ghanaopendata/ghanaian-research-english huggingface dataset:
Adherence To Healthcare Waste Management Protocols In Selected Health Facilities, Greater Accra And Eastern Regions, Ghana, 2021.

Background Managing healthcare waste is crucial for infection prevention and control. The World Health Organization targets proper management of the 15% infectious waste generated in healthcare settings. We examined adherence to proper healthcare waste management in two regions of Ghana and its predictors to improve occupational health and safety. Methods A cross-sectional study assessed 104 health facilities in the Greater Accra and Eastern Regions of Ghana in 2021. A checklist was adapted from the WHO/UNICEF Water and Sanitation for Health Facility Improvement tool. Data was col lected using interviews, observation and records review. Adherence levels were categorized as<50% score being low, 50%–79% as medium and≥80% as high. Descriptive and inferential analyses were done with signifcance considered at 95% confdence level and results presented using texts, tables and charts. Results Of 104 facilities, majority, 54.8% (57/104) were in Greater Accra with 45.2% (47/104) in Eastern Region. Across the two regions, Community-Based Health Planning and Services (CHPS) Compounds were 38.4% (40/104) with 26.9% (28/104) of facilities having high adherence to healthcare waste management protocols. Factors that infuenced adher ence included availability of placenta pit (AOR=27.28, CI: 3.09–240.64), having PPEs (AOR=9.52, CI: 1.27–71.24) and presence of colour coded waste bins (AOR=16.63, CI: 1.28–216.31). Conclusion Adherence to HCWM protocols was low among facilities in Eastern and Greater Accra regions. Factors that infuenced adherence were related to availability of logistics. Health facility heads should ensure the availability of waste management logistics to ensure high-level adherence to waste management protocols.

Source: UG
Adherence to oral anti-diabetic drugs among patients attending a Ghanaian teaching hospital

Background: The burden of diabetes mellitus, especially Type-2, continues to increase across the world. Medication adherence is considered an integral component in its management. Poor glycemic controls due to medication nonadherence accelerates the development of long-term complications which consequently leads to increased hospitalization and mortality. Objective: This study examined the level of adherence to oral antidiabetic drugs among patients who visited the teaching hospital and explored the probable contributory factors to non-adherence. Methods: A cross-sectional descriptive study using systematic sampling to collect quantitative data was undertaken. Questionnaires were administered to outpatients of the medical department of a teaching hospital in Ghana. Logistic regression was performed with statistical significance determined at p<0.05. Results: A total of 200 diabetic patients participated in the study. Using the Morisky Medication Adherence scale, the level of adherence determined was 38.5%. There were significant correlations between level of adherence and educational level [(OR)=1.508; (CI 0.805-2.825), P=0.019), and mode of payment [(OR)=1.631; (CI 0.997-2.669), P=0.05). Conclusion: Adherence in diabetic patients was low among respondents and this can be improved through education, counseling and reinforcement of self-care. There were several possible factors that contributed to the low adherence rate which could benefit from further studies. © 2015, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved.

Source: UG
Adherence to sulfadoxine-pyrimethamine fve-dose policy among pregnant women in an urban slum in Ghana: a mixed-methods study

Background Malaria in pregnancy (MiP) is a public health concern especially for pregnant women living in slums. The World Health Organization recommends at least three doses of Sulfadoxine-Pyrimethamine (SP) to prevent MiP. In Ghana, it is recommended that pregnant women receive a minimum of fve doses of the medication. This study sought to determine the level of adherence to IPT5 policy and factors associated with adherence among pregnant women in a slum community in Ghana. Methods This was a cross-sectional study involving 232 nursing mothers and four healthcare workers at the St. Martin’s Memorial Hospital, Sukura, Ghana. Sociodemographic characteristics of nursing mothers were obtained using an interview-administered questionnaire. Data on the number of SP doses and other obstetrics characteristics were collected by reviewing the antenatal record books. To obtain information about healthcare and health system factors associated with adherence to the five-dose policy, four healthcare providers were interviewed. A data extraction form was used to obtain information about the availability of SP at the facility. Results The level of adherence to IPT5 was 8.6% (20/232) (95% CI 5.0–12.3) among the participants. Only 8.4% of the participants received their first dose at 16 weeks. Respondents who began ANC in the second trimester were 81% less likely to adhere to IPT5 than those who began in the first trimester (aOR=0.19, 95% CI 90.01–0.65, p<0.008). Healthcare provider and health system factors that influence IPT5 uptake include healthcare providers’ knowledge of IPTp-SP guidelines, the practice of Directly Observed Therapy, education of pregnant women, training of healthcare providers, and availability of water. SP was available at the facility during the period of review. Conclusion Adherence to the IPTp-SP five-dose policy was suboptimal. Pregnant women who started ANC early were more likely to adhere to the policy. Provider knowledge, DOT practice, training, education of pregnant women and water availability were also found to influence adherence. Encouraging early ANC visits and providing healthcare workers with necessary training can substantially improve adherence in slum areas.

Source: UG
Adherence to the test, treat and track strategy for malaria control among prescribers, Mfantseman Municipality, Central Region, Ghana

The test, treat, and track (T3) strategy is directed at ensuring diagnosis and prompt treatment of uncomplicated malaria cases. Adherence to T3 strategy reduces wrong treatment and prevents delays in treating the actual cause of fever that may otherwise lead to complications or death. Data on adherence to all three aspects of the T3 strategy is sparse with previous studies focusing on the testing and treatment aspects. We determined adherence to the T3 strategy and associated factors in the Mfantseman Municipality of Ghana. Methods We conducted a health facility based cross-sectional survey in Saltpond Municipal Hospital and Mercy Women’s Catholic Hospitals in Mfantseman Municipality of the Central Region, Ghana in 2020. We retrieved electronic records of febrile outpatients and extracted the test ing, treatment and tracking variables. Prescribers were interviewed on factors associated with adherence using a semi-structured questionnaire. Data analyses was done using descriptive statistics, bivariate, and multiple logistic regression. Results Of 414 febrile outpatient records analyzed, 47 (11.3%) were under five years old. About 180 (43.5%) were tested with 138 (76.7%) testing positive. All positive cases received antimalar ials and 127 (92.0%) were reviewed after treatment. Of 414 febrile patients, 127 (30.7%) were treated according to the T3 strategy. Higher odds of adherence to T3 were observed for patients aged 5–25 years compared to older patients (AOR: 2.5, 95% CI: 1.27–4.87, p = 0.008). Adherence was low among physician assistants compared to medical officers (AOR 0.004, 95% CI 0.004–0.02, p<0.001). Prescribers trained on T3 had higher adherence (AOR: 99.33 95% CI: 19.53–505.13, p<0.000). Conclusion Adherence to T3 strategy is low in Mfantseman Municipality of the Central Region of Ghana. Health facilities should perform RDTs for febrile patients at the OPD with priority on low cadre prescribers during the planning and implementation of interventions to improve T3 adherence at the facility level.

Source: UG
Adherence to the three-component Hepatitis B virus vaccination protocol among healthcare workers in hepatitis B virus endemic settings in Ghana

Background: The WHO and CDC recommend that HCWs who are at risk of HBV infection should vaccinate as adults early in their career by receiving 3 doses of HB vaccine at a schedule of months 0,1,6 and perform post vaccination serological testing 1–2 months after vaccination. This study assessed adherence to all three com ponents of the HBV vaccination program. Methods: The study was a hospital-based analytical cross-sectional study involving 340 HCWs who were randomly selected. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of HCWs adhering to the three components of the HBV vaccination protocol was computed. The multivariable analysis procedure identified the factors associated with overall adherence. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. Results: HBV vaccination coverage was 60.9 % and adherence to 3-doses, 0,1,6 vaccination schedules and post vaccination serological testing were 46.8 %, 38 % and 13 % respectively. Overall adherence was intermediate at the population level with only 6.2 % of the study participants adhering to all three components of the HBV vaccination protocol. HCWs who had low-risk perception for HBV had the lowest odds of completely adhering to all three indicators recommended for HBV vaccination (aOR = 0.15; 95 %CI = 0.04–0.58). Also, male HCWs have lower odds of adhering to all three components of HBV vaccination compared to their female counterparts (aOR = 0.65; 95 %CI = 1.17–2.50). Conclusion: Adherence to the three components of HBV vaccination recommended for HCWs is low in this study. Failure to receive the recommended three-dose series of HBV vaccine at the recommended 0,1,6 schedule has implications for achieving seroprotection or development of antibodies against HBV. Failure to perform post vaccination testing 1–2 months after HBV vaccination has implications for timely PEP management following occupational exposures. All three components of an ideal HBV vaccination program are important and should be used collectively to guide facility led HCW vaccination programs. Occupational health and safety programs, Infection prevention and control, as well as health promotion campaigns in health facilities, should promote adherence to all three components of HBV vaccination programs.

Source: UG
Adherence to Treatment Regimen among Type 2 Diabetics at the Ridge Hospital, Accra.

