000 population; P = .03). Population-level spatial access within 2 hours to a hospital that performed 1 to 11 and at least 12 of each bellwether procedure was 83.2% (uncertainty interval [UI], 82.2%–83.4%) and 71.4% (UI, 64.4%–75.0%), respectively. Five hospitals were identified for targeted capability improvement. CONCLUSIONS AND RELEVANCE Almost 30% of Ghanaians cannot access essential surgery within 2 hours. Bellwether capability is a useful metric for essential surgery more broadly. Similar strategic planning exercises might be useful for other low-income and middle-income countries aiming to improve access to essential surgery. PMID:27331865

An analysis of socio-demographic patterns in child malnutrition trends using Ghana demographic and health survey data in the period 1993–2008

PubMed Central

2013-01-01

Background A small but growing body of research indicates that progress in reducing child malnutrition is substantially uneven from place to place, even down to the district level within countries. Yet child malnutrition prevalence and trend estimates available for public health planning are mostly available only at the level of global regions and/or at country level. To support carefully targeted intervention to reduce child malnutrition, public health planners and policy-makers require access to more refined prevalence data and trend analyses than are presently available. Responding to this need in Ghana, this report presents trends in child malnutrition prevalence in socio-demographic groups within the country’s geographic regions. Methods The study uses the Ghana Demographic and Health Surveys (GDHS) data. The GDHS are nationally representative cross-sectional surveys that have been carried out in many developing countries. These surveys constitute one of the richest sources of information currently available to examine time trends in child malnutrition. Data from four surveys were used for the analysis: 1993, 1998, 2003 and 2008. Results The results show statistically significant declining trends at the national level for stunting (F (1, 7204) = 7.89, p ≤ .005), underweight (F (1, 7441) = 44.87, p ≤ .001) and wasting (F (1, 7130) = 6.19, p ≤ .013). However, analyses of the sex-specific trends revealed that the declining trends in stunting and wasting were significant among males but not among females. In contrast to the national trend, there were significantly increasing trends in stunting for males (F (1, 2004) = 3.92, p ≤ .048) and females (F (1, 2004) = 4.34, p ≤ .037) whose mothers had higher than primary education, while the trends decreased significantly for males and females whose mothers had no education. Conclusions At the national level in Ghana, child malnutrition is significantly declining. However, the aggregate national trend masks important deviations in certain socio-demographic segments, including worsening levels of malnutrition. This paper shows the importance of disaggregated analyses of national child malnutrition data, to unmask underlying geographic and socio-demographic differences. PMID:24131558

The new World Health Organization recommendation on the 2-dose measles vaccine schedule and the way forward in African Region

PubMed Central

Biellik, Robin Julian; Davis, Robert

2017-01-01

The new W.H.O. recommendation, which drops the coverage criterion for adoption of the 2-dose measles vaccine schedule, makes some African countries eligible for the 2-dose schedule which were previously ineligible. We look at the implications of the new recommendation for Ethiopia and Nigeria, the two largest African countries which are eligible under the new recommendation. PMID:29296149

Literacy and The Casette "Teacher"

ERIC Educational Resources Information Center

Bosscher, Kathleen

1976-01-01

A critical assessment of the 10-year Experimental World Literacy Program (EWLP), which consisted of a series of pilot projects and micro-experiments in different countries (Algeria, Ecuador, Iran, Mali, Ethiopia, Guinea, Madgascar, Tanzania, Sudan, Zambia, and Venezuela) sponsored by UNESCO, United Nations Development Program (UNDP), and various…

Unemployed Youth: Alternative Approaches to an African Crisis.

ERIC Educational Resources Information Center

Livingstone, Ian

1989-01-01

This article draws on the findings of seven country studies of youth employment programs in Africa (Botswana, Somalia, Zambia, Malawi, Kenya, Ethiopia, and Mauritius). Considered are public service/public works programs, agricultural development, employable skills development and vocationalization of education, and national youth services. (SK)

Teachers' Professional Development in Schools: Rhetoric versus Reality

ERIC Educational Resources Information Center

Gemeda, Fekede Tuli; Fiorucci, Massimiliano; Catarci, Marco

2014-01-01

Across the country of Ethiopia, a centrally planned and prescribed professional development programme was implemented in schools, with the intention of enhancing teachers' knowledge, skills and disposition, thereby improving student learning and achievement. This article explores and describes the lived experiences of teachers involved in…

Predictors of quality of life in patients with diabetes mellitus in two tertiary health institutions in Ghana and Nigeria.

