Food and its preparation conditions in hotels in Accra, Ghana: A concern for food safety

Although a lot of work has been done on the safety of street foods in most  developing countries, not much has been done with regards to the hotel industry. A pilot study to investigate food and its preparation conditions in ten selected hotels in Accra, the capital of Ghana with respect to food safety was therefore initiated in 2005/2006. A total of 184 samples; 105 swabs of kitchen working surfaces, cutlery and plates; 29, 30, and 20 samples of food, water and fruit juice  respectively were taken for microbial analysis from ten highly patronized hotels between December 2005 and June 2006. Standard microbiological methods were used for isolation, enumeration, and identification of bacteria. Thirty Seven (37) of the swab samples showed the presence of coliforms while Escherichia coli was absent in all the 105 samples. The total count of aerobic bacteria was high in the swabs from the working surfaces and cutting boards (> 103 cfu/ml). All the food samples tested negative for Salmonella, Staphylococcus and E. coli. Coliforms and E. coli were not detected in any of the 30 water samples tested, Ten of the fruit juice samples tested positive for coliforms although E. coli was absent in all the 20  samples. Most of the swabs that registered the presence of coliforms were from  chopping boards, pastry and working tables suggesting that the method of cleaning these surfaces should be improved. The microbial quality of all the food samples tested was satisfactory with aerobic colony counts of less than 104 cfu/g and no pathogens detected in 25g of food sample, which is the standard for ready to eat foods. The water samples also met the  satisfactory criteria of no coliforms detected in 100mls of water. No pathogens were detected in the fruit juice samples, but with the exception of ginger juice, all were contaminated with coliforms which suggests that, stringent measures be applied in the preparation and handling of these juices. As a result of this study staff and management of these hotels are now  implementing Good Hygienic Practices (GHP) and Hazard Analysis and Critical Control Points (HACCP).Key words: Food, Coliforms, Salmonella, Staphylococcu

Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016–40

Background: Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040. Methods: We extracted historical data on gross domestic product (GDP) and health spending for 188 countries from 1995 to 2015, and projected annual GDP, development assistance for health, and government, out-of-pocket, and prepaid private health spending from 2015 through to 2040 as a reference scenario. These estimates were generated using an ensemble of models that varied key demographic and socioeconomic determinants. We generated better and worse alternative future scenarios based on the global distribution of historic health spending growth rates. Last, we used stochastic frontier analysis to investigate the association between pooled health resources and UHC index, a measure of a country's UHC service coverage. Finally, we estimated future UHC performance and the number of people covered under the three future scenarios. Findings: In the reference scenario, global health spending was projected to increase from US$10 trillion (95$20 trillion (18 trillion to 22 trillion) in 2040. Per capita health spending was projected to increase fastest in upper-middle-income countries, at 4·2% (3·4–5·1) per year, followed by lower-middle-income countries (4·0%, 3·6–4·5) and low-income countries (2·2%, 1·7–2·8). Despite global growth, per capita health spending was projected to range from only $40 (24–65) to$413 (263–668) in 2040 in low-income countries, and from $140 (90–200) to$1699 (711–3423) in lower-middle-income countries. Globally, the share of health spending covered by pooled resources would range widely, from 19·8% (10·3–38·6) in Nigeria to 97·9% (96·4–98·5) in Seychelles. Historical performance on the UHC index was significantly associated with pooled resources per capita. Across the alternative scenarios, we estimate UHC reaching between 5·1 billion (4·9 billion to 5·3 billion) and 5·6 billion (5·3 billion to 5·8 billion) lives in 2030. Interpretation: We chart future scenarios for health spending and its relationship with UHC. Ensuring that all countries have sustainable pooled health resources is crucial to the achievement of UHC. Funding: The Bill & Melinda Gates Foundation

Food And Its Preparation Conditions In Hotels In Accra, Ghana: A Concern For Food Safety

Although a lot of work has been done on the safety of street foods in most developing countries, not much has been done with regards to the hotel industry. A pilot study to investigate food and its preparation conditions in ten selected hotels in Accra, the capital of Ghana with respect to food safety was therefore initiated in 2005/2006. A total of 184 samples; 105 swabs of kitchen working surfaces, cutlery and plates; 29, 30, and 20 samples of food, water and fruit juice respectively were taken for microbial analysis from ten highly patronized hotels between December 2005 and June 2006. Standard microbiological methods were used for isolation, enumeration, and identification of bacteria. Thirty Seven (37) of the swab samples showed the presence of coliforms while Escherichia coli was absent in all the 105 samples. The total count of aerobic bacteria was high in the swabs from the working surfaces and cutting boards (> 103 cfu/ml). All the food samples tested negative for Salmonella, Staphylococcus and E. coli. Coliforms and E. coli were not detected in any of the 30 water samples tested, Ten of the fruit juice samples tested positive for coliforms although E. coli was absent in all the 20 samples. Most of the swabs that registered the presence of coliforms were from chopping boards, pastry and working tables suggesting that the method of cleaning these surfaces should be improved. The microbial quality of all the food samples tested was satisfactory with aerobic colony counts of less than 104 cfu/g and no pathogens detected in 25g of food sample, which is the standard for ready to eat foods. The water samples also met the satisfactory criteria of no coliforms detected in 100mls of water. No pathogens were detected in the fruit juice samples, but with the exception of ginger juice, all were contaminated with coliforms which suggests that, stringent measures be applied in the preparation and handling of these juices. As a result of this study staff and management of these hotels are now implementing Good Hygienic Practices (GHP) and Hazard Analysis and Critical Control Points (HACCP)

