15 research outputs found

    Sachet water quality and product registration : a cross-sectional study in Accra, Ghana

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    The study's objectives were to assess the extent to which packaged water producers follow product registration procedures and to assess the relationship between product registration and drinking water quality in Accra, Ghana. Following preliminary analysis of a national water quality survey, 118 packaged sachet water samples were collected by sampling all brands sold by 66 vendors. A sample of vendors was selected from two high-income and two low-income areas of Accra, Ghana. Sachet packaging and labelling details were recorded and compared to a regulatory database to assess product registration. All samples were weighed and tested for faecal indicator bacteria and selected physico-chemical parameters. Product registration numbers and brand names could be matched to regulatory records for 77 of 118 sachets (65.2%). All samples tested were compliant with national water quality standards for faecal indicator bacteria and nitrate. Brand registration was not associated with any of the quality indicators considered. The results of this study suggest that while a substantial proportion of sachet water is sold without formal product registration, the microbial quality of the unlicensed water is consistently high in Accra, Ghana. Further examination of regulatory enforcement and monitoring will be needed to ensure sustained high water quality over time

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

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    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

    Willingness to work in rural areas and the role of intrinsic versus extrinsic professional motivations - a survey of medical students in Ghana

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    <p>Abstract</p> <p>Background</p> <p>Retaining health workers in rural areas is challenging for a number of reasons, ranging from personal preferences to difficult work conditions and low remuneration. This paper assesses the influence of intrinsic and extrinsic motivation on willingness to accept postings to deprived areas among medical students in Ghana.</p> <p>Methods</p> <p>A computer-based survey involving 302 fourth year medical students was conducted from May-August 2009. Logistic regression was used to assess the association between students' willingness to accept rural postings and their professional motivations, rural exposure and family parental professional and educational status (PPES).</p> <p>Results</p> <p>Over 85% of students were born in urban areas and 57% came from affluent backgrounds. Nearly two-thirds of students reported strong intrinsic motivation to study medicine. After controlling for demographic characteristics and rural exposure, motivational factors did not influence willingness to practice in rural areas. High family PPES was consistently associated with lower willingness to work in rural areas.</p> <p>Conclusions</p> <p>Although most Ghanaian medical students are motivated to study medicine by the desire to help others, this does not translate into willingness to work in rural areas. Efforts should be made to build on intrinsic motivation during medical training and in designing rural postings, as well as favour lower PPES students for admission.</p

    Earth System's Gatekeeping of “One Health” Approach to Manage Climate-Sensitive Infectious Diseases

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    Global response to climate-sensitive infectious diseases has been uncertain and slow. The understanding of the underlying vulnerabilities which forms part of changes created by forces within the Earth system has never before been critical until the coronavirus disease 2019, “COVID-19” pandemic with the initial developmental phase linked to weather elements and climate change. Hence, the heightened interest in climate-sensitive infectious diseases and GeoHealth, evident in the renewed calls for “One Health” approach to disease management. “One Health” explains the commonality of human and animal medicine, and links to the bio-geophysical environment, yet are at crossroads with how forces within the Earth system shape etiologies, incidences, and transmission dynamics of infectious diseases. Hence, the paper explores how these forces, which are multistage and driven by climate change impacts on ecosystems affect emerging infectious diseases, leading to the question “what drive the drivers of diseases?” Three questions that challenge broad theories of Earth system science on boundaries and connectivity emerged to guide study designs to further interrogating disease surveillance and health early warning systems. This is because, climate change (a) drives prevailing biological health hazards as part of forces within the Earth system, (b) shifts disease control services of ecosystems and functioning to effectively regulate disease incidence, and (c) modifies pathogen—species hosts relationships. Hence, the need to rethink pluralistic concepts of climate-sensitive diseases in their infection and management from a GeoHealth perspective, which “One Health” potentially conveys, and to also maintain ecosystem health

    Inter-observer reliability in transect-based observations of environmental waste in Greater Accra and Kisumu: implications for waste management

