Heavy marketing of energy-dense nutrient-poor foods around public basic schools in greater Accra region, Ghana

The one- page abstract provided here relates to a study which examined the extent and nature of marketing of foods, alcoholic and non-alcoholic beverages nearby selected schools in Ghana’s most urbanized region, Greater Accra. Policies and actions are needed to protect pupils from marketing practices as found in this study

How healthy are our supermarkets? availability of healthy and unhealthy, ultra-processed foods in supermarkets of selected districts of greater Accra region, Ghana

The conference paper reports on a study that demonstrates extensive availability of unhealthy/ ultra-processed foods in supermarkets found within selected districts. For every healthy food, there were nine unhealthy ones. Towards a healthier supermarket food environment, the Food and Drugs Authority in partnership with other stakeholders needs to institute measures that improve availability of healthy foods within supermarkets

'What the herbal medicine can do for me in a week, the orthodox does in a year': Perceived efficacy of local alternative therapies influences medication adherence in patients with atherosclerotic cardiovascular disease.

BACKGROUND: There is strong evidence that anti-platelet therapy, ACE inhibitors, beta-blockers and statins are cost-effective in reducing subsequent cardiovascular disease (CVD) events in patients with atherosclerotic cardiovascular disease (ACVD). In some settings, only a low proportion of people have access to these medications, and even lower adhere to them. The current study explored and presents data on the causes of poor adherence to orthodox medication and motivations for alternative therapies in patients with established atherosclerotic cardiovascular disease (ACVD). METHODS: The study was conducted among city-dwelling adults with ACVD in Accra - Ghana's capital city. Eighteen interviews were conducted with patients with established ACVD. A follow-up focus group discussion was conducted with some of them. The protocol was approved by two ethics review committees based in Ghana and in the United Kingdom. All participants were interviewed after informed consent. Analysis was done with the Nvivo qualitative data analysis software. RESULTS: We identified motivations for use of alternatives to orthodox therapies. These cover the five dimensions of adherence: social and economic, health-care system, condition-related, therapy-related, and patient-related dimensions. Perceived inability of an orthodox medication to provide immediate benefit is an important motivator for use of alternative forms of medication. CONCLUSIONS: A multiplicity of factors precipitate non-adherence to orthodox therapies. Perceived efficacy and easy access to local alternative therapies such as herbal and faith-based therapies are important motivators

Exploring Barriers to Medication Adherence Using COM-B Model of Behaviour Among Patients with Cardiovascular Diseases in Low- and Middle-Income Countries: A Qualitative Study.

INTRODUCTION: In 2016, cardiovascular diseases (CVDs) led to 17.9 million deaths worldwide, representing 31% of all global deaths. CVDs are the leading cause of mortality worldwide and significant barriers to achieving the sustainable development goals. Modern medicines have been significant in improving health outcomes. However, non-adherence to medication is one of the reasons behind adverse health-related outcomes among patients suffering from atherosclerotic cardiovascular disease in low- and middle-income countries. PATIENTS AND METHODS: This qualitative study was conducted at two tertiary care hospitals in India and Ghana. A total of 35 in-depth interviews were conducted with atherosclerosis cardiovascular disease (ASCVD) patients. The data were analysed thematically using the Capability Opportunity and Motivation (COM-B) framework. FINDINGS: The findings were summarised under three important broad themes of the COM-B framework: capability, opportunity and behaviour. Under capability, comprehension of disease, medication schedule, and unplanned travel affected adherence among patients. Cost of medication, insurance and access were the critical factors under opportunity, which negatively influenced medication adherence. Mood, beliefs about treatment and outcome expectations under motivation led to non-adherence among patients. Apart from these factors, some important health system factors such as health care experience and trust in the facilities and reliance on alternative medication also affected adherence in both countries. CONCLUSION: This study has highlighted that the health system factors have dominantly influenced adherence to medication in India and Ghana. In India, we found participants to be satisfied with their health care provided at the government hospitals. However, limited time for consultation, lack of well-stocked pharmacy and unclear prescription negatively influenced adherence among participants in India and Ghana. The study emphasises that the health system needs to be strengthened, and the patients' belief system needs to be explored to address the issue of medication adherence in LMICs

Perspective: Food environment research priorities for Africa—Lessons from the Africa Food Environment Research Network

Over the last 2 decades, many African countries have undergone dietary and nutrition transitions fuelled by globalization, rapid urbanization, and development. These changes have altered African food environments and, subsequently, dietary behaviors, including food acquisition and consumption. Dietary patterns associated with the nutrition transition have contributed to Africa's complex burden of malnutrition—obesity and other diet-related noncommunicable diseases (DR-NCDs)—along with persistent food insecurity and undernutrition. Available evidence links unhealthy or obesogenic food environments (including those that market and offer energy-dense, nutrient-poor foods and beverages) with suboptimal diets and associated adverse health outcomes. Elsewhere, governments have responded with policies to improve food environments. However, in Africa, the necessary research and policy action have received insufficient attention. Contextual evidence to motivate, enable, and create supportive food environments in Africa for better population health is urgently needed. In November 2020, the Measurement, Evaluation, Accountability, and Leadership Support for Noncommunicable Diseases Prevention Project (MEALS4NCDs) convened the first Africa Food Environment Research Network Meeting (FERN2020). This 3-d virtual meeting brought researchers from around the world to deliberate on future directions and research priorities related to improving food environments and nutrition across the African continent. The stakeholders shared experiences, best practices, challenges, and opportunities for improving the healthfulness of food environments and related policies in low- and middle-income countries. In this article, we summarize the proceedings and research priorities identified in the meeting to advance the food environment research agenda in Africa, and thus contribute to the promotion of healthier food environments to prevent DR-NCDs, and other forms of malnutrition