PubMed

Ababio, Grace K; Bosomprah, Samuel; Olumide, Adesola; Aperkor, Nicholas; Aimakhu, Chris; Oteng-Yeboah, Audrey; Agama, Joan; Chaplin, William F; Okuyemi, Kola S; Amoah, Albert G B; Ogedegbe, Gbenga

2017-01-01

Patients with chronic diseases such as Type 2 diabetes mellitus (DM) usually have a relatively poor quality of life (QoL), because the cost of care (living expenses and health) or diet restrictions are heavily felt by these patients, and this is of a public health concern. However, limited data on DM QoL exist in Ghana and Nigeria. This makes it imperative for data to be collated in that regard. We adopted the Strengthening The reporting of observational studies in epidemiology (STROBE) consensus checklist to survey the patients with DM seen at the diabetic clinic at the Department of Medicine of the Korle-Bu Teaching Hospital and University College Hospital, Ibadan, Nigeria. Patients with Type 2 DM aged 40 years and older were recruited by using systematic random sampling method. The World Health Organization Quality of Life-BREF, diabetes empowerment scale, and DM knowledge scale were used to assess QoL, patient empowerment, and knowledge of DM, respectively. The predictors of QoL were determined using multiple linear regression analyses. A total of 198 patients in Ghana and 203 patients in Nigeria completed the survey, with female-to-male ratio being 3:1 and 2:1, respectively. The overall QoL in both countries was relatively low: 56.19 ± 8.23 in Ghana and 64.34 ± 7.34 in Nigeria. In Ghana, significant correlates of higher scores on the QoL scale were medication adherence (P = 0.02) and employment status (P = 0.02). Among patients in Nigeria, employment status (P = 0.02) and DM empowerment (0.03) were significant predictors of QoL in patients with DM. Our study revealed an association between a number of psychosocial factors and QoL among patients with DM in Ghana and Nigeria.

Geographical Inequalities and Social and Environmental Risk Factors for Under-Five Mortality in Ghana in 2000 and 2010: Bayesian Spatial Analysis of Census Data.

PubMed

Arku, Raphael E; Bennett, James E; Castro, Marcia C; Agyeman-Duah, Kofi; Mintah, Samilia E; Ware, James H; Nyarko, Philomena; Spengler, John D; Agyei-Mensah, Samuel; Ezzati, Majid

2016-06-01

Under-five mortality is declining in Ghana and many other countries. Very few studies have measured under-five mortality-and its social and environmental risk factors-at fine spatial resolutions, which is relevant for policy purposes. Our aim was to estimate under-five mortality and its social and environmental risk factors at the district level in Ghana. We used 10% random samples of Ghana's 2000 and 2010 National Population and Housing Censuses. We applied indirect demographic methods and a Bayesian spatial model to the information on total number of children ever born and children surviving to estimate under-five mortality (probability of dying by 5 y of age, 5q0) for each of Ghana's 110 districts. We also used the census data to estimate the distributions of households or persons in each district in terms of fuel used for cooking, sanitation facility, drinking water source, and parental education. Median district 5q0 declined from 99 deaths per 1,000 live births in 2000 to 70 in 2010. The decline ranged from <5% in some northern districts, where 5q0 had been higher in 2000, to >40% in southern districts, where it had been lower in 2000, exacerbating existing inequalities. Primary education increased in men and women, and more households had access to improved water and sanitation and cleaner cooking fuels. Higher use of liquefied petroleum gas for cooking was associated with lower 5q0 in multivariate analysis. Under-five mortality has declined in all of Ghana's districts, but the cross-district inequality in mortality has increased. There is a need for additional data, including on healthcare, and additional environmental and socioeconomic measurements, to understand the reasons for the variations in mortality levels and trends.

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:26683463

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

PubMed

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

2016-09-01

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

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

PubMed Central

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

2016-01-01

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

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.

