Data Accuracy and Completeness of Monthly Midwifery Returns Indicators of Ejisu Juaben Health Directorate of Ghana

The broad range of activities contained in the provision of Primary Health Care (PHC) places a burden on providers to make optimal use of limited resources to achieve maximal health benefit to the population served. All too often, ad hoc decisions and personal preferences guide PHC resource allocations, making accountability for results impossible. Problems constraining Routine Health Information System (RHIS) performance in low-income countries include: poor data quality; limited use of available information; weaknesses in how data are analyzed and poor RHIS management practices. This study sought to investigate these constraints. A non-experimental before and after study involving bassline assessment of data accuracy and completeness, application of innovative strategies such as mentoring and coaching of Health Information Officers in data quality improvement process. Coincidentally, the intervention improved both data accuracy and completeness performance significantly among the participating facilities. The outstanding performance may be attributed to management's new orientation and growing interest towards quality data. Engaging frontline staff in data quality improvement work and provision of regular feedback leads to improvement in data accuracy and completeness. This has implications for decision-making and resource allocation, especially in low-income countries, where the routine health information management system relies heavily on paper work

Optimisation of Plate Thickness Using Finite Difference Method

A finite difference numerical method of solving biharmonic equation is presented. The biharmonic equation and plate theory are used to solve a classical engineering problem involving the optimisation of plate thickness to minimise deformations and stresses in the plate. Matlab routines were developed to solve the resulting finite difference equations. The results from the finite difference method were compared with results obtained using ANSYS finite element formulation. Using the finite difference method, a plate thickness of 277 mm was obtained with a mesh size of 3 m and a plate thickness of 271 mm was obtained with a mesh size of 1 m., whiles using ANSYS finite element formulation, a plate thickness of 270 mm was obtained. The significance of these results is that, by using off-the-shelf general application tool and without resorting to expensive dedicated application tool, simple engineering problems could be solved. Keywords: Finite Difference (FD), Biharmonic Equation, Finite Element (FE), Plate Theory Journal of Science & Technology (Ghana) Vol. 28 (3) 2008: pp. 135-15

Wastewater use in urban agriculture: an exposure and risk assessment in Accra, Ghana

Wastewater use in urban agriculture is common as a result of rapid urbanisation and increasingcompetition for water. This study sought to assess critical exposures associated with the transmission of faecal pathogens among farmers and consumers of wastewater irrigated produce andto assess the adoption of the multiple-barrier approach advocated by the WHO guidelines tominimise health risks. From September 2012 to August 2013, 323 soil and irrigation water samples,and 501 raw produce and ready-to-eat salad samples were collected from fields, markets,and kitchens in Accra, Ghana. All samples were analysed for E. coli using standard procedures.In addition, 693 participants including farmers, vendors, and consumers were interviewed andobserved. The results showed that irrigation water was significantly more contaminated thanfarm soil, though exposure to soil was found to pose the key risk to farmers due to hand-to mouth  events (10 events/day). Over 80% of the produce samples were found contaminated with E. coli, with street food salad found to be the most contaminated (4.23 Log E. coli/g). Risk factors identified for produce contamination included farm soil, wastewater use, and poor food and environmental hygiene. Awareness of the source of irrigation water was low, but despite the high awareness of health risk, consumers did not prioritize health indicators when buying produce.The study recommends the promotion of interventions that would result in more direct benefits to producers and vendors, together with hygiene education/inspection, hygiene certification, andenforcement of food safety byelaws in order to protect health.Keywords: Ghana, wastewater irrigation, produce, risk perceptions, multiple-barrier approac

Assessing coherence between sector policies and Climate Compatible Development: Opportunities for triple wins

