Agro-climatic and hydrological characterization of selected watersheds in northern Ghana

United States Agency for International Developmen

Analysis of water quality of selected irrigation water sources in northern Ghana

Small-scale irrigation continues to cushion the food security gap in sub-Saharan Africa. Irrigation is largely governed by water availability, soil type and crop water requirements, among other factors. Thus, a study was conducted to assess the suitability of various water sources for irrigation in northern Ghana. Specifically, the study sought to assess quality of water sources in the Savelugu, Kasena-Nankana East, and Nabdam districts for small-scale irrigation development. The water quality parameters used were: pH, electrical conductivity (ECw), sodium adsorption ratio (SAR), sodium percent (Na%), soluble sodium percentage (SSP), magnesium adsorption ratio (MAR), Kelley's ratio (KR), total hardness (TH), Chloride (Cl), E. coli, and Faecal coliforms. While we found most of the irrigation water sources, including small reservoirs, dams, wells and rivers suitable, few unsuitable irrigation water sources were also identified. Overall, the study found that opportunities for scaling small-scale irrigation exist in all the sites. The knowledge generated from this study will guide irrigation water use, and agricultural policy for sustainable smallholder irrigation development in the region

Predictors of medication nonadherence among hypertensive clients in a Ghanaian population: Application of the hill-bone and perceived barriers to treatment compliance scale

Background and Aim: Nonadherence to antihypertensive medication impairs optimal blood pressure and is influenced by multiple interrelating factors. Knowing the complexity of medication nonadherence and its associated factors is essential for intervention strategies. This study evaluated the predictors of medication nonadherence among hypertensive clients in a Ghanaian population. Methods: This was a hospital-based cross-sectional study conducted at the Hypertensive Clinic of the Kwame Nkrumah University of Science and Technology (KNUST) Hospital, Kumasi, Ghana. A self-designed questionnaire, the Hill-Bone Compliance to High Blood Pressure Therapy and Perceived Barriers to Treatment Compliance Scales, were used for data collection from 246 hypertensives. Data were analyzed using Statistical Package for Social Sciences, version 25. Results: Medication nonadherence was observed among 8.5% of the study participants. In a multivariate regression model perceived noneffectiveness of medication (odds ratio [OR] = 1.76, 95% confidence interval [CI]: 1.34–2.31, p \u3c 0.001) and barriers to alcohol and smoking cessation (OR = 2.83, 95% CI: 1.31–6.13, p = 0.008) were associated increased odds of antihypertensive medication nonadherence. Also, patients who do not know their total prescription (OR = 8.81, 95% CI: 2.28–34.0, p = 0.002) were more likely to be nonadherent to their antihypertensive medications. Moreover, clients who associate signs/symptoms of palpitations (OR = 5.82, 95% CI: 1.31–25.80, p = 0.021), poor sleep (OR = 3.92, 95% CI: 1.09–14.12, p = 0.036) and decreased sexual drive (OR = 4.74, 95% CI: 0.96–23.28, p = 0.055), were more likely to be nonadherent to antihypertensive medication. Conclusion: In conclusion, we observed a lower nonadherence rate among hypertensive clients in a Ghanaian population with correlates being medication-related factors. Most importantly, perceived noneffectiveness of medication, barriers to smoking and alcohol cessation, palpitations, poor sleep, and decreased sexual drive significantly predicted lower adherence and could serve as indicators for high risk of nonadherence to antihypertensive medications

Agro-Climatic and hydrological characterization of selected watersheds of northern Ghana. IWMI Working Paper 173. Colombo, Sri Lanka: IWMI.

This paper provides the climatic and biophysical context of three watersheds in northern Ghana. The objective of the study is to describe the agro-climatic and hydrological features of the watersheds from a landscape perspective. The analyses show that water surplus occurs about 3 months in a year, with only one month providing a significant surplus. Small-scale irrigation is, therefore, carried out in the dry months between November and June. The quality of water used for irrigation from wells, reservoirs and rivers is good for irrigation and domestic purposes. The soil chemical parameters across the study sites show that the soils are suitable for irrigation and crop system intensification, although it requires substantial fertilizer inputs. The paper concludes that there are opportunities from both a soil quality and water availability perspective to enhance sustainable intensification through small- and medium-scale irrigation in the selected watersheds

A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients

Abstract Background Therapeutic communication is essential in the provision of quality healthcare to patients. The purpose of this study was to explore the perceived barriers to effective therapeutic communication among patients and nurses at Komfo Anokye Teaching Hospital,Kumasi. Methods An exploratory study design was employed using a qualitative approach. A purposive sampling technique was used to select 13 nurses and patients who were interviewed using an unstructured interview guide. Interviews were audio-taped, transcribed verbatim and analyzed using thematic content analysis. Results Patient-related characteristics that were identified as barriers to effective therapeutic communication included socio-demographic characteristics, patient-nurse relationship, language, misconception, as well as pain. Nurse-related characteristics such as lack of knowledge, all-knowing attitude, work overload and dissatisfaction were also identified as barriers to effective therapeutic and environmental-related issues such as noisy environment, new to the hospital environment as well as unconducive environment were identified as barriers to effective therapeutic communication among patients and nurses at Komfo Anokye Teaching Hospital,Kumasi. Conclusion Nurse-patient communication is an inseparable part of the patients’ care in every health setting; it is one of the factors that determine the quality of care. Several patient-related characteristics, nurse- related characteristics and environmental-related issues pose as barriers to effective therapeutic communication at Komfo Anokye Teaching Hospital,Kumasi and have ultimately; resulted in reducing effective communication at the wards. Therefore, all the barriers must be eradicated to promote effective therapeutic communication

Early gestational profiling of oxidative stress and angiogenic growth mediators as predictive, preventive and personalised (3P) medical approach to identify suboptimal health pregnant mothers likely to develop preeclampsia

Pregnant women, particularly in developing countries are facing a huge burden of preeclampsia (PE) leading to high morbidity and mortality rates. This is due to delayed diagnosis and unrecognised early targeted preventive measures. Adapting innovative solutions via shifting from delayed to early diagnosis of PE in the context of predictive diagnosis, targeted prevention and personalisation of medical care (PPPM/3 PM) is essential. The subjective assessment of suboptimal health status (SHS) and objective biomarkers of oxidative stress (OS) and angiogenic growth mediators (AGMs) could be used as new PPPM approach for PE; however, these factors have only been studied in isolation with no data on their combine assessment. This study profiled early gestational biomarkers of OS and AGMs as 3 PM approach to identify SHS pregnant mothers likely to develop PE specifically, early-onset PE (EO-PE) and late-onset PE (LO-PE)

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways