ghanaopendata/ghanaian-research-english huggingface dataset:
Strengthening Applied Epidemiology in West Africa: Progress, Gaps, and Advancing a Regional Strategy to Improve Health Security

The ability to prevent, promptly detect, and appropriately respond to a public health threat is essential for health security. Field epidemiology training has helped increase the quality and quantity of the public health workforce to strengthen disease surveillance, outbreak preparedness and response, and general public health capacity. We conducted a desk review on the status of the Field Epidemiology and Laboratory Training Program model in 16 countries in West Africa. We also developed a questionnaire and shared it with West African Health Organization (WAHO) member states to document their experiences and the status of training in their countries. WAHO organized a regional 3-day consultative meeting with major stakeholders in the region to examine progress, gaps, and challenges, and outline a roadmap to strengthen the Field Epidemiology and Laboratory Training Program. Stakeholders shared their experiences, engaged in discussions to identify strengths and gaps, and made plans for a way forward. Member states are at different levels of implementing field epidemiology and laboratory training programs in their countries, and, therefore, major gaps remain in the number and distribution of trained episode biologists throughout West Africa. Member states implement different variants of the program and in some instances, the same cadre of health workers are trained in different but comparable programs with different funding streams. Two member states had not begun implementing the training program. Developing regional centers of excellence was recommended in the long term while collaboration among member states to train the required number of epidemiologists to fill the acute needs could be helpful in the short and medium term. Curriculum harmonization and expansion, deployment and use of trained epidemiologists, accreditation of training institutions, and generation of indigenous funding streams are recommended to improve the Field Epidemiology and Laboratory Training Program in West Africa.

Source: UG
Strengthening health district management competencies in Ghana, Tanzania and Uganda: Lessons from using action research to improve health workforce performance

Background To achieve Universal Health Coverage (UHC), more health workers are needed; also critical is supporting optimal performance of existing staff. Integrated human resource management (HRM) strategies, complemented by other health systems strategies, are needed to improve health workforce performance, which is possible at district level in decentralised contexts. To strengthen the capacity of district management teams to develop and implement workplans containing integrated strategies for workforce performance improvement, we introduced an action-research-based management strengthening intervention (MSI). This consisted of two workshops, follow-up by facilitators and meetings between participating districts. Although often used in the health sector, there is little evaluation of this approach in middle-income and low-income country contexts. The MSI was tested in three districts in Ghana, Tanzania and Uganda. This paper reports on the appropriateness of the MSI to the contexts and its effects. Methods Documentary evidence (workshop reports, workplans, diaries, follow-up visit reports) was collected throughout the implementation of the MSI in each district and interviews (50) and focus-group discussions (6) were conducted with managers at the end of the MSI. The findings were analysed using Kirkpatrick’s evaluation framework to identify effects at different levels. Findings The MSI was appropriate to the needs and work patterns of District Health Management Teams (DHMTs) in all contexts. DHMT members improved management competencies for problem analysis, prioritisation and integrated HRM and health systems strategy development. They learnt how to refine plans as more information became available and the importance of monitoring implementation. The MSI produced changes in team behaviours and confidence. There were positive results regarding workforce performance or service delivery; these would increase with repetition of the MSI. Conclusions The MSI is appropriate to the contexts where tested and can improve staff performance. However, for significant impact on service delivery and UHC, a method of scaling up and sustaining the MSI is required.

Source: UG
Strengthening health system leadership for better governance: what does it take?

This editorial provides an overview of the six papers included in this special supplement on health leadership in Africa. Together the papers provide evidence of leadership in public hospital settings and of initiatives to strengthen leadership development. On the one hand, they demonstrate both that current leadership practices often impact negatively on staff motivation and patient care, and that contextual factors underpin poor leadership. On the other hand, they provide some evidence of the positive potential of new forms of participatory leadership, together with ideas about what forms of leadership development intervention can nurture new forms of leadership. Finally, the papers prompt reflection on the research needed to support the implementation of such interventions.

Source: UG
Strengthening laboratory surveillance of viral pathogens: Experiences and lessons learned building next-generation sequencing capacity in Ghana

Most research activities involve the use of molecular methods such as regular PCR (PCR), quantitative PCR (Q-PCR), genomic sequence and analysis using different software, genetic engineering, probe hybridization techniques, biological and molecular cloning, evaluation of immune markers for laboratory diagnosis of infections, serological assays involving the use of rapid tests, ELISA-based evaluations and immunofluorescent assay techniques.

Source: UG
Strengthening Maternal, Infant, and Young Child Nutrition Training and Counseling in Ghana: A Community-Based Approach

Background: Evidence-based maternal, infant, and young child nutrition (MIYCN) counseling provides caregivers with essential nutrition education to optimize infant and young child feeding practices and subsequently improve child growth and development. Effective integration of responsive feeding (RF) into current MIYCN training requires working with priority communities. Objectives: The study objectives were to 1) assess MIYCN knowledge and practices among Ghanaian caregivers, 2) identify factors influencing RF/responsive parenting (RP) among Ghanaian caregivers, 3) identify barriers and facilitators influencing MIYCN training and counseling among Ghanaian health care providers, and 4) document recommendations for integrating an RF curriculum into the existing MIYCN training. Methods: This was a qualitative study, conducted within the Central Region of Ghana, based on 1) 6 focus groups with caregivers of young children (<36 mo; n = 44) and 2) in-depth interviews with health care providers (n = 14). Focus group transcripts were coded independently, consensus was reached, and a final codebook was developed. The same coding process and thematic analysis were applied to the in-depth interviews. Results: Caregivers identified 3 domains influencing the primary outcome of RF/RP knowledge and practices and the secondary outcome of MIYCN: 1) health care provider counseling; 2) support from family, friends, and community members; and 3) food safety knowledge and practice. Providers identified barriers to MIYCN provider training as well as caregiver counseling which included limited access to financial and counseling resources and limited qualified staff to deliver infant and young child feeding counseling. Identified facilitators included the availability of funding and counseling staff with adequate resources. Healthcare providers strongly endorsed integrating an RF curriculum into MIYCN training and counseling along with providing RF training and distribution of RF materials/tools to facilities. Conclusions: Healthcare providers directly influenced RF/RP practices through MIYCN counseling. Strengthening MIYCN counseling through the integration of an RF curriculum into MIYCN training is desired by the community.

Source: UG
Strengthening post-graduate educational capacity for health policy and systems research and analysis: The strategy of the Consortium for Health Policy and Systems Analysis in Africa

Background: The last 5-10 years have seen significant international momentum build around the field of health policy and systems research and analysis (HPSR + A). Strengthening post-graduate teaching is seen as central to the further development of this field in low- and middle-income countries. However, thus far, there has been little reflection on and documentation of what is taught in this field, how teaching is carried out, educators' challenges and what future teaching might look like. Methods: Contributing to such reflection and documentation, this paper reports on a situation analysis and inventory of HPSR + A post-graduate teaching conducted among the 11 African and European partners of the Consortium for Health Policy and Systems Analysis in Africa (CHEPSAA), a capacity development collaboration. A first questionnaire completed by the partners collected information on organisational teaching contexts, while a second collected information on 104 individual courses (more in-depth information was subsequently collected on 17 of the courses). The questionnaires yielded a mix of qualitative and quantitative data, which were analysed through counts, cross-tabulations, and the inductive grouping of material into themes. In addition, this paper draws information from internal reports on CHEPSAA's activities, as well as its external evaluation. Results: The analysis highlighted the fluid boundaries of HPSR + A and the range and variability of the courses addressing the field, the important, though not exclusive, role of schools of public health in teaching relevant material, large variations in the time investments required to complete courses, the diversity of student target audiences, the limited availability of distance and non-classroom learning activities, and the continued importance of old-fashioned teaching styles and activities. Conclusions: This paper argues that in order to improve post-graduate teaching and continue to build the field of HPSR + A, key questions need to be addressed around educational practice issues such as the time allocated for HPSR + A courses, teaching activities, and assessments, whether HPSR + A should be taught as a cross-cutting theme in post-graduate degrees or an area of specialisation, and the organisation of teaching given the multi-disciplinary nature of the field. It ends by describing some of CHEPSAA's key post-graduate teaching development activities and how these activities have addressed the key questions. 2016 Erasmus et al.

Source: UG
Strengthening public health education in population and reproductive health through an innovative academic partnership in Africa: The gates partners experience

Poor reproductive health constitutes one of the leading public health problems in the world, particularly in sub-Saharan Africa (SSA). We report here an academic partnership that commenced in 2003 between a US institution and six universities in SSA. The partnership addresses the human resources development challenge in Africa by strengthening public health education and research capacity to improve population and reproductive health (PRH) outcomes in low-resource settings. The partnership's core activities focused on increasing access to quality education, strengthening health research capacity and translating scholarship and science into policy and practices. Partnership programmes focused on the educational dimension of the human resources equation provide students with improved learning facilities and enhanced work environments and also provide faculty with opportunities for professional development and an enhanced capacity for curriculum delivery. By 2007, 48 faculty members from the six universities in SSA attended PRH courses at Johns Hopkins University, 93 PRH courses were offered across the six universities, 625 of their master's students elected PRHconcentrations and 158 had graduated. With the graduation of these and future student cohorts, the universities in SSA will systematically be expanding the number of public health practitioners and strengthening programme effectiveness to resolve reproductive health needs. Some challenges facing the partnership are described in this article. © 2010 Taylor & Francis.

Source: UG
Strengthening quality of acute care through feedback from patients in Ghana

Introduction Quality of acute care has attracted attention in recent years with policy initiatives in Ghana. Such initiatives need to be complemented with patient feedback systems for strengthening quality. Therefore the goal of this study is to examine factors associated with quality of acute care and to propose a range of options for improving the existing model of healthcare delivery. Methods Cross-sectional data were collected from 379 patients presenting to emergency centres in five public health facilities. A structured questionnaire developed based on the literature and expert advice by physicians and nurses was used to collect data. Principal component analysis (PCA) was used to extract the factors salient to patients' perspective of quality of care. Logistic regression was then used to examine association between these factors and overall quality of acute care. Results The majority of the patients (17.2%) presented with obstetrical related conditions, 15% with Road Traffic Accidents (RTAs), 11.3% with diarrhoea related problems and the least number (8.4%) with bronchial asthma. The average days of admission was high for patients with bronchial asthma (mean = 9), RTA (mean = 8) and burns (means = 7). The PCA produced four factors of quality (interpersonal care; prompt care; physical environment and privacy; drugs and equipment) all of which had a positive statistically significant association with overall quality of acute care after controlling for patient's socio-demographic characteristics. Conclusion Study findings provide important feedback not only for optimising clinical operations but also for improving in-hospital quality of acute care with short-term and long-term approaches. © 2014 African Federation for Emergency Medicine.

Source: UG
Strengthening research capacity through regional partners: the HRP Alliance at the World Health Organization

Background: Improvements in health cannot occur without cutting-edge research informing the design and implementation of health programmes and policies, highlighting the need for qualified and capable researchers and institutions in countries where disease burden is high and resources are limited. Main body: Research capacity strengthening efforts in low- and middle-income countries have included provision of training scholarships for postgraduate degrees, often in high-income countries, internships at research universities/centres, short courses, as well as involvement with research groups for hands-on experience, among others. The HRP Alliance provides opportunities for developing local research capacity in sexual and reproductive health and rights through institutions based in low- and middle-income countries linked with ongoing and past collaborative studies. It is a network of HRP research partner institutions, World Health Organization (WHO) country and regional offices, WHO special programmes and partnerships, and WHO collaborating centres. Conclusion: It is through the HRP Alliance that HRP seeks to improve population health by strengthening local research capacity in sexual and reproductive health across the globe, with focus in low- and middle-income countries, in alignment with WHO’s quest of promoting healthier populations.

Source: UG
Strengthening the influenza vaccine virus selection and development process

Most research activities involve the use of molecular methods such as regular PCR (PCR), quantitative PCR (Q-PCR), genomic sequence and analysis using different software, genetic engineering, probe hybridization techniques, biological and molecular cloning, evaluation of immune markers for laboratory diagnosis of infections, serological assays involving the use of rapid tests, ELISA-based evaluations and immunofluorescent assay techniques.

Source: UG
Strengthening the influenza vaccine virus selection and development process. Report of the 3rd WHO Informal Consultation for Improving Influenza Vaccine Virus Selection held at WHO headquarters, Geneva, Switzerland, 1-3 April 2014

Most research activities involve the use of molecular methods such as regular PCR (PCR), quantitative PCR (Q-PCR), genomic sequence and analysis using different software, genetic engineering, probe hybridization techniques, biological and molecular cloning, evaluation of immune markers for laboratory diagnosis of infections, serological assays involving the use of rapid tests, ELISA-based evaluations and immunofluorescent assay techniques.

Source: UG
Strengths and challenges with spiritual care: Student feedback from the EPICC Spiritual Care Self-Assessment Tool