Climate Compatible Development (CCD) aims to deliver adaptation and mitigation without compromising development progress. To date, adaptation, mitigation and development related to key climate-sensitive sectors have often been treated separately. This paper uses qualitative document analysis, content analysis, expert interviews and a multi-stakeholder workshop to: examine the extent to which policies in climate-sensitive sectors align in framing adaptation, mitigation and development action; and identify key areas of policy coherence in Ghana. The paper answers the following questions: (i) To what extent are Ghana's agriculture, energy, water, forest and wildlife sector policies aligned with climate adaptation, mitigation and development? (ii) What is the extent of policy coherence amongst climate-sensitive sector policies? (iii) Where are the key intervention points available to enhance CCD activities? Findings demonstr ate that Ghana's climate-sensitive sector policies in agriculture, water, energy, forest and wildlife arenas have elements that demonstrate good alignment with adaptation, mitigation, and development priorities. However, as yet, there is only "limited coherence" between climate-sensitive sector policies. The paper identifies the following intervention points: (i) the need to attach greater importance to the threat posed by climate change to agriculture; and (ii) the need to address the lack of inter-agency and inter-ministerial approaches for building partnerships with other stakeholders. Multi-stakeholder workshop discussions highlighted significant challenges relating to limited coordination amongst institutions and agencies, limited institutional capacity and a lack of resources in ensuring coherence. This requires strengthening of national institutions such as the Environmental Protection Agency (EPA) to provide appropriate mechanisms to ensure effective collaboration amongst climate-sensitive sectors to deliver "triple wins". The EPA could exert greater influence by nominating "climate champions" in sector ministries

Trace elements contamination of soils around gold mine tailings dams at Obuasi, Ghana

This study investigated the issue of tailings dams as a potential source of trace elements contamination in soils at the Obuasi gold mine in Ghana. Soil samples taken from depths of up to 12 cm and within a radius of 400 m from the tailings dams (active and recommissioned), were analysed for As, Cu, Pb and Zn using atomic absorption spectrometry. Average concentrations of As, Cu, Pb and Zn in soils around the active tailings dams were respectively 581±130, 39.64 ± 3.02, 24.22 ± 2.62 and 72.64 ± 8.01 mg/kg. Soils in the vicinity of the decommissioned tailings dam registered increased values - 1711 ± 172, 71.44 ± 5.27, 38.67 ± 3.59 and 168.1 ± 36.2 mg/kg for As, Cu, Pb and Zn respectively. Both types of tailings dams impacted adjoining soils with greater concentrations of the trace elements when compared to undisturbed control soils. Arsenic was above the Netherlands intervention value of 55 mg/kg dry weight, even in control soils. The following trend of accumulation was observed in the soils: As>Zn>Cu>Pb. Improved tailings management strategies, among other factors, might have influenced the reduced level of trace elements contamination at the active tailings dams’ site

Assessment of contamination of singed hides from cattle and goats by heavy metals in Ghana

Many local butchers in Ghana have been using scrap tyres as substitute for firewood to singe slaughtered ruminants. This study analysed such singed hides from seven goats and three cattle in unregulated local slaughtering operations near the Kumasi abattoir, for risk of heavy metal contamination (Mg, Mn, Cu, Ni, Cd, Pb and Zn) using atomic absorption spectrometry. Relative to unsinged control hides, singed treatments generally elevated heavy metal levels in both goats and cattle hides. Magnesium, Mn, Cu, Ni and Cd concentrations in un-singed goats hide increased by 23, 29, 54, 24 and 20% respectively to 108.63 ± 3.85, 0.83 ± 0.13, 1.63 ± 0.13, 2.15 ± 0.29 and 2.26 ± 0.20 mg/kg in the singed material. Similarly, singeing increased Mg, Mn, Cu, Ni, Cd and Zn concentrations in cattle hide by 94, 49, 130, 33, 174 and 1055% to 80.0 ± 5.25, 2.13 ± 0.26, 5.67 ± 1.24, 3.50 ± 0.17, 4.20 ± 0.17, and 204.49 ± 36.69 mg/kg respectively. Lead concentration in cattle hide on the other hand decreased by 34% upon singeing, from 4.61 ± 0.30 mg/kg in un-singed controls to 3.06 ± 0.26 mg/kg in singed material. High concentrations of the metals in singed hides could not be entirely attributed to the singed treatment alone, in view of considerable background levels of heavy metals recorded in the un-singed samples; a situation that probably reflected a larger problem of heavy metal pollution in the local environment. Concentrations of Cd and Pb in hides were above maximum permissible levels (MPLs) of 0.05 and 0.01 mg/kg respectively set by the European Commission Regulation, whilst Zn was also above MPL of 50.0 mg/kg, according to the Meat Food Products Order of India. It was concluded that the hides were potentially unsafe for human consumption.Key words: Heavy metal contamination, meat products, singed treatments, consumed animal hide

Community perceptions of a malaria vaccine in the Kintampo districts of Ghana.

BACKGROUND: Malaria remains the leading cause of morbidity and mortality in sub-Saharan Africa despite tools currently available for its control. Making malaria vaccine available for routine use will be a major hallmark, but its acceptance by community members and health professionals within the health system could pose considerable challenge as has been found with the introduction of polio vaccinations in parts of West Africa. Some of these challenges may not be expected since decisions people make are many a time driven by a complex myriad of perceptions. This paper reports knowledge and perceptions of community members in the Kintampo area of Ghana where malaria vaccine trials have been ongoing as part of the drive for the first-ever licensed malaria vaccine in the near future. METHODS: Both qualitative and quantitative methods were used in the data collection processes. Women and men whose children were or were not involved in the malaria vaccine trial were invited to participate in focus group discussions (FGDs). Respondents, made up of heads of religious groupings in the study area, health care providers, traditional healers and traditional birth attendants, were also invited to participate in in-depth interviews (IDIs). A cross-sectional survey was conducted in communities where the malaria vaccine trial (Mal 047RTS,S) was carried out. In total, 12 FGDs, 15 IDIs and 466 household head interviews were conducted. RESULTS: Knowledge about vaccines was widespread among participants. Respondents would like their children to be vaccinated against all childhood illnesses including malaria. Knowledge of the long existing routine vaccines was relatively high among respondents compared to hepatitis B and Haemophilus influenza type B vaccines that were introduced more recently in 2002. There was no clear religious belief or sociocultural practice that will serve as a possible barrier to the acceptance of a malaria vaccine. CONCLUSION: With the assumption that a malaria vaccine will be as efficacious as other EPI vaccines, community members in Central Ghana will accept and prefer malaria vaccine to malaria drugs as a malaria control tool. Beliefs and cultural practices as barriers to the acceptance of malaria vaccine were virtually unknown in the communities surveyed

Modelling Formal and Informal Domestic Water Consumption in Accra

Urban utilities in developing countries are often unwilling to extend coverage or improve services for fear that not enough water is available. This study used modelling to project the city-level water demand implications of slum water improvements in Accra (Ghana). The research collated existing data around water use patterns and also used purpose-designed surveys to explore usage and demand in slum communities in more depth

Wastewater use in urban agriculture: an exposure and risk assessment in Accra, Ghana

In order to minimize the health risks to agricultural workers, and consumers of wastewater irrigated produce, the World Health Organisation has developed guidelines for the safe use of wastewater in agriculture. This study sought to test the appropriateness of the current Quantitative Microbial Risk Assessment model and the multiple-barrier approach advocated by the WHO guidelines. Over a one year period, over 500 produce and ready-to-eat salad samples were collected from fields, markets, and kitchens in Accra, Ghana, and over 300 soil and irrigation water samples were collected. All samples were analysed for E. coli, human adenovirus and norovirus using standard microbiological procedures. In addition, almost 700 participants including farmers, food vendors, and consumers were interviewed and observed to assess critical exposures associated with the transmission of faecal pathogens. The results showed that irrigation water was significantly more contaminated than farm soil, though exposure to soil was found to pose the key risk to farmers due to hand-to-mouth events. Over 80% of produce samples were found contaminated with E. coli, with street food salad being the most contaminated (4.23 Log E. coli/g), and that consumption of salads did not meet health standards. Risk factors identified for produce contamination included farm soil contamination, wastewater use for irrigation, poor hygiene, and operating with a hygiene permit. Awareness of the source of irrigation water was low, but despite the high awareness of health risk, consumers did not prioritize health indicators when buying produce from vendors. Similarly, farmers’ awareness of health risk did not influence their adoption of safer farm practices. The study recommends the promotion of interventions that would result in more direct benefits to producers and vendors, together with hygiene education and inspection, hygiene certification and enforcement of food safety byelaws in order to increase the uptake of the multi-barrier approach