Diabetes mellitus is a chronic disease that occurs when the pancreas is no longer able to produce insulin, or when the body cannot make good use of the insulin it produces. There are three main types of diabetes. The most common type is the Type 2 diabetes which represents 90% of cases worldwide .The other types of diabetes are Type 1 diabetes and gestational diabetes. Type 2 diabetics are faced with challenges and experiences such as financial difficulties, forgetfulness, and problems taking the medication, stigmatization, depression and anxiety. These experiences hinder their ability to adhere to treatment. The study seeks to explore the factors that influence treatment adherence at the Ridge Hospital in Accra. An exploratory descriptive research design was used for the study. Fourteen participants were recruited from December 2015 – March 2016. Interviews were conducted in the English and Twi languages. Interviews conducted in the local language were translated into the English afterwards. Data was analyzed using thematic content analysis. The study identified some factors that influence treatment adherence. These include knowledge of the diabetes, complications to avoid, efforts to improve the condition and benefits of adherence. It also identified some barriers to adherence such as forgetfulness, difficulty taking medication, depression, anxiety, stigma, blindness, amputation and others. The study recommended ways that health providers could employ to intensify patient education on each visit. This education would be holistic in order to increase the rate of adherence by the people living with diabetes. Future research into adherence to treatment regimen among diabetics which looks at the health providers‟ perspective can be carried out.

Source: UG
Adipocytokines in obese Ghanaian subjects with or without type 2 diabetes

Objective This study aimed to evaluate serum leptin and high sensitivity C-reactive protein (hsCRP) concentrations in obese Ghanaians with or without type 2 diabetes and to find out the extent to which their levels are influenced by underlying disorders. Results Obese subjects with type 2 diabetes had lower leptin but higher hsCRP levels compared with obese non-diabetic controls. There were negative correlations within the control group for glucose vs % muscle mass (r = − 0.378, p = 0.016), leptin vs % muscle mass (r = − 0.555, p = 0.001) and within the obese diabetic group for leptin vs % muscle mass (r = − 0.602, p = 0.001). Obese persons without diabetes were about three times more likely to have higher leptin levels compared with their obese diabetic counterparts (Odds ratio = 3.315, p < 0.001). Obese females independently had a tenfold increase in leptin levels compared with obese males.

Source: UG
Adiposity and hyperleptinemia during the first trimester among pregnant women with preeclampsia

Background: Leptin levels start increasing from the early stages of pregnancy, irrespective of the maternal body mass index. Leptin levels are increased in pregnant women with preeclampsia (PE) and may precede the clinical onset of the disease, with peaks occurring around 28 weeks of gestation. This study was aimed at determining whether serum leptin concentration and body fat percentage are significantly altered during the first trimester in pregnancies that subsequently develop PE and whether such changes are useful in predicting the disease. Materials and methods: This was a prospective longitudinal study conducted among pregnant women in Ho municipality. A cohort of 314 pregnant women was monitored from the first antenatal visit to delivery period at the Volta Regional Hospital, Ho, Ghana. Maternal serum leptin and lipid profile were analyzed and body fat percentage determined during first trimester. Body mass index was also calculated. Results: First trimester serum leptin level (P<0.0001) and body fat percentage (P<0.0001) were significantly higher in those who developed PE than those who did not; while triglycerides (P=0.8600), total cholesterol (P=0.5620), high-density lipoprotein (P=0.5880), low-density lipoprotein (P=0.4870) and very low-density lipoprotein (P=0.6540) did not show any significant difference between those with PE and those without PE. Conclusion: Leptin levels are increased significantly during the first trimester of pregnancy in obese women with PE, and these increases precede the onset of PE. © 2017 Yeboah et al.

Source: UG
Adjectives and Qualification: An overview. In M. E. Kropp Dakubu, G. Akanlig-Pare, E. Kweku Osam &amp; Kofi K. Saah, (Editors). Studies in the Languages of the Volta Basin 6, Parts 1&amp;2

One of the outcomes arising out of the Legon-Trondheim Linguistics Project was a number of studies carried out on the adjective as a word class in the languages of the Volta Basin. Generally, it has been established that these languages have lexical items that could be classified as such, though the number in each language differs. The studies have looked at the morphology and syntax of adjectives and this paper provides an overview of the research done on adjectives and qualification in the languages.

