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

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

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

A systematic review of academic performance of Children with Disabilities (CWDs) in inclusive education schools in Low and Middle-Income Countries (LMICs)

Globally it is estimated that about 150 million children are living with disabilities. Inclusive education inspires the participation of all students in the learning process in the same classroom. However, it is really difficult to find thorough, credible accounts of disabled children's access to education, enrolment, attendance, and results. This review evaluated academic performance, including access to school, enrolment, attendance, and results of Children with disabilities (CWD) in LMICs. In reporting this systematic review, the researchers followed the recommended Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting standards. The authors conducted searches using Science Direct, PubMed, Scopus, and Google Scholar electronic databases. The study's major findings indicate that CWDs in inclusive schools perform poorly academically compared to their non-disabled peers. Consequently, the researchers recommend more primary research to evaluate the academic performance of CWDs and the progress of inclusive education in LMICs

Perspectives in musculoskeletal injury management by traditional bone setters in Ashanti, Ghana

Background: The popularity of the services of traditional bone setters (TBS) in Ghana as an alternative health care requires exploration and documentation of the perspectives of providers and users.  Objective: To explore and document the perspectives of providers and users of the services of TBS in the management of musculoskeletal injuries in the Ashanti region, Ghana. Methods: From the social constructivist and qualitative approach, in-depth interviews were used to explore the perspectives of eight TBS and 16 users of their services, selected purposively through snowballing. Thematic content analysis (TCA) was employed. Results: High recovery rate, warm reception, prompt attention, and the relatively lower charges, are reported to motivate the patronage of the services of TBS for the management of fractures in the legs, arms, ribs, joint bones dislocations, waist and spinal cord problems. The TBS combined traditional and orthodox procedures, using plant and animal-based materials, beliefs, spirituality (God-given) and physical therapy in the management of musculoskeletal injuries. No adverse experience was reported by either the providers or users of the traditional management methods. Conclusion: With plant and animal-based materials, TBS are observed to combine traditional and orthodox procedures to confidently manage musculoskeletal injuries to the satisfaction of their highly motivated patrons. Although over 60% of the TBS attribute the healing power behind their practice to God, the rest do not discount the role of spiritual therapy. Further studies expanded to include the perspectives of non-users of the services of the TBS will authenticate the findings of this study

Pregnant women and alcohol use in the Bosomtwe district of the Ashanti region-Ghana.

Drinking alcohol in pregnancy is a serious public health concern worldwide. This study sought to determine the magnitude and socio-demograhic characteristics of pregnant women attending Antenatal clinic in the Bosomtwe district, Ghana who drank alcohol and to assess their general knowledge about the effects of alcohol in pregnancy. The study, a descriptive cross-sectional, was conducted in all the ten health facilities providing reproductive health care with a sample size of 397 pregnant women using structured questionnaires. The findings of the study were that 20.4% of pregnant women drank alcohol. The 25-29 year group 26 (34.0%), married 50 (61.7%) and Junior High School Educated 37 (45.7%) as well as Christians 69 (85.0%) and traders 28 (34.6%) drank most. Majority 77 (33.5%) heard about the detrimental effects of alcohol at Antenatal Clinics (ANC). The District Health Management Team (DHMT) should strengthen health education on alcohol at ANC and through the radio as well as the DHMT collaborating with the Ghana Education Service to embark on education of school pupils and students on the harmful effects of alcohol in pregnancy

Living with HIV in Ghana : disclosure of status and experiences of persons receiving antiretroviral therapy

Barriers to treatment faced by people living with HIV (PLWH) have been well explored in the literature. Despite the importance of antiretroviral therapy (ART) in the treatment of HIV and prevention of AIDS, in the Ghanaian context only about 32% of infected persons have access to treatment. This underscores a need to understand the experiences of PLWH receiving ART to provide baseline information for policymakers’ efforts to increase access to treatment. This study captures the voices of PLWH who were receiving ART in Ghana. A total of 35 participants receiving treatment in a hospital setting (11 males, 24 females; mean age 38 years, age range 21–60 years) took part in semi-structured face-to-face interviews to discuss their opinions about the cause of their HIV infection and its impact on their lives. The study found that the participants were susceptible to discrimination in their communities and at health care facilities. Some participants experienced marriage breakdowns, unemployment, social isolation, and were unable to perform everyday chores and responsibilities. Concerted efforts to address the barriers to treatment faced by PLWH are needed

[In Press] Inclusivity in neo-liberal policy environment : preparedness of mass media to support disability awareness campaigns in Ghana

Purpose: The mass media have been described as an important institution in educating society about persons with disabilities and in facilitating their acceptance. However, calls to project a positive public image of persons with disabilities and to develop an inclusive society have coincided with the neo-liberal approach to policymaking, whereby government plays a minimised role in the provision of basic services to citizens. Although the extant literature from advanced countries has found stereotypical and disempowering portrayals of persons with disabilities in the mass media, this area remains unresearched in developing countries. The purpose of this study was to explore how the managers of media organisations conceptualise disability, their perception of the role and contribution of the media towards promoting effective public awareness campaigns about persons with disabilities. Methods: This descriptive, qualitative study draws on a purposive sample of 20 participants consisting of general managers, news editors and programme managers from ten media organisations in a region in Ghana. A semi-structured interview guide was developed from the literature, which included tenets of neo-liberalism, to collect the data. Results: The study found that the majority of respondents cited medical model explanations of disability. Also, they were unprepared to prioritise disability issues due to lack of public interest in disability programmes and lack of funds and sponsorship for disability programmes. Conclusion: Governments must offer tax rebates to media organisations to enable them to prioritise disability issues. Other recommendations for developing media interest in disability issues are also discussed.Implications for rehabilitation This study shows limited understanding of disability among decision-makers or key players in media organisations in Ghana. In an environment of meritocracy, persons with disabilities who struggle to access education in Ghana, may be unable to secure jobs at media organisation. This study shows that media organisations seem unprepared to support or project image of persons with disabilities because such ventures come with no reward. We conclude that if the government is committed towards achieving an inclusive society in Ghana, it could offer tax rebate to media organisations to enable them cover disability programmes