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Journal articles on the topic 'Primary health care – Ghana'

Author: Grafiati
Published: 4 June 2021
Last updated: 11 February 2022

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1

Amofah, George K. "Ghana: Selective versus Comprehensive Primary Health Care." Tropical Doctor 24, no. 2 (1994): 76–78. http://dx.doi.org/10.1177/004947559402400212.

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The furore which surrounded the debate over selective versus comprehensive primary health care (PHC) world wide appears to have died down. After 10 years of PHC implementation in Ghana, however, it is imperative that we revisit the issue in the Ghanaian context. This is because the choice either way has implications for programme planning, implementation, financing and the achievement of stated health policy goals in Ghana. Here I shall attempt to analyse the issues involved in Selective and Comprehensive PHC, outline the advantages and disadvantages of each strategy and suggest a compromise strategy in the Ghanaian context.
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2

Hoff, Wilbur. "Traditional Health Practitioners as Primary Health Care Workers." Tropical Doctor 27, no. 1_suppl (1997): 52–55. http://dx.doi.org/10.1177/00494755970270s116.

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The author conducted a field study in 1993 to evaluate the effectiveness of four projects that were training traditional health practitioners (THPs) to provide primary health care (PHC) services in Ghana, Mexico, and Bangladesh. The study, funded by a grant from the World Health Organization, Division of Strengthening Health Services, concluded that incorporating trained THPs in PHC programmes can be cost effective in providing essential and culturally relevant health services to communities. The main objective of the study was to evaluate how effective the training projects were and to determine what impacts they might have upon the communities served. A qualitative field evaluation was performed using data collected from project documents, observations, and field interviews with a selection of health agency staff, THPs, and community members. A summary of results is presented from the four field studies. For details refer to the full report1.
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3

Adjei, Sam. "Assessing the effect of primary health care on mortality in Ghana." Journal of Biosocial Science 21, S10 (1989): 115–25. http://dx.doi.org/10.1017/s0021932000025323.

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The primary health care programme in Ghana has two objectives: (1) to achieve basic primary health care for 80% of the population of the country by 1990; (2) to attack the disease problems that contribute to 80% of the unnecessary deaths and disability afflicting Ghanaians, also by 1990.
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Smith, F. "Community pharmacy in Ghana: enhancing the contribution to primary health care." Health Policy and Planning 19, no. 4 (2004): 234–41. http://dx.doi.org/10.1093/heapol/czh028.

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5

Macarayan, Erlyn K., Hannah L. Ratcliffe, Easmon Otupiri, et al. "Facility management associated with improved primary health care outcomes in Ghana." PLOS ONE 14, no. 7 (2019): e0218662. http://dx.doi.org/10.1371/journal.pone.0218662.

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Campbell, B. C., and A. B. Heywood. "Development of a Primary Health Care Information System in Ghana: Lessons Learned." Methods of Information in Medicine 36, no. 02 (1997): 63–68. http://dx.doi.org/10.1055/s-0038-1634694.

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Abstract:In Ghana, between January 1990 and September 1993, a series of steps were undertaken to review the existing vertical reporting procedures and to develop an integrated Health Management Information System (HMIS) for Primary Health Care (PHC).These steps included a situation analysis of the existing reporting systems; participatory design of tools for planning, data collection, feedback and reporting; field test and revision of the modified system; training of staff at all levels; development of tools for self-assessment and stimulation of routine feedback to lower levels and reporting of analysed indicators to higher levels.There were some notable achievements which included promotion of self-reliance, improved data relevance and accuracy, as well as strengthened supervision and support. However, it was difficult to identify the most appropriate institutional location for the HMIS; over-emphasis on process leads to reduced implementation; reporting was still given greater priority than analysis and use of data, and systems for collection and use were still cumbersome and time consuming. It is also difficult to prove that having better information really improves decision-making, or even coverage and quality of PHC service delivery.These issues, as well as lessons learned, are discussed in the paper.
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Smilkstein, G., H. A. Addy, E. A. Gyebi-Ofosu, and E. H. O. Parry. "Medical Education’s Role in Primary Care/Community Health: A Model from Kumasi, Ghana." American Journal of Preventive Medicine 2, no. 5 (1986): 273–77. http://dx.doi.org/10.1016/s0749-3797(18)31318-7.

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8

Javadi, Dena, John Ssempebwa, John Bosco Isunju, et al. "Implementation research on sustainable electrification of rural primary care facilities in Ghana and Uganda." Health Policy and Planning 35, Supplement_2 (2020): ii124—ii136. http://dx.doi.org/10.1093/heapol/czaa077.

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Abstract Access to energy is essential for resilient health systems; however, strengthening energy infrastructure in rural health facilities remains a challenge. In 2015–19, ‘Powering Healthcare’ deployed solar energy solutions to off-grid rural health facilities in Ghana and Uganda to improve the availability of maternal and child health services. To explore the links between health facility electrification and service availability and use, the World Health Organization (WHO), in partnership with Dodowa Health Research Centre and Makerere University School of Public Health, carried out an implementation research study. The objectives of this study were to (1) capture changes in service availability and readiness, (2) describe changes in community satisfaction and use and (3) examine the implementation factors of sustainable electrification that affect these changes. Data were collected through interviews with over 100 key informants, focus group discussions with over 800 community members and health facility assessment checklist adapted from the WHO’s Service Availability and Readiness Assessment tool. Implementation factors were organized using Normalization Process Theory constructs. The study found that access to energy is associated with increased availability of health services, access to communication technologies, appropriate storage of vaccines and medicines, enhanced health worker motivation and increased community satisfaction. Implementation factors associated with improved outcomes include stakeholder engagement activities to promote internalization, provision of materials and information to encourage participation, and establishment of relationships to support integration. Barriers to achieving outcomes are primarily health systems challenges—such as drug stockouts, lack of transportation and poor amenities—that continue to affect service availability, readiness and use, even where access to energy is available. However, through appropriate implementation and integration of sustainable electrification, strengthened energy infrastructure can be leveraged to catalyze investment in other components of functioning health systems. Improving access to energy in health facilities is, therefore, necessary but not sufficient for strengthening health systems.
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9

Manu, Alexander, Nabila Zaka, Christina Bianchessi, Edward Maswanya, John Williams, and Shams E. Arifeen. "Respectful maternity care delivered within health facilities in Bangladesh, Ghana and Tanzania: a cross-sectional assessment preceding a quality improvement intervention." BMJ Open 11, no. 1 (2021): e039616. http://dx.doi.org/10.1136/bmjopen-2020-039616.

