Role-players in abortion decision-making in the Accra Metropolis, Ghana

BACKGROUND: Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana. METHODS: A retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data. RESULTS: The findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and “Others” (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations. CONCLUSION: A number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision

Trends in Health Insurance Subscription at Cape Coast, Ghana: A Retrospective Study from 2005 – 2014

Even though a major objective of the Ghana National Health Insurance Scheme at its promulgation in 2003 was a universal subscription by 2008, the scheme covered 38.3 per cent of the Ghanaian population by 2014. We examined trends in health insurance subscription at Cape Coast from 2005 to 2014. The study was conducted with data from the National Health Insurance Scheme from 2005 to 2014. A record review approach was adopted in extracting records of insurance subscription within the period under review. Data collected were presented using percentages and chi-square statistics. Subscription to the scheme declined from 43.9 per cent in 2005 to 40.6 per cent in 2014. There were more female than male subscribers in all the years under review. Subscription increased for persons under 18 years and those in the informal sector over the ten-year period, but declined for Social Security and National Insurance Trust contributors and pensioners, the aged, indigents, and pregnant women. The study underscores the need for the National Health Insurance Authority to increase subscription to the scheme through innovative ways such as sharing the scheme’s achievements through improved advertisement and contracting private entities through public-private partnerships to augment its efforts at recruiting more subscribers.

Examining internal audit process of selected local governments in the central region of Ghana

Purpose: Globally and historically, internal auditing has been used to enhance the efficiency and effectiveness of organisations. The internal audit process helps to achieve the desired objectives of organisations including local governments by preventing irregularities in operations. Guided by institutional theory and based on primary data as well as employing the interpretive research philosophy, the paper examined the internal audit process of selected local government institutions in the Central Region of Ghana.Methodology: Purposive sampling technique was used to select seven key informants for interview by the use of interview guide. The data were analysed using pattern matching and content analysis based on themes.Findings: The main finding was that the internal auditors hardly performed all tasks involved in the internal audit process due to irregularities in operations. This constrained the achievement of assignment objectives. The recommendation was that the Head of Local Government Service should sanction auditors who flout the process.Originality/Value: This study is meant to raise awareness of stakeholders of local governments on the need to improve internal audit practices for effective and efficient resource utilisation to enhance service delivery to the citizens.peer-reviewe

Socio-demographic trends in overweight and obesity among parous and nulliparous women in Ghana

Background Overweight and obesity are among the leading threats to global health because of their association with increased risk of morbidity and mortality. Much of the research on overweight and obesity among women largely generalize without due cognisance to differences in their reproductive history. This study explored differences in trends in overweight/obesity, and associated factors between parous and nulliparous women in Ghana. Methods Anthropometric measurements from three nationally representative Ghana Demographic and Health Surveys (2003, 2008 and 2014) were analysed using descriptive statistics and multivariate binary logistic regression. Results Over all, overweight/obesity increased between 2003 and 2014, with disproportionately higher rates among parous women (from about 30 % in 2003 to about 48 % in 2014) than nulliparous women (from about 15 % in 2003 to about 24 % in 2014). Age, wealth quintile and marital status were associated with overweight/obesity similarly in both women groups. However, there were variations in the association between parous and nulliparious women by educational level, type of locality, occupation and ethnicity. Conclusion The trend of overweight/obesity in Ghana warrants urgent national level public health attention to help curb the situation. Such interventions should be tailored bearing in mind the peculiar differences in associated factors between parous and nulliparous women.BioMed Central open acces

Improving access to health care facilities through decentralisation in Ghana : Improving access to health care facilities through decentralisation in Ghana

The study assessed the impact of decentralization on physical accessibility to healthcare facilities in ghana. It was conducted in the Asante Akim North Municapility,New Juaben Municipality and Twifu-Heman-Lower Denkyira district. The study was conceptualised within the geographical accessibility framework and the Geographic Information Systems (GIS) technique was used to create health buffers. It was found that health care facilities were expanded and physical accessibility improved, partly as a result of the implementation of the decentralisation programme. However, the study showed that the inequalities between and within Municipalities and Districts were not addressed. A meaningful intervention by the Municipal/District Assemblies (MDAs) and the Ghana Health Service • (GHS) on inequalities requires mapping of existing health facilities. Application ofcoverage models using GIS is therefore recommended to the MDAs in collaboration with the GHS in order to reduce inequalities in physical accessibility to health care facilities

Adolescent Sexual and Reproductive Health in Ghana: A Synthesis of Research Evidence

