EXPOSURE TO MALARIA PREVENTION MESSAGES AND INSECTICIDE TREATED BEDNET USAGE AMONG CHILDREN UNDER FIVE YEARS IN GHANA

This paper assesses exposure to messages on malaria prevention among household heads with children 0-4 years in Ghana, and examines whether exposure influences use of ITNs among these children in their households and if certain types of exposure (television, radio, health worker) are associated with ITN usage. We used data collected in the 2008 Ghana Demographic and Health Survey for which over 12,000 households were selected for interview. We used a final sample of 1770 households in our analyses. Bivariate and multivariate techniques were employed to examine the relationship between household head's level of exposure to malaria prevention messages and use of ITNs among children under five. Children under five years whose household heads had exposure to malaria prevention messages had over twice the odds of using ITNs as those whose household heads had no exposure. Household heads who were exposed through health workers and the radio had about 40 percent higher odds of using ITNs for their children under five years compared to those who did not have exposure through these channels while controlling for other channels. Campaigns must go beyond the production of messages regarding the hanging of bednets to include information on behaviour of mosquitoes to improve use of ITNs. Community-based educational campaigns involving health workers are recommended to target universal use of ITNs among under-five children in Ghana. There is also the need to improve literacy in order for other channels of information such as newspapers and posters to achieve similar results

A Competing Risk Analysis of Women Dying of Maternal, Infectious, or Non-Communicable Causes in the Kintampo Area of Ghana

Background: Maternal, infectious, and non-communicable causes of death combinedly are a major health problem for women of reproductive age (WRA) in sub-Saharan Africa (SSA). Little is known about the relative risks of each of these causes of death in their combined form and their demographic impacts. The focus of studies on WRA has been on maternal health. The evolving demographic and health transitions in low- and middle-income countries (LMICs) suggest a need for a comprehensive approach to resolve health challenges of women beyond maternal causes.Methods: Deaths and person-years of exposure (PYE) were calculated by age for WRA within 15–49 years of age in the Kintampo Health and Demographic Surveillance System (KHDSS) area from January 2005 to December 2014. Causes of death were diagnosed using a standard verbal autopsy questionnaire and the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Identified causes of death were categorized into three broad areas, namely, maternal, infectious, and non-communicable diseases. Multiple decrements and associated single decrement life table methods were used.Results: Averting any of the causes of death was seen to lead to improved life expectancy, but eliminating infectious causes of death leads to the highest number of years gained. Infectious causes of death affected all ages and the gains in life expectancy, assuming that these causes were eliminated, diminished with increasing age. The oldest age group, 45–49, had the greatest gain in reproductive-aged life expectancy (RALE) if maternal mortality was eliminated.Discussion: This study demonstrated the existence of a triple burden. Infectious causes of death are persistently high while deaths from non-communicable causes are rising and the level of maternal mortality is still unacceptably high. It recommends that attention should be given to all the causes of death among WRA

Potential gains in reproductive-aged life expectancy if maternal mortality were eradicated from the Kintampo districts of Central Ghana.

BACKGROUND: Almost 99% of pregnancy or childbirth-related complications globally is estimated to occur in developing regions. Yet, little is known about the demographic impact of maternal causes of death (COD) in low-and middle-income countries. Assuming that critical interventions were implemented such that maternal mortality is eradicated as a major cause of death, how would it translate to improved longevity for reproductive-aged women in the Kintampo districts of Ghana? METHODS: The study used longitudinal health and demographic surveillance data from the Kintampo districts to assess the effect of hypothetically eradicating maternal COD on reproductive-aged life expectancy by applying multiple decrement and associated single decrement life table techniques. RESULTS: According to the results, on the average, women would have lived an additional 4.4 years in their reproductive age if maternal mortality were eradicated as a cause of death, rising from an average of 28.7 years lived during the 2005-2014 period to 33.1 years assuming that maternal mortality was eradicated. The age patterns of maternal-related mortality and all-cause mortality depict that the maternal-related mortality is different from the all-cause mortality for women of reproductive age. CONCLUSION: This observation suggests that other COD are competing with maternal mortality among the WRA in the study area and during the study period

Implementation of Ghana’s Health User Fee Policy and the Exemption of the Poor: Problems and Prospects

Like many other African countries, Ghana has been implementing a cost-sharing policy in its health sector since the 1990s. The adoption of this policy and the consequent charging of user fees for health services was due to stagnating economies and associated budgetary constraints and increasing gaps between supply and demand for basic social services that have been characteristic of African countries since the 1970s. The main objectives for the adoption of cost-sharing policies have been to improve both quality and access to health services. Studies focusing on the experience of African countries with the implementation of user fees indicate varying findings on the impact of user fees on their health delivery systems. The access of the poor, in particular, has been adversely affected, according to the findings of a number of studies. Policies, such as targeting the poor, have not been effectively implemented to mitigate the impacts of the user fee policy on their access. This paper examines the problems associated with granting exemption to the poor in Ghana. It also discusses the prospects of considering the poor in alternative policies that may be adopted in future. Its main findings indicate that a number of shortcomings of policy adoption, particularly the lack of specification of criteria by which the poor can be identified, make it difficult for health workers to grant exemptions. Further findings show that declining government budget allocations and supplies might have made it imperative for the facility manager to be more concerned about collecting revenue than attending to financial access of the poor. The study, however, suggests that despite the shortcomings of the targeting policy and its implementation, it should continue to be an important component of health policy, considering the vast inequalities in income in the population

Food beliefs and practices in urban poor communities in Accra: implications for health interventions

Abstract Background Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Methods Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Results Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. Conclusions The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed

Additional file 2: of Food beliefs and practices in urban poor communities in Accra: implications for health interventions

Description of food items. Description of data: this file provides description of the food items listed in the study. (DOCX 11 kb

Additional file 1: of Food beliefs and practices in urban poor communities in Accra: implications for health interventions

Detailed background characteristics of study respondents. Description of data: this file provides detail information about the socio-demographic charcteristics of the study participants (DOCX 17 kb

Investigation on children with acute non-communicable diseases and their caregivers in developing countries

Objective: To investigate children with acute non-communicable diseases (NCDs) and their caregivers in developing countries. Methods: A cross-sectional survey was conducted in three out of the ten regions of Ghana. A total of 1540 caregivers/parents of children with NCDs were interviewed. Data was analysed with the aid of IBM SPSS version 20. Statistical techniques used in the analysis included frequencies, means, SD and factor analysis. Findings were analysed according to the major themes of the study. Results: Caregivers indicated that the incidence of NCDs among children is on the increase. They also believed that enemies can cause diseases in children. Caregivers tend to seek treatment in hospitals/clinics rather than from traditional or herbal medicine. However, they complement biomedical treatment with prayers for healing/deliverance. It was also found that NCDs have a negative effect on the physical and mental development of children as well as their school performance; and caring for children with NCDs also poses material, emotional and financial burden to caregivers. Conclusions: Serious attention needs to be given to the development and implementation of policies to better the lot of children with NCDs. Conscious efforts need to be made to encourage and assist the caregivers with necessary resources to cater for their children's educational and health needs in particular