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ObjectiveTo assess respectful maternity care (RMC) in health facilities.DesignCross-sectional study.SettingForty-three (43) facilities across 15 districts in Bangladesh, 16 in Ghana and 12 in Tanzania.ParticipantsFacility managers; 325 providers (nurses/midwives/doctors)—Bangladesh (158), Ghana (86) and Tanzania (81); and 849 recently delivered women—Bangladesh (295), Ghana (381) and Tanzania (173)—were interviewed. Observation of 641 client–provider interactions was conducted—Bangladesh (387), Ghana (134) and Tanzania (120).AssessmentTrained social scientists and clinicians assessed infrastructure, policies, provision and women’s experiences of RMC (emotional support, respectful care and communication).Primary outcomeRMC provided and/or experienced by women.ResultsThree (20%) facilities in Bangladesh, four (25%) in Ghana and three (25%) in Tanzania had no maternity clients’ toilets and one-half had no handwashing facilities. Policies for RMC such as identification of client abuses were available: 81% (Ghana), 73% (Bangladesh) and 50% (Tanzania), but response was poor. Ninety-four (60%) Bangladeshi, 26 (30%) Ghanaian and 20 (25%) Tanzanian providers were not RMC trained. They provided emotional support during labour care to 107 (80%) women in Ghana, 95 (79%) in Tanzania and 188 (48.5%) in Bangladesh, and were often courteous with them—236 (61%) in Bangladesh, 119 (89%) in Ghana and 108 (90%) in Tanzania. Due to structural challenges, 169 (44%) women in Bangladesh, 49 (36%) in Ghana and 77 (64%) in Tanzania had no privacy during labour. Care was refused to 13 (11%) Tanzanian and 2 Bangladeshi women who could not pay illegal charges. Twenty-five (7%) women in Ghana, nine (6%) in Bangladesh and eight (5%) in Tanzania were verbally abused during care. Providers in all countries highly rated their care provision (95%–100%), and 287 (97%) of Bangladeshi women, 368 (97%) Ghanaians and 152 (88%) Tanzanians reported ‘satisfaction’ with the care they received. However, based on their facility experiences, significant (p<0.001) percentages—20% (Ghana) to 57% (Bangladesh)—will not return to the same facilities for future childbirth.ConclusionsFacilities in Bangladesh, Ghana and Tanzania have foundational systems that facilitate RMC. Structural inadequacies and policy gaps pose challenges. Many women were, however, unwilling to return to the same facilities for future deliveries although they (and providers) highly rated these facilities.
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10

Bell, Griffith, Erlyn K. Macarayan, Hannah Ratcliffe, et al. "Assessment of Bypass of the Nearest Primary Health Care Facility Among Women in Ghana." JAMA Network Open 3, no. 8 (2020): e2012552. http://dx.doi.org/10.1001/jamanetworkopen.2020.12552.

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Kanmiki, Edmund Wedam, James Akazili, Ayaga A. Bawah, et al. "Cost of implementing a community-based primary health care strengthening program: The case of the Ghana Essential Health Interventions Program in northern Ghana." PLOS ONE 14, no. 2 (2019): e0211956. http://dx.doi.org/10.1371/journal.pone.0211956.

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12

Asamani, James Avoka, Christmal Dela Christmals, and Gerda Marie Reitsma. "Health Service Activity Standards and Standard Workloads for Primary Healthcare in Ghana: A Cross-Sectional Survey of Health Professionals." Healthcare 9, no. 3 (2021): 332. http://dx.doi.org/10.3390/healthcare9030332.

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The attainment of health system goals is largely hinged on the health workforce availability and performance; hence, health workforce planning is central to the health policy agenda. This study sought to estimate health service activity standards and standard workloads at the primary health care level in Ghana and explore any differences across health facility types. A nationally representative cross-sectional survey was conducted among 503 health professionals across eight health professions who provided estimates of health service activity standards in Ghana’s Primary Health Care (PHC) settings. Outpatient consultation time was 16 min, translating into an annual standard workload of 6030 consultations per year for General Practitioners. Routine nursing care activities take an average of 40 min (95% CI: 38–42 min) for low acuity patients; and 135 min (95% CI: 127–144 min) for high dependency patients per inpatient day. Availability of tools/equipment correlated with reduced time on clinical procedure. Physician Assistants in health centres spend more time with patients than in district hospitals. Midwives spend 78 min more during vaginal delivery in health centres/polyclinics than in district/primary hospital settings. We identified 18.9% (12 out of 67) of health service activities performed across eight health professional groups to differ between health centres/polyclinics and district/primary hospitals settings. The workload in the health facilities was rated 78.2%, but as the workload increased, and without a commensurate increase in staffing, health professionals reduced the time spent on individual patient care, which could have consequences for the quality of care and patient safety. Availability of tools and equipment at PHC was rated 56.6%, which suggests the need to retool these health facilities. The estimated standard workloads lay a foundation for evidence-based planning for the optimal number of health professionals needed in Ghana’s PHC system and the consequent adjustments necessary in both health professions education and the budgetary allocation for their employment. Finally, given similarity in results with Workload Indicators of Staffing Need (WISN) methodology used in Ghana, this study demonstrates that cross-sectional surveys can estimate health service activity standards that is suitable for health workforce planning just as the consensus-based estimates advocated in WISN.
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13

Ahiabu, Mary-Anne, Britt P. Tersbøl, Richard Biritwum, Ib C. Bygbjerg, and Pascal Magnussen. "A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana." Health Policy and Planning 31, no. 2 (2015): 250–58. http://dx.doi.org/10.1093/heapol/czv048.

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14

Amonoo-Lartson, R., M. Alpaugh-Ojermark, and A. Neumann. "An Approach to Evaluating the Quality of Primary Health Care in Rural Clinics in Ghana." Journal of Tropical Pediatrics 31, no. 5 (1985): 282–85. http://dx.doi.org/10.1093/tropej/31.5.282.

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15

Williams, Dinsie B., Jillian C. Kohler, Andrew Howard, Zubin Austin, and Yu-Ling Cheng. "A framework for the management of donated medical devices based on perspectives of frontline public health care staff in Ghana." Medicine Access @ Point of Care 4 (January 2020): 239920262094136. http://dx.doi.org/10.1177/2399202620941367.

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Background: Transnational funders provide up to 80% of funds for medical devices in resource-limited settings, yet sustained access to medical devices remains unachievable. The primary goal of this study was to identify what factors hinder access to medical devices through the perspectives of frontline public hospital staff in Ghana involved in the implementation of transnational funding initiatives. Methods: A case study was developed that involved an analysis of semi-structured interviews of 57 frontline technical, clinical and administrative public health care staff at 23 sites in Ghana between March and April 2017; a review of the national guidelines for donations; and images of abandoned medical devices. Results: Six key themes emerged, demonstrating how policy, collaboration, quality, lifetime operating costs, attitudes of health care workers and representational leadership influence access to medical devices. An in-depth assessment of these themes has led to the development of an enterprise-wide comprehensive acquisition and management framework for medical devices in the context of transnational funding initiatives. Conclusion: The findings in this study underscore the importance of incorporating frontline health care staff in developing solutions that are targeted at improving delivery of care. Sustained access to medical devices may be achieved in Ghana through the adoption of a rigorous and comprehensive approach to acquisition, management and technical leadership. Funders and public health policy makers may use the study’s findings to inform policy reform and to ensure that the efforts of transnational funders truly help to facilitate sustainable access to medical devices in Ghana.
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Abuosi, Aaron Asibi, Samuel Kaba Akoriyea, Gloria Ntow-Kummi, et al. "Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study." Journal of Patient Safety and Risk Management 25, no. 5 (2020): 177–86. http://dx.doi.org/10.1177/2516043520958579.

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Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.
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Armah, Paul, and Dmitry Kicha. "Primary health care in Ghana: the structure and functions in relation to preventing neglected tropical diseases." Archiv Euromedica 10, no. 3 (2020): 12–17. http://dx.doi.org/10.35630/2199-885x/2020/10/3.2.

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Baozhen, Dai, Minkah Andrews Yaw, Osei-Assibey Mandella Bonsu, and Agyemang Fredua Sylvester Prempeh. "Assessing Factors Affecting the Patronage of Health Insurance Schemes: An Evidence of Ghana." Journal of Public Administration and Governance 9, no. 1 (2019): 73. http://dx.doi.org/10.5296/jpag.v9i1.14442.

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The Ghana Health Insurance Scheme was established to ensure enhancement in the quality of rudimentary health care services to all citizens. Notwithstanding the seemingly splendid financing structure, yet, there is empirical evidence of low enrolment. The study investigated the factors that have accounted for the truncated patronage of the health insurance scheme in Ghana. It also seeks to ascertain the factors that motivate individuals to join the scheme and finally examine the challenges of the scheme coverage expansion. The study used both interview, primary, and secondary data. The cross-sectional model was used to investigate the factors effects on NHIS. It was revealed that Income level, family characteristics, risk perception, and health care system delivery has an imperative negative influence on the low enrolment of the NHIS scheme in Ghana. However, questionnaires and interviews were used to find out from respondents and clients on the motivations and challenges associated with the scheme. The findings revealed that majority of the respondents agreed that access to free drugs is the strong arsenal that motivates individuals reluctant joining the scheme. The study further revealed that, majority of the respondents representing 87% have the notion that, negative attitude of the service providers at the health centers was the main barrier of the scheme among subscribers and non- subscribers in Ghana. Our results have practical implication that, intensive education should be enrolled out by the National Health Insurance Authority (NHIA) to change the negative perception of people in relation to the challenges among both subscribers and non-subscribers.
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Anyinam, Charles A. "The Social Costs of the International Monetary Fund's Adjustment Programs for Poverty: The Case of Health Care Development in Ghana." International Journal of Health Services 19, no. 3 (1989): 531–47. http://dx.doi.org/10.2190/6ytw-vx7w-hddq-q927.

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A primary health care (PHC) strategy was adopted in Ghana in 1978, but the civilian government at the time failed to implement the program designed to achieve health for all Ghanaians. In 1982, the revolutionary military government under Rawlings indicated its commitment to the full implementation of the PHC program. In this article, the author seeks to examine the extent to which the Economic Recovery Program initiated by the Rawlings' regime, its policy of decentralization and mobilization of the masses, and its promise to institute some fundamental organizational and structural changes in the health care delivery system, are contributing to the process of achieving “health for all” Ghanaians.
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Acquah-Hagan, Gertrude, Daniel Boateng, Emmanuel Appiah-Brempong, Peter Twum, Joseph Amankwa Atta, and Peter Agyei-Baffour. "Access Differentials in Primary Healthcare among Vulnerable Populations in a Health Insurance Setting in Kumasi Metropolis, Ghana: A Cross-Sectional Study." Advances in Public Health 2021 (July 27, 2021): 1–14. http://dx.doi.org/10.1155/2021/9911436.

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Background. Access to healthcare remains a challenge towards the achievement of the Sustainable Development Goals in Ghana. There still remain inequalities in the distribution of health services especially among vulnerable groups despite sustained efforts to strengthen the health system. This study was conducted to analyze access differentials among different vulnerable groups in the context of primary healthcare under a National Health Insurance Scheme (NHIS) in Ghana. Methods. This study was a descriptive cross-sectional study conducted among multilevel participants of vulnerable groups in Kumasi Metropolis: 710 vulnerable people constituting elderly/aged (n = 359), pregnant women (n = 117), head poters (teenage girls who migrated from the northern Ghana mainly to the capital cities of the Ashanti and Greater Accra region to help in carrying of goods for their livelihood) (n = 86), sex workers (n = 75), and other vulnerable groups (people with disabilities and street participants) (n = 73). Data were collected using a semistructured questionnaire. Poisson regression with robust variance was used to access the association between vulnerability and access to healthcare. Results. Close to a fifth, 18.5% of the study respondents were unable to access care at any point in time during the last 12 months. Reasons for the inability to access healthcare included limited funding (69.7%), poor attitude of service providers (7.6%), distance to health centers (8.3%), and religious reasons (6.2%). More than 95% of respondents were insured under the NHIS, but acceptability of service provision under the NHIS was low among the vulnerable groups. In the crude models, pregnant women had lower prevalence of access to medications as compared to the elderly (prevalence ratio (PR): 0.88; 95% CI: 0.80–0.98). Head poters and other vulnerable groups were also less likely to view healthcare as affordable as compared to the elderly. The differences in healthcare access observed were attenuated after adjustment for sociodemographic characteristics and healthcare-related factors. Conclusions. Despite the introduction of a NHIS in Ghana, this study highlights challenges in healthcare access among vulnerable populations independent of the type of vulnerability. This suggests the need for stakeholders to work to address access differentials in the NHIS and adopt other innovative care strategies that may have broader applicability for all populations.
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Apalayine, Gamel B., and Fabian A. Ehikhamenor. "The information needs and sources of primary health care workers in the Upper East Region of Ghana." Journal of Information Science 22, no. 5 (1996): 367–73. http://dx.doi.org/10.1177/016555159602200505.

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Dzokoto, A. W., D. Mabey, Y. Adu-Sarkordie, and N. A. Addo. "O22.1 Evaluation of Syphilis Point of Care Tests Conducted by Midwives at Primary Health Facilities in Ghana." Sexually Transmitted Infections 89, Suppl 1 (2013): A68.3—A69. http://dx.doi.org/10.1136/sextrans-2013-051184.0209.

