ghanaopendata/ghanaian-research-english huggingface dataset:
Factors associated with syphilis screening uptake among pregnant women in health facilities in Brong Ahafo Region of Ghana

Abstract Background Congenital syphilis is a consequence of undiagnosed, untreated, or inadequately treated maternal syphilis and results in serious adverse outcomes. It is easily diagnosed and in Ghana it is treated at points of care free; yet most pregnant women attending antenatal clinic (ANC) in Ghana are not screened. This study identified some factors influencing syphilis screening uptake at medical facilities during pregnancy in the Brong Ahafo Region of Ghana. Method A cross-sectional study was conducted in two districts in Brong Ahafo Region of Ghana. All the health facilities in the selected districts that run antenatal services were assessed on their preparedness to screen syphilis for pregnant women. Interviews were conducted among 390 pregnant women attending ANC at five hospitals in the two districts to identify individual and community level barriers to syphilis screening. Results In all 37 health facilities conducted antennal clinics in the two districts in 2013, 75.7% of the health facilities were public; Techiman had the higher number of health facilities (64.9%), test kits were available in only 29.7% of the health facilities and 43.2% of 37 health facilities were conducting syphilis screening. Majority of the pregnant women (57.7%) were within the age range of 20–29 years, 53.1% were in their third trimester, 32.6% in second trimester and 14.3% were in the first trimester. Syphilis screening was 52.4% among 37 health facilities. Among 390 pregnant women who participated in the study syphilis screening was 21.1%. At the health facility level, screening was significantly associated with the type of hospital (whether private or public), availability of test kits, and trained personnel, such as doctors/midwives and syphilis education. At the individual level, attending a public hospital (OR=5.49; 95% CI=1.71-17.65), willingness to request screening (OR=2.72; 95% CI=1.09-5.88), and being in the third trimester of pregnancy (OR=16.47; 95% CI=2.02-132.81) were significantly associated with syphilis screening uptake. Conclusion Despite government’s free screening policy for syphilis among pregnant women, the coverage of antenatal screening is still low. Training of lower level health workers and regular supply of logistics are crucial for the success of the syphilis prevention programme.

Source: UG
Factors associated with the family reintegration stability for children with a residential care experience in Ghana

There is limited evidence on family reintegration for children who have been in residential care within the African context. The goal of this study is to find out what factors impact reintegration institutionalized children’s desire to remain with their biological parents or extended family. The dataset included records for 659 interviewed children and their guardians. However, the analyses were limited to 408 cases with complete data on the dependent and independent variables. Most of the children in the study (73%) preferred to remain with their relatives. The age of the child, length of time spent in residential care, and having a case file were all factors linked to the children’s wish to stay with their family. Based on the findings of the study, social workers should do a full assessment and documentation to decide if reintegration is appropriate and prepare the child and family, and give follow-up assistance to ensure stable reintegration. Social workers must also link reunified families to long-term support, such as enrollment on the Livelihood Empowerment against Poverty social protection program, and they should monitor placements to improve the stability of the reintegration.

Source: UG
Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana

Background: In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. Methods: This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. Results: Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. Conclusions: The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty. © 2018 The Author(s).

Source: UG
Factors associated with unconstrained growth among affluent Ghanaian children

Aim: To identify socio-economic factors associated with unconstrained growth among children living in well-off neighbourhoods of Accra, Ghana. Methods: A cross-sectional study involving the assessment of the anthropometric status of preschool children. Children (n = 309) between the ages of 12 and 23 mo who live in affluent communities in Accra, Ghana were recruited for the study. Weight, length and mid-upper arm circumference were taken. Information was collected on household demographics and socio-economic status, including parental education and household income. Associations between these variables and attained growth were analysed to establish cutoffs for screening children with unconstrained growth. Results: The mean weight-for-age (WA), length-for-age (LA) and weight-for-length (WL) Z-scores of the sub-sample selected on the basis of high socio-economic criteria were -0.18, -0.40 and 0.16, respectively. Among these well-off children, 0% were underweight, 3.0% were stunted and 0% were wasted (Z-scores <-2). Factors associated with better anthropometric status were paternal education and household income. Two screening criteria combining the two variables were selected: polytechnic education and income > ¢1 000 000 (US$435) or university education and income >¢200 000. Conclusions: The children experiencing unconstrained growth belonged to a sub-population of affluent households characterized by high paternal education and household income. This subpopulation was targeted for screening for the WHO Multicentre Growth Reference Study in Ghana.

