Data Accuracy and Completeness of Monthly Midwifery Returns Indicators of Ejisu Juaben Health Directorate of Ghana

The broad range of activities contained in the provision of Primary Health Care (PHC) places a burden on providers to make optimal use of limited resources to achieve maximal health benefit to the population served. All too often, ad hoc decisions and personal preferences guide PHC resource allocations, making accountability for results impossible. Problems constraining Routine Health Information System (RHIS) performance in low-income countries include: poor data quality; limited use of available information; weaknesses in how data are analyzed and poor RHIS management practices. This study sought to investigate these constraints. A non-experimental before and after study involving bassline assessment of data accuracy and completeness, application of innovative strategies such as mentoring and coaching of Health Information Officers in data quality improvement process. Coincidentally, the intervention improved both data accuracy and completeness performance significantly among the participating facilities. The outstanding performance may be attributed to management's new orientation and growing interest towards quality data. Engaging frontline staff in data quality improvement work and provision of regular feedback leads to improvement in data accuracy and completeness. This has implications for decision-making and resource allocation, especially in low-income countries, where the routine health information management system relies heavily on paper work

Rural Origin and Exposure Drives Ghanaian Midwives Reported Future Practice

A primary cause of Ghana’s higher than global average maternal mortality rate is limited access to maternal care in rural areas. To date, few studies have examined how rural background/training of midwives impacts their future willingness to work in remote areas. The purpose of this paper is to describe the relationship between Ghanaian student midwife place of origin and rural training on their willingness to choose a future rural practice location. A cross-sectional computer-based survey was completed by 238 final year Ghanaian midwifery students from two public midwifery training schools located in urban Ghana between October and December 2009. The relationship between rural exposure and willingness to work in rural Ghana was analyzed using independent t-test, chi-square, and bivariate logistic regression. Participants who experienced a rural rotation (OR: 1.51, 95% CI: 0.71, 3.22) and those born in a rural area (OR: 2.24, 95% CI: 0.74, 6.75) resulted in greater odds ratio to choose rural practice following graduation. This study indicates an association between midwifery students’ place of origin and training and their willingness to practice in a rural area after graduation. (Afr J Reprod Health 2014; 18[3]: 95-100)Keywords: Midwifery, Ghana, human resources for health, maldistribution, rural practice, rural incentive

Integrating herbal medicine into mainstream healthcare in Ghana: clients' acceptability, perceptions and disclosure of use.

Although there are current efforts to integrate herbal medicine (HM) into mainstream healthcare in Ghana, there is paucity of empirical evidence on the acceptability and concurrent use of HM, in the formal health facilities in Ghana. This study sought to determine client perception, disclosure and acceptability of integrating herbal medicine in mainstream healthcare in Kumasi, Ghana. A cross-sectional study was conducted from May to August, 2015. Five hundred patients presenting at the outpatient departments of Kumasi South, Suntreso and Tafo Government Hospitals in Kumasi were randomly selected. Interviews were conducted with the use of structured questionnaires. A logistic regression analysis, using backward selection, was conducted to determine the influence of socio-demographic and facility related factors on the odds of using HM at the facility. All statistical tests were two-sided and considered significant at a p-value of <0.05. Majority of the study respondents were females (64.8%) and the median age was 36 years. Less than half, 42.2%, of the respondents utilized HM services when they visited the health facility. Reasons for using HM at the facility level included 'being effective' (24.4%), 'easy to access' (25.3%) and 'being comparatively cheaper' (16%). About 86% never disclosed previous use of HM to their health care providers. Socio-economic status and perception of service provision influenced use of herbal medicines. Respondents who rated themselves wealthy had increased odds of using herbal medicines at the health facility as compared to those who rated themselves poor (OR = 4.9; 95%CI = 1.6-15.3). This study shows that integration of herbal medicine is feasible and herbal medicines may be generally accepted as a formal source of healthcare in Ghana. The results of this study might serve as a basis for improvement and upscale of the herbal medicine integration programme in Ghana

Prevalence and knowledge of hypertension among people living in rural communities in Ghana: a mixed method study.