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23

Addison, Naa Okaikor, Stefanie Pfau, Eric Koka, et al. "Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana." PLOS Neglected Tropical Diseases 11, no. 2 (2017): e0005331. http://dx.doi.org/10.1371/journal.pntd.0005331.

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Gyamfi, Addae Boateng Adu, and Benjamin Adjei. "Child Welfare Clinic Attendance among Children 24-59 Months in Assin North Municipality, Ghana." International Journal for Innovation Education and Research 1, no. 4 (2013): 59–68. http://dx.doi.org/10.31686/ijier.vol1.iss4.126.

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Child welfare clinics form an important component of the health care system in Ghana and renders invaluable health care services to children under five years. Despite the numerous advantages associated with child welfare clinic attendance, there are reported cases of low attendance among children 24-59 months. It is in line with this that the study examined child welfare attendance among children aged 24-59 months. Employing both qualitative and quantitative methods, the study selected 240 respondents for primary data collection and analysis in the Assin North Municipality of Ghana. It was established that child welfare clinic attendance declines by age of the child due to schooling, completion of immunization schedule and distance to the clinics among other factors. It was also found that the level of education of caregivers and distance travelled to the child welfare clinic have influence on child welfare clinic attendance. On the bases of the findings recommendations were made to capture children 24-59 months for child welfare services in schools. Secondly, health workers should sensitize care givers on the importance of child welfare clinic attendance for children aged 24-59 months.
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Mayhew, Susannah H., Gill Walt, Louisiana Lush, and John Cleland. "Donor Agencies' Involvement in Reproductive Health: Saying One Thing and Doing Another?" International Journal of Health Services 35, no. 3 (2005): 579–601. http://dx.doi.org/10.2190/k46b-rrxj-95m4-jdqu.

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The debates about what services constitute reproductive health, how these services should be organized, managed, and delivered, and what the role of donor agencies' support should be mirror the long-standing debates on how best to implement primary health care. After briefly reviewing the development of the discourse on primary health care and reproductive health, the authors present results of qualitative research in Ghana, Kenya, and Zambia that indicate a range of factors influencing and explaining the way donors operate in these countries and consider the implications of these results for the delivery of comprehensive reproductive health services. These findings are compared with South Africa, a country with limited donor activity. In the light of the complex interplay of factors, the authors suggest that donors' words and actions frequently do not correlate. Conclusions are drawn as to the potential for donor support for integrated reproductive health service delivery in sub-Saharan Africa, drawing on the research to provide lessons and a reappraisal of the role of donors in health sector aid.
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Toma, Ghazwan, Akye Essuman, and Michael D. Fetters. "Family medicine residency training in Ghana after 20 years: resident attitudes about their education." Family Medicine and Community Health 8, no. 4 (2020): e000394. http://dx.doi.org/10.1136/fmch-2020-000394.

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ObjectiveIn addition to assessing educational needs of family medicine trainees in Ghana, we sought to assess whether those entering the training programme aimed to pursue an academic career.DesignA case study using an anonymous cross-sectional survey through collaboration between faculty members from the family medicine departments of Ghana and the University of Michigan.SettingThe family medicine postgraduate trainees and the most recent graduates in the three training sites, Accra, Kumasi and Mampong, as well as modular residents in Ghana served as the targeted participants during data collection between October and November of 2018.ParticipantsSecond and third year family medicine residents, fellows (known as senior residents in Ghana) and recent graduates were invited to participate in this study. Thirty-five of 77 eligible subjects provided responses (46% response rate), but five records were eliminated due to incomplete data to yield a survey completion rate of 39% (30/77).ResultParticipants were mostly men (n=19), and the average age of respondents was 37 years old. The participants indicated the residency programmes needed more faculty 97% (n=29), supervision during outpatient care 87% (n=26) and lectures 83% (n=25). The main reason provided by respondents for entering residency programme in family medicine, which is currently not required for practising primary care in Ghana, was to obtain more education 93% (n=28). Participants who had completed the residency programme were much more likely to be interested in becoming faculty compared with those still in residency (p <0.001).ConclusionThe research confirms the need for more faculty and the importance of investing in faculty development resources for ensuring a robust programme. These findings provide constructive feedback that could improve residency curricula of the local and regional family medicine training programmes and supports investing in trainees and new graduates as future faculty candidates.
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Gbagbo, Fred, and Emmanuel Morhe. "Increasing access to intrauterine contraceptive device uptake in Ghana: stakeholders views on task sharing service delivery with community health nurses." Ghana Medical Journal 54, no. 2 (2020): 114–20. http://dx.doi.org/10.4314/gmj.v54i2.10.

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Introduction: Evidence supporting successful task sharing to increase Intrauterine Contraceptive Device (IUD) uptake exist in some developing countries that have challenges with availability of trained health professionals. Although Community Health Nurses (CHNs) in Ghana are trained to provide primary health care including emergency deliveries in rural communities, they are not professionally mandated to provide IUD services.Objectives: To explore stakeholders’ views on task sharing IUD services with CHNs in Ghana.Methods: This qualitative case study was conducted in Accra, Ghana between June and September 2018. Focus group discussions and in-depth interviews were used to collect data from purposively selected participants. Included in the study were policy makers, policy implementing institutions, service regulators, Non-Governmental Organisations, field providers and service end users. Interviews were recorded and transcribed verbatim. We manually performed thematic analysis of data and findings were appropriately described by paraphrasing and/or quoting relevant responses verbatim.Results: There is a general mixed feeling towards task sharing IUD services with community health nurses in Ghana. Policy makers, programmers, gynaecologists and IUD users interviewed believed that CHNs are capable of providing safe IUD services when well trained, adequately resourced and supervised. Based on some field experiences of complications associated with IUD insertions, participants who were midwives clearly indicated the need for effective training and careful implementation strategies.Conclusions: Despite concerns about user safety, respondents endorsed task-sharing IUD services with trained CHNs in Ghana. Implementation study focusing on competency-based IUD training for selected CHNs is recommended to provide empirical evidence to back policy decisions.Keywords: Task-sharing, IUD, Community Health Nurses, Policy, GhanaFunding: Marie Stopes Ghana funded the field work.
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Mi Kim, Young, Adrienne Kols, Gary Lewis, Dan Odallo, and Fitri Putjuk. "Analysis of client-provider interactions in family planning consultations in primary health care clinics in Kenya, Ghana, and Indonesia." Patient Education and Counseling 34 (May 1998): S37. http://dx.doi.org/10.1016/s0738-3991(98)90082-9.

