Browsing by Author "Biney, A."
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Item Community perceptions of universal health coverage in eight districts of the Northern and Volta regions of Ghana(Global Health Action, 2020-02-03) Biney, A.; Wright, K.J.; Kushitor, M.; Awoonor-Williams, J.K.; Bawah, A.A.; Phillips, J.F.Background: Ever since Ghana embraced the 1978 Alma-Ata Declaration, it has consigned priority to achieving ‘Health for All.’ The Community-based Health Planning and Services (CHPS) Initiative was established to close gaps in geographic access to services and health equity. CHPS is Ghana’s flagship Universal Health Coverage (UHC) Initiative and will soon completely cover the country with community-located services. Objectives: This paper aims to identify community perceptions of gaps in CHPS maternal and child health services that detract from its UHC goals and to elicit advice on how the contribution of CHPS to UHC can be improved. Method: Three dimensions of access to CHPS care were investigated: geographic, social, and financial. Focus group data were collected in 40 sessions conducted in eight communities located in two districts each of the Northern and Volta Regions. Groups were comprised of 327 participants representing four types of potential clientele: mothers and fathers of children under 5, young men and young women ages 15–24. Results: Posting trained primary health-care nurses to community locations as a means of improving primary health-care access is emphatically supported by focus group participants, even in localities where CHPS is not yet functioning. Despite this consensus, comments on CHPS activities suggest that CHPS services are often compromised by cultural, financial, and familial constraints to women’s health-seeking autonomy and by programmatic lapses constrain implementation of key components of care. Respondents seek improvements in the quality of care, community engagement activities, expansion of the range of services to include emergency referral services, and enhancement of clinical health insurance coverage to include preventive health services. Conclusion: Improving geographic and financial access to CHPS facilities is essential to UHC, but responding to community need for improved outreach, and service quality is equivalently critical to achieving this goal.Item Does education mitigate the adverse impact of bridewealth on women's reproductive autonomy?(Genus, 2014) Dodoo, F.N.-A.; Horne, C.; Biney, A.Recent research finds evidence that bridewealth payment in Africa creates reproductive obligations for women. The present paper explores the effectiveness of female education – an important policy weapon for addressing sexual and reproductive health disadvantages of women in the developing world -- in mitigating bridewealth’s adverse impact on women’s sexual autonomy. We conducted a vignette experiment in which we manipulated a woman’s bridewealth status (bridewealth had not been paid, had been partially paid, or had been completely paid) and her behavior (either in the reproductive or business domain). Our results suggest that female schooling may have more liberalizing effects in some domains than in others, and that efforts to increase women’s reproductive autonomy should consider the normative obligations created by bridewealth payment. The research and policy implications are discussed.Item Orthomolecular Medicine and Biochemical Basis of Health(2018-02-22) Olu-Sawyerr, E.; Biney, A.Dr. Olu-Sawyerr has specialised in the treatment of chronic/degenerative diseases, including cancer and infertility, and success rate in all cases is remarkably high. This seminar will focus on a discussion about his use of orthomolecular medicine as the best means to improving and sustaining one's healthItem Research Capacity Building Integrated into PHIT Projects: Leveraging Research and Research Funding to Build National Capacity(BMC Health Services Research, 2017-12) Hedt-Gauthier, B.L.; Chilengi, R.; Jackson, E.; Michel, C.; Napua, M.; Odhiambo, J.; Bawah, A.; Hingora, A.; Mboya, D.; Exavery, A.; Tani, K.; Manzi, F.; Pemba, S.; Phillips, J.; Kante, A.M.; Ramsey, K.; Baynes, C.; Awoonor-Williams, J.K.; Nimako, B.A.; Kanlisi, N.; Jackson, E.F.; Sheff, M.C.; Kyei, P.; Asuming, P.O.; Biney, A.; Ayles, H.; Mwanza, M.; Chirwa, C.; Stringer, J.; Mulenga, M.; Musatwe, D.; Chisala, M.; Lemba, M.; Mutale, W.; Drobac, P.; Cyamatare Rwabukwisi, F.; Hirschhorn, L.R.; Binagwaho, A.; Gupta, N.; Nkikabahizi, F.; Manzi, A.; Condo, J.; Farmer, D.B.; Sherr, K.; Cuembelo, F.; Michel, C.; Gimbel, S.; Wagenaar, B.; Henley, C.; Kariaganis, M.; Manuel, J.L.; Pio, A.ackground: Inadequate research capacity impedes the development of evidence-based health programming in sub-Saharan Africa. However, funding for research capacity building (RCB) is often insufficient and restricted, limiting institutions' ability to address current RCB needs. The Doris Duke Charitable Foundation's African Health Initiative (AHI) funded Population Health Implementation and Training (PHIT) partnership projects in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia) to implement health systems strengthening initiatives inclusive of RCB. Methods: Using Cooke's framework for RCB, RCB activity leaders from each country reported on RCB priorities, activities, program metrics, ongoing challenges and solutions. These were synthesized by the authorship team, identifying common challenges and lessons learned. Results: For most countries, each of the RCB domains from Cooke's framework was a high priority. In about half of the countries, domain specific activities happened prior to PHIT. During PHIT, specific RCB activities varied across countries. However, all five countries used AHI funding to improve research administrative support and infrastructure, implement research trainings and support mentorship activities and research dissemination. While outcomes data were not systematically collected, countries reported holding 54 research trainings, forming 56 mentor-mentee relationships, training 201 individuals and awarding 22 PhD and Masters-level scholarships. Over the 5 years, 116 manuscripts were developed. Of the 59 manuscripts published in peer-reviewed journals, 29 had national first authors and 18 had national senior authors. Trainees participated in 99 conferences and projects held 37 forums with policy makers to facilitate research translation into policy. Conclusion: All five PHIT projects strongly reported an increase in RCB activities and commended the Doris Duke Charitable Foundation for prioritizing RCB, funding RCB at adequate levels and time frames and for allowing flexibility in funding so that each project could implement activities according to their trainees' needs. As a result, many common challenges for RCB, such as adequate resources and local and international institutional support, were not identified as major challenges for these projects. Overall recommendations are for funders to provide adequate and flexible funding for RCB activities and for institutions to offer a spectrum of RCB activities to enable continued growth, provide adequate mentorship for trainees and systematically monitor RCB activities.Item The Role of Remittances on the Adaptive Capacity of Smallholder Farmers in the Lawra District of the Upper West Region of Ghana.(University of Ghana, 2019-10) Biney, A.The changing climate pattern in the Northern Regions of Ghana has influenced the movement of people, especially the youth, out of the Lawra District in the Upper West Region. Smallholder farmers that still live in the District tend to rely on remittances sent by their migrant relatives to support their livelihoods, however, little is known about how these remittances influence their adaptation processes. This study assesses smallholder farmers‘ perception on climate change and its impacts; examines the income generated from smallholders‘ farming activities, the expenditure patterns and how it contributes to adaptation strategies; and evaluates the various forms of support to smallholder farmers including remittances and how they contribute to their adaptation strategies. In addition, migrant‘s perceptions of the use of their remittances to their origin households was examine. This mainly descriptive study adopted the mixed methods approach, using data from household surveys and Focused Group Discussions (FGDs). The Conceptual Framework was adapted from the Sustainable Livelihood Framework (SLF) and was used to assess the adaptive capacity of the farmers with respect to use of remittances. A sample size of 98 smallholder farm households in the Lawra District that receive remittances were specifically selected and interviewed. Five (5) migrants who reside outside the District and remit home were also interviewed for qualitative understanding of their motive and perception for remitting. This study found that 98 percent of smallholder farmers and all interviewed migrants have some knowledge of climate change. Annually, the majority of farmers (87.2%) earn less than GH¢300 (US$69) from farming activities and less than GH¢300 from remittances, both in the previous farming season. Only 21.4 percent of farmers received external support from government and NGOs for their farming activities. Overall, 85 percent of farmers spent remittances on consumables such as food and not on available adaptation options as those require substantial capital input. The migrants perceived remitting home as a responsibility but understand that it does not meet the needs of the household. It is recommended that a formal system is put in place that will improve the medium of remitting home.Item Urban Family Planning in Sub‑Saharan Africa: an Illustration of the Cross‑sectoral Challenges of Urban Health(Journal of Urban Health, 2022) Harpham, T.; Biney, A.; Ganle, J.; et al.The multi-sectoral nature of urban health is a particular challenge, which urban family planning in sub-Saharan Africa illustrates well. Rapid urbanisation, mainly due to natural population increase in cities rather than rural-urban migration, coincides with a large unmet urban need for contraception, especially in informal settlements. These two phenomena mean urban family planning merits more attention. To what extent are the family planning and urban development sectors