ghanaopendata/ghanaian-research-english huggingface dataset:
Treatment of malaria in Ghana: summary of present state

The primary objective in the control of malaria in most countries in Africa south of the Sahara is the prevention of mortality and reduction of morbidity from malaria. To achieve this demands a situation that allows for prompt diagnosis and adequate treatment of malaria cases and the protection of vulnerable groups. it also calls for the implementation of feasible preventive and control measures based on sound epidemiological data. Through the Primary Health Care System, it should be possible to develop a process through which this objective could be achieved. For such a system to succeed, there will be the need for community commitment to the objective and a well-defined referral system. It also demands that there should be adequate knowledge about the chemotherapeutic agents to be used in treating an episode of acute malaria and the recognition of complications. Treatment therefore is now an important weapon in the control of malaria.

Source: UG
Treatment outcomes among children treated for uncomplicated severe acute malnutrition: a retrospective study in Accra, Ghana

The objectives of the study were to describe outcomes of children with uncomplicated severe acute malnutrition (SAM) attending community-based management of acute malnutrition (CMAM) treatment centres in Accra Metropolitan Area (AMA) and explore factors associated with non-adherence to clinic visits and defaulting from the treatment programme. Design: A retrospective cohort study analysing routinely collected data on children with uncomplicated SAM enrolled into CMAM in 2017 was conducted. Setting: Study was conducted at seven sites comprising Princess Marie Louise Children’s Hospital, three sub-metropolitan health facilities and three community centres, located in five sub-metropolitan areas in AMA. Participants: Children with uncomplicated SAM aged 6–59 months, enrolled from community-level facilities (pure uncomplicated SAM, PUSAM) or transferred after completing inpatient care (post-stabilisation uncomplicated SAM, PSSAM), partici pated in the study. Results: Out of 174 cases studied (105 PUSAM, sixty-nine PSSAM), 56·3 % defaulted, 34·5 % recovered and 8·6 % were not cured by 16 weeks. No deaths were recorded. Mid-upper arm circumference (MUAC) increased by 2·2 (95 % CI 1·8, 2·5) mm/week with full compliance and 0·9 (95 % CI 0·6, 1·2) mm/week with more than two missed visits. In breast-feeding children, MUAC increased at a slower rate than in other children by 1·3 (95 % CI 1·0, 1·5) mm/week. Independent predictors of subsequent missed visits were diarrhoea and fever, while children with MUAC < 110 mm on enrolment were at increased risk of defaulting. Conclusion: A high default rate and a long time to recovery are challenges for CMAM in AMA. Efforts must be made to improve adherence to treatment to improve outcomes.

Source: UG
Treatment Seeking Behaviour among Women with Infertility in Greater Accra Region

Infertility is a significant public health issue with grave social consequences that seems to affect women more than men. Globally, 15% of couples in their reproductive stage of development are affected with infertility at an estimated prevalence of 48.5 to 70 million couples worldwide. The vulnerable impression of infertility makes women with infertility wander in circles not knowing exactly what to do to avert childlessness; worsening their plight, wasting time and increasing treatment cost. This study therefore explored the treatment seeking behaviour among women with infertility in Greater Accra Region, using the Theory of Reasoned Action as an organising framework. An exploratory descriptive design was employed. Semi-structured interviews were conducted on 14 women with infertility through purposive and snowball sampling technique. Data were drawn from women with infertility in the community who visited churches, hospitals, herbal clinics and prayer camps. Thematic content analysis was employed for data analysis after audio recorded interviews transcribed verbatim. Out of which seven major themes and twenty-two subthemes were derived. The findings revealed that women with infertility consult herbalists, seek hospital treatment, and engage in faith-based spiritual activities in addition to modification of their lifestyle in order to have children. However attention was drawn to the fact that financial limitation, religion, menopause, inadequate knowledge about infertility treatment, among others are possible barriers to seeking treatment. These findings have implications for Nursing practice, Nursing research, community sensitization and counselling. Recommendations are made to Ghana Health Service and fertility clinics to train frontline healthcare providers in the management of infertility in Ghana.

Source: UG
Treatment strategies underpinning the global programme to eliminate lymphatic filariasis (Review)

Lymphatic filariasis (LF) is a disease targeted for elimination. The global strategy is a once-yearly, single-dose, two-drug regimen utilised by communities at risk for LF, with the goal of reaching 80% population coverage yearly, for at least 5 years, in order to interrupt transmission of LF. Where onchocerciasis is co-endemic, the regimen is ivermectin 200 - 400 μg/kg plus albendazole 400 mg; elsewhere, the regimen should be diethylcarbamazine 6 mg/kg plus albendazole 400 mg. This paper reviews in detail the evidence for the efficacy and safety of these two-drug regimens underpinning the global strategy and makes recommendations for future developments in chemotherapy for LF, focusing on unresolved issues. These include optimal frequency, duration and end point of treatment, tools for monitoring successful therapy and means for detecting the potential development of resistance to any of the three antifilarial drugs on which the Global Programme to Eliminate LF depends.