Draws upon quantitative and qualitative social science research to provide an overview of current knowledge on adolescent sexual and reproductive health issues in Ghana, with a focus on HIV prevention

Household wealth, residential status and the incidence of diarrhoea among children under-five years in Ghana

This study examines the impact that the joint effect of household wealth quintile and urban–rural residence has on the incidence of diarrhoea among Ghanaian children. Data for this paper were drawn from the Ghana Multiple Indicator Cluster Survey (MICS) of 2006. Descriptive and logistic regression was applied to analyse data on 3466 children. Rural residents are less likely, albeit insignificant, to report diarrhoea compared with those in urban areas. Significant wealth gradients are manifested in childhood experiences of diarrhoea. However, an interaction of wealth with residence does not show significant disparities. Controlling for other important covariates of childhood, the odds of diarrhoea incidence were significantly higher among: the rural poorer (OR = 4.869; 95% CI = 0.792, 29.94), the rural middle (OR = 7.477; 95% CI = 1.300, 42.99), the rural richer (OR = 6.162; 95% CI = 0.932, 40.74) and the rural richest (OR = 6.152; 95% CI = 0.458, 82.54). Apart from residential status and wealth quintile, female children (OR = 0.441; 95% CI = 0.304, 0.640), older children (OR = 0.968; 95% CI = 0.943, 0.993), having a mother with secondary and higher education (OR = 0.313; 95% CI) had lesser odds of experiencing diarrhoea. The findings show that there is a need to apportion interventions intended to improve child health outcomes even beyond residential status and household wealth position

Geospatial analysis of childhood morbidity in Ghana.

IntroductionChildhood morbidities are common in Ghana. The present study sought to geospatially analyze morbidities among children (0-23 months of age) using five different survey datasets (1993-2014) from the Ghana Demographic and Health Survey.MethodsLogistic regression was used to examine childhood morbidity within a place of residence. Then three spatial statistical tools were applied to analyze morbidities among children (0-23 months of age). These tools were: spatial autocorrelation (Global Moran's I)-used to examine clustering or dispersion patterns; cluster and outlier analysis (Anselin's local Moran's I)-to ascertain geographic composition of childhood morbidity clusters and outliers; and hot spot analysis (Getis-Ord G)-to identify clusters of high values (hot spots) and low values (cold spots).ResultsChildren in rural areas were much burdened with the occurrence of childhood morbidity. The study revealed positive spatial autocorrelation for childhood morbidity in Ghana. Childhood morbidity (diarrhoea, ARI, anaemia, and fever) clusters were identified within districts in the country. Children in rural areas were more likely to be morbid with diarrhoea, anaemia, and fever compared to those in urban areas. Hot spot districts for diarrhoea, anaemia and fever were mainly situated in semi-arid areas and those with ARI were located both at the semi-arid areas and coastal portions of Ghana.ConclusionRural children are much exposed to have higher burden of a childhood morbidity compared to their urban counterparts. Most semi-arid districts in Ghana are burdened with diarrhoea, ARI, anaemia, and fever. To minimize the occurrence of childhood morbidity in Ghana, designing of more context-based interventions to target hot spots districts of these morbidities are required in order to use scarce resources judiciously

Barriers and motivations for health insurance subscription in Cape Coast, Ghana: a qualitative study

Abstract Background One of the main objectives of the Ghana National Health Insurance Scheme, at its establishment in 2003, was to ease financial burden of the full cost recovery policy, particularly on the poor. However, currently, majority of the scheme’s subscribers are individuals in the upper wealth quintile, as the poor in society rather have not subscribed. We explored the motivational factors as well as the barriers to health insurance subscription in the Cape Coast Metropolis of Ghana. Methods This study collected qualitative data from 30 purposively selected subscribers and non-subscribers to the National Health Insurance Scheme using an in-depth interview guide. Results Major motivational factors identified were; affordable health insurance premium, access to free drugs, and social security against unforeseen health challenges. Encouragement by friends, family members, and colleagues, was also found to motivate subscription to the health insurance. The major barriers to health insurance subscription included; long queues and waiting time, perceived poor quality of drugs, and negative attitude of service providers both at the healthcare facilities and the health insurance office. The study underscores the need for the National Health Insurance Authority to conduct intensive education to change the negative perception people have regarding the quality of health insurance drugs. Efforts should also be made to reduce the waiting time in accessing healthcare with the National Health Insurance Scheme card. This would motivate more people to subscribe or renew their membership. Conclusions The implication of barriers found is that people may not subscribe to the scheme in subsequent years. This would, therefore, consequently defeat the objective of achieving universal healthcare coverage with the scheme