Hospital based maternity care in Ghana : findings of a confidential enquiry into maternal deaths

Background: In Ghana, a universal free delivery policy was implemented to improve access to delivery care in health facilities, thereby improving access to skilled attendance and reducing maternal mortality. Objective: A confidential enquiry was conducted to ascertain if changes had occurred in the care provided by reviewing the care given to a sample of maternal deaths before and after introduction of the policy. Method: Twenty women who died as a result of pregnancy-related complications (maternal deaths) in selected hospitals in two regions were assessed by a clinical panel, guided by a maternal death assessment form. Unlike the traditional confidential enquiry process, both adverse and favourable factors were identified. Findings: Clinical care provided before and after the introduction of the fee exemption policy did not change, though women with complications were arriving in hospital earlier after the introduction of the policy. On admission, however, they received very poor care and this, the clinical panel deduced could have resulted in many avoidable deaths; as was the case before the implementation of the policy. Consumables, basic equipment and midwifery staff for providing comprehensive emergency obstetric care were however found to be usually available. Conclusion: Our findings suggest that the already poor delivery care services women received remained unchanged after introduction of the policy.This work was undertaken as part of an international research programme - Immpact (Initiative for Maternal Mortality Programme Assessment). See: http://www.abdn.ac.uk/immpact, funded by the Bill & Melinda Gates Foundation, the Department for International Development (DFID), the European Commission and the Unites States Agency for International Development (USAID)

Waste Dump Closure and Cost Estimates at AngloGold Ashanti Iduapriem

AngloGold Ashanti Iduapriem Mine is a surface gold mine which produces waste rock in its operations. The waste rock forms waste dumps which grow over the years, and will ultimately need to be closed down when they are filled to the maximum capacity. The mine has closure plans for the waste dumps and the closure activity will incur cost. This research was carried out to study the waste dump reclamation and closure plan for the Ajopa waste dump, and estimate the associated cost. The aim of the closure is to establish a permanent stable landscape that is environmentally compatible with surrounding undisturbed land. The waste dump will be closed with a progressive rehabilitation technique. The key activities involved in the reclamation plan, which are earthworks, capping and revegetation were identified and studied into detail. The reclamation plan and cost estimates were prepared on the basis that AngloGold Ashanti Iduapriem Mine would contract with a third-party contractor to fully execute the required closure and reclamation activities. The cost was then estimated using price quotes from vendors or contractors located around the mining area. Results showed that waste dump closure and reclamation programme for Iduapriem Mine are consistent with Ghana Mining and Environmental guidelines. The total closure and reclamation cost was estimated to be US$ 581 488.18. Since any delay in the closure and reclamation could incur additional cost, it was advised that the mine should execute the closure and reclamation plan without delay. Keywords: Waste Dump, Reclamation, Revegetation, Estimate

Revenue Forecasting Using Trend Analysis

Given the inadequacy of the revenue base to cope with the targeted level of economic activities due to the ever-increasing demands of the populace, governments of developing countries (including Ghana) often engage in deficit financing. There is now a consensus among interested parties on the need to address the problem effectively. An appraisal of the budgetary process in Ghana shows that annual expenditure proposals are always anchored on projected revenue, thus the accuracy of revenue projection is a necessary condition for devising an appropriate framework for fiscal deficit management in Ghana. This study, therefore, analyses the revenue collection of the Customs, Excise and Preventive Service (CEPS) for the period 2008-2012 to devise a reasonably accurate projection for the individual tax components. This will assist in the design of an appropriate expenditure profile as a means of averting any future fiscal deficit in the country. The data were sourced from the Research and Monitoring Department of CEPS and was analyzed using time series analysis. Overall, the study reports a satisfactory level of revenue performance of the three tax heads; Import Duty, Import VAT and Petroleum Tax. The study concludes that the current revenue profile of CEPS is sustainable with prospect for significant improvement in subsequent years. The accuracy measures were employed on the various tax inputs and their mean percentage errors, mean absolute deviation and mean squared deviations were compared to decide on which method will be the pest model for revenue projection. As regard to the results obtained the growth curve model will be the preferred method in forecasting revenues in the Customs Excise and Preventive Service in Ghana. Keywords: import duty, import vat, petroleum tax national health insurance levy (NHIL