working together on this? Policy document analysis and stakeholder interviews from both the family planning and urban development sectors, across eight sub-Saharan African countries, show how cross-sectoral barriers can stymie efforts, but they can also identify some points of connection which can be built upon. Differentiating historical, political, and policy landscapes means that entry points to promote urban family planning have to be tailored to the context. Such entry points can include infant and child health, female education and employment, and urban poverty reduction. Successful cross-sectoral advocacy for urban family planning requires not just solid evidence but also internal consensus and external advocacy: FP actors must consensually frame the issue per local preoccupations, and then communicate the resulting key messages in concerted and targeted fashion. More broadly, success also requires that the environment be made conducive to cross-sectoral action. example, through clear requirements in the planningItem What do you do with success? the science of scaling up a health systems strengthening intervention in Ghana(BioMed Central Ltd., 2018) Phillips, J.F.; Awoonor-Williams, J.K.; Bawah, A.A.; Nimako, B.A.; Kanlisi, N.S.; Sheff, M.C.; Asuming, P.O.; Kyei, P.E.; Biney, A.; Jackson, E.F.Background: The completion of an implementation research project typically signals the end of research. In contrast, the Ghana Health Service has embraced a continuous process of evidence-based programming, wherein each research episode is followed by action and a new program of research that monitors and guides the utilization of lessons learned. This paper reviews the objectives and design of the most recent phase in this process, known as a National Program for Strengthening the Implementation of the Community-based Health Planning and Services (CHPS) Initiative in Ghana (CHPS+). Methods: A mixed method evaluation strategy has been launched involving: i) baseline and endline randomized sample surveys with 247 clusters dispersed in 14 districts of the Northern and Volta Regions to assess the difference in difference effect of stepped wedge differential cluster exposure to CHPS+ activities on childhood survival, ii) a monitoring system to assess the association of changes in service system readiness with CHPS+ interventions, and iii) a program of qualitative systems appraisal to gauge stakeholder perceptions of systems problems, reactions to interventions, and perceptions of change. Integrated survey and monitoring data will permit multi-level longitudinal models of impact; longitudinal QSA data will provide data on the implementation process. Discussion: A process of exchanges, team interaction, and catalytic financing has accelerated the expansion of community-based primary health care in Ghana's Upper East Region (UER). Using two Northern and two Volta Region districts, the UER systems learning concept will be transferred to counterpart districts where a program of team-based peer training will be instituted. A mixed method research system will be used to assess the impact of this transfer of innovation in collaboration with national and regional program management. This arrangement will generate embedded science that optimizes prospects that results will contribute to national CHPS reform policies and action. © 2018 The Author(s).Item Women’s post-abortion contraceptive use: are predictors the same for immediate and future use?(University of Ghana, 2020-03-05) Kayi, E.; Biney, A.This study sought to identify the socio-demographic, reproductive, partner-related and facility-level characteristics which are associated with immediate and subsequent uptake of post-abortion contraception. The study used the 2017 Ghana Maternal Health Survey (GMHS) data which comprised 1,383 women who had an abortion within the five years preceding the survey. Binary logistic regression analyses were performed to examine associations between the predictor variables and outcome variables, both immediate and subsequent contraceptive use. The findings indicate that age, type of place of residence, and health provider’s pre- or post-abortion family planning counselling were significantly associated with both immediate and subsequent use of modern contraception. Compared to women had induced abortion service provision from health professionals, women who had their abortion from non-health professionals were twice as likely to use contraception immediately post-abortion. Among subsequent contraception users, the predictors included marital status, contraceptive use at index pregnancy, and place where abortion was performed. Partner-related characteristics were not significantly associated with both immediate and subsequent contraceptive use. The study findings are relevant and informative for designing target interventions to facilitate contraception use among young post-abortion women. Expanding access to and availability of post-abortion family planning counselling and services, in addition to the availability of a variety of modern contraceptives, is key to increasing the contraceptive prevalence rate among post-abortion women