Source: UG
Adjustment Profiles of Low-Income Caregivers from the United States and South Africa: Contrasts and Commonalities

Although low-income parents living in under-resourced communities in the United States and around the world face challenges, many do well while others struggle in one or more areas of functioning. The present study examined patterns of adjustment among maternal caregivers living in the United States (US) (N = 320) and South Africa (SA) (N = 324). Cluster analyses across four domains of functioning representing both positive and negative adjustment and conducted within country revealed similar patterns of adjustment, with a majority of caregivers (37.8% in the US; 47.5% in SA) landing in a “holding steady” pattern, exhibiting good but not exceptional adjustment. Other patterns of adjustment (three additional in the US sample; two additional in the SA sample) showed elevated impairment in somatic complaints, problems with alcohol, or life satisfaction. In both the US and SA, support from family, friends, and neighbors differentiated the adjustment profiles. Further, both current stressors within and outside of the family and previous stressors including direct and indirect exposure to violence discriminated caregivers who were “holding steady” from those who were struggling in one or more domains. Additionally, across both countries, caregivers who were “holding steady” evidenced less avoidant coping. Implications of this work for fostering resilience among caregivers and their children are discussed.

Source: UG
Adjustments in purchasing arrangements to support the COVID-19 health sector response: evidence from eight middle-income countries

The COVID-19 pandemic has triggered several changes in countries’ health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19-related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine). We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run.

Source: UG
Administration of melatonin improves testicular blood flow, circulating hormones, and semen quality in Shiba goats

Despite the role of melatonin in the regulation of the sleep-wake cycle and seasonal-reproduction, the present study investigated, for the first time, the potential role of melatonin on testicular blood flow (TBF) in goats. Twelve sexually mature male Shiba goats were exposed to a single s.c. injection of either melatonin suspended in one ml of corn oil (melatonin group; 36 mg/goat; n ¼ 5) or one ml of corn oil (control group; n ¼ 7). Monitoring the changes in TBF was done one week before (W-1), at the time of injection (W0), and once a week for 8 weeks after injection using color-pulsed Doppler ultrasonography. Concentrations of FSH, LH, inhibin, testosterone (T), estradiol (E2), and insulin-like growth factor-1 (IGF- 1) in plasma were determined by radioimmunoassay. Melatonin and nitric oxide (NO) concentrations were measured using enzyme immunoassay kits. Moreover, semen collection and evaluation of some sperm parameters were performed once a week. Results revealed decreases (P < 0.05) in the Doppler indices (resistive index, pulsatility index) of the testicular arteries from W2 till W6 in the melatonin group. FSH, LH, and inhibin concentrations did not change between the two groups, while T, E2, IGF-1, NO, and melatonin concentrations increased (P < 0.05) in the melatonin group compared to the control. Estradiol and NO concentrations increased (P < 0.05), coinciding with decreases in the values of Doppler indices. Notable (P < 0.05) improvements in most parameters of semen quality were seen in the melatonin group. In conclusion, melatonin induced a stimulatory effect on TBF in Shiba goats and possibly, it could be a potential to improve male goats fertility

Source: UG
Administrative practices of health professionals and use of artesunate-amodiaquine by community members for treating uncomplicated malaria in southern Ghana: implications for artemisinin-based combination therapy deployment

Objective: To investigate the use of artemisinin-based combination and monotherapy by community members and the administrative practices of health professionals in treating malaria in Ghana. Method: This study is a community-based cross-sectional survey in 11 rural and urban areas in southern Ghana. Using the interviewer method, close-ended questionnaires were administered to community members. Similar questionnaires were also administered in health facilities, community pharmacies and licensed chemical shops. Results: A total of 1085 individuals comprising 959 non-health professionals and 126 health professionals were interviewed. Fifty-seven per cent of the community members visit pharmacies/drug stores as the first point of call when they suspect malaria. According to the participating drug sellers, artemether-lumefantrine (AL) is the most prescribed/sold anti-malarial drug (59.2%), followed by dihydroartemisinin (35%), sulfadoxine-pyrimethamine (33.0%) and artesunate-amodiaquine (AS-AQ) (27.2%). The majority of customers who visit pharmacies or drug stores without prescription have their anti-malarial drug selected by the shop attendant; in situations like that, dihydroartemisinin and artesunate monotherapies are sold just as AS-AQ and AL. Chloroquine is still sold by some drug vendors, 5years after its proscription. Conclusion: Whereas the use of AS-AQ and AL are acceptable, the frequent use of dihydroartemisinin and artesunate monotherapy threatens the future of ACTs.

Source: UG
Administrative Reforms in the Ghanaian Public Services for Government Business Continuity During the COVID-19 Crisis

The COVID-19 pandemic caused significant disruptions to public service delivery but heightened citizens demand for services. We examined public sector reforms implemented in the Ghanian public sector to ensure public service continuity during the COVID-19 pandemic. Using content analysis and key informant interviews, found that reforms such as flexible working schedule, redesign of offices, directorates, and installations of equipment, online monitoring and assessment of targets, and conducting services online were instrumental in ensuring the continuity of government business. We recommend that public sector managers allocate adequate resources to digital-based public sector reforms to better prepare for transboundary human threats such as Covid-19.

Source: UG