The policy framework for NCD prevention in Ghana.

Noncommunicable diseases (NCDs) are a growing public health challenge in Ghana. Health promotion can provide useful avenues to reduce the incidence of NCDs in the country. We used the Ottawa Framework to assess health promotion efforts for the prevention and control of NCDs in Ghana. Data were collected using key informant interviews and documentary sources. A content analysis approach was adopted for data analysis using Nvivo 11 Software. We found a strong policy framework for NCD prevention in Ghana with the ratification of several international protocols and resolutions and the development of national and specific NCD-related policies. Implementation of these policies, however, remains achallenge due to limited resources and the overconcentration on communicable diseases. Attempts have been made to create a supportive environment through increased access to NCD services but there are serious challenges. Respondents believe the current environment does not support healthy eating and promotes unhealthy use of alcohol. The Community-based Health Planning and Services (CHPS) program engenders community participation in health but has been affected by inadequate resources. Personal skills and education programs on NCDs are erratic and confined to a few municipalities. We also found that NCD services in Ghana continue to be clinical and less preventative. These findings have far-reaching implications for practice and require health planners in Ghana to pay equal attention in terms of budgetary allocations and other resources to both NCDs and communicable diseases.</div

Measures aimed at creating a supportive environment for NCD prevention in Ghana.

Measures aimed at creating a supportive environment for NCD prevention in Ghana.</p

Sero-prevalence and risk factors for hepatitis E virus infection among pregnant women in the Cape Coast Metropolis, Ghana

<div><p>Background</p><p>Hepatitis E virus is an emerging infection in Africa with poor maternal and foetal outcomes. There is scanty data on the sero-prevalence of HEV infection among pregnant women in Ghana. This study highlighted the prevalence and risk factors associated with HEV infection among pregnant women in Cape Coast Metropolis, Central Region of Ghana.</p><p>Methods</p><p>A multicenter (3 selected sites) analytical cross sectional study involving 398 pregnant women in the Cape Coast metropolis was conducted. HEV (Anti-HEV IgG and Anti-HEV IgM) ELISA was performed. Sero-positive women had liver chemistries done and data collected on maternal and neonatal outcomes. Data analyses were performed using Stata version 13 software (STATA Corp, Texas USA).</p><p>Results</p><p>Mean age was 28.01 (± 5.93) years. HEV sero-prevalence was 12.2% (n = 48) for IgG and 0.2% (n = 1) for IgM with overall of 12.3%. The odds of being HEV sero-positive for women aged 26–35 years was 3.1 (95% CI: 1.1–8.1), p = 0.02 and ≥36 years it was 10.7 (95% CI; 3.4–33.5), p = 0.0001. Living in urban settlement was associated with lowest odds of HEV infection {OR 0.4 (95% CI; 0.2–0.8), p = 0.01}. Factors with no statistical evidence of association include main source of drinking water and history of blood transfusion. The sero-prevalence of HEV IgG increased progressively across trimesters with the highest among women in their third trimester (55.3%). None of the 49 HEV sero-positive women had elevated ALT level. Ten (N = 41) of the neonates born to sero-positive women developed jaundice in the neonatal period. The mean birth weight was 3.1kg (SD 0.4).</p><p>Conclusion</p><p>HEV sero-prevalence among pregnant women in the Cape Coast Metropolis is high enough to deserve more attention than it has received so far. It is therefore important to conduct further research on the potential impact on maternal and neonatal mortality and morbidity in Ghana.</p></div

Socio-demographic characteristics of study participants (N = 398).

<p>Socio-demographic characteristics of study participants (N = 398).</p

Liver function results of 49 pregnant women who were positive for HEV IgG and/or IgM.

<p>Liver function results of 49 pregnant women who were positive for HEV IgG and/or IgM.</p

Pregnancy and neonatal outcome among HEV positive women (N = 42).

<p>Pregnancy and neonatal outcome among HEV positive women (N = 42).</p

Factors associated with HEV IgG positivity among study participants.

<p>Factors associated with HEV IgG positivity among study participants.</p

Obstetric and other relevant parameters of study participants.

<p>Obstetric and other relevant parameters of study participants.</p

Health care provider demographics.

<p>Health care provider demographics.</p

Excerpts from the semi-structured interview tool used with providers.

<p>Excerpts from the semi-structured interview tool used with providers.</p