Learning Management System Adoption in the University: Exploring the Experiences of Canadian and International Students

Using the unified theory of acceptance and use of technology (UTAUT) model, this paper seeks to explore student’s experiences in using Sakai, a learning management system at Brock University. Adopting a mixed methods approach, the study examined the effects of performance expectancy, effort expectancy, social influence and facilitating conditions on user satisfaction. Further inquiries were made on the moderating effects of both gender and the technology experiences of students and how these variables impacted their experiences. The results indicate that although students perceive Sakai as a useful learning tool, they were concerned about the platform’s ease of use. Aside from technology experience the results showed that gender and the cultural background of students did not determine the extent to which a student would achieve satisfaction using Sakai

Statistical Exploration of Academic Performance of Students in some Selected Programmes of the University of Cape Coast

Education is a basic human right to which every individual should have access to. Every country designs education that will be suitable for it citizens so as to achieve as a whole the country’s educational aims and objectives. Academic performance is a subject of great concern in Ghanaian education and is the main criterion that is used to admit students into both Senior High and University education. The main objective of the study  was to investigate whether there exit exist a relationship between academic performance at the Senior High School (SHS) and that of university. The study answered the following research questions:   Which variables significantly contribute to academic performance of the students at University level? ; Are the variables stated reliable to predict the results of students in future? The data for the study were secondary data obtained from the Data Processing Unit, University of Cape Coast. In all, result of thousand one hundred and fifty three (1153) students were collected. Convenience sampling was used for data collection. Statistical analyses were done using Minitab. Regression analysis was  the main statistical tool for this study. The study revealed that students’ Grade Point Average (GPA) at the university  has little to do with their previous academic performance at the Senior High School. Programme offered  contributes significantly  to academic performance at the University. Although, there was a weak relationship between the explanatory variables, there were some variables that contributes or determines students’ academic performance. The study recommends that students performance at the University should not solely based on entry aggregate. Other factors can also be considered such as programme, academic environment, the availability of academic resources, teaching empowerment, student attitude, and finance. Key Words: Grade Point Average, Entry Aggregate, Programme, Performance, Senior High Schoo

A Statistical Analysis of Vehicle Accident Cases in the Western Region, Ghana

Motor-vehicle accident is an unexpected event which produces unintended injury, death or property damage involving one or more vehicles on the road. The focus of this study was to examine the rate of reported Motor- Vehicle  accidents in the Western Region of Ghana and also to determine the type of vehicles that are involved in such accidents as well as the periods in which these accidents occur. The analysis of data was carried out by the use of percentages, chi-square and analysis of variance. The data is a monthly returns submitted by the Western Region Branch of Driver and Vehicle Licensing Department (DVLA) in collaboration with National Road Safety Commission (NRSC) and the Motor Traffic and Transport Unit (MTTU).On the question of serious and fatal accidents, fatal accidents increased over the period of study whiles that of serious accidents decreased. It was also observed that private vehicles contributed to most of the accidents followed by commercial vehicles whiles tractor and earth moving machines, bicycles and carts contributed less to the number of recorded accidents.However the period of occurrence of accidents over the years was mostly recorded in the first and fourth quarters, which falls within the festive seasons in Ghana i.e. Easter and Christmas seasons. Further analysis also revealed that the type of vehicles involved in accidents and the year of occurrences are not dependent. Finally though the accident rate was decreasing over the period of study the mean accident rate over the years under study are not different. Key words: Motor Traffic and Transport Unit, National Road Safety Commission, Vehicle Licensing Departmen