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    Transect surveys are widely used to quantify mismanaged plastic waste discarded to the environment. However, very fewstudies have quantified inter-observer reliability in environmental waste surveys. The aim of this study was to assess inter-observer reliability for a set of environmental waste indicators derived from transect surveys in slum areas of two sub-SaharanAfrican cities. Pairs of observers independently recorded counts of scattered waste items, large waste piles, and burnt wastealong 64 environmental transects in Kisumu, Kenya, and Greater Accra, Ghana. Concordance correlation coefficients wereused to measure inter-observer reliability for derived indicators measuring mismanaged waste density, waste composi-tion, waste origins of policy concern, and waste disposal practices. Evidence across all observers consistently showed thatsingle-use disposable diapers, discarded Personal Protective Equipment, and bagged or bottled water are locally importantconstituents of mismanaged waste in both cities that should be addressed through urban waste management strategies. Inboth cities, there was generally excellent inter-observer reliability for density of burnt waste and density of large waste piles(concordance correlation coefficient &gt; 0.9 for all but one observer pair), but weak to moderate inter-observer reliability forscattered waste density and densities of specific waste items such as disposable nappies and discarded Personal ProtectiveEquipment. Our study shows that beach litter survey protocols can be adapted for use in slums. However, to generate robustestimates of scattered waste, its composition, and waste origins of policy concern in slums, assessment of inter-observerreliability should be incorporated into field team training

    Subsidized Sachet Water to Reduce Diarrheal Disease in Young Children: A Feasibility Study in Accra, Ghana

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    Use of drinking water sold in plastic bags (sachet water) is growing rapidly in west Africa. The impact on water consumption and child health remains unclear, and a debate on the taxation and regulation of sachet water is ongoing. This study assessed the feasibility of providing subsidized sachet water to low-income urban households in Accra and measured the resultant changes in water consumption. A total of 86 children, 6–36 months of age in neighborhoods lacking indoor piped water, were randomized to three study arms. The control group received education about diarrhea. The second arm received vouchers for 15 L/week/child of free water sachets (value: $0.63/week) plus education. The third arm received vouchers for the same water sachet volume at half price plus education. Water consumption was measured at baseline and followed for 4 months thereafter. At baseline, 66 of 81 children (82%) drank only sachet water. When given one voucher/child/week, households redeemed an average 0.94 vouchers/week/child in the free-sachet-voucher arm and 0.82 vouchers/week/child in the half-price arm. No change in water consumption was observed in the half-price arm, although the study was not powered to detect such differences. In the free-sachet-voucher arm, estimated sachet water consumption increased by 0.27 L/child/day (P = 0.03). The increase in sachet water consumption by children in the free-sachet-voucher arm shows that provision of fully subsidized water sachets might improve the quality of drinking water consumed by children. Further research is needed to quantify this and any related child health impacts

    Rethinking North–South Research Partnerships Amidst Global Uncertainties: Leveraging Lessons Learned from UK GCRF Projects during COVID-19

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    International research and development projects (or grand challenge projects) consist of multicultural, multi-country, multi-sectoral, and multi-stakeholder initiatives aimed at poverty reduction. They are usually conceived as partnerships between actors in the global north–south. The COVID-19 pandemic was a major unexpected disruption to ongoing projects and challenged their already complex management. The aim of this paper is to present evidence on how international development projects were impacted by COVID-19 with a particular focus on the relationship between research institutions in the north and south. We conducted a mixed-methods research study, combining a reflective exercise with the co-author team and a survey with principal investigators, project managers, and capacity development leads drawn from 31 Global Challenges Research Fund (GCRF) projects funded through the UK government’s Official Development Assistance (ODA) and focused on social–ecological system research. The survey contained closed- and open-ended questions in order to (i) demonstrate how those involved in managing projects adapted to risks, including both threats and opportunities, presented by the COVID-19 pandemic, and (ii) consider the implications for tailoring adaptive management approaches in international research projects amidst uncertainties, with a special focus on enhancing equities in global north–south partnerships. The paper offers the following recommendations on designing, planning, and implementing international research and development projects: (i) devolve project management in order to enhance project resilience and improve north–south equities; (ii) allocate dedicated resources to enable equitable north–south research partnerships; (iii) rely more on hybrid and agile approaches for managing a project’s life cycle; and (iv) improve resource flexibility, transparency, and communication through enhanced funder–implementer collaboration
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