Molecular epidemiological studies on animal trypanosomiases in Ghana

PubMed Central

2012-01-01

Background African trypanosomes are extracellular protozoan parasites that are transmitted between mammalian hosts by the bite of an infected tsetse fly. Human African Trypanosomiasis (HAT) or sleeping sickness is caused by Trypanosoma brucei rhodesiense or T. brucei gambiense, while African Animal Trypanosomiasis (AAT) is caused mainly by T. vivax, T. congolense, T. simiae,T. evansi and T. brucei brucei. Trypanosomiasis is of public health importance in humans and is also the major constraint for livestock productivity in sub-Saharan African countries. Scanty information exists about the trypanosomiasis status in Ghana especially regarding molecular epidemiology. Therefore, this study intended to apply molecular tools to identify and characterize trypanosomes in Ghana. Methods A total of 219 tsetse flies, 248 pigs and 146 cattle blood samples were collected from Adidome and Koforidua regions in Ghana in 2010. Initial PCR assays were conducted using the internal transcribed spacer one (ITS1) of ribosomal DNA (rDNA) primers, which can detect most of the pathogenic trypanosome species and T. vivax-specific cathepsin L-like gene primers. In addition, species- or subgroup-specific PCRs were performed for T. b. rhodesiense, T. b. gambiense, T. evansi and three subgroups of T. congolense. Results The overall prevalence of trypanosomes were 17.4% (38/219), 57.5% (84/146) and 28.6% (71/248) in tsetse flies, cattle and pigs, respectively. T. congolense subgroup-specific PCR revealed that T. congolense Savannah (52.6%) and T. congolense Forest (66.0%) were the endemic subgroups in Ghana with 18.6% being mixed infections. T. evansi was detected in a single tsetse fly. Human infective trypanosomes were not detected in the tested samples. Conclusion Our results showed that there is a high prevalence of parasites in both tsetse flies and livestock in the study areas in Ghana. This enhances the need to strengthen control policies and institute measures that help prevent the spread of the parasites. PMID:23025330

Groundwater Exploration for Rural Communities in Ghana, West Africa

NASA Astrophysics Data System (ADS)

McKay, W. A.

2001-05-01

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

The long-term cognitive consequences of early childhood malnutrition: the case of famine in Ghana.

PubMed

Ampaabeng, Samuel K; Tan, Chih Ming

2013-12-01

We examine the role of early childhood health in human capital accumulation. Using a unique data set from Ghana with comprehensive information on individual, family, community, school quality characteristics and a direct measure of intelligence together with test scores, we examine the long-term cognitive effects of the 1983 famine on survivors. We show that differences in intelligence test scores can be robustly explained by the differential impact of the famine in different parts of the country and the impacts are most severe for children under two years of age during the famine. We also account for model uncertainty by using Bayesian Model Averaging. Copyright © 2013 Elsevier B.V. All rights reserved.

Efficiency, equity and feasibility of strategies to identify the poor: an application to premium exemptions under National Health Insurance in Ghana.

PubMed

Jehu-Appiah, Caroline; Aryeetey, Genevieve; Spaan, Ernst; Agyepong, Irene; Baltussen, Rob

2010-05-01

This paper outlines the potential strategies to identify the poor, and assesses their feasibility, efficiency and equity. Analyses are illustrated for the case of premium exemptions under National Health Insurance (NHI) in Ghana. A literature search in Medline search was performed to identify strategies to identify the poor. Models were developed including information on demography and poverty, and costs and errors of in- and exclusion of these strategies in two regions in Ghana. Proxy means testing (PMT), participatory welfare ranking (PWR), and geographic targeting (GT) are potentially useful strategies to identify the poor, and vary in terms of their efficiency, equity and feasibility. Costs to exempt one poor individual range between US$11.63 and US$66.67, and strategies may exclude up to 25% of the poor. Feasibility of strategies is dependent on their aptness in rural/urban settings, and administrative capacity to implement. A decision framework summarizes the above information to guide policy making. We recommend PMT as an optimal strategy in relative low poverty incidence urbanized settings, PWR as an optimal strategy in relative low poverty incidence rural settings, and GT as an optimal strategy in high incidence poverty settings. This paper holds important lessons not only for NHI in Ghana but also for other countries implementing exemption policies. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

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.

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.

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.

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.

Establishing space research capability in Ethiopia

NASA Astrophysics Data System (ADS)

Bosinger, T.; Damtie, B.; Usoskin, I. G.

