Browsing by Author "Ankrah, D."
Now showing 1 - 8 of 8
Results Per Page
Sort Options
Item Advanced pharmacy practice of a doctor of pharmacy student at an allied surgical ward in a hospital in Africa(Heliyon, 2023) Ofei-Palm, C.N.K.; Gbadago, D.; Tetteh, R.; Koduah, A.; Ankrah, D.; Buabeng, K.O.Introduction: The pharmacy profession is undergoing transformational change in Ghana. The role of pharmacists has become more patient-focused with increased accountability and responsibility. Aim: This study is aimed at reporting the experiential learning on the clinical interventions made and documented at the Allied Surgical Wards of Korle-Bu Teaching Hospital (KBTH). This involves a review of patient’s medical records during the Advanced Pharmacy Practice Experience (APPE) learning. One case each from Eye, Ear, Nose, Throat, (ENT) and Dental units’ subspecialty were reviewed from October 7, 2019 to November 15, 2019 b y a Pharm D student. Conclusion: The student was able to make prompt clinical interventions that contributed to patient care in clinical wards assigned during her clinical clerkship.Item Advancing the application of systems thinking in health: Provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme - a systems approach(Health Research Policy and Systems, 2014-08) Agyepong, I.A.; Aryeetey, G.C.; Nonvignon, J.; Asenso-Boadi, F.; Dzikunu, H.; Antwi, E.; Ankrah, D.; Adjei-Acquah, C.; Esena, R.; Aikins, M.; Arhinful, D.K.Background: Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour.Methods: A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. Results: There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. Conclusions: As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear perspectives, since the latter fail to recognize the effects of context and the between-methods and context interactions in producing net effects. © 2014 Agyepong et al.; licensee BioMed Central Ltd.Item Advancing the application of systems thinking in health: provider payment and service supply behaviour and incentives in the Ghana National Health Insurance Scheme ¿ a systems approach(2014-08-05) Agyepong, I.A.; Aryeetey, G.C.; Nonvignon, J.; Asenso-Boadi, F.; Dzikunu, H.; Antwi, E.; Ankrah, D.; Adjei-Acquah, C.; Esena, R.; Aikins, M.; Arhinful, D.K.Abstract Background Assuring equitable universal access to essential health services without exposure to undue financial hardship requires adequate resource mobilization, efficient use of resources, and attention to quality and responsiveness of services. The way providers are paid is a critical part of this process because it can create incentives and patterns of behaviour related to supply. The objective of this work was to describe provider behaviour related to supply of health services to insured clients in Ghana and the influence of provider payment methods on incentives and behaviour. Methods A mixed methods study involving grey and published literature reviews, as well as health management information system and primary data collection and analysis was used. Primary data collection involved in-depth interviews, observations of time spent obtaining service, prescription analysis, and exit interviews with clients. Qualitative data was analysed manually to draw out themes, commonalities, and contrasts. Quantitative data was analysed in Excel and Stata. Causal loop and cause tree diagrams were used to develop a qualitative explanatory model of provider supply incentives and behaviour related to payment method in context. Results There are multiple provider payment methods in the Ghanaian health system. National Health Insurance provider payment methods are the most recent additions. At the time of the study, the methods used nationwide were the Ghana Diagnostic Related Groupings payment for services and an itemized and standardized fee schedule for medicines. The influence of provider payment method on supply behaviour was sometimes intuitive and sometimes counter intuitive. It appeared to be related to context and the interaction of the methods with context and each other rather than linearly to any given method. Conclusions As countries work towards Universal Health Coverage, there is a need to holistically design, implement, and manage provider payment methods reforms from systems rather than linear perspectives, since the latter fail to recognize the effects of context and the between-methods and context interactions in producing net effects.Item Antibiotic Prescribing Patterns in Ghana, Uganda, Zambia and Tanzania Hospitals: Results from the Global Point Prevalence Survey (G-PPS) on Antimicrobial Use and Stewardship Interventions Implemented(Antibiotics 2021, 2021) D’Arcy, N.; Ashiru-Oredope, D.; Olaoye, O.; Afriyie, D.; Akello, Z.; Ankrah, D.; Asima, D.M.; . Banda, D.C.; Barrett, S.; Brandish, C.; Brayson, J.; Benedict, P.; Dodoo, C.C.; Garraghan, F.; Hoyelah, J.; Jani, Y.; Kitutu, F.E; Kizito, I.M.; Larbi, A-K.; Mirfenderesky, M.; Murdan, S.; Murray, C.; Obeng-Nkrumah, N.; J’Pathim