Source: UG
Factors associated with uncontrolled blood pressure among Ghanaians: Evidence from a multicenter hospital-based study

Background The burden of uncontrolled hypertension in Low-and-Middle Income Countries (LMICs) is high, with an increased risk of cardiovascular diseases and chronic renal failure in these settings. Objective To assess the factors associated with uncontrolled blood pressure control in a cross-section of Ghanaian hypertensive subjects involved in an on-going multicenter epidemiological study aimed at improving access to hypertension treatment. Methods A cross-sectional study involving 2,870 participants with hypertension with or without diabetes who were enrolled at 5 hospitals in Ghana (2 tertiary, 2 district and 1 rural hospital). Data on demographics, medical history, lifestyle factors, anti-hypertensive medications and treatment adherence were collected. The 14-item version of the Hill-Bone compliance to high blood pressure therapy scale was used to assess adherence to treatment in 3 domains namely adherence to medications, salt intake and clinic appointments. Questionnaires on knowledge, attitudes and practices on hypertension, sources of antihypertensive medications and challenges with accessing these medications were also administered. Blood pressure, weight and height were measured for each subject at enrollment. Factors associated with uncontrolled blood pressure (>140/90mmHg) were assessed using a multivariate logistic regression model. Results The mean ± SD age of study participants was 58.9 ± 16.6 years, with a female preponderance (76.8%). Among study participants, 1,213 (42.3%) study participants had blood pressure measurements under control. Factors that remained significantly associated with uncontrolled blood pressure with adjusted OR (95% CI) included receiving therapy at a tertiary level of care: 2.47 (1.57–3.87), longer duration of hypertension diagnosis: 1.01 (1.00–1.03), poor adherence to therapy: 1.21 (1.09–1.35) for each 5 points higher score on the Hill-Bone scale, reported difficulties in obtaining antihypertensive medications: 1.24 (1.02–1.49) and number of antihypertensive medications prescribed: 1.32 (1.21–1.44). Conclusion We have found high rates of uncontrolled blood pressure among Ghanaian patients with hypertension accessing healthcare in public institutions. The system-level and individual-level factors associated with poor blood pressure control should be addressed to improve hypertension management among Ghanaians. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Source: UG
Factors Associated with Uptake of Intermittent Preventive Treatment of Malaria in Pregnancy: A Cross-Sectional Study in Private Health Facilities in Tema Metropolis, Ghana

Introduction. Intermittent preventive treatment of malaria in pregnancy with sulfadoxine pyrimethamine (IPTp-SP) is effective in preventing the adverse consequences of malaria on birth outcomes. Methods. A cross-sectional survey was carried out among antenatal and postnatal women and midwives at private health facilities in Tema using the mixed method to investigate factors associated with uptake of IPTp-SP. Antenatal and postnatal women were consecutively enrolled and data on their sociodemographic characteristics and antenatal service utilization collected using a questionnaire and review of antenatal care (ANC) records. In-depth interviews involving attending midwives were conducted and data on ANC service delivery collected. The interviews were manually analyzed. Bivariate and multiple logistic regression analyses were done to determine factors associated with uptake of SP. Results. Of the 382 respondents, 178 (46.6%) took ≥ 3 doses of SP. Uptake was similar for those who had delivered and those yet to deliver (χ2 =2.94, p > 0.05). Ninety-seven of the 176 (55.1%) women who initiated antenatal visit during the first trimester received ≥ 3 doses of SP whilst 42.0% (76/181) of those who started during the second trimester received ≥ 3 doses (χ2 = 5.64, p = 0.02). Those who initiated ANC during the second trimester received more doses compared to those who started during the third trimester (χ2 = 4.43, p = 0.04). Respondents who attended ANC > 5 times increased their uptake by 83% compared to those who attended < 5 times (OR 0.2, 95% C.I 0.12-0.31). There was poor adherence to directly observed treatment and low knowledge of midwives on IPTp-SP protocol. Conclusion. Early initiation and regular visit to antenatal care centres promoted uptake of optimal doses of SP.

Source: UG
Factors Associated With Vaccine Default In Southern Ghana Based On Data From The RTSS Malaria Vaccine Trial In Cape Coast.

