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

Using Quality Improvement Process to Enhance Health Staff Confidence and Competence in Health Information System Tasks in the Ejisu Juaben Municipal Health Directorate, Ghana

Routine Health Information is faced with huge challenges which reduce its decision making and planning yields. The objective of the study was 1) to undertake competency gap analysis of health staff’s performance in routine health information tasks, 2) implement quality improvement process training module, 3) to measure the improvement in the competency level of health staff in performing RHIS tasks after application of Quality Improvement Process principles. A quasi-experimental, uncontrolled before and after study was conducted in 18 health facilities in the Ejisu Juaben Municipal Health Directorate, Ghana. The study involved assessment of competency level and training of 141 staff using Data Quality Improvement Process (DQIP) training module over a twelve-month period. RHIS task competence was measured by a pencil and paper test that measured the ability of respondents to perform calculations, and to interpret and use RHIS results, based on the same indicators as used dimension of confidence level. The study found huge competency gaps among staff amidst high confidence in undertaking RHIS tasks while their performance of these tasks scored objectively, yielded low average scores of improvements in competency gaps; data analysis (-36.9%: +3.6%), data interpretation (-42.2%: +9.8%) and use of data (-44.6%: +2.6%) in the baseline and endline evaluations respectively. The study concludes that Quality Improvement Process (QIP) centred training drives the effectiveness of staff competency in performing RHIS tasks, but not necessarily their confidence level

Mobile phone use among commercial drivers in Ghana: An important threat to road safety

Background: Ghana passed a law in 2012 banning the use of mobile phones while driving. However, data on compliance to the law has been lacking.Objective: To examine factors associated with mobile phone use while driving among Ghanaian commercial drivers.Methods: A survey was conducted among 627 commercial drivers (98.0% response rate). Bivariate and multivariate logistic regressions were performed to determine how a priori covariates influenced commercial drivers’ use of phones while driving. The covariates included driver age, education, driving route distance, driving under the influence (DUI), and knowledge that phone use during driving causes distraction.Results: Respondents were aware of the law (94.7%) but compliance was low (38%). Drivers who did not believe that cell phone use contributed to crash risk were more likely to report distracted driving (AOR 2.02,95%CI 1.05-3.9). Drivers who had completed primary (AOR 4.49,95%CI 1.14-17.78) or at least senior high school (AOR 6.89,95%CI 1.5-31.59) had increased odds of using the phone while driving, compared to those having no formal education. Drivers with 6-10 years (AOR 2.00,95%CI 1.00-3.98) or >10 years driving experience (AOR 2.87,95%CI 1.24-6.62) were more likely to report distracted driving compared to those with ≤5 years’ experience. Drivers who travelled longer distances were more likely to report distracted driving (AOR 2.41,95%CI 1.23-4.71). Those who had never engaged in DUI were less likely to use the phone while driving (AOR 0.06,95%CI 0.01-0.43).Conclusion: Future prevention efforts for distracted driving in Ghana will require targeted distracted driving enforcement and education for commercial drivers and their passengers. Funding: This study was funded, in part, by a grant (D43-TW007267) from the Fogarty International Center, US National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Keywords: Mobile phone, commercial drivers, Ghana, road safety, distracted drivin

Expectations of and Challenges in Marriage among People with Disabilities in the Yendi Municipality of Ghana

The importance of marriage cannot be underestimated as it provides social, economic and emotional benefits to partners. This study was conducted to ascertain the challenges disabled people encounter in their marriage within the Yendi Municipality of Ghana. An exploratory design with qualitative approach was conducted in which 16 participants were selected through snowballing technique. Face-to-face in-depth interview was used to collect the data through audio recordings. Data-led thematic analysis was used to categorize the transcribed data into themes which have been presented as main findings. Their expectations have not been met as they are confronted with several challenges in their marriages from society, economic and domestic fields. People with disabilities within the Yendi Municipality who are married and facing challenges should form self-help groups to manage and deal with their challenges collectively. Keywords: Expectations and challenges in marriage, people with disabilities, Yendi Municipality, Ghan

“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

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

Antibiotics Availability and Usage in Health Facilities: A Case of the Offinso-South Municipality of Ghana

The use of antibiotics has received increased public health attention in recent times because their irrational use could pose a global health problem. Since the introduction of antimicrobial agents, there has been an association between antibiotic use and the development of antimicrobial resistance. The emergence of antibiotic resistance is primarily due to excessive and often unnecessary use of antibiotics in humans. This study therefore sought to assess antibiotics availability and usage in a municipal area of Ghana. The study was retrospective and descriptive in nature. Folders of 300 patients were sampled from a municipal hospital and three health centres. Simple random sampling technique was used in the recruitment of patients’ folders. The study revealed a high antibiotics usage in the municipality. Overall, respiratory tract infections rated the highest so far as conditions for which antibiotics were prescribed were concerned. The penicillins which were the frequently prescribed antibiotics formed 50% of prescriptions for the treatment of gastroenteritis, which was in violation of the existing standard treatment guidelines to be adhered to by prescribers. Regular training and refresher courses could be organized for prescribers towards ensuring the adherence to the existing treatment guidelines. Key words: antibiotics, availability, usage, health facilitie

Prevalence of Hypertension and Obesity among Women in Reproductive Age in the Ashaiman Municipality in the Greater Accra Region of Ghana

Ghana like many other developing countries is faced with a double burden of infectious and chronic non-communicable diseases. It is increasingly being recognised that unhealthy behavioural patterns such as poor dietary habits, physical inactivity, smoking, and excessive alcohol consumption significantly contribute to the development of many chronic non-communicable diseases such as hypertension, obesity, stroke, type II diabetes and cardiovascular diseases. This study sought to determine the prevalence of hypertension and obesity among women in reproductive age (? 20 ? 45); describe the dietary habits of the women; and ascertain how this may contribute to hypertension and obesity among the respondents. A descriptive cross-sectional study using interviewer-administered questionnaires was carried out among 254 women in reproductive age in the Ashiaman municipality. Study participants were selected through systematic sampling. The weight (kg) of the participants was taken using Salter scale and the height was also measured in cm using a stadiometer. Both weight and height measurements were used to calculate participants’ body mass index (BMI) and blood pressure (BP) readings were performed using a sphygmomanometer. The results showed that the prevalence rate of hypertension and obesity among the respondents was 20.1% and 9.8% respectively. The daily dietary choices of respondents revealed that all the respondents (254) consumed carbohydrates/fats & oils  food daily with  less than a third of the respondents (80) including vitamins and mineral rich food which are mainly fruits and vegetables into daily diet. The results also indicated that 20.5% women who consumed carbohydrates, fats & oils daily were hypertensive whereas the rest (79.5%) were normotensive. Effective and targeted health education and behaviour change interventions directed towards this segment of the population should be developed and implemented urgently. Key Words: Hypertension, obesity, prevalence, dietary habi

Experiences of primary caregivers of children with cerebral palsy across the trajectory of diagnoses in Ghana

Background: Cerebral palsy (CP) is a non-progressive disorder of posture or movement caused by a lesion to the developing brain that results in functional limitations. The diagnosis of CP can vary from one child to another, causing family stress because of vague and unknown outcomes of the disorder. Although there are negative attitudes in Ghanaian societies towards primary caregivers and children with disabilities, fewer attempts have been made to understand their experiences. Objectives: The main aim of this study was to explore the experiences of primary caregivers across the trajectory of the diagnosis (before, during and after) of CP in the setting of a tertiary hospital. Method: Using Social Capital Theory as framework, 40 primary caregivers of children with CP, who were receiving treatment at a major referral hospital in Ghana, were interviewed about their experiences before, during and after diagnosis. Results: The results that emerged from the thematic analysis were discussed as follows: experiences before diagnosis, experiences during the diagnosis and experiences after the diagnosis. Particularly, participants discussed their inability to access essential services such as education for their children with CP. Conclusion: In light of systemic challenges faced by participants and their children with CP, the need for health policymakers to prioritise the public education about CP, promoting the well-being of caregivers and other implications of the study have been discussed