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29

Phillips, James F., Elizabeth F. Jackson, Ayaga A. Bawah, Patrick O. Asuming, and John Koku Awoonor-Williams. "The fertility impact of achieving universal health coverage in an impoverished rural region of Northern Ghana." Gates Open Research 3 (September 13, 2019): 1537. http://dx.doi.org/10.12688/gatesopenres.12993.1.

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Background: When a successful Navrongo Health Research Centre service experiment demonstrated means for reducing high fertility and childhood mortality in a traditional societal setting of northern Ghana, the Ministry of Health launched a program of national scaling up known as the Community-based Health Planning and Services (CHPS) initiative. For two decades, CHPS has been Ghana’s flagship program for achieving universal health coverage (UHC). When monitoring during its first decade determined that the pace of CHPS scale-up was unacceptably slow, the Ghana Health Service launched the Ghana Essential Health Interventions Program (GEHIP) in four Upper East Region districts to test means of accelerating to CHPS implementation and improving its quality of care. Methods: To evaluate GEHIP, a two-round randomized sample survey was fielded with clusters sampled at baseline that were reused in the endline to facilitate difference-in-difference estimation of changes in fertility associated with GEHIP exposure. Monitoring operations assessed the location, timing, and content of CHPS primary health care. Discrete time hazard regression analysis on merged baseline and endline birth history data permit estimation of GEHIP fertility and CHPS access effects, adjusting for hospital and clinical service access and household social and economic confounders. Results: GEHIP exposure was associated with an immediate acceleration of CHPS implementation and coverage. Women residing in households with CHPS services had only slightly lower fertility than women who lacked convenient access to CHPS. GEHIP impact on contraceptive use was statistically significant but marginal; GEHIP exposure was associated with increasing unmet need. Conclusion: Results challenge the assumption that achieving UHC will reduce excess fertility. Social mobilization, community-outreach, connection of family planning discussions with male social networks are elements of the Navrongo success story that have atrophied with CHPS scale-up. Achieving UHC does not address the need for renewed attention to these family planning focused strategies.
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Apreh Siaw, Nicholas, and Samuel Kwofie. "Assessment of the Effects of the Free Maternal Health Policy on Maternal Health: A Case Study of New Juaben Municipality, Koforidua, Ghana." International Journal of Business and Social Research 6, no. 7 (2016): 51. http://dx.doi.org/10.18533/ijbsr.v6i7.292.

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<p>The main objective of the study was to verify the effect of the free maternal care policy on maternal health in the New Juaben Municipality, Ghana. The population for the study encompassed women of the child bearing age (10-49) in the New Juaben Municipality. Both primary and secondary sources of data were employed for this study. Purposive and accidental sampling procedures were used to select the respondents. The sample size was two hundred (200). This study used trend analysis as its main approach of analyzing the available data. The findings show that antenatal attendance has been increasing over the years. This is attributed to the introduction of the free maternal health policy. However, quality of care remains a problem due to the enormous attendance. It was also recommended that there is still a great need to introduce other measures to reduce maternal mortality in the municipality. It was also recommended that quality of care must be addressed and also more efforts should be made in the services that have provided to the patients. It was concluded that, although the policy has not eradicated maternal mortality completely yet it has contributed to its significant reduction in the region.</p>
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Kofie, Richard Y., and Lasse Møller-Jensen. "Towards a framework for delineating sub-districts for primary health care administration in rural Ghana: A case study using GIS." Norsk Geografisk Tidsskrift - Norwegian Journal of Geography 55, no. 1 (2001): 26–33. http://dx.doi.org/10.1080/00291950119232.

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Kofie, Richard Y., and Lasse Møller-Jensen. "Towards a framework for delineating sub-districts for primary health care administration in rural Ghana: a case study using GIS." Norsk Geografisk Tidsskrift 55, no. 1 (2001): 26–33. http://dx.doi.org/10.1080/002919501300061382.

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Polepeddi, Lalith, and Elizabeth Barden. "Three-dimensional modeling of a primary health care clinic in Ho, Ghana: its contribution to student engagement, fundraising, and program planning." Global Health Action 3, no. 1 (2010): 5060. http://dx.doi.org/10.3402/gha.v3i0.5060.

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Debrah, Samuel, Peter Donkor, Charles Mock, et al. "Increasing the use of continuing professional development courses to strengthen trauma care in Ghana." Ghana Medical Journal 54, no. 3 (2020): 197–200. http://dx.doi.org/10.4314/gmj.v54i3.11.

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Injury is a major cause of death and disability in Ghana. Strengthening care of the injured is essential to reduce this burden. Trauma continuing professional development (CPD) courses are an important component of strengthening trauma care. In many countries, including Ghana, their use needs to be more uniformly promoted. We propose lowcost strategies to increase the utilization of trauma CPD in Ghana, especially in district hospitals and higher need areas. These strategies include developing plans by regional health directorates and teaching hospitals for the regions for which they are responsible. Lists could be kept and monitored of which hospitals have doctors with which type of training. Those hospitals that need to have at least one doctor trained could be flagged for notice of upcoming courses in the area and especially encouraged to have the needed doctors attend. The targets should include at least one surgeon or one emergency physician at all regional or large district hospitals who have taken the Advanced Trauma Life Support (ATLS) (or locally-developed alternative) in the past 4 years, and each district hospital should have at least one doctor who has taken the Primary Trauma Care (PTC) or Trauma Evaluation and Management (TEAM) (or locally-developed alternatives) in the past 4 years. Parallel measures would increase enrollment in the courses during training, such as promoting TEAM for all medical students and ATLS for all surgery residents. It is important to develop and utilize more “home grown” alternatives to increase the long-term sustainability of these efforts,
 Keywords: trauma, injury, education, training, continuing professional developmentFunding: None
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Sarfo-Kantanka, Osei, Fred Stephen Sarfo, Eunice Oparebea Ansah, and Ishmael Kyei. "Spectrum of Endocrine Disorders in Central Ghana." International Journal of Endocrinology 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/5470731.