Source: UG
Treatment-Seeking Behaviour and Social Health Insurance in Africa: The Case of Ghana Under the National Health Insurance Scheme

Health insurance is attracting more and more attention as a means for improving health care utilization and protecting households against impoverishment from out-of-pocket expenditures. Currently about 52 percent of the resources for financing health care services come from out of pocket sources or user fees in Africa. Therefore, Ghana serves as in interesting case study as it has successfully expanded coverage of the National Health Insurance Scheme (NHIS). The study aims to establish the treatment-seeking behaviour of households in Ghana under the NHI policy. The study relies on household data collected from three districts in Ghana covering the 3 ecological zones namely the coastal, forest and savannah. Out of the 1013 who sought care in the previous 4 weeks, 60% were insured and 71% of them sought care from a formal health facility. The results from the multinomial logit estimations show that health insurance and travel time to health facility are significant determinants of health care demand. Overall, compared to the uninsured, the insured are more likely to choose formal health facilities than informal care including self-medication when ill. We discuss the implications of these results as the concept of the NHIS grows widely in Ghana and serves as a good model for other African countries.

Source: UG
Tree Species Diversity and Socio-economic Perspectives of the Urban (Food) Forest of Accra, Ghana

Urban and peri-urban forestry has emerged as a complementary measure to contribute towards eliminating urban hunger and improved nutritional security. However, there is scanty knowledge about the composition, diversity, and socioeconomic contributions of urban food trees in African cities. This paper examines the diversity and composition of the urban forest and food trees of Accra and sheds light on perceptions of urbanites regarding food tree cultivation and availability in the city. Using a mixed methods approach, 105 respondents in six neighborhoods of Accra were interviewed while over 200 plots (100-m2 each) were surveyed across five land use types. Twenty-two out of the 70 woody species in Accra have edible parts (leaves, fruits, flowers, etc.). The food-tree abundance in the city is about half of the total number of trees enumerated. The species richness and abundance of the food trees and all trees in the city were significantly different among land use types (p < 0.0001) and neighborhood types (p < 0.0001). The diversity of food-bearing tree species was much higher in the poorer neighborhoods than in the wealthier neighborhoods. Respondents in wealthier neighborhoods indicated that tree and food-tree cover of the city was generally low and showed greater interest in cultivating food (fruit) trees and expanding urban forest cover than poorer neighborhoods. These findings demonstrate the need for urban food policy reforms that integrate urban-grown tree foods in the urban food system/culture.

Source: UG
Trend and causes of neonatal mortality in the kassena-nankana district of northern Ghana, 1995-2002

OBJECTIVES: To describe the trend and causes of neonatal deaths in a rural district in northern Ghana. METHODS: Descriptive analysis of data collected from the Navrongo Demographic Surveillance System and verbal autopsies conducted on all neonatal deaths from 1995-2002. RESULTS: Of 1118 recorded neonatal deaths 1068 (95.5%) could be analysed. Only 13.2% of deaths occurred at the health facility; 62.7% occurred in the early neonatal period, with prematurity (38%) and birth injuries (19%) as leading causes. Infectious causes (66%) were the major contributors to late neonatal deaths. Infanticide accounted for 4.9% of all neonatal deaths. The cause-specific mortality rate for neonatal tetanus remained under 2.5% throughout the 8-year period. Overall, the neonatal mortality rate declined at an average of 2.5 per 1000 live births per year: Down by nearly 50% from 40.9 (95%C.I. 34.1-46.8) in 1995 to 20.5 (95%C.I.17.3-22.7) in 2002. CONCLUSION: The various health interventions undertaken in this district have had the collateral effect of causing decline in neonatal mortality. Neonatal mortality could be further reduced by preventing and treating neonatal infections, having skilled attendance at delivery and the elimination of infanticide. Data from demographic surveillance sites may be useful in monitoring trends in child mortality. © 2006 Blackwell Publishing Ltd.

Source: UG
Trend and determinants of contraceptive use among women of reproductive age in Ghana

The study examined the trend in contraceptive use among sexually active women of reproductive age in Ghana. The study also investigated the socioeconomic determinants of contraceptive use. Cross tabulations and logistic regression analyses were performed on data from the Ghana Demographic and Health Surveys 1988 - 2008. The results indicate low contraceptive use among women with marked variation in contraceptive use across various socioeconomic groups and administrative regions. Evidence from the logistic regressions suggests that improving education and reducing poverty are critical in improving contraceptive use and reducing unmet need for family planning. Child survival, access to family planning services and knowledge of contraceptive methods were also found to be significant determinants of contraceptive use. The importance of improving financial and infrastructural access to contraceptives was confirmed by the findings of the study. © 2014 Union for African Population Studies. All Rights reserved.