Olum, W.; Opintan, J.A.; Panford-Quainoo, E.; Pauwels, I.; Sefah, I.; Sneddon, J.; Jones, A.C.; Versporten, A.Antimicrobial resistance (AMR) remains an important global public health issue with antimicrobial misuse and overuse being one of the main drivers. The Global Point Prevalence Survey (G-PPS) of Antimicrobial Consumption and Resistance assesses the prevalence and the quality of antimicrobial prescriptions across hospitals globally. G-PPS was carried out at 17 hospitals across Ghana, Uganda, Zambia and Tanzania. The overall prevalence of antimicrobial use was 50% (30–57%), with most antibiotics prescribed belonging to the WHO ‘Access’ and ‘Watch’ categories. No ‘Reserve’ category of antibiotics was prescribed across the study sites while antimicrobials belonging to the ‘Not Recommended’ group were prescribed infrequently. Antimicrobials were most often prescribed for prophylaxis for obstetric or gynaecological surgery, making up between 12 and 18% of total prescriptions across all countries. The most prescribed therapeutic subgroup of antimicrobials was ‘Antibacterials for systemic use’. As a result of the programme, PPS data are now readily available for the first time in the hospitals, strengthening the global commitment to improved antimicrobial surveillance. Antimicrobial stewardship interventions developed included the formation of AMS committees, the provision of training and the preparation of new AMS guidelines. Other common interventions included the presentation of findings to clinicians for increased awareness, and the promotion of a multi-disciplinary approach to successful AMS programmes. Repeat PPS would be necessary to continually monitor the impact of interventions implemented. Broader participation is also encouraged to strengthen the evidence baseItem Beyond certification: Investigating the nexus between compliance with sustainable agriculture standard and livelihood assets of certified smallholder cocoa farmers in Ghana(Cogent Food & Agriculture, 2023) Ankuyi, F.; Tham-Agyekum, E.K.; Ankrah, D.; et al.Studies have shown that farmers appear to deviate from set certification standards after they have passed audits and received their certificate. This usually makes them vulnerable and affects their livelihood assets. Therefore, this study set out to investigate the nexus between certified smallholder cocoa farmers’ continual compliance with sustainable agriculture standard (SAS) and their livelihood assets. The research was conducted in the Sefwi Wiawso Municipality of Ghana. Data were collected from a survey of 400 cocoa farmers. Ordered logistic regression modelling, Chi-square test, frequencies, means, standard deviations, and percentages were used to analyze data. The findings show that 43.5% of the certified cocoa farmers complied moderately with SAS. Gender, farm size, land ownership, access to credit, engaging in income-generating activities outside of farming, assistance provided by License Buying Companies and extension contact were the determinants of farmers’ level of compliance with SAS. The study revealed a statistically significant association between farmer compliance and livelihood assets. Efforts to increase access to credit for cocoa farmers must be accompanied by efforts to promote and educate farmers on sustainable farming practices.Item Effect of climate variability adaptation strategies on maize yield in the Cape Coast Municipality, Ghana(Cogent Food & Agriculture, 2023) Ankrah, D.; Okyere, C.; Mensah, J.; Okata, E.Maize is a major staple produced by most peasant farmers in Ghana, amidst climate variabilities that potentially thwart the attainment of global sus tainable development goals (SDGs), specifically SDG −2 of zero hunger. Ordinarily, one expects the extant literature to be replete on a nexus between climate varia bility adaptation strategies and maize yields. Ironically, there appears to be scant information on the expected nexus in Ghana’s coastal areas. The dual questions about what adaptation strategies significantly affect maize yield, and the extent (magnitude) to which climate variability strategies affect maize yield beg answer ing. Inspired by these research questions, the objective of this article is to examine the effect of climate variability adaptation strategies on maize yield. This study relies on a cross-sectional data covering 197 smallholder maize farmers in the Cape Coast Metropolitan Assembly of Ghana’s Central Region. The study is deeply rooted in a quantitative approach employing multiple linear regression and a treatment effect model (inverse probability weighted regression adjustment—IPWRA). Our findings reveal that adaptation strategies correlate with maize yields. Specifically, estimates from the IPWRA show that irrigation and changes in planting dates positively correlate with maize yields. The implication is that these adaptation strategies improve maize yields. Smallholder farmers are encouraged to adopt effective climate variability adaptation strategies to minimize the adverse risks associated with climate variability. The government of Ghana’s initiative for arid regions, dubbed as the “one village one dam” initiative can be upscaled to southern Ghana to ensure sustainable agricultural development.Item Effect of climate variability adaptation strategies on maize yield in the Cape Coast Municipality, Ghana(Cogent Food & Agriculture, 2023) Ankrah, D.; Okyere, C.; Mensah, J.; Okata, E.Maize is a major staple produced by most peasant farmers in Ghana, amidst climate variabilities that potentially thwart the attainment of global sus tainable development goals (SDGs), specifically SDG −2 of zero hunger. Ordinarily, one expects the extant literature to be replete on a nexus between climate varia bility adaptation strategies and maize yields. Ironically, there appears to be scant information on the expected nexus in Ghana’s coastal areas. The dual questions about what adaptation strategies significantly affect maize yield, and the extent (magnitude) to which climate variability strategies affect maize yield beg answer ing. Inspired by these research questions, the objective of this article is to examine the effect of climate variability adaptation strategies on maize yield. This study relies on a cross-sectional data covering 197 smallholder maize farmers in the Cape Coast Metropolitan Assembly of Ghana’s Central Region. The study is deeply rooted in a quantitative approach employing multiple linear regression and a treatment effect model (inverse probability weighted regression adjustment—IPWRA). Our findings reveal that adaptation strategies correlate with maize yields. Specifically, estimates from the IPWRA show that irrigation and changes in planting dates positively correlate with maize yields. The implication is that these adaptation strategies improve maize yields. Smallholder farmers are encouraged to adopt effective climate variability adaptation strategies to minimize the adverse risksassociated with climate variability. The government of Ghana’s initiative for arid regions, dubbed as the “one village one dam” initiative can be upscaled to southern Ghana to ensure sustainable agricultural developmentItem A review of the Ghana National Health Insurance Scheme claims database: possibilities and limits for drug utilization research(Basic and Clinical Pharmacology and Toxicology, 2019-01) Ankrah, D.; Hallas, J.; Odei, J.; Asenso-Boadi, F.; Dsane-Selby, L.; Donneyong, M.Background: There are inadequate data on prescribed drug utilization in Sub-Saharan Africa (SSA). Drug utilization research (DUR) in this region is hampered by lack of access to databases that capture prescribed drug utilization such as health insurance claims, electronic medical records and disease registries. The primary objective of this MiniReview was to describe the content of the NHIS claims database in the context of the health care system in Ghana. We will also review the possibilities and limitations of analysing this novel database for drug utilization research (DUR) in Ghana. Methods: We reviewed the history, composition of the database, coverage and health systems in Ghana. To demonstrate the application of the NHIS claims database for DUR, we reviewed the NHIS’ drug formulary (NHIS medicines’ list), assessed and quantified the utilization of the top 25 most commonly prescribed medicines and their distributions by age, sex, region of residence and by MDCs. Results: As of December 2014, about 40% (~10.5 million) of the Ghanaian population were active beneficiaries of NHIS. There were 1.43 million unique patients in the NHIS claims database who received services from about 81 providers located in 9 out of the 10 regions in Ghana. The mean age of this sample of beneficiaries was 31 (standard deviation, 22) years, a third of whom were aged <18 years old. Nearly, 2 out of every 3 beneficiaries were females. On average, there were approximately 3 outpatient visits per beneficiary in 2015. There were about 522 unique drugs on the NHIS medicine list. Overall, analgesic was the most prescribed class of medicine (mostly paracetamol and diclofenac). Antimalarials, artemether-lumefantrine, were observed as the second most prescribed medicines followed by anti-infectives (metronidazole) and antihypertensives (amlodipine). Conclusion: The Ghana NHIS claims database is a great resource for DUR. This database could also be extended to facilitate pharmacoepidemiological and other health services’ research especially if transformed into one of the existing standardized common data models. © 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society)