A Regional Comparative Analysis on The Role of Electoral Politics in the Decline of Africa\u27s Public Sector

The early post-independence periods saw Africa have efficient Public Sector Institutions. Over a decade, there seems to be a decadent in the public sector. The study examines the regional analysis of government effectiveness in Africa. The study uses data given by the World Bank\u27s Governance Indicator from 55 African countries from 2002 to 2018. The study uses Panel Regression Analysis Model of Random Effects and Pooled Ordinary Least Squares to assess government effectiveness in the five regions of Africa. The findings indicate that Southern African countries performed best as compared to its counterpart regions, followed by North Africa. However, East, West and Central African countries had low scores on government effectiveness. The results imply that electoral politics and political interference hurt the performances of public institutions on the continent

Security Challenges in Ghana, the Imperative, of States Security Agencies: A Study of the Ghana Police Service

Security is necessary for a stable democracy as well as flourishing development Security challenges are prevalent in both developing as well as developed countries However a historical as well as recent security challenge in less developed countries suggests a rather interesting picture in comparison to developed countries This study sought to unravel the security challenges in Ghana and the imperative of Ghana Police Service as a security agency The mixed-method of data collection was used The study established that armed robbery cybercrime and political vigilantism are the major security challenges in Ghana It was revealed that the inefficiency of the police is as results of political interference lack of logistics poor condition of service like accommodation unfair treatment of junior officers among others The insight gained led to the following recommendations depoliticizing the police institution upgrading their system to enhance effective communication organization of periodic refresher courses among other

Access to cardiovascular medicines in low- and middle-income countries: a mini review

Abstract Background Many cardiovascular (CV) medicines are required for long term. However, with their limited resources, low- and middle-income countries (LMICs) may have challenges with access to cardiovascular medicines. The aim of this review was to provide a summary of available evidence on access to cardiovascular medicines in LMICs. Methods We searched PubMed and Google scholar for English language articles on access to cardiovascular medicines for the period 2010–2022. We also searched for articles reporting measures for challenges in access to CV medicines from 2007 to 2022. Studies conducted in LMICs, and reporting availability and affordability were included for review. We also reviewed studies reporting affordability or availability using the World Health Organisation/Health Action International (WHO/HAI) method. Levels of affordability and availability were compared. Results Eleven articles met the inclusion criteria for review on availability and affordability. Although availability appears to have improved, many countries did not meet the availability target of 80%. Between economies and within countries, there are equity gaps in access to CV medicines. Availability is lower in public health facilities than private facilities. Seven out of 11 studies reported availability less than 80%. Eight studies which investigated availability in the public sector reported less than 80% availability. Overall, CV medicines, especially combined treatments are not affordable in the majority of countries. Simultaneous achievement of availability and affordability target is low. In the studies reviewed, less than 1–53.5 days wages were required to purchase one month supply of CV medicines. Failure to meet affordability was 9–75%. Five studies showed that, on average 1.6 days’ wages of the Lowest-Paid Government Worker (LPGW) was required to purchase generic CV medicines in the public sector. Efficient forecasting and procurement, increased public financing and policies to improve generic use, among others are measures for improving availability and affordability. Conclusions Significant gaps exist in access to cardiovascular medicines in LMICs, and in many low—and lower middle—income countries access to cardiovascular medicines is low. To improve access and achieve the Global Action Plan on non-communicable diseases in these countries, policy interventions must be urgently instituted

Drug‐related problems among hospitalized hypertensive and heart failure patients and physician acceptance of pharmacists' interventions at a teaching hospital in Ghana

Abstract Background Hypertensive and heart failure patients frequently require multiple drug therapy which may be associated with drug‐related problems (DRPs). Aim To determine the frequency, types, and predictors of DRPs, and acceptance of pharmacists' interventions among hospitalized hypertensive and heart failure patients. Method It was a prospective cross‐sectional study at the internal medicine department wards of Korle Bu Teaching Hospital (KBTH) between January and June 2019 using a validated form (the pharmaceutical care form used by clinical pharmacists at the medical department). DRPs were classified based on the Pharmaceutical Care Network Europe (PCNE) Classification scheme for DRPs V8.02. Descriptive and inferential statistics were used for data analysis. Results A total of 247 DRPs were identified in 134 patients. The mean number of DRPs was 1.84 (SD: 1.039) per patient. Most DRPs occurred during the prescribing process (40.5%; n(DRPs) = 100), and the highest prescribing problem was untreated indication (11.7%; n = 29). Other frequent DRPs were medication counseling need (25.1%; n = 62), administration errors 10.1%(n = 25), drug interaction (10.5%; n = 26), and “no” or inappropriate monitoring (10.5%; n = 26). The number of drugs received significantly predicted the number of DRPs (adjusted odds ratio [AOR]: 9.85; 95% CI: 2.04–47.50; p < 0.001). Clinical variables were significant predictors of number of DRPs (diabetic status: AOR: 0.41, 95% CI: 0.18–0.98, p < 0.05; statin use: AOR: 0.34, 95% CI: 0.14–0.81, p < 0.05; antiplatelet use: AOR: 5.95, 95% CI: 2.03–17.48, p < 0.01). Average acceptance of interventions by physicians was 71.6% (SD: 11.7). Most (70.6%; n = 48) accepted interventions were implemented by physicians (resolved). Conclusion DRPs frequently occur, with most problems identified in the prescribing process. Medication counseling was frequently needed. Patients' number of drugs and clinical factors predicted the occurrence of DRPs. Physicians accepted and implemented most interventions. Our findings suggest that clinical pharmacists have an important role in cardiovascular patient care, but this study should be replicated in other hospitals in Ghana to corroborate these findings

