A predictive model and socioeconomic and demographic determinants of under-five mortality in Sierra Leone.

Sierra Leone is among the countries that recorded high under-five child mortality rate in the world. To design and implement policies that can address this public health challenge, the present study developed a predictive model of factors that explained under-five mortality in Sierra Leone using the 2008 and 2013 Sierra Leone Demographic and Health Survey (SDHS) datasets. LASSO regression technique was used to select the predictors to build the under-five predictive single-level logit and multilevel logit models. Statistical analyses were performed in the R freeware version 3.6.1. About 588 (10.4%) and 1320 (11.1%) children under five were reported dead in 2008 and 2013, respectively. The significant predictors of under-five mortality in Sierra Leone were the total number of children ever born, number of children under five in the household, mother's birth in the last five years, mother's number of living children, and number of household members, household wealth, maternal contraceptive use and intention, number of eligible women in the household, type of toilet facility, sex of the child, and weight of the child at birth. The study identified certain predictors that deserve policy attention and interventions to strengthen the efforts of creating child welfare and survival atmosphere in Sierra Leone

High-risk water and sanitation practices: evidence of underreporting from eight countries

Water and sanitation indicators in the erstwhile Millennium Development Goals (MDGs) failed to capture high-risk practices such as unimproved water consumption and open defecation undertaken on a regular basis. In conjunction with local partners, we used a mobile platform to implement representative randomized household surveys in eight countries across Asia and Africa (n=245,054) to quantify the presence and magnitude of such underreporting. Our study identified the use of high-risk practices as a regular option to be greater than their use as the main option. Across the study areas, this consistent underreporting amounted to 26 million (unimproved water) and 50 million (open defecation) people not being targeted for suitable policy interventions. A deeper analysis of Ghana shows poor and rural households are more likely to engage in high-risk practices. Current metrics inflate water and sanitation progress, and need to be adapted for the complex world we live in

For money or service? a cross-sectional survey of preference for financial versus non-financial rural practice characteristics among ghanaian medical students

Abstract Background Health worker shortage and maldistribution are among the biggest threats to health systems in Africa. New medical graduates are prime targets for recruitment to deprived rural areas. However, little research has been done to determine the influence of workers' background and future plans on their preference for rural practice incentives and characteristics. The purpose of this study was to identify determinants of preference for rural job characteristics among fourth year medical students in Ghana. Methods We asked fourth-year Ghanaian medical students to rank the importance of rural practice attributes including salary, infrastructure, management style, and contract length in considering future jobs. We used bivariate and multivariate ordinal logistic regression to estimate the association between attribute valuation and students' socio-demographic background, educational experience, and future career plans. Results Of 310 eligible fourth year medical students, complete data was available for 302 students (97%). Students considering emigration ranked salary as more important than students not considering emigration, while students with rural living experience ranked salary as less important than those with no rural experience. Students willing to work in a rural area ranked infrastructure as more important than students who were unwilling, while female students ranked infrastructure as less important than male students. Students who were willing to work in a rural area ranked management style as a more important rural practice attribute than those who were unwilling to work in a rural area. Students studying in Kumasi ranked contract length as more important than those in Accra, while international students ranked contract length as less important than Ghanaian students. Conclusions Interventions to improve rural practice conditions are likely to be more persuasive than salary incentives to Ghanaian medical students who are willing to work in rural environments a priori. Policy experiments should test the impact of these interventions on actual uptake by students upon graduation.http://deepblue.lib.umich.edu/bitstream/2027.42/112499/1/12913_2011_Article_1837.pd

Wheelchair accessibility to public buildings in the Kumasi metropolis, Ghana

Background: Accessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life. Objective: This study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006). Methods: Eighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers’ counters were measured and computed. Results: Out of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors. Conclusion: The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users

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

The prevalence and correlates of depression among older adults in greater kumasi of the ashanti region