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Background.Although an increasing burden of endocrine disorders is recorded worldwide, the greatest increase is occurring in developing countries. However, the spectrum of these disorders is not well described in most developing countries.Objective.The objective of this study was to profile the frequency of endocrine disorders and their basic demographic characteristics in an endocrine outpatient clinic in Kumasi, central Ghana.Methods.A retrospective review was conducted on endocrine disorders seen over a five-year period between January 2011 and December 2015 at the outpatient endocrine clinic of Komfo Anokye Teaching Hospital. All medical records of patients seen at the endocrine clinic were reviewed by endocrinologists and all endocrinological diagnoses were classified according to ICD-10.Results.3070 adults enrolled for care in the endocrine outpatient service between 2011 and 2015. This comprised 2056 females and 1014 males (female : male ratio of 2.0 : 1.0) with an overall median age of 54 (IQR, 41–64) years. The commonest primary endocrine disorders seen were diabetes, thyroid, and adrenal disorders at frequencies of 79.1%, 13.1%, and 2.2%, respectively.Conclusions.Type 2 diabetes and thyroid disorders represent by far the two commonest disorders seen at the endocrine clinic. The increased frequency and wide spectrum of endocrine disorders suggest the need for well-trained endocrinologists to improve the health of the population.
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Kumbeni, Maxwell Tii, Paschal Awingura Apanga, Eugene Osei Yeboah, and Isaac Bador Kamal Lettor. "Knowledge and preventive practices towards COVID-19 among pregnant women seeking antenatal services in Northern Ghana." PLOS ONE 16, no. 6 (2021): e0253446. http://dx.doi.org/10.1371/journal.pone.0253446.

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Background COVID-19 is a novel respiratory disease associated with severe morbidity and high mortality in the elderly population and people with comorbidities. Studies have suggested that pregnant women are more susceptible to COVID-19 compared to non-pregnant women. However, it’s unclear whether pregnant women in Ghana are knowledgeable about COVID-19 and practice preventive measures against it. This study sought to assess the knowledge and preventive practices towards COVID-19 among pregnant women seeking antenatal services in Northern Ghana. Methods A cross-sectional study was conducted using a structured questionnaire in the Nabdam district in Ghana. A total of 527 pregnant women were randomly sampled from health facilities offering antenatal care services in the district. Multivariable logistic regression analysis was used to assess the association between the predictors and outcome variables. Results The prevalence of adequate knowledge and good COVID-19 preventive practices were 85.6%, (95% CI: 82.57, 88.59) and 46.6%, (95% CI: 42.41, 50.95) respectively. Having at least a primary education, residing in an urban area, and receiving COVID-19 education at a health facility were positively associated with adequate knowledge on COVID-19. Factors positively associated with good COVID-19 preventive practices were older age, having at least a primary education, pregnant women with a chronic disease, and living in an urban area. Multiparity was negatively associated with good COVID-19 preventive practices. Conclusion Although majority of women had adequate knowledge of COVID-19, less than half of them were engaged in good COVID-19 preventive practices. Education of pregnant women on COVID-19 preventive practices should be intensified at health facilities while improving upon the water, sanitation and hygiene need particularly in rural communities.
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Bhana, Arvin, Inge Petersen, Kim L. Baillie, Alan J. Flisher, and The MHaPP Research Programme Consor. "Implementing the World Health Report 2001 recommendations for integrating mental health into primary health care: A situation analysis of three African countries: Ghana, South Africa and Uganda." International Review of Psychiatry 22, no. 6 (2010): 599–610. http://dx.doi.org/10.3109/09540261.2010.536152.

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Skerratt, Sandra M., and Olivia G. Wilson. "Assessment of Cardiovascular Risk for Prevention and Control of Cardiovascular Disease in Ghana’s Northern Region A Cross-sectional Study of 4 Rural Districts using World Health Organization / International Society of Hypertension (WHO/ISH) Risk Prediction Charts." Global Journal of Health Science 13, no. 6 (2021): 1. http://dx.doi.org/10.5539/gjhs.v13n6p1.

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Ghana is experiencing an increase in cardiovascular (CVD) -related mortality with poor rural communities suffering greater complications and premature deaths. The point of this exploratory research is to evaluate the prevalence of CVD risk factors and to calculate the cardiovascular risk among adults aged > 40 years in Ghana’s Northern Region. A cross-sectional study was performed with 536 subjects. A pre-tested questionnaire, anthropometric measurements, and standardized WHO/ISH risk prediction charts assessed for 10-year risk of a fatal or non-fatal major cardiovascular event according to age, sex, blood pressure, smoking status, and diabetes mellitus status. Low, moderate and high CVD prevalence risk in females was 88.4%, 7.1%, and 4.5% while in males the prevalence was 91.3%, 5.8%, and 2.9%, respectively. Hypertension was noted as a clinically significant risk factor with females at 37.3% versus males at 32%. The 10-year risk of a fatal or non-fatal cardiovascular event was statistically significant for females according to age group. A moderate to high CVD risk of a fatal or non-fatal cardiovascular event was found in 10.4% of subjects. Notable CVD risk factors included a high prevalence of hypertension. Decentralizing care to local village healthcare facilities is one way to tackle cardiovascular risk reduction. Task shifting of primary care duties from physicians to nurses in terms of cardiovascular (CV) risk assessment and management of uncomplicated CV risk factors is a potential solution to the acute shortage of trained health staffs for the control and prevention of CVD in Northern Ghana.
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Sakeah, Evelyn, Raymond Akawire Aborigo, Cornelius Debpuur, Engelbert A. Nonterah, Abraham Rexford Oduro, and John Koku Awoonor-Williams. "Assessing selection procedures and roles of Community Health Volunteers and Community Health Management Committees in Ghana’s Community-based Health Planning and Services program." PLOS ONE 16, no. 5 (2021): e0249332. http://dx.doi.org/10.1371/journal.pone.0249332.

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Background Community participation in health care delivery will ensure service availability and accessibility and guarantee community ownership of the program. Community-based strategies such as the involvement of Community Health Volunteers (CHVs) and Community Health Management Committees (CHMCs) are likely to advance primary healthcare in general, but the criteria for selecting CHVs, CHMCs and efforts to sustain these roles are not clear 20 years after implementing the Community-based Health Planning Services program. We examined the process of selecting these cadres of community health workers and their current role within Ghana’s flagship program for primary care–the Community-based Health Planning and Services program. Methods This was an exploratory study design using qualitative methods to appraise the health system and stakeholder participation in Community-based Health Planning and Services program implementation in the Upper East region of Ghana. We conducted 51 in-depth interviews and 33 focus group discussions with health professionals and community members. Results Community Health Volunteers and Community Health Management Committees are the representatives of the community in the routine implementation of the Community-based Health Planning and Services program. They are selected, appointed, or nominated by their communities. Some inherit the position through apprenticeship and others are recruited through advertisement. The selection is mostly initiated by the health providers and carried out by community members. Community Health Volunteers lead community mobilization efforts, support health providers in health promotion activities, manage minor illnesses, and encourage pregnant women to use maternal health services. Community Health Volunteers also translate health messages delivered by health providers to the people in their local languages. Community Health Management Committees mobilize resources for the development of Community-based Health Planning and Services program compounds. They play a mediatory role between health providers in the health compounds and the community members. Volunteers are sometimes given non-financial incentives but there are suggestions to include financial incentives. Conclusion Community Health Volunteers and Community Health Management Committees play a critical role in primary health care. The criteria for selecting Community Health Volunteers and Community Health Management Committees vary but need to be standardized to ensure that only self-motivated individuals are selected. Thus, CHVs and CHMCs should contest for their positions and be endorsed by their community members and assigned roles by health professionals in the CHPS zones. Efforts to sustain them within the health system should include the provision of financial incentives.
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Krumholz, Abigail R., Allison E. Stone, Maxwell A. Dalaba, James F. Phillips, and Philip B. Adongo. "Factors facilitating and constraining the scaling up of an evidence-based strategy of community-based primary care: Management perspectives from northern Ghana." Global Public Health 10, no. 3 (2014): 366–78. http://dx.doi.org/10.1080/17441692.2014.981831.

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Steinhorst, Jonathan, Leslie Mawuli Aglanu, Sofanne J. Ravensbergen, et al. "‘The medicine is not for sale’: Practices of traditional healers in snakebite envenoming in Ghana." PLOS Neglected Tropical Diseases 15, no. 4 (2021): e0009298. http://dx.doi.org/10.1371/journal.pntd.0009298.

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Background Snakebite envenoming is a medical emergency which is common in many tropical lower- and middle-income countries. Traditional healers are frequently consulted as primary care-givers for snakebite victims in distress. Traditional healers therefore present a valuable source of information about how snakebite is perceived and handled at the community level, an understanding of which is critical to improve and extend snakebite-related healthcare. Method The study was approached from the interpretive paradigm with phenomenology as a methodology. Semi-structured interviews were conducted with 19 traditional healers who treat snakebite patients in two rural settings in Ghana. From the Ashanti and Upper West regions respectively, 11 and 8 healers were purposively sampled. Interview data was coded, collated and analysed thematically using ATLAS.ti 8 software. Demographic statistics were analysed using IBM SPSS Statistics version 26. Findings Snakebite was reportedly a frequent occurrence, perceived as dangerous and often deadly by healers. Healers felt optimistic in establishing a diagnosis of snakebite using a multitude of methods, ranging from herbal applications to spiritual consultations. They were equally confident about their therapies; encompassing the administration of plant and animal-based concoctions and manipulations of bite wounds. Traditional healers were consulted for both physical and spiritual manifestations of snakebite or after insufficient pain control and lack of antivenom at hospitals; referrals by healers to hospitals were primarily done to receive antivenom and care for wound complications. Most healers welcomed opportunities to engage more productively with hospitals and clinical staff. Conclusions The fact that traditional healers did sometimes refer victims to hospitals indicates that improvement of antivenom stocks, pain management and wound care can potentially improve health seeking at hospitals. Our results emphasize the need to explore future avenues for communication and collaboration with traditional healers to improve health seeking behaviour and the delivery of much-needed healthcare to snakebite victims.
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Meyer, Anna C., Constance Opoku, and Katherine J. Gold. "“They Say I Should not Think About It:”: A Qualitative Study Exploring the Experience of Infant Loss for Bereaved Mothers in Kumasi, Ghana." OMEGA - Journal of Death and Dying 77, no. 3 (2016): 267–79. http://dx.doi.org/10.1177/0030222816629165.

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Despite the high rate of infant mortality in Ghana, few studies have explored the maternal experience of infant loss and the perinatal grieving process. As part of a larger study that interviewed 153 mothers with a sick infant, this 1-year follow-up study reinterviewed eight mothers from the original cohort whose infant died since the study began. Mothers were queried about mental health, coping, and cultural issues related to the loss. Mothers were often discouraged from speaking or thinking about the death due to fear of psychological harm and impact on fertility. Primary coping mechanisms involved seeking support within the community and accepting the loss as God’s will. Mothers desired more communication from health-care providers at the time of death. Despite the cultural norm of silent acceptance in the face of perinatal loss, intense maternal grief and desire to mourn may allow more opportunities for health-care workers to support bereaved mothers.
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Tette, Edem M. A., Benjamin Demah Nuertey, Emmanuel A. Azusong, and Naa Barnabas Gandau. "The Profile, Health Seeking Behavior, Referral Patterns, and Outcome of Outborn Neonates Admitted to a District and Regional Hospital in the Upper West Region of Ghana: A Cross-Sectional Study." Children 7, no. 2 (2020): 15. http://dx.doi.org/10.3390/children7020015.

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Neonatal mortality is the major contributor to under-five mortality rates in many low and middle income countries. We examined the health practices, care-seeking behavior, and referral of sick outborn neonates to a district and regional hospital in the Upper West Region of Ghana. The study was a cross-sectional study conducted over an eight (8) month period in 2018. Data were obtained from caregiver interviews and case notes. Altogether, 153 outborn neonates were examined. Inappropriate practices including the use of enemas, cord care with cow dung, and herbal baths were found. Three babies treated this way died. The majority of caregivers sought care at a health facility. However, 67 (44%) sought care only after their babies were ill for ≥7 days, suggesting the influence of a period of confinement on health seeking. More than half, 94 (61.4%), of the facilities visited referred patients to destination hospitals without giving any treatment. Delayed care-seeking was associated with a low birth weight, using home remedies, and a maternal age of ≥30 years. Altogether, 12 neonates (7.8%) died, consisting of three males and nine females (p = 0.018). Socio-cultural factors strongly influence health seeking behavior and the health outcome of neonates in this setting. There appeared to be a limited repertoire of interventions for treating neonatal disease in primary care.
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Afoakwa, Prince, Seth Domfeh, Bright Afranie, et al. "Asymptomatic Bacteriuria and Anti-Microbial Susceptibility Patterns among Women of Reproductive Age. A Cross-Sectional Study in Primary Care, Ghana." Medical Sciences 6, no. 4 (2018): 118. http://dx.doi.org/10.3390/medsci6040118.