It is often considered by various sources and institutions around the world that promotion of space physics activities in a developing country like Ethiopia is a waste of time and resources. It has, of course, some sense: developing countries should put all their efforts in improving the standard of life, infrastructure and basic education. However, it is straightforward to realize that nowadays improvement in any of the basic needs of developing countries is related to high technology (e.g. mobile phones, GPS, remote sensing). This means that a developing country has to take care of recruiting specialists among their own people who can take part in the decision making processes which are increasingly of global nature. Moreover, many citizens of developing countries are studying and working abroad attaining high expertise. As a matter of fact, there are more Ethiopians with PhD in physics working abroad than in the country. These people are lost for the benefit of their own country if there is no need for their profession in their home country. There is no doubt that the main task of improving the standard of living cannot be achieved without development and social transformation of the society, which can take place efficiently in a self-adopting and dynamic process. In line with the above argument, we have initiated the establishment of the Washera Space Physics Laboratory (WASPL) at Addis Ababa University in Ethiopia. It is a collaboration project between Oulu University and Addis Ababa University. The laboratory is expected to start operation of a pulsation magnetometer and photometer in September 2004. Other types of standard geophysical instruments are to be installed in subsequent missions. The project is of mutual interest of both parties. The equatorial ionosphere is still a poorly investigated region of our near Earth's space. In a first pilot investigation the existence and properties of the ionospheric Alfvén resonator (IAR) in the equatorial ionosphere is addressed. WASPL is expected to join worldwide activities in monitoring local and global atmosphereic and ionospheric parameters. There is also a plan to install a neutron monitor to measure galactic and solar cosmic rays. WASPL will be situated at the magnetic equator and at 2500m above seal level, which make it a unique place to carry out space physics experiments. In this paper, we describe WASPL in some more details. Interested scientists may participate with us and/or start similar initiatives.

Meat Consumption Culture in Ethiopia

PubMed Central

Jo, Cheorun

2014-01-01

The consumption of animal flesh food in Ethiopia has associated with cultural practices. Meat plays pivotal and vital parts in special occasions and its cultural symbolic weight is markedly greater than that accorded to most other food. Processing and cooking of poultry is a gender based duty and has socio-cultural roles. Ethiopians are dependent on limited types of animals for meats due to the taboo associated culturally. Moreover, the consumption of meat and meat products has a very tidy association with religious beliefs, and are influenced by religions. The main religions of Ethiopia have their own peculiar doctrines of setting the feeding habits and customs of their followers. They influence meat products consumption through dictating the source animals that should be used or not be used for food, and scheduling the days of the years in periodical permeation and restriction of consumptions which in turn influences the pattern of meat consumption in the country. In Ethiopia, a cow or an ox is commonly butchered for the sole purpose of selling within the community. In special occasions, people have a cultural ceremony of slaughtering cow or ox and sharing among the group, called Kircha, which is a very common option of the people in rural area where access of meat is challenging frequently. PMID:26760739

Reproductive and Obstetric Factors Are Key Predictors of Maternal Anemia during Pregnancy in Ethiopia: Evidence from Demographic and Health Survey (2011)

PubMed Central

Alemu, Taddese; Umeta, Melaku

2015-01-01

Anemia is a major public health problem worldwide. In Ethiopia, a nationally representative and consistent evidence is lacking on the prevalence and determinants during pregnancy. We conducted an in-depth analysis of demographic and health survey for the year 2011 which is a representative data collected from all regions in Ethiopia. Considering maternal anemia as an outcome variable, predicting variables from sociodemographic, household, and reproductive/obstetric characteristics were identified for analyses. Logistic regression model was applied to identify predictors at P < 0.05. The prevalence of anemia among pregnant women was 23%. Maternal age, region, pregnancy trimester, number of under five children, previous history of abortion (termination of pregnancy), breastfeeding practices, and number of antenatal care visits were key independent predictors of anemia during pregnancy. In conclusion, the level of anemia during pregnancy is a moderate public health problem in Ethiopia. Yet, special preventive measures should be undertaken for pregnant women who are older in age and having too many under five children and previous history of abortion. Further evidence is expected to be generated concerning why pregnant mothers from the eastern part of the country and those with better access to radio disproportionately develop anemia more than their counterparts. PMID:26417454