Browsing by Author "Asalu, G.A."
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Item Community-Based Health Planning and Services Plus programme in Ghana: A qualitative study with stakeholders in two Systems Learning Districts on improving the implementation of primary health care(2020-01-08) Bawah, A.A.; Kweku, M.; Amu, H.; Awolu, A.; Adjuik, M.; Ayanore, M.A.; Manu, E.; Tarkang, E.E.; Komesuor, J.; Asalu, G.A.; Aku, F.Y.; Kugbey, N.; Anumu, F.; Boateng, L.A.; Alornyo, J.S.; Glover, R.; Letsa, T.; Kanlisi, N.S.; Awoonor-Williams, J.K.; Phillips, J.F.; Gyapong, J.O.In 1999, Ghana introduced the Community-Based Health Planning and Services (CHPS) as the key primary health care strategy. In this study, we explored the challenges, capacity development priorities, and stakeholder perspectives on improving the CHPS concept as it has been fraught with a myriad of challenges since its inception. Our study is the outcome of the national programme for strengthening the implementation of CHPS Initiative in Ghana (CHPS+) introduced in 2017. Methods This exploratory research was a qualitative study conducted in two Systems Learning Districts (SLDs) of CHPS+ in the Volta Region of Ghana from March to May, 2018. Four focus group discussions and two general discussions were conducted among 60 CHPS+ stakeholders made up of health workers and community members. Data analyses were conducted using conceptual content analysis. Statements of the participants were presented as quotes to substantiate the views expressed. Results Negative attitude, high attrition, inadequacy and unavailability of health professionals at post when needed were challenges associated with the health professionals. Late referrals lack of proper community entry and engagement, non-availability of essential logistics, distance of CHPS compounds from communities, and inadequate funding were challenges associated with the health system. Lack of community ownership of the CHPS programme, lack of security at CHPS compounds, and late reporting of cases by the community members were also realised as challenges emanating from the community members. Priority areas for capacity development of health workers identified included logistics management, community entry and engagement, emergency delivery, managing referrals at the CHPS level, and resuscitation of newborns. Conclusion Health-worker, community, and health systems-based challenges inhibit the implementation of CHPS in Ghana. Capacity development of health professionals and continuous community engagement are avenues that can improve implementation of the programmeItem Nutrition And Health-Related Information Disclosure On Pre-Packed Food Products From Local Retail Shops In Accra(ajfand, 2022) Asalu, G.A.; Axame, W.K.; Manu, A.; Laar, A.; Aryeetey, R.The prevalence of obesity and diet related non-communicable diseases (NCDs) are rapidly increasing in Africa. Consumption of pre-packaged foods is one of the main drivers of these NCDs. Pre-packaged foods tend to contain high levels of energy, fat, sugar, and salt, which are known risk factors for NCDs. Food labels can guide consumers to make informed healthy food choices. Therefore, it is important to analyze how healthrelated information is communicated on food labels. In Ghana, there is paucity of evidence on what health-related information is available to consumers of pre-packaged foods. This study describes health-related information on labelled pre-packaged foods sold in local retail shops in Accra. A cross-sectional survey and quantitative content analysis of food label information were employed in this study. Pre-packaged food labels photograph data were sourced from shops and content analyzed to describe their healthrelated information. Nutrition and health-related information were classified using the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support (INFORMAS) system. Three hundred and fifty-one (N=351) pre-packaged foods and non-alcoholic beverages were sampled, out of which 2.3% products were unlabelled. Out of 343 labelled products, 92% disclosed ingredient list information and 68.8% had nutrition declaration. Between the two nutrition labelling formats: Back-of-Pack (BOP) and Front of Pack (FOP), BOP was the dominant (87.3%) format. Various types of FOPs were identified however, Guidelines Daily Allowance (GDA) was the most common format. The study found that 18% of labelled pre-packaged foods carried nutrition claim and about 7% had a health claim. Most of the claims were written and the others were a combination of words, numbers, and pictures/symbols. This study has shown a high disclosure of health-related label information on pre-packaged food but information presentations on labels were not consistent. The insight gained from this study shows that the presentation of health-related label information does not meet the current recommendations of Codex and the benchmarks set out by INFORMAS in promoting a healthy food environment.Item Pre-Packaged Food Labelling And Use Among Households In Accra(University Of Ghana, 2021-09) Asalu, G.A.The rate of diet-related non-communicable diseases (NCDs) is increasing rapidly in Africa. Consumption of pre-packaged foods which are nutrient-poor and calorie-rich is one of the main drivers of NCDs. Food labels can guide consumers to make healthy food choices. In Ghana, there is paucity of evidence on the type of nutrition and