Blood pressure—lowering medication prescribing, its adherence to guidelines and relationship with blood pressure control at a family medicine department

Abstract Background In many resource‐constrained countries, control of blood pressure (BP) is low. Antihypertensive drug prescribing practices may influence BP control. However, adherence of prescribing to treatment guidelines may not be optimal in resource‐constrained settings. The aim of this study was to evaluate the pattern of blood pressure‐lowering medication prescribing, and how it adheres to treatment guidelines, and to identify the relationship between medication prescriptions and BP control. Methods It was a cross‐sectional study of hypertensive outpatients at the Korle Bu Teaching Hospital (KBTH) Family Medicine department (FMD)/Polyclinic. Data was collected with a validated structured form. Adherence of “prescribing” to recommendations of the 2017 Standard Treatment Guidelines of Ghana and 2018 European Society of Cardiology guidelines was assessed using a composite measure. We analyzed data with SPSS. Results About 81% (247/304) of patients received two or more antihypertensive drugs. Most patients (41%; 267/651) received calcium channel blockers (CCB), and 21.8% (142/651), 15.7% (102/651) and 12.7% (83/651) were on diuretics, angiotensin‐receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors respectively. CCB plus RAS inhibitor (50%) was the most prescribed two‐drug combination. Number of BP drugs per patient had a statistically significant inverse relationship with BP control (beta Coefficient = –0.402; 95% Cl: 1.252–2.470; p = 0.015). The composite adherence score was 0.73 (moderate adherence) but Single‐pill combination (SPC) was poor (3.2%; n = 8). Conclusion Most patients received multiple‐pill combination treatment, and overall adherence to guidelines was suboptimal, largely owing to complex drug therapy. Number of drugs predicted BP control. Our findings suggest a need to prioritize simplified treatment, and implement other strategies to improve hypertension guideline adherence. Further research on the influence of SPC on BP control may inform future hypertension guidelines in Ghana and elsewhere in Africa

Microbial Bioremediation and Biodegradation of Petroleum Products&mdash;A Mini Review

The demand for technological and industrial change has become heavily dependent on the availability and use of petroleum products as a source of energy for socio-economic development. Notwithstanding, petroleum and petrochemical products are strongly related to global economic activities, and their extensive distribution, refining processes, and final routes into the environment pose a threat to human health and the ecosystem. Additional global environmental challenges related to the toxicological impact of air, soil, and water pollutants from hydrocarbons are carcinogenic to animals and humans. Therefore, it is practical to introduce biodegradation as a biological catalyst to address the remediation of petroleum-contaminated ecosystems, adverse impacts, the complexity of hydrocarbons, and resistance to biodegradation. This review presents the bioremediation of petroleum hydrocarbon contaminants in water and soil, focusing on petroleum biodegradable microorganisms essential for the biodegradation of petroleum contaminants. Moreover, explore the mineralization and transformation of complex organic and inorganic contaminants into other simpler compounds by biological agents. In addition, physicochemical and biological factors affecting biodegradation mechanisms and enzymatic systems are expanded. Finally, recent studies on bioremediation techniques with economic prospects for petroleum spill remediation are highlighted

Microbial Bioremediation and Biodegradation of Petroleum Products—A Mini Review

The demand for technological and industrial change has become heavily dependent on the availability and use of petroleum products as a source of energy for socio-economic development. Notwithstanding, petroleum and petrochemical products are strongly related to global economic activities, and their extensive distribution, refining processes, and final routes into the environment pose a threat to human health and the ecosystem. Additional global environmental challenges related to the toxicological impact of air, soil, and water pollutants from hydrocarbons are carcinogenic to animals and humans. Therefore, it is practical to introduce biodegradation as a biological catalyst to address the remediation of petroleum-contaminated ecosystems, adverse impacts, the complexity of hydrocarbons, and resistance to biodegradation. This review presents the bioremediation of petroleum hydrocarbon contaminants in water and soil, focusing on petroleum biodegradable microorganisms essential for the biodegradation of petroleum contaminants. Moreover, explore the mineralization and transformation of complex organic and inorganic contaminants into other simpler compounds by biological agents. In addition, physicochemical and biological factors affecting biodegradation mechanisms and enzymatic systems are expanded. Finally, recent studies on bioremediation techniques with economic prospects for petroleum spill remediation are highlighted

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways