Aedes (Stegomyia) Mosquitoes in the Ashanti Region of Ghana: Implications for Yellow Fever Paucity

A research was carried out to map Aedes mosquito vectors of Yellow Fever (YF) in 4 localities (KNUST, Ejisu, Angola and Akropong) in the Ashanti Region of Ghana to identify and catalogue the various species of Aedes mosquitoes that may occur in the Region. This is to ascertain possible factors (both physical and biological) that may influence the population densities of Aedes mosquitoes and the possible reasons for the paucity of YF in the Region. Several species of Aedes mosquitoes were encountered and identified. Of all the mosquito species identified, Aedes aegypti was the predominant (81%). This was followed by Aedes vittatus (3.3%) and Toxorhynchites brevipalpis (3.1%). The bulk of the other mosquitoes apart from Aedes and Toxorhynchites brevipalpis was only 9.5%.  The research analyzed the output of elliptical profile model generated for 4 Aedes vectors (n=2,7492) and 4 sample locations. Analysis of the model output  reveals that the standard deviational ellipse is significantly better able to predict the linear distribution of Aedes populations within the geographical region. The relationship between the orientation of the elliptical profiles and the mean linear orientation of the corresponding quarters was assessed to reveal a moderate but significant association.  These findings demonstrate that the sample locations vis-à-vis pH concentration impact on the distributions of Aedes within the geographical area and supports the ecological variability within the sample locations. Keywords: Yellow Fever, Aedes mosquitoes, Toxorhynchites brevipalpis,  pH Range, GI

Utilization of Healthcare Services by the Elderly Patients at Korle-Bu Teaching Hospital, Accra

Objective: The study assessed the association between predisposing, enabling and need factors on utilization of healthcare services by the elderly attending the Korle-Bu Teaching Hospital. Methods: The study was a descriptive cross-sectional survey using a mixed method approach. Simple random sampling was used to sample three hundred and sixty-one elderly patients from seven (7) Out-Patient Departments in the Korle-Bu Teaching Hospital who responded to a structured questionnaire. Ordinal Logistic Regression was used to determine the association between the predisposing, enabling and need factors of the elderly and variables measuring utilization of healthcare. In the qualitative study, purposive and convenient samplings were used to select 76 elderly persons from the seven Out-Patient Departments of the hospital. Content analysis was used to analyze the voice recorded qualitative interview data and explained using an appropriate theory. Quantitative findings: The elderly who obtained above secondary school education were 0.49 times less likely to rate accessibility of healthcare on a higher scale compared with the elderly with pre-secondary education (OR=0.49, 95% CL; 0.28-0.85, p=0.11). The elderly who were beneficiaries of NHI were 0.42 times less likely (OR=0.42, 95% CI; 0.18-0.97) to rate accessibility of healthcare services on a higher scale compared with the elderly who were non-beneficiaries (p=0.042).  The elderly with multiple chronic conditions were 1.56 times more likely to rate the cost of healthcare on a higher scale compared with the elderly with one chronic condition (OR=1.56, 95% CI=1.04-2.34, p=0.03).  Qualitative findings: The elderly persons described the waiting time as long and stressful. They developed swollen feet and bodily pains due to the long waiting time. They clarified that the diagnostic investigation, medication and consultation fees were expensive, leading to postponement of their subsequent visits and deterioration of their health. Conclusion: Cost was a determining factor in utilizing healthcare. The study recommends that policy makers should include elderly persons from age 60 years to 69 years in the National Health Insurance exemption policy to enable the majority of them to utilize healthcare. Additionally, there is the need to review visits to the healthcare units to schedule time appointments to reduce the long and stressful waiting time

Assessment of capacity for health policy and systems research and analysis in seven African universities: results from the CHEPSAA project

The importance of health policy and systems research and analysis (HPSR+A) is widely recognized. Universities are central to strengthening and sustaining the HPSR+A capacity as they teach the next generation of decision-makers and health professionals. However, little is known about the capacity of universities, specifically, to develop the field. In this article, we report results of capacity self- assessments by seven universities within five African countries, conducted through the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA). The capacity assessments focused on both capacity ‘assets’ and ‘needs’, and covered the wider context, as well as organizational and individual capacity levels. Six thematic areas of capacity were examined: leadership and governance, organizations’ resources, scope of HPSR+A teaching and research, communication, networking and getting research into policy and practice (GRIPP), demand for HPRS+A and resource environment. The self-assessments by each university used combinations of document reviews, semi-structured interviews and staff surveys, followed by comparative analysis. A framework approach, guided by the six thematic areas, was used to analyse data. We found that HPSR+A is an international priority, and an existing activity in Africa, though still neglected field with challenges including its reliance on unpredictable international funding. All universities have capacity assets, such as ongoing HPSR+A teaching and research. There are, however, varying levels of assets (such as differences in staff numbers, group sizes and amount of HPSR+A teaching and research), which, combined with different capacity needs at all three levels (such as individual training, improvement in systems for quality assurance and fostering demand for HPSR+A work), can shape a future agenda for HPSR+A capacity strengthening. Capacity assets and needs at different levels appear related. Possible integrated strategies for strengthening universities’ capacity include: refining HPSR+A vision, mainstreaming the subject into under- and post-graduate teaching, developing emerging leaders and aligning HPSR+A capacity strengthening within the wider organizational development.Web of Scienc