Source: UG
Trends and causes of socioeconomic inequalities in maternal healthcare in Ghana, 2003–2014

Purpose The purpose of this paper is to assess the trends of socioeconomic-related inequalities in maternal healthcare utilization in Ghana between 2003 and 2014 and examine the causes of inequalities in maternal healthcare utilization in Ghana. Design/methodology/approach Data are drawn from three rounds of the Ghana Demographic and Health Survey collected in 2003, 2008 and 2014, respectively. The authors employ two alternative measures of socioeconomic inequalities in health – the Wagstaff and Erreygers indices – to examine the trends of socioeconomic inequalities in maternal healthcare utilization. The authors proceed to decompose the causes of inequalities in maternal healthcare by applying a recently developed generalized decomposition technique based on recentered influence function regressions. Findings The study finds substantial pro-rich inequalities in maternal healthcare utilization in Ghana. The degree of inequalities has been decreasing since 2003. The elimination of user fees for maternal healthcare has contributed to achieving equity and inclusion in utilization. The decomposition analysis reveals significant contributions of individual, household and locational characteristics to inequalities in maternal healthcare. The authors find that educational attainment, urban residence and challenges with physical access to healthcare facilities increase the socioeconomic gap in maternal healthcare utilization. Originality/value There is a need to target vulnerable women who are unlikely to utilize maternal healthcare services. In addition to the elimination of user fees, there is a need to reduce inequalities in the distribution and quality of maternal health services to achieve universal coverage in Ghana.

Source: UG
Trends and determinants of socioeconomic inequalities in sexual and reproductive health among women in Ghana

Purpose – This study aims to estimate the degree and nature of socioeconomic-related inequalities in sexual and reproductive health in Ghana and further assesses causes of these inequalities using decomposition technique. The authors assess the contribution of personal characteristics of the woman including access to health information and health seeking behaviours, household and locational characteristics to inequalities in sexual and reproductive health in Ghana. The study uses data from the three rounds of the Ghana Demographic and Health Survey conducted in 2003, 2008 and 2014. Design/methodology/approach – Two indicators – use of modern contraceptives and intention to use modern contraceptives – are used to measure sexual and reproductive health of sexually active women. A wealth index, based on household ownership of assets, consumer goods and living conditions, is used as a measure of socioeconomic status. The paper estimates a concentration index to the relationship between cumulative health and socioeconomic rank. Paper procedures to apply decomposition techniques to determine the causes of socioeconomic inequalities in health based on a linear health regression model. Findings – The study finds evidence of varying degrees of socioeconomic-related inequalities in sexual and reproductive health indicators. Specifically, the study finds that whilst use of modern contraceptives was concentrated among women in households with high socioeconomic status in 2003 and 2008, modern contraceptive use was prevalent among women in low socioeconomic status households in 2014. Equally, the study finds significant pro-poor inequalities in the intentions to use modern contraceptives in 2003 and 2014. The degree of socioeconomic inequalities in the intentions to use modern contraceptives increased between 2003 and 2014. Originality/value – There is the lack of evidence on the degree, nature and causes of socioeconomicrelated inequalities, which in tend impedes the design and implementation of sexual and reproductive health policies targeted at vulnerable and under-served populations. In addition, there is the need to study inequalities in health over time to monitor progress of health delivery systems towards equitable and universal coverage and understand the evolution of the determinants.

Source: UG
Trends and Inequalities in the Incidence of Acute Myocardial Infarction among Beijing Townships, 2007–2018

Acute myocardial infarction (AMI) poses a serious disease burden in China, but studies on small-area characteristics of AMI incidence are lacking. We therefore examined temporal trends and geographic variations in AMI incidence at the township level in Beijing. In this cross-sectional analysis, 259,830 AMI events during 2007–2018 from the Beijing Cardiovascular Disease Surveillance System were included. We estimated AMI incidence for 307 consistent townships during consecutive 3-year periods with a Bayesian spatial model. From 2007 to 2018, the median AMI incidence in townships increased from 216.3 to 231.6 per 100,000, with a greater relative increase in young and middle-aged males (35–49 years: 54.2%; 50–64 years: 33.2%). The most pronounced increases in the relative inequalities was observed among young residents (2.1 to 2.8 for males and 2.8 to 3.4 for females). Townships with high rates and larger relative increases were primarily located in Beijing’s northeastern and southwestern peri-urban areas. However, large increases among young and middleaged males were observed throughout peri-urban areas. AMI incidence and their changes over time varied substantially at the township level in Beijing, especially among young adults. Targeted mitigation strategies are required for high-risk populations and areas to reduce health disparities across Beijing.