Nutrition-sensitive education and social protection policies have implications for food-based dietary guidelines for Ghana

Ghana continues to address persistent malnutrition through political action and programme development. Government-led efforts have included the formulation of multi-sectoral policies and programmes to improve the diet and nutritional status of various at-risk population groups. Globally, an important tool for promoting healthy diets are Food-Based Dietary Guidelines (FDBGs). To achieve and sustain the desired goal of promoting healthy eating habits and lifestyles, FBDGs require, among many factors, supportive national policies and programmes. When coherently incorporated in relevant nutrition-related policies and programmes, FBDGs enhance their impact on shaping and sustaining healthier dietary habits. In this context, it is essential to understand the national policy and programme environment and its potential contribution during the formulation of FBDGs. The present review aimed to identify existing nutrition-related education and social protection policies and programmes in Ghana and their relevance to the development and implementation of FBDGs. Previously conducted scoping reviews, gap analyses, and a benchmarking report of Ghana’s public health nutrition policies were used as information sources to identify relevant policies and programmes. Additionally, websites of relevant government ministries, departments and agencies were searched to retrieve applicable policies or actions that were not included in previous reviews. Nutrition-related education policies that were identified primarily support school health services, whereas social protection policies broadly target social assistance, social welfare, social equity and insurance-based policies and programmes. Specific ways these policies and programmes could support the development and implementation of Ghana’s dietary guidelines include embedding FBDGs in the school nutrition curriculum to motivate healthier food choices by schoolchildren and using FBDGs to plan meals provided as part of the country’s school feeding programme. Regarding social protection, existing instruments such as food transfers, social pensions and conditional cash transfers could be aligned with FBDGs to ensure vulnerable households can access foods and follow recommended guidelines. Although some nutrition actions are incorporated in existing policies and programmes, there are opportunities to improve their nutrition sensitivity

Providing Measurement, Evaluation, Accountability, and Leadership Support (MEALS) for Non-communicable Diseases Prevention in Ghana: Project Implementation Protocol

Background: This study describes the rationale, adaptation, and final protocol of a project developed to address the increase in obesity and nutrition-related non-communicable diseases (NR-NCDs) in Ghana. Code-named the Measurement, Evaluation, Accountability, and Leadership Support for NCDs (MEALS4NCDs) project, it aims to measure and support public sector actions that create healthy food marketing, retail, and provisioning environments for Ghanaian children using adapted methods from the International Network for Food and Obesity/NCDs Research Monitoring and Action Support (INFORMAS). Methods: The protocol for this observational study draws substantially from the INFORMAS\u27 Food Promotion and Food Provision Modules. However, to appraise the readiness of local communities to implement interventions with strong potential to improve food environments of Ghanaian children, the MEALS4NCDs protocol has innovatively integrated a local community participatory approach based on the community readiness model (CRM) into the INFORMAS approaches. The setting is Ghana, and the participants include health and nutrition policy-makers, nutrition and food service providers, consumers, school authorities, and pupils of Ghanaian basic schools. Results: The study establishes a standardized approach to providing implementation science evidence for the prevention of non-communicable diseases (NCDs) in Ghana. It demonstrates feasibility and the innovative application of the INFORMAS expanded food promotion and food provision modules, together with the integration of the CRM in a lower-middle income setting. Conclusion: The research will facilitate the understanding of the processes through which the INFORMAS approach is contextualized to a lower-middle income African context. The protocol could be adapted for similar country settings to monitor relevant aspects of food environments of children

How ready are community stakeholders to implement interventions to address the marketing and availability of unhealthy foods and beverages in and around schools in the Greater Accra Region of Ghana? Abstract of the 22nd International Congress of Nutrition, Tokyo (Japan), December 6-11, 2022

22nd International Congress of Nutritio

Availability of healthy and unhealthy foods in modern retail outlets located in selected districts of Greater Accra region, Ghana. Abstract of the 22nd International Congress of Nutrition, Tokyo (Japan), December 6-11, 2022

22nd International Congress of Nutritio

Addressing the marketing and availability of unhealthy food and beverages in and around selected schools in Ghana: a community readiness appraisal

Objective:This study assessed stakeholder readiness to address unhealthy food and beverage marketing and availability in/around Public Basic Schools (for children 4–15 years) in Greater Accra Region, the highly urbanised administrative capital of Ghana.Desing:The community readiness model was used to conduct in-depth mixed methods interviews with stakeholders. Using predefined anchored rating statements, quantitative readiness scores ranging from 1 to 9 were generated. Thematic qualitative analysis was undertaken to understand barriers and facilitators that could influence the implementation of interventions.Setting:Greater Accra Region, GhanaParticipants:18 key informants from various school/education/citizen sectors, which together represented the ‘school community’ of Greater Accra Region.Results:The mean readiness scores indicated that the ‘school community’ was at the ‘preplanning’ stage of readiness (4.44±0.98) to address the marketing and availability of unhealthy food and beverages in and around schools. The mean readiness score for ‘leadership’ was the highest of all dimensions (5.36±1.60), corresponding to the ‘preparation’ stage. The lowest scores were found for ‘community knowledge of efforts’ (3.19±2.45) and ‘resources for efforts’ (3.64±0.87), both of which were at a ‘vague awareness’ stage.Conclusion:The ‘school community’ recognised that the marketing and availability of unhealthy food and beverages was a problem. Additionally, current leadership was actively supportive of continuing/improving efforts that create healthier children’s food environments. However, actions that aim to increase the ‘school community’s’ knowledge of existing interventions and securing resources to sustain those interventions are needed before introducing readiness appropriate strategies