Aim: To explore qualitative data from students' self-reported competencies in spiritual care gathered during testing of a student self-assessment tool based on the EPICC Spiritual Care Education Standard. Design: Reflexive thematic analysis of qualitative data from a multinational study on validating a new self-assessment tool. Methods: The EPICC Spiritual Care Education Standard for competency in spiritual care was developed to enhance nurses' and midwives' ability to provide spiritual care by creating a baccalaureate education standard for spiritual care competencies. Spiritual care researchers then developed a self-assessment tool to raise student awareness of spirituality and track personal and professional growth in spiritual care competency. The EPICC Spiritual Care Competency Self-Assessment Tool, tested at eight universities in five countries, provided many opportunities for student comments, resulting in rich qualitative data presented here. Results: Themes related to strengths, weaknesses and areas for improvement. Identified strengths were similar across countries: caring attitudes, general knowledge of caring and compassion and good communication skills. Weaknesses/challenges touched on spirituality as overlooked in some cultures but part of life for others, complex questions were hard to understand, and self-assessment tools are common for some and rare for others. Areas for improvement included need for knowledge of religious and other deeply held beliefs and for greater spiritual assessment skills. Similarities across countries related to basic training in communication and compassionate care for nurses globally. Differences lay in the challenges and/or barriers for spiritual care and may relate to cultures within countries and/or university test sites. Relevance to clinical practice: The Tool raises awareness of spirituality among students and working nurses, providing an accessible way to self-check personal and professional growth in spiritual care competencies, which increases student and nurse capacity to become more knowledgeable and skilled in facilitating spiritual care, thus be role models for students at the intersection of spirituality and health.

Source: UG
Strengths, disconnects and lessons in local and central governance of the response to the first wave of COVID-19 in Ghana

Objectives: To explore governance, coordination and implementation actors, structures and processes, facilitators, and barriers within local government and between central and local government in Ghana’s COVID-19 response dur ing the first wave of the outbreak. Design: Cross-sectional single case study. Data collection involved a desk review of media, policy and administrative documents and key informant in-depth interviews. Setting: Two municipalities in the Greater Accra region of Ghana Participants: Local government decentralised decision makers and officials of decentralised departments. Interventions: None. Main Outcome Measures: None Results: Coordination between the national and local government involved the provision of directives, guidelines, training, and resources. Most of the emergency response structures at the municipal level were functional except for some Public Health Emergency Management Committees. Inadequate resources challenged all aspects of the re sponse. Coordination between local government and district health directorates in risk communication was poor. Dur ing the distribution of relief items, a biased selection process and a lack of a bottom-up approach in planning and implementation were common and undermined the ability to target the most vulnerable beneficiaries. Conclusions: Adequate financing and equipping of frontline health facilities and workers for surveillance, laboratory and case management activities, transparent criteria to ensure effective targeting and monitoring of the distribution of relief items, and a stronger bottom-up approach to the planning and implementation of interventions need to be given high priority in any response to health security threats such as COVID-19.

Source: UG
Streptococcus pneumoniae serotypes/serogroups causing invasive disease in Riyadh, Saudi Arabia: extent of coverage by pneumococcal vaccines.

BACKGROUND: Serogroup distribution of sterile site pneumococcal isolates varies between developing and developed countries as well as between different geographical regions. The potential efficacy of any pneumococcal vaccine depends on the degree of representation of the prevalent serogroups in the vaccine. We conducted this study to determine the prevalent pneumococcal serogroups causing invasive infections in Riyadh, Saudi Arabia and to estimate the coverage by the various pneumococcal conjugate vaccines. METHODS: S. pneumoniae isolated between February 2000 and November 2001 from sterile sites of patients of all age groups were collected from 8 major hospitals in Riyadh and serogrouped using the latex agglutination method. RESULTS: Isolates from 78 patients, 72% of whom were children, were studied. Eighty-eight percent of the isolates belonged to only 10 serogroups/serotypes, namely 6 and 19, 1 and 15, 14 and 23, 7, 18 and 22, in descending order of frequency. Potential coverage of the 7-valent, 9-valent, and 11-valent conjugate vaccines were 54%, 65% and 73%, respectively. The rate of reduced penicillin susceptibility in the serogroups represented in the 7-valent conjugate vaccine was significantly higher than in the non-vaccine serogroups (62% vs. 25%; P=0.0023). CONCLUSION: The currently available 7-valent pneumococcal conjugate vaccine provides sub-optimal coverage to serogroups causing invasive diseases in our community. However, this vaccine would be a useful adjunct to penicillin prophylaxis in at-risk patients in the community. The effectiveness of the vaccine would be greater if serotype 15 could be included.

Source: UG
Stress and coping among litigants in the civil litigation process in Ghana

Few studies have examined the challenges litigants face in the civil litigation process in Africa and Ghana. The study sought to investigate the effect of type of litigant on stress, and coping. Using both purposive and convenience sampling techniques, 262 litigants using the High Courts at the court complex in Accra, Ghana, were sampled for the study. Most respondents were male (88.9%), with a mean age of 48.1 (SD = 13.25). A significant effect of type of litigant on stress, and coping was observed. Those litigating as individuals experienced more stress: intrusion, and avoidance compared with those litigating on behalf of their companies. Consequently, those litigating as individuals used more coping strategies compared with those litigating on behalf of their companies. These findings are discussed in relation to relevant literature

Source: UG