health-related label information that consumers are exposed to, and whether consumers use such information in their purchase decisions. Therefore, this study assessed label characteristics of pre-packaged foods, and determined the drivers of label use among consumers in urban Accra. This study employed a quantitative cross-sectional multi-method design. A survey of food labels was conducted in community-based retail shops. Information on labels of pre-packaged foods were obtained by taking pictures and analysing the contents based on the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support’s (INFORMAS) taxonomy. Besides, respondents (510) were selected using a multi-stage sampling technique. Participants were interviewed, using a structured pre-tested questionnaire. Questions assessed consumers’ pre-packaged food use behaviour, their perceptions of health-related label information, understanding of food labels and socio-demographic covariates. Three hundred and fifty-one (N=351) pre-packaged foods were sampled. Out of 343 labelled products, 68.8% had nutrition declaration information. Back- of-Pack (BOP) nutrition label formats were dominant (87.3%) compared to the Front-of -Pack (FOP) format. Guideline Daily Amount (GDA) was the commonest FOP identified. Nutrition claims were twice as frequent as health claims. Most products (>84%) with health and nutrition claims complied with FDA and Codex Alimentarius standards. Although the disclosure of nutrition and health-related information was appreciable it did not meet the current recommendations set out by Codex and INFORMAS in promoting a healthy environment. Majority of survey respondents (79.4%) were females and had at least secondary school-level education (65.3%). Most households (77%) purchased pre-packaged foods from traditional markets or corner shops and a few (7%) purchased from supermarkets. Most consumers had a positive perception of food labels, and their purchase behaviour was driven more by taste and price. Although most (62%) respondents reported adequate understanding of labels, objective assessments showed a lower (9%) consumer knowledge and skill in using labels. Only a third of respondents were food label users. Labels were used mainly to ascertain product safety and less likely for nutrition and health reasons. Higher proportions (45%) of non-label users indicated technical nature of label information and limited understanding as reasons for not using labels. In multiple logistic regression modelling, being part of a larger household (AOR: 2.41; 95% CI: 1.16-4.99), having tertiary education (AOR: 6.75; 95% CI: 1.99-22.88), adequate nutrition-related knowledge of labels (AOR: 1.92; 95% CI: 1.15-3.20) and food label understanding (AOR: 2.51; 95% CI: 1.19-5.29) as well as individuals with self-reported understanding of labels (AOR: 10.06; 95% CI: 2.40-42.27) predicted food label use. However, a multiple linear regression analysis the following variables: levels of education, individuals with food allergies, those who had a previous education on the use of labels, those who perceived labels are easy to understand and individuals who self-reported adequate food label understanding showed positive association with the use of health-related label information. Therefore, these findings suggest that educational interventions and labelling policy reforms are needed to encourage, enable, and improve consumer use of nutrition and health-related information on food labels in Ghana.Item Volunteer responsibilities, motivations and challenges in implementation of the community-based health planning and services (CHPS) initiative in Ghana: qualitative evidence from two systems learning districts of the CHPS+ project(BMC Health Services Research, 2020-05-29) Boateng, L.A.; Kweku, M.; Manu, E.; Amu, H.; Aku, F.Y.; Adjuik, M.; Tarkang, E.E.; Komesuor, J.; Asalu, G.A.; Amuna, N.N.; Alornyo, J.S.; Glover, R.; Bawah, A.A.; Letsa, T.; Awoonor-Williams, J.K.; Phillips, J.F.; Gyapong, J.O.Background: Community volunteerism is essential in the implementation of the Community-based Health Planning and Services (CHPS) in Ghana. We explored the responsibilities, motivations and challenges of community health management committees (CHMCs) in two CHPS+ Project districts in Ghana. Methods: We used a qualitative approach to collect data through 4 focus group discussions among a purposive sample of community health volunteers in December 2018 and analysed them thematically. Results: Community health management committees (CHMCs) were found to provide support in running the CHPS programme through resource mobilisation, monitoring of logistics, assisting the Community Health Officers (CHO) in the planning of CHPS activities, and the resolution of conflicts between CHOs and community members. The value, understanding and protective functions were the key motivations for serving on CHMCs. Financial, logistical and telecommunication challenges, lack of recognition and cooperation from community members, lack of motivation and lack of regular skill development training programmes for CHMC members who serve as traditional birth attendants (TBAs) were major challenges in CHMC volunteerism. Conclusion: Community health volunteerism needs to be prioritised by the Ghana Health Service and other health sector stakeholders to make it attractive for members to give off their best in the discharge of their responsibilities