Knowledge and understanding of hypertension and its associated health risks remain inadequate despite increasing trend of hypertension prevalence. This study was conducted to assess the prevalence, knowledge and perceptions of hypertension in rural communities in Ghana. A mixed method study involving 534 subjects was employed. Data was collected in six communities from May to December 2014 with structured questionnaires and interview guides. A logistic regression analysis was conducted to estimate the influence of the socio-demographic factors on knowledge of hypertension. Qualitative data was thematically analyzed. The mean systolic blood pressure (BP) was higher in men than women (127.42mmHg versus 124.42mmHg). The proportion of hypertensives was 21.4% and was higher among men in all age categories. Knowledge on some risk factors of hypertension was extremely low. Having formal education was associated with higher odds of knowledge of hypertension (Adjusted odds ratio [AOR]; 95% confidence interval [CI]=2.28; 1.25-4.16). Several misconceptions such as the use of agro-chemicals, fertilizers and excess vitamins were identified as causes of hypertension. This study demonstrates an increased prevalence of hypertension, knowledge gaps and misconceptions surrounding hypertension in rural communities in Ghana. This evidence is useful in streamlining interventional programmes aimed at improving knowledge and prevention of hypertension

Gendered perceptions and adaptation practices of smallholder cocoa farmers to climate variability in the Central Region of Ghana

Understanding gendered adaptation practices among smallholder cocoa farmers is crucial to ensuring sustainable cocoa production in Ghana. This study examined the gendered perceptions and adaptation practices of smallholder cocoa farmers to climate variability in three selected communities (Breman Ayipey, Breman Baako and Breman Kuntanase) in the Asikuma-Odoben-Brakwa District of the Central Region, Ghana. The study adopted a mixed-methods approach including household surveys and focus group discussions with 10 participants in each community. Mann-Kendall trend test was used to determine the rainfall and temperature changes in the study district from 2000 to 2015. Results indicated that there was no significant difference between male and female farmers’ perceptions of climate variability (p > 0.05). Both male and female farmers perceived an increasing temperature, rainfall, windstorms and flooding for the past 15 years. The Mann-Kendall trend test showed that annual rainfall and temperature had increased over the study period although the trends were not statistically significant (p > 0.05). Both male and female farmers had resorted to the use of different adaptation practices to reduce the threats of climate variability. There was a substantial difference between adaptation practices used by male and female farmers such as changing planting dates, use of drought tolerant hybrids, shade management, livestock rearing and income from sale of properties (p < 0.05). The study recommends policy formulations that incorporate gender perspectives into climate change adaptation practices among smallholder cocoa farmers in Ghana

Climate information services available to farming households in Northern Region, Ghana

Climate information services can build the resilience of African farmers to address the increasing threats associated with climate change. This study used household surveys with 200 farmers and focus group discussions to identify the types of climate information services available to farming households in two selected districts (Tolon and Nanton) in the Northern Region of Ghana. The study also identified the dissemination channels and the barriers faced by farmers in their access and use of climate information services for building climate resilience in Ghanaian farming systems. Multinomial logistic regression analysis was used to evaluate the determinants of farmers’ access to climate information services. Results show that 70% of the surveyed farmers had access to varied forms of climate information services. The most prevalent meteorological variables accessible to them were rainfall, temperature, and windstorms in the form of daily and weekly weather forecasts, with only very limited availability and use of seasonal climate forecasts. Radio, television, and advice from extension agents were reported as the major dissemination channels by study respondents. A majority of the farmers reported lack of communication devices, mistrust in weather and climate forecasts, and lack of visual representations in the forecasts as major barriers to access and use of climate information services. The results highlight the importance of timely and reliable access to climate information services in enhancing farmers’ decision-making capacities and the need for training and recruitment of more extension agents to work with farmers on linking climate information services to targeted actions on crop and land management

Effect of climate variability on yields of selected staple food crops in northern Ghana

Agriculture in Ghana is vulnerable to the adverse effects of climate variability. This poses a challenge to food security across the country. Despite this vulnerability, limited research has been conducted to understand the effect of climate variability on the yields of staple food crops in Ghana. This study assessed the effect of climate variability on the yields of selected staple food crops (millet, sorghum, rice, groundnut and maize). The study used the Mann-Kendall trend test and multiple regression analysis to assess how climate variability (in annual rainfall, onset, cessation, number of dry days and temperature) has affected the yields of selected food crops in five districts in northern Ghana (Bole, Nanton, Tolon, Kassena Nankana East and Wa) over a 21-year period (1995–2016). Results suggested a marginal decrease in annual rainfall (p > 0.05) and a significant increase in temperature (p < 0.05) over the period of study in the districts. Variability in the onset, cessation, length of rainy days and number of dry days was statistically significant from year to year, and also across the districts (p < 0.05). Results indicated substantial variability in the yields of the selected staple food crops. Temperature, number of dry days, onset, annual rainfall and cessation explained about 43%, 32%, 30%, 25% and 14%, respectively of the variations in the yields of groundnut, sorghum, millet, maize and rice. Our results generally suggest that the changing climate substantially affects food production in the study districts, highlighting the need for adaptations including the use of agricultural diversification and the greater use of drought tolerant varieties of these staple crops, as well as the continuing investment in crop breeding programmes to enhance drought tolerance