Abstract Background Approximately two million Ghanaians suffer from mental disorders including depression. The WHO defines it as an illness characterized by constant sadness and loss of interest in activities that a person usually enjoys doing and this condition is the leading cause of mental disorders; however, the burden of depression on the aged population is fairly unknown. A better appreciation of depression and its predictors is necessary to design appropriate policy interventions. Therefore, this study aims to assess the prevalence and correlates of depression among older people in the Greater Kumasi of the Ashanti region. Methods A cross-sectional study design with a multi-stage sampling approach was employed to recruit and collect data from 418 older adults aged 60 years and above at the household level in four enumeration areas (EAs) within the Asokore Mampong Municipality. Households within each EAs were mapped and listed by trained resident enumerators to create a sampling frame. Data was collected electronically with Open Data Kit application over 30 days through face-to-face interaction using the Geriatric Depression Scale (GDS). The results were summarized using descriptive and inferential statistics. A multivariable logistics regression using a forward and backward stepwise approach was employed to identify the predictors of depression in the study sample. All analyses were performed using STATA software version 16, and the significance level was maintained at a p-value  80 years), and lower economic class respondents. The rate was 43.4% for both consumers of alcohol and smokers with a history of stroke (41.2%) and taking medication for chronic conditions (44.2%). The predictors of depression in our study were being single, low class [aOR = 1.97; 95% CI = 1.18–3.27] and having other chronic conditions [aOR = 1.86; 95% CI = 1.59–4.62], and the inability to manage ones’ own affairs [aOR = 0.56; 95% CI = 0.32–0.97]. Conclusion The study provides data that can inform policy decisions on the care of the elderly with depression in Ghana and other similar countries, confirming the need to provide support efforts towards high-risk groups such as single people, people with chronic health conditions, and lower-income people. Additionally, the evidence provided in this study could serve as baseline data for larger and longitudinal studies

Causes, trends and severity of musculoskeletal injuries in Ghana

Abstract Background Musculoskeletal [MSK] injuries are common causes of long-term pain and physical disability which affect many people worldwide. The economic and social impacts on the individual, society and national health systems are enormous making a matter of public health concern. Therefore, this study examined the causes and extent of MSK injuries in a referral hospital in Ghana. Methods A prospective study design with consecutive sampling method was used to recruit patients admitted at Trauma Unit as well as those receiving orthopaedic reviews at St. Joseph’s Orthopaedic Hospital over a ten-month period. A structured questionnaire, Visual Analogue Scale (VAS) and Abbreviated Injury Scale (AIS) were used to collect data which were analysed descriptively using SPSS version 20. Results A total of 269 MSK injury patients were identified - of these, 137 (50.9%) males with an average age of 38 years (SD = 19.88). Nearly half (49.1%) of the injuries sustained were fractures, and common causes were vehicular crash 113 (42.0%) and fall 68 (25.3%). Body parts affected most were the knee (19.62) and the mean levels of pain for all injuries were 6.04 ± 2.44 and 3.25 (±1.50) respectively. Conclusion Ghana needs a healthy population to steer its development trajectory. Policy makers in Ghana should pay attention to both preventive as well as management of MSK injuries, or else, most of the country’s working class could live with lasting effects of injuries which may have significant impacts on the economy

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

Contraceptive Characteristics of Women Living with HIV in the Kumasi Metropolis, Ghana

Objectives: Contraceptive use among women living with HIV is important to prevent the transmission of the infection to their partners, prevent unintended pregnancies and prevent the mother-to-child transmission of the infection. The study sought to determine the contraceptive characteristics of women living with HIV in the Kumasi metropolis. Methods: A cross-sectional study was conducted from July to August 2012 at two HIV/AIDS clinics in the Kumasi Metropolis in the Ashanti Region, Ghana. Interviewer- administered questionnaires were used to collect data from two hundred and ninety five women. Data from one hundred and eighty three women living with HIV and who were sexually active were analsed. Factors associated with contraceptive use were examined using logistic regression. Results: The overall contraceptive use was high; 84.7% were using a modern contraceptive method. The male condom was the commonest contraceptive method (77.0%) used and this was the main contraceptive method promoted at the HIV/AIDS clinic. Dual method usage was low (4.4%). Multivariate analysis showed that the significant predictor of contraceptive use was HIV status disclosure to partner (AOR 0.25; 95% CI = 0.07-0.87;p = 0.03). Conclusion and Public Health Implications: The integration of family planning and HIV/AIDS services could stress dual method use and encourage HIV status disclosure to partner. Key words: Contraceptives • Condom • Women Living with HIV/AIDS • Ghana Copyright © 2013 Gyimah et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited