Treatment Effects and Integrated Morbidity Control of Schistosomiasis

Schistosomiasis is caused by the blood fl uke and leads to signifi cant ill-health and economic burden. The disease is common in the tropics and subtropics and acquired through contact with freshwater bodies infested with the infective cercariae shed from the intermediate host snail. From a public health perspective, the three most important species are Schistosoma mansoni and S. japonicum (causing intestinal schistosomiasis) and S. haematobium (causing urinary schistosomiasis). Schistosomiasis is endemic in 76 countries and territories worldwide (Engels et al. 2002; Steinmann et al. 2006) with around 85% of the infections confi ned to sub- Saharan Africa (Savioli et al. 1997; Chitsulo et al. 2000). Schistosomiasis is largely confi ned to rural dwellings and exacerbates poverty (Hotez et al. 2008; Wang et al. 2008). In some areas of sub-Saharan Africa there is an overlap in distribution of S. mansoni and S. haematobium resulting in mixed infections (WHO 2002). This thesis focuses on urinary schistosomiasis due to S. haematobium and intestinal schistosomiasis due to S. mansoni. Schistosomiasis is largely related to poverty, and efforts to alleviate poverty through development of water-related projects tend to increase transmission of the infection (Poda et al. 2004; Steinmann et al. 2006). Mostly children, women and farmers in poor rural areas who depend on water contact for recreational, domestic or occupational activities are affected. Peri-urban schistosomiasis is on the increase (Kloetzel et al. 1994; Chimbari & Chirundu 2003; Njiokou et al. 2004), and movement of displaced people from confl ict zones has contributed to the spread of the disease to previously non-endemic areas (Chitsulo et al. 2000)

Comprendre les réparations

Cet article présente une analyse préliminaire de la logique morale qui sous-tend les revendications de réparations de groupe pour les violations massives des droits de l’homme telles que l’esclavage, l’apartheid, le colonialisme et le génocide. Je commence par la justification des réparations dans des cas individuels. Typiquement, un « auteur » fait du tort à une victime, puis offre une réparation à cette victime. J’examine un certain nombre de raisonnements qui autorisent cette pratique. La réparation est perçue comme un moyen de rétablir la victime, d’exprimer la reconnaissance d’un tort, de rétablir la relation entre la victime et l’auteur. Je montre que toutes ces théories s’accompagnent de difficultés pour les types de réparations que nous abordons ici. D’abord, tant la victime que l’auteur sont des groupes et certains de ces groupes ne remplissent pas les conditions nécessaires à l’action collective. Ensuite, les victimes sont décédées depuis longtemps. Dans une perspective de regard vers l’avenir, j’avance enfin que plusieurs raisons favorisent les transferts de ressources à grande échelle que les arguments en faveur des réparations cherchent à justifier par des considérations qui privilégient un regard tourné vers le passé.Understanding Reparation. A Preliminary Reflection. – This paper offers a preliminary analysis of the moral logic of claims for group reparation for large-scale historical abuses of human rights such as slavery, apartheid, colonialism, and genocide. I begin with the rationale for reparation in individual cases. In the model case, a perpetrator wrongs a victim, and then offers reparation to that victim. I examine a number of rationales for this practice: as restoring the victim; as expressing acknowledgment of the wrong; as restoring the relationship between victim and perpetrator. I show that there are difficulties on all these theories for the kinds of reparations I am discussing. There are difficulties, first, because the victim and perpetrator are groups and some of the relevant groups do not meet the conditions for collective agency. Then there are difficulties when the victims are long dead. I argue, finally, that there are forward-looking reasons to favor many of the large-scale transfers of resources that reparations arguments seek to justify by backward-looking considerations

Integrating biomedical and herbal medicine in Ghana:experiences from the Kumasi South Hospital: a qualitative study

BACKGROUND: Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. METHODS: Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants’ interviews was employed to collect data. RESULTS: Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. CONCLUSIONS: The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations

Analytical Study of the Implications of Text Illustrations on Lower Primary Pupils' Construal in the Classroom: The Case of Illustrations in Ghanaian Language and Literacy Textbook

Illustrations used in textbooks for lower primary school teaching form an integral part of pupils’ cognitive abilities. Ghanaian publishers and illustrators give marginal attention to the liaison between textbook illustrations and their corresponding text when illustrating for children in lower primary schools. The incongruities between text and its illustrations in the textbooks pose challenges to lower primary pupils in their quest to understand, interpret and match text with adjoining illustrations. The study adopted qualitative research design to study how the misalliance of text and illustrations in textbooks affects teaching and learning at the lower primary level in selected Ghanaian schools in the Ashanti Region. Illustrations in the Ghanaian language and Literacy textbook (Asante Twi) for the lower primary level was chosen for the study.  Two (2) lower primary schools were sampled for the study based on proximity. One (1) teacher was sampled from each school; and a total of eighty (80) pupils were also censused from the 2 schools with convenience and purposive techniques. Thirty-nine (39) and forty-one (41) pupils were used in school A and B respectively. Prospectively, Seguin’s model evaluates that there are standard illustrations in the Ghanaian language and literacy textbook. Conversely, the study evidenced that misalliances between text and its illustrations in textbook affected teaching and learning thereby resulting in pupils’ abysmal academic performance in terms of their comprehension of the illustrations to the various passages read. The teaching methods adopted by individual teachers also played a contributing factor to pupils’ understanding or misinterpretation of the text and its illustration.  The study advocates that text and illustrations in textbooks should equally match in the passage to enable lower primary pupils make meaning and create appropriate mental models of text and its adjoining text illustrations. Keywords: Illustrations, Textbooks, lower primary schools, Language and Literacy, Asante Twi, Ghana