Volume 7 No. 5 2007 FOOD AND ITS PREPARATION CONDITIONS IN HOTELS IN ACCRA, GHANA: A CONCERN FOR FOOD SAFETY

ABSTRACT Although a lot of work has been done on the safety of street foods in most developing countries, not much has been done with regards to the hotel industry. A pilot study to investigate food and its preparation conditions in ten selected hotels in Accra, the capital of Ghana with respect to food safety was therefore initiated in 2005/2006. A total of 184 samples; 105 swabs of kitchen working surfaces, cutlery and plates; 29, 30, and 20 samples of food, water and fruit juice respectively were taken for microbial analysis from ten highly patronized hotels between December 2005 and June 2006. Standard microbiological methods were used for isolation, enumeration, and identification of bacteria. Thirty Seven (37) of the swab samples showed the presence of coliforms while Escherichia coli was absent in all the 105 samples. The total count of aerobic bacteria was high in the swabs from the working surfaces and cutting boards (> 10 3 cfu/ml). All the food samples tested negative for Salmonella, Staphylococcus and E. coli. Coliforms and E. coli were not detected in any of the 30 water samples tested, Ten of the fruit juice samples tested positive for coliforms although E. coli was absent in all the 20 samples. Most of the swabs that registered the presence of coliforms were from chopping boards, pastry and working tables suggesting that the method of cleaning these surfaces should be improved. The microbial quality of all the food samples tested was satisfactory with aerobic colony counts of less than 10 4 cfu/g and no pathogens detected in 25g of food sample, which is the standard for ready to eat foods. The water samples also met the satisfactory criteria of no coliforms detected in 100mls of water. No pathogens were detected in the fruit juice samples, but with the exception of ginger juice, all were contaminated with coliforms which suggests that, stringent measures be applied in the preparation and handling of these juices. As a result of this study staff and management of these hotels are now implementing Good Hygienic Practices (GHP) and Hazard Analysis and Critical Control Points (HACCP)

Additional file 3: of Effectiveness of capacity building interventions relevant to public health practice: a systematic review

Table S1. (Characteristics of included papers) to be linked approximately here (DOCX 37 kb

Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995\u20132015

Background: Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries. Methods: We collected published data on domestic health spending, from 1995 to 2015, from a diverse set of international agencies. We tracked development assistance for health from 1990 to 2017. We also extracted 5385 datapoints about HIV/AIDS spending, between 2000 and 2015, from online databases, country reports, and proposals submitted to multilateral organisations. We used spatiotemporal Gaussian process regression to generate complete and comparable estimates for health and HIV/AIDS spending. We report most estimates in 2017 purchasing-power parity-adjusted dollars and adjust all estimates for the effect of inflation. Findings: Between 1995 and 2015, global health spending per capita grew at an annualised rate of 3\ub71% (95% uncertainty interval [UI] 3\ub71 to 3\ub72), with growth being largest in upper-middle-income countries (5\ub74% per capita [UI 5\ub73\u20135\ub75]) and lower-middle-income countries (4\ub72% per capita [4\ub72\u20134\ub73]). In 2015, 9\ub77 trillion (9\ub77 trillion to 9\ub78 trillion) was spent on health worldwide. High-income countries spent 6\ub75 trillion (6\ub74 trillion to 6\ub75 trillion) or 66\ub73% (66\ub70 to 66\ub75) of the total in 2015, whereas low-income countries spent 70\ub73 billion (69\ub73 billion to 71\ub73 billion) or 0\ub77% (0\ub77 to 0\ub77). Between 1990 and 2017, development assistance for health increased by 394\ub77% (29\ub79 billion), with an estimated 37\ub74 billion of development assistance being disbursed for health in 2017, of which 9\ub71 billion (24\ub72%) targeted HIV/AIDS. Between 2000 and 2015, 562\ub76 billion (531\ub71 billion to 621\ub79 billion) was spent on HIV/AIDS worldwide. Governments financed 57\ub76% (52\ub70 to 60\ub78) of that total. Global HIV/AIDS spending peaked at 49\ub77 billion (46\ub72\u201354\ub77) in 2013, decreasing to 48\ub79 billion (45\ub72 billion to 54\ub72 billion) in 2015. That year, low-income and lower-middle-income countries represented 74\ub76% of all HIV/AIDS disability-adjusted life-years, but just 36\ub76% (34\ub74 to 38\ub77) of total HIV/AIDS spending. In 2015, 9\ub73 billion (8\ub75 billion to 10\ub74 billion) or 19\ub70% (17\ub76 to 20\ub76) of HIV/AIDS financing was spent on prevention, and 27\ub73 billion (24\ub75 billion to 31\ub71 billion) or 55\ub78% (53\ub73 to 57\ub79) was dedicated to care and treatment. Interpretation: From 1995 to 2015, total health spending increased worldwide, with the fastest per capita growth in middle-income countries. While these national disparities are relatively well known, low-income countries spent less per person on health and HIV/AIDS than did high-income and middle-income countries. Furthermore, declines in development assistance for health continue, including for HIV/AIDS. Additional cuts to development assistance could hasten this decline, and risk slowing progress towards global and national goals. Funding: The Bill & Melinda Gates Foundation

Trends in future health financing and coverage: future health spending and universal health coverage in 188 countries, 2016–40

Achieving universal health coverage (UHC) requires health financing systems that provide prepaid pooled resources for key health services without placing undue financial stress on households. Understanding current and future trajectories of health financing is vital for progress towards UHC. We used historical health financing data for 188 countries from 1995 to 2015 to estimate future scenarios of health spending and pooled health spending through to 2040