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Background: Asymptomatic bacteriuria (ASB) poses serious future clinical repercussions for reproductive women. The study determined the prevalence of asymptomatic bacteriuria along with anti-microbial susceptibility patterns among women of reproductive age in a primary care facility. Method: The study recruited a total of 300 women of reproductive age attending the Tetteh Quarshie Memorial Hospital at Akuapem-Mampong, Ghana, between January and March 2018. Questionnaires were administered to obtain demographic data and predisposing risk factors of ASB. An early-morning midstream urine sample was collected from participants. Urinalysis, urine culture, and anti-microbial susceptibility testing were performed. Results: The mean age of participants was 25.43 years. The overall prevalence rate of ASB was 40.3%. The prevalence was higher among pregnant women compared to non-pregnant women (33.3% vs 7.0%). The most common bacterial isolate was E. coli (47.0%) followed by Proteus spp. (36.4%), Klebsiella spp. (8.3%), and E. faecalis (8.3%). Leukocyturia (35.0%) followed by nitrate (30.0%) were the most common urine abnormalities identified on dipstick urinalysis. Most bacteria isolates showed increased resistance to ampicillin (95.04%) and tetracycline (95.04%) while most of the bacterial isolates were sensitive to levofloxacin (94.35%). Demographic characteristics including age (p < 0.001), educational level (p < 0.001), residency (p = 0.001), and marital status (p = 0.005) were significantly associated with ASB. Lifestyle characteristics such as sexual status (p = 0.001) and frequency of washing of intimate parts after sexual intercourse (p < 0.001) were also significantly associated with ASB. Conclusion: Asymptomatic bacteriuria, particularly E. coli and Proteus spp. are prevalent in the urine of pregnant women living in Akuapem-Mampong municipality. Hence public education along with early screening of ASB is essential to reducing future risk of reproductive health complications. Future studies are required to assess the impact of public health on the rate of bacterial infections.
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Prytherch, Helen, Melkidezek T. Leshabari, Christiane Wiskow, et al. "The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana and Tanzania." Global Health Action 5, no. 1 (2012): 19120. http://dx.doi.org/10.3402/gha.v5i0.19120.

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Gureje, Oye, John Appiah-Poku, Toyin Bello, et al. "Effect of collaborative care between traditional and faith healers and primary health-care workers on psychosis outcomes in Nigeria and Ghana (COSIMPO): a cluster randomised controlled trial." Lancet 396, no. 10251 (2020): 612–22. http://dx.doi.org/10.1016/s0140-6736(20)30634-6.

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Dawson, Cromwell Prince, Genevieve Cecilia Aryeetey, Samuel Agyei Agyemang, Kofi Mensah, Rebecca Addo, and Justice Nonvignon. "Costs, burden and quality of life associated with informal caregiving for children with Lymphoma attending a tertiary hospital in Ghana." International Journal of Care Coordination 23, no. 4 (2020): 165–72. http://dx.doi.org/10.1177/2053434520981357.

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Introduction Primary family caregivers provide substantial support in the management of lymphoma, potentially affecting their quality of life and increasing household health care costs. Our aim was thus to determine the economic costs and quality of life of primary caregivers of children with lymphoma. Methods This cross-sectional study involved primary informal caregivers of children with lymphoma attending the pediatric cancer unit at Komfo Anokye Teaching Hospital. The study adopted a cost-of-illness approach to estimate the direct costs (medical and non- medical) incurred and indirect cost (productive losses) to caregivers over the one-month period preceding the data collection. Zarit Burden Interview was used to determine caregiver burden and EUROHIS-QoL tool was used to determine the quality of life of primary caregivers. Results The average cost of managing lymphoma in children was estimated to be US$440.32, 97% of which were direct costs. On average, caregiver burden was 26.3 on the scale of 0 to 48. About 94% of caregivers reported high burden, with more males reporting high burden. Overall, average quality of life among caregivers was 2.20 on the 1 to 5 range. Approximately 85% of respondents reported low quality of life, with females reporting lower quality of life than males. Discussion This study shows that lymphoma is associated with substantial cost and increased burden, and affects quality of life of family caregivers. Future studies can explore the impact of social protection interventions (in the form of health insurance) to reduce the household economic burden of managing lymphoma in children.
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Nyarko, Samuel, Anthony Kusi, and Kwabena Opoku - Mensah. "Utilization of health facility delivery services in the Jomoro District of the Western Region of Ghana." Third Edition of the HSI Journal: Volume 2 Issue 1, 2021 Publication. 2, no. 1 (2021): 173–80. http://dx.doi.org/10.46829/hsijournal.2021.6.2.1.173-180.

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Background: In the year 2000, member states of the United Nations pledged to work towards a three-quarters reduction in the 1990 maternal mortality ratio by 2015 in line with Millenium. Development Goal 5, but this could not be achieved. This pledge became imperative given the high maternal mortality being recorded, especially among developing countries. The high maternal deaths in developing countries have been attributed partly to the lack of access to skilled birth attendants during delivery. Objective: This study aimed to investigate factors that influence the utilization of health facility delivery services among pregnant women in the Jomoro District of the Western Region of Ghana. Methods: The study used data from a cross-sectional survey among women aged 18 - 49 yr. living in the Jomoro District of Ghana and had given birth between 2012 and 2016 (n = 374). The study participants were randomly selected from women who attended child welfare clinics on clinic days with their babies in eighteen communities. The study used a structured questionnaire to solicit for information about the women’s demographic and socio-economic characteristics, community characteristics and health systems factors likely to influence their decision to seek skilled delivery care as well as their experiences relating to their last delivery. Bivariate analyses were performed between the primary dependent variable and background characteristics of the respondents. Factors influencing the choice of place of delivery were estimated by multiple logistic regression analysis. Data analysis was performed using STATA Statistical Software, Release 14. Results: About 61.0% (n= 228/374) of the women had their last delivery at a health facility while the remaining 38.8% (n= 145/374) delivered at home without skilled assistance. In multivariate analysis, women aged 25 – 29 yr. were less likely to have a skilled delivery (aOR, 0.40; 95% CI: 0.17 - 0.93). Also, professional women had 4.77 odds of having skilled delivery (aOR, 4.77; 95% CI: 1.53 - 14.93). Distance to the nearest health facility also had a statistically significant association with skilled delivery. Women living at 10 – 19 km to a health facility were less likely to have a skilled delivery (aOR, 0.56; 95% CI: 0.32 - 0.97). In addition, the presence of a midwife at a health facility increased the odds of skilled delivery among women (aOR, 4.59; 95% CI: 2.47 - 8.55). Conclusion: Interventions aimed at increasing the uptake of delivery care services to achieve the SDG’s target on maternal mortality must consider improving the socio-economic wellbeing of women in addition to removing the physical and health system barriers impeding access and utilisation of delivery care services.
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Agyepong, Irene Akua, Evelyn Ansah, Margaret Gyapong, Sam Adjei, Guy Barnish, and David Evans. "Strategies to improve adherence to recommended chloroquine treatment regimes: a quasi-experiment in the context of integrated primary health care delivery in Ghana." Social Science & Medicine 55, no. 12 (2002): 2215–26. http://dx.doi.org/10.1016/s0277-9536(01)00366-5.

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Kofi, Asaah, and Najim Ussiph. "Optimizing Access to Primary Health Care Services in Rural Communities using Geographical Information System (GIS): A Case of Atwima Mponua District of Ghana." International Journal of Computer Applications 163, no. 10 (2017): 30–36. http://dx.doi.org/10.5120/ijca2017913728.

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