Source: UG
Trends and projections of universal health coverage indicators in Ghana, 1995-2030: A national and subnational study

Ghana has made significant stride towards universal health coverage (UHC) by implementing the National Health Insurance Scheme (NHIS) in 2003. This paper investigates the progress of UHC indicators in Ghana from 1995 to 2015 and makes future predictions up to 2030 to assess the probability of achieving UHC targets. National representative surveys of Ghana were used to assess health service coverage and financial risk protection. The analyses estimated the coverage of 13 prevention and four treatment service indicators at the national level and across wealth quintiles. In addition, we calculated catastrophic health payments and impoverishment to assess financial hardship and used a Bayesian regression model to estimate trends and future projections as well as the probabilities of achieving UHC targets by 2030. Wealth-based inequalities and regional disparities were also assessed. At the national level, 14 out of the 17 health service indicators are projected to reach the target of 80% coverage by 2030. Across wealth quintiles, inequalities were observed amongst most indicators with richer groups obtaining more coverage than their poorer counterparts. Subnational analysis revealed while all regions will achieve the 80% coverage target with high probabilities for the prevention services, the same cannot be applied to the treatment services. In 2015, the proportion of households that suffered catastrophic health payments and impoverishment at a threshold of 25% non-food expenditure were 1.9% (95%CrI: 0.9–3.5) and 0.4% (95%CrI: 0.2–0.8), respectively. These are projected to reduce to 0.4% (95% CrI: 0.1–1.3) and 0.2% (0.0–0.5) respectively by 2030. Inequality measures and subnational assessment revealed that catastrophic expenditure experienced by wealth quintiles and regions are not equal. Significant improvements were seen in both health service coverage and financial risk protection over the years. However, inequalities across wealth quintiles and regions continue to be cause of concerns. Further efforts are needed to narrow these gaps.

Source: UG
Trends for Diarrhea Morbidity in the Jasikan District of Ghana: Estimates from District Level Diarrhea Surveillance Data, 2012-2016

About 22% of childhood deaths in developing countries are attributable to diarrhea. In poor resource settings, diarrhea morbidities are correlated with poverty and socio-contextual factors. Diarrhea rates in Ghana are reported to be high, with cases estimated at 113,786 among children under-five years in 2011. This study analyzed the trends of diarrhea morbidity outcomes in the Jasikan District of Ghana. A retrospective analysis of records on diarrhea data for a five years’ period (January 2012 to December 2016) was undertaken. There was a total of 17740 diarrhea case reports extracted from District Health Information Management System (DHIMS) II database in an Excel format which was then exported to Stata version 14 for data cleaning, verification, and analysis. Excel version 2016 was used to plot the actual observed cases by years to assess trends and seasonality. There was a period incidence rate of 272.02 per 1000 persons with a decreasing annual growth rate of 1.85%. Declines for diarrhea generally occurred from November to December and increased from January upwards, evidence that most cases of diarrhea in this study were reported in the harmattan season. High incidence of diarrhea was found to be common among under-five children and among females. Decreasing trend of diarrhea incidence which was identified in this research within the five years’ period understudied shows that, by the year 2020, there will be a sharp decline in the incidence rate of diarrhea reported cases in Jasikan District, given improvements in the external environmental conditions in the district, all things being equal.

Source: UG
Trends in agriculturally-relevant rainfall characteristics for small-scale agriculture in Northern Ghana

This study set out to investigate the trends of agriculturally-relevant rainfall characteristics among small-scale farmers in the rainfall-sensitive dry savanna agro-ecological zone of northern Ghana. Interviews are used to identify characteristics of rainfall which are deemed by the farmers as important in their food production. Time series daily rainfall data from 1960-2007 is then used to identify trends in these variables which include the amount and temporal distribution of rainfall, occurrence of extreme daily rainfall events, the onset of rains, risk of dry spells and coefficient of variability of rains. The risk of dry spells for varying number of days following the planting period is computed using first-order Markov chain modeling. We find that there is a significant increase in mean rainfall per rain day and the coefficient of variation or summer rainfall amounts. No significant change in the onset of rains, the annual rainfall amount or maximum rainfall days are established. However, a significant decrease in the number of rain days and the probability of dry spells of up to seven and eleven days in the first four weeks of the planting season is revealed. There is need for development of an agricultural policy framework designed to understand the growing risks associated with agricultural production among small-scale farmers, and to improve management practices to accommodate and adapt to the new challenges of varying rainfall.

Source: UG