The Lorenz system: A route from stability to chaos

The theory of deterministic chaos has generated a lot of interest and continues to be one of the much-focused research areas in the field of dynamics today. This is due to its prevalence in essential parts of human lives such as electrical circuits, chemical reactions, the flow of blood through the human system, the weather, etc. This thesis presents a study of the Lorenz equations, a famous example of chaotic systems. In particular, it presents the analysis of the Lorenz equations from stability to chaos and various bifurcation scenarios with numerical and graphical interpretations. It studies concepts of non-linear dynamical systems such as equilibrium points, stability, linearization, bifurcation, Lyapunov function, etc. Finally, it discusses how the Lorenz equations serve as a model for the waterwheel (in detail), and the convection roll for fluid.The theory of deterministic chaos has generated a lot of interest and continues to be one of the much-focused research areas in the field of dynamics today. This is due to its prevalence in essential parts of human lives such as electrical circuits, chemical reactions, the flow of blood through the human system, the weather, etc. This thesis presents a study of the Lorenz equations, a famous example of chaotic systems. In particular, it presents the analysis of the Lorenz equations from stability to chaos and various bifurcation scenarios with numerical and graphical interpretations. It studies concepts of non-linear dynamical systems such as equilibrium points, stability, linearization, bifurcation, Lyapunov function, etc. Finally, it discusses how the Lorenz equations serve as a model for the waterwheel (in detail), and the convection roll for fluid.

Design and implementation of community engagement interventions towards healthcare quality improvement in Ghana:a methodological approach

BackgroundNearly four decades after the Alma-Ata declaration of 1978 on the need for active client/community participation in healthcare, not much has been achieved in this regard particularly in resource constrained countries like Ghana, where over 70 % of communities in rural areas access basic healthcare from primary health facilities. Systematic Community Engagement (SCE) in healthcare quality assessment remains a grey area in many health systems in Africa, albeit the increasing importance in promoting universal access to quality basic healthcare services.Purpose/objectiveDesign and implement SCE interventions that involve existing community groups engaged in healthcare quality assessment in 32 intervention primary health facilities.MethodsThe SCE interventions form part of a four year randomized controlled trial (RCT) in the Greater Accra and Western regions of Ghana. Community groups (n = 52) were purposively recruited and engaged to assess non-technical components of healthcare quality, recommend quality improvement plans and reward best performing facilities. The interventions comprised of five cyclical implementation steps executed for nearly a year. Wilcoxon sign rank test was used to ascertain differences in group perceptions of service quality during the first and second assessments, and ordered logistic regression analysis performed to determine factors associated with groups’ perception of healthcare quality.ResultsHealthcare quality was perceived to be lowest in non-technical areas such as: information provision to clients, directional signs in clinics, drug availability, fairness in queuing, waiting times, and information provision on use of suggestion boxes and feedback on clients’ complaints. Overall, services in private health facilities were perceived to be better than public facilities (p < 0.05). Community groups dominated by artisans and elderly members (60+ years) had better perspectives on healthcare quality than youthful groups (Coef. =1.78; 95 % CI = [−0.16 3.72]) and other categories of community groups (Coef. = 0.98; 95 % CI = [−0.10 2.06]).ConclusionsNon-technical components of healthcare quality remain critical to clients and communities served by primary healthcare providers. The SCE concept is a potential innovative and complementary quality improvement strategy that could help enhance client experiences, trust and confidence in healthcare providers. SCE interventions are more cost effective, community-focused and could easily be scaled-up and sustained by local health authorities

Determinants of enrollment in the NHIS for women in Ghana

Background The National Health Insurance Scheme (NHIS) was introduced in 2005 to provide equitable access to healthcare. Furthermore, concessions were made for pregnant women, yet inequities in access continue to exist. This study explores whether dimensions of social exclusion explain why some groups of women are not benefitting from the scheme. Methods Data was collected from 4050 representative households in five districts. Logistic regression is used to examine the factors that determine enrolment of women under the NHIS. Results The study sample consists of a sub-sample of 3,173 women out of whom 58% were insured. The majority (64.9%) of the women were in the reproductive age (15-45 years). The results show that wealth status, age, health status, locality, perception about the quality of care at health facilities and perception of the NHIS, are the key factors that determine enrolment into the scheme. Conclusion With women dominating the informal sector of Ghana’s economy which is often characterised by relatively low incomes, these inequities in access need to be addressed