Malaria has been a severe global and public health concern for the last couple of decades. Ghana, like many other countries in sub–Saharan Africa, is most affected by the disease, with children facing dire consequences. The recent introduction of the RTS, S malaria vaccine holds great potential in reducing malaria fatalities in children. However, RTS, S implementation have inherent challenges that raise the stakes of vaccine defaults in piloted areas in Ghana. In this study, we examine the predictors of RTS, S vaccine defaults using a cross-sectional research design that covers a sample of 765 caregivers in Southern Ghana. Classification models (Binary logistic regression and Random Forest) were performed to identify critical socio-demographic, health and RTS, S related predictors. The findings show that more than a third (38.43%) of children defaulted at least one dose of the malaria vaccine. Key predictors of defaults included sub-metro of residence, cost of traveling to health facilities, experience of adverse events, knowledge about the vaccine doses, caregiver’s employment status, and religion. Our findings emphasize the need for targeted interventions to reduce defaults, mainly focusing on caregiver education on vaccines, reducing financial barriers to healthcare access, and addressing concerns about adverse events.

Source: UG
Factors Associated With Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana.

Background. Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study evaluated duration and factors that influenced waiting time from first presentation to start of definitive treatment. Method. We conducted a hospital-based retrospective study of 205 breast cancer patients starting definitive treatment at Korle Bu Teaching Hospital between May and December 2013. We used descriptive statistics to summarize patient characteristics. Mann–Whitney U and Kruskal–Wallis tests and Spearman rank correlation were performed to examine the patients, health system, and health worker factors associated with median waiting time. Poisson regression was used to examine the determinants of waiting time. Results. The mean age of the patients was 51.1 ± 11.8 years. The median waiting time was 5 weeks. The determinants of waiting time were level of education, age, income, marital status, ethnicity, disease stage, health insurance status, study sites, time interval between when biopsy was requested and when results were received and receipt of adequate information from health workers. Conclusion. A prolonged waiting time to treatment occurs for breast cancer patients in Ghana, particularly for older patients, those with minimal or no education, with lower income, single patients, those with late disease, those who are insured, and who did not receive adequate information from the health workers. Time to obtain biopsy reports should be shortened. Patients and providers need education on timely treatment to improve prognosis.

Source: UG
Factors Constraining University for Development Studies in Community Engagement in Northern Ghana

University for Development Studies (UDS) was established in 1992 with an explicit mandate to blend its academic work with that of the community in order to provide constructive interaction for the total development of northern Ghana in particular, and the country as a whole. Past research has shown that UDS has appreciably linked its teaching, research, and service roles to the socio-economic needs of northern Ghana. This study sought to illuminate the key factors constraining the university in its community engagement programs. It employed an interpretive research paradigm through semi-structured interviews and documentary analysis. In all 20 participants were purposefully drawn from specific units within the university for the study. Results from the study showed that inadequate funding of community engagement activities by the national government and regional authorities, inadequate infrastructural development in northern Ghana, lack of ability and readiness of the regional economy to absorb university knowledge and graduates, lack of specific internal incentive structures to motivate academics to engage in activities of regional nature and unwillingness of some academics to engage in activities of regional nature serve as the key factors constraining the regional role of the university. The study, therefore, recommends that if UDS is recognized as a key player in the development of Northern Ghana, then, the national government, regional authorities, and university administrators need to create an enabling environment and put in place appropriate policy support structures to stimulate an effective engagement of the university with its surrounding communities.

Source: UG
Factors Contributing to Divorce in Ghana: An Exploratory Analysis of Evidence From Court Suits

In Ghana, some divorce cases are conducted through the courts, and the reasons for such cases are important to gauge the factors that account for the dissolution of marriages in Ghana. This study was conducted to explore in-depth, the factors that lead to divorce using court suits in Ghana. Data were obtained from 30 lawsuits consisting of 11 men and 19 women with an age range of 29–71 years. Reasons for marital dissolution were assembled from a 10-year period (2007–2017) cases of divorce from the Greater Accra Region of Ghana. Conventional content analysis identified six main factors as possible reasons for divorce: infidelity, abuse, financial support, intimacy, financial problems, third-party intrusion and gender-role ideology. Men were likely to seek for divorce at an older age compared to women. Women attributed reasons for divorce to lack of respect from the husband and gender-role ideology. Our findings underscore the need for pre-marital counseling psychologists to help would-be couples address pertinent issues which could lead to distress and ultimately divorce in their marriages.

