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

The Effects of Organizational Culture and Commitment on Job Satisfaction: Cross-Sectorial Comparison of Legal Services Sector in Ghana

Organizational culture and commitment has been deliberated as a key factor in ensuring job satisfaction. The study was undertaken to determine the impact of organisational culture on employees’ organisational commitment in ensuring job satisfaction among some staff in the Legal Services sector in Ghana. A quantitative philosophy, utilizing self-controlled reviews in questionnaire was used to collect data from 48 respondents. The data were analysed using SPSS version 21 software. Linear regression analysis was used to test for the impact of the independent variable (organisational culture) and the dependant variable (organizational commitment). The findings of the study revealed that organisational culture has an impact on commitment. The study recommends that the legal services sector of Ghana should take pragmatic steps in creating opportunities for employee development and improvement in the1 human 1resource1 policies. They should ensure effective organisational communication and good leadership practices to attain the ultimate goal of job satisfaction. Keywords: Organisational Culture, Organisational Commitment, Job Satisfaction, Legal Service

Prevalence of attention-deficit/hyperactivity disorder among primary school children in Oforikrom, Ghana based on the disruptive behavior disorders rating scale

OBJECTIVE: To determine the prevalence of attention-deficit/hyperactivity disorder (ADHD) among primary school children in Oforikrom, Kumasi, Ghana. METHODS: 10 of 35 primary schools in Oforikrom were readily available. Of 2000 children aged 5 to 13 years selected, 1540 (77%) of their parents/guardians consented to participate. Their parents/guardians and six teachers from each school were asked to complete the Disruptive Behavior Disorders Rating Scale to screen children for the presence of ADHD, oppositional defiant disorder, or conduct disorder. Children who displayed symptoms (pretty much or very much) in most related items as determined by parents and/or teachers were considered positive cases. RESULTS: The mean age of 1540 pupils was 9 ± 2.16 years. Most (31%) were primary 4 pupils. 5% of pupils displayed ADHD symptoms (attention deficit disorder subtype in 36%, hyperactivity disorder subtype in 27%, and combined subtype in 37%). Of them, 51% were male. Most (19%) of those who displayed the symptoms were in primary 5. CONCLUSION: The prevalence of ADHD among primary school children in Oforikrom was 5%. 51% of those with ADHD symptoms were male. Most (19%) of those with ADHD symptoms were in primary 5

Feasibility of abstinence as a preventive strategy for HIV/AIDS control in the University student community in Kumasi, Ghana.

HIV is spreading and the youth bear the brunt of its onslaught. Though abstinence until marriage is thought to be the most effective method of HIV prevention for the youth, others think it is ineffective. This study assessed the feasibility of abstinence in preventing HIV/AIDS spread among tertiary students of the KNUST. Study type was non- interventional, descriptive and design current cross- sectional. Study participants were selected by stratified sampling, followed by systematic sampling. A total of 300 participants were sampled. Seventy nine (79%) (95% CI, 73.9-83.8) said STIs could be avoided by abstaining from sex. Ninety six (96%) (95% CI, 93.5-98.3%) said HIV could be acquired via sex. Ninety six (96%) (95% CI, 93.8- 98.5%) of those who said HIV could be avoided said it could be done by abstaining from sex. Seventy two (72%) were of the view that sex should start only after marriage. Sixty nine 69% (95% CI, 63.3-74.4%) said they would wait till after marriage to involve in sex. Sixty seven (67%) (95% CI, 60.7- 72.1%) were encouraged by peers to abstain from sex, Seventy four (74%) (95% CI, 68.5- 79.1%) thought colleagues their age had premarital sex and 28% (95% CI, 22.5- 33.4%) said they were pressured to have sex. Thirty one (31%) (95% CI, 25.6- 36.7%) of respondents were sexually experienced. There is the general view that HIV/AIDS spread among the youth can be reduced by abstaining from sex until marriage and that abstinence could and should be encouraged as a preventive strategy for HIV/AIDS.Journal of Science and Technology (Ghana) Vol. 27 (2) 2007: pp. 1-

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

Stroke in Ashanti region of Ghana

Objective: To determine the morbidity and mortality in adult in-patients with stroke admitted to the KomfoAnokye Teaching Hospital (KATH).Methods: A retrospective study of in-patients with stroke admitted to the KATH, from January 2006 todecember 2007 was undertaken. Data from admission and discharge registers were analysed to determinestroke morbidity and mortality.Results: Stroke constituted 9.1% of total medical adult admissions and 13.2% of all medical adult deathswithin the period under review. The mean age of stroke patients was 63.7 (95% ci=62.8, 64.57) years. Males were younger than females. The overall male to female ratio was 1:0.96, and the age-adjusted risk of death from stroke was slightly lower for females than males (relative risk= 0.88; 95% ci=0.79, 1.02, p=0.08). The stroke case fatality rate was 5.7% at 24 hours, 32.7% at 7 days, and 43.2% at 28 days.Conclusion: Stroke constitutes a significant cause of morbidity and mortality in Ghana. Major efforts are needed in the prevention and treatment of stroke. Population-based health education programs and appropriate public health policy need to be developed. This will require a multidisciplinary approach of key players with a strong political commitment. There is also a clear need for further studies on this topic including, for example, an assessment of care and quality of life after discharge from hospital. The outcomes of these studies will provide important information for the prevention efforts.Keywords: Stroke, Cerebrovascular disease, CVD, Komfo Anokye Teaching Hospital, Ghan

Cost-effectiveness analysis of point-of-care rapid testing versus laboratory-based testing for antenatal screening of syphilis in Brazil

Objectives Severe consequences of mother-to-child transmission of syphilis and high increasing incidence of congenital syphilis remains an important public health problem in Brazil. Our objective was to assess the cost-effectiveness of a rapid point-of-care test (RT) and treatment of positive mothers immediately compared with a laboratory-based standard test (ST) with treatment at next follow-up visit. Methods A decision analytic model was developed to estimate the incremental cost-effectiveness ratio (ICER) between antenatal syphilis screening strategies. The model was built with lifetime horizon from Brazilian health system perspective using 3% and 5% discount rates. A hypothetical cohort of pregnant women at reproductive age were used in the model. Health outcomes: low birth weight, stillbirths, neonatal deaths and congenital syphilis were estimated in disability-adjusted life-years (DALYs) lost. Microcosting study and secondary data provided parameters of direct medical costs. Probabilistic sensitivity analysis was undertaken. Results For base case, the mean cost per pregnant woman screened was $2.63 (RT) and$2.48 (ST), respectively. Maternal syphilis was associated with a loss of 0.0043 DALYs (RT) and 0.0048 DALYs (ST) per mother screened. Expected value of incremental cost per DALY averted was $298.08. After 10 000 probabilistic sensitivity analysis model runs, incremental cost and health benefits were$0.15 (95% credible interval –1.56 to 1.92) and 0.00042 DALYs (95% credible interval –0.0036 to 0.0044), respectively, with a mean ICER of $357.44 per DALY. Screening with RT has a 58$3,200 per DALY. Conclusions In Brazil, antenatal screening with syphilis RT and immediate treatment is likely to be cost-effective compared with standard screening and must be prioritized in local settings