Application of Generalized Estimating Equations to Non-Life Insurance Claims Reserve in Ghana -A Case Study

Claim reserves often take greater percentage of the liabilities of non-life insurance. The chain ladder method is the most widely used method for estimating these reserves though this method omits the possible existence of correlation within accident years. In Ghana, it is difficult to determine which methods are used in estimating claims reserve as almost all insurance companies are adamant to give any information on claims reserve. In this paper the Generalised Estimating Equation (GEE) framework is used to estimate claims reserve using data from SIC insurance company (Bolgatanga Branch) in Ghana. GEE allows for the incorporation of dependencies within accident years. The Quasi-Likelihood Information Criterion (QIC) and Correlation Information Criterion (CIC) were used as the criteria for model comparison and selection. The results show that the canonical Chain Ladder method and the GEE techniques can be used in Ghana to estimate insurance claims reserve. However, the GEE technique provides better estimate than the canonical Chain Ladder method

“We are Seen but not Recognized”; Disability Stigma and Disabled People’s Exclusion from Community Activities: The Case of Disabled People in a Traditional Community in Ghana

Society has a way of categorising and assigning expectations to its members. There are also rules regarding the norms and processes of dealing with problems of daily life. If a rule is broken during interactions between individuals in society resulting in abnormal situation, it can be labelled as stigma. When people perceive individuals as possessing socially unacceptable attributes, they assign negative qualities to the person and results in devaluation of the individual. Data was collected from disabled people and their leaders in the Kumasi Metro who were registered with the Department of Social Welfare. A qualitative study was conducted in which Interview and Focus Group Discussions were employed to collect data from respondents.  Purposive sampling technique was adopted to select 35 respondents for the study. After each data collection activity the recorded audio tapes and field notes taken during the interview were translated into English and later word processed. Data editing and categorisation was done manually based on the research objective. The study found that disability is stigmatised as a result of the reaction of society towards individuals who have impairments, disabled people have been given names based on their disability, disabled people have also lost the opportunity to inherit family wealth and to be installed as chiefs, and are unable to represent their communities and families at social functions. It is recommended that there should be effective public education on disability and the scientific causes of the condition.  Keywords: Stigma, Community-exclusion, Ghana, Disability, Society, Culture and Labelin

“AMPE” Exercise Programme Has Positive Effects on Anthropometric and Physiological Parameters of School Children: A Pilot Study

BACKGROUND: Projection of the effectiveness of house-hold physical activity may be a vital tool to improve active lifestyle. Although ampe is a common house-hold recreational physical activity among all population groups especially school children in Ghana, no empirical evidence of its effects on the anthropometric and physiological parameters of the children. This pilot study examined the effect of ampe exercise programme on the anthropometric and physiological parameters of school children.METHODS: Purposive and stratified sampling techniques were applied to recruit 78 school children (ages of 9 to 12, mean age of 10.65±0.94 years). The participants attended 40 minutes of ampe exercise program three times per week, for four weeks consecutively. Body mass index, waist circumference, hip circumference, waist-to-hip ratio; % body fat, diastolic blood pressure, systolic blood pressure and heart rate were measured prepost training.RESULTS: Ampe exercise programme produced positive effects on all parameters. Body weight (0.31%) and body mass index (0.58%) decreased significantly (P<0.05). Systolic blood pressure (3.15%), diastolic blood pressure (1.92%) and heart rate (2.13) significantly improved (P<0.05). CONCLUSION: Ampe exercise programme is effective as paediatric obesity house-hold intervention to provide the impetus for active lifestyles of school children

Assessing the Impact and Uses of the Disability Common Fund Among Persons with Disabilities in Kumasi Metropolis in Ghana

The Disability Common Fund (DCF) is a social protection program aimed at alleviating poverty among persons with disabilities in Ghana. Since its introduction, little has been done to examine if beneficiaries use the fund for its intended purposes. The study was conducted to assess beneficiaries’ perception of the sufficiency of the fund, what the fund was used for and the possible impact on the lives of beneficiaries in the Kumasi Metropolis, and make recommendation for improvement. This cross-sectional quantitative study obtained survey data from120 beneficiaries of the fund in the Kumasi Metropolis. Findings indicated that the DCF was used for a variety of purposes, which could be beneficial to the recipients of the fund. These included procurement of assistive devices, awareness creation, enabling the environment, payment of school fees of dependents and assisting beneficiaries to access healthcare. Although respondents complained of the insufficiency of the fund and delays in releasing of funds to the beneficiaries, the fund has had some positive impacts on their lives. It is recommended that the fund be increased and disbursed in a timely manner in order for the DCF to serve its intended purpose