Source: UG
Factors contributing to low uptake and renewal of health insurance: a qualitative study in Ghana

Background: The effort to expand access to healthcare and reduce health inequalities in many low income countries have meant that many have adopted different levels of social health protection mechanisms. Ghana introduced a National Health Insurance Scheme (NHIS) in 2005 with the aim of removing previous barriers created by the user fees financing system. Although the NHIS has made health accessible to some category of people, the majority of Ghanaians (60 %) are not enroled on the scheme. Earlier studies have looked at various factors that account for this low uptake. However, we recognise that this qualitative study will nuance the depth of these barriers to enrolment. Methods: Minimally structured, qualitative interviews were conducted with key stakeholders at the district, regional and national levels. Focus group discussions were also undertaken at the community level. Using an inductive and content analytic approach, the transcripts were analyzed to identify and define categories that explain low uptake of health insurance. Results: The results are presented under two broad themes: sociocultural and systemic factors. Sociocultural factors identified were 1) vulnerability within certain groups such as the aged and the disabled groups which impeded access to the NHIS 2) cultural and religious norms which discouraged enrolment into the scheme. System-wide factors were 1) inadequate distribution of social infrastructure such as healthcare facilities, 2) weak administrative processes within the NHIS, and 3) poor quality of care. Conclusions: Mapping the interplay of these dynamic relations between the NHIS, its clients and service providers, the study identifies critical factors at the policy-making level, service provider level, and client level (reflective in household and community level institutional arrangements) that affect enrolment in the scheme. Our findings inform a number of potential reforms in the area of distribution of health resources and cost containment to expand coverage, increase choices and meeting the needs of the end user.

Source: UG
Factors contributing to the development of anaemia in Plasmodium falciparum malaria: What about drug-resistant parasites?

A major manifestation of complicated malaria especially among children is severe anaemia, the pathogenesis of which is not well understood. Among other factors, suppression of the bone marrow's response to erythropoietin, which is rapidly reversed after successful treatment of the malaria, has been implicated in its pathogenesis. Since resolution of malaria restores erythropoiesis, we hypothesized that drug-resistant strains of Plasmodium falciparum would increase the risk of severe anaemia developing from initially uncomplicated malaria. Using both in vivo and in vitro drug-sensitivity tests we compared the prevalence of drug-resistant malaria between severe malarial anaemia (SA) and non-anaemic malaria (NAM) patients. Assessment of treatment outcome using the WHO in vivo criteria showed no significant difference in parasite resistance between the two groups. The mean parasite clearance time was also comparable. Treatment failures of about 14 per cent and 12 percent were observed between SA and NAM patients respectively. The in vitro drug susceptibility test showed overall mean IC 50 values of 0.41×10-6 mol/l and 0.32×10-6 mol/l blood for SA and NAM groups respectively. Geometric mean pre-treatment blood levels of chloroquine did not differ much between the two groups. Findings from this study could not therefore implicate drug-resistant parasites in the pathogenesis of severe malarial anaemia. © 2006 Oxford University Press.

Source: UG
Factors facilitating and constraining the scaling up of an evidence-based strategy of community-based primary care: Management perspectives from northern Ghana

From 1994 to 2003, the government of Ghana investigated the child survival and fertility impacts of community-based primary care nurses and volunteer mobilisation efforts. This study, known as the Navrongo Project, demonstrated improved health outcomes and was scaled-up as the Community-based Health Planning and Services (CHPS) Initiative. Studies suggest that scaled-up CHPS services have not fully replicated the impact of the Project. This study investigates implementation challenges that could explain this atrophy by assembling the perspectives of health care managers that have experience with both the Project and CHPS. Data from in-depth interviews of health managers are analysed using deductive content analysis. Respondents exhibited a consistent vision of doorstep services with regard to the Project and CHPS. They shared the perspective that while scale-up has progressed slowly, it has expanded the range of services provided. Respondents felt, however, that the original emphasis on community involvement has atrophied with scale-up and that current operations are managed less rigorously than during the Project. Thus, while the expanded scope of CHPS has increased access to health care, the original focus on community engagement has faded. The original Project leadership strategy merits review for ways to integrate leadership development into scale-up activities.

Source: UG