Browsing by Author "Coleman, N.A."
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Item Determination of Household Use of Iodated Salt in The Hohoe District in the Volta Region, Ghana(University of Ghana, 2000-09) Amoussou-Gohoungo, L.O.; Amuah, E.; Coleman, N.A.; University of Ghana, College of Health Sciences School of Public HealthIn recent years, iodine deficiency disorders (IDD) have emerged as an important public health problem in Ghana. In the Hohoe district the prevalence o f goitre was 26% (Asibey- Berko, et al 1994). Ghana has adopted the continuous use o f iodated salt as a solution to 1DD. This was supported by Act 523, which requires that, any salt meant for human and animal consumption in Ghana should be iodized. After the launching o f a national campaign against IDD at Hohoe in 1997, awareness on the importance o f the use o f iodated salt was created in the district. However, the results o f the 1998 Ghana Demographic and Health Survey (GDHS, 1998) showed that the Volta region had the lowest percentage o f households using iodated salt (10%). The DHMT o f the Hohoe district health administration is worried over the low utilization o f iodated salt in the Volta region and more so because Hohoe is an endemic goitre area in the region. The study therefore was a cross-sectional survey that aimed at establishing the proportion o f people using iodated salt, and factors affecting the use o f iodated salt in the district. It took place in thirty communities. Three hundred women in charge o f household cooking and 50 salt sellers were interviewed using structured questionnaire. The study examined their awareness o f the importance o f iodated salt, its availability, affordability, and utilization in the district. The salt used for household cooking was tested for iodine. T he study rev e a le d th a t the level o f aw a re n e s s o f the im p o rta n c e o f io d a ted sa lt w a s very low in sa lt se lle rs, as 7 0% o f th em h ad low level o f aw a re n e s s . T h o u g h 243 (8 1% ) w om en in ch a rg e o f h o u s e h o ld c o o k in g sa id th e y h a d h e a rd o f io d a ted salt, o n ly 2 0 1 (6 7% ) sa id th e y k n ow the b e n e fits a s so c ia te d w ith th e use o f io d a te d salt. H ow ev er, it is re a lly su rp ris in g to n o te that, o u t o f th e 201 w h o c la im ed th ey k n ow its b en e fit, 8, 66. an d 127 o f the w om en had h igh, m o d e ra te an d low lev e l o f aw a re n e s s a b o u t io d a ted salt, re sp e c tiv e ly . With rega rd to a v a ila b ility o f io d a ted sa lt o n ly 8% o f s a lt se lle rs w e re s e llin g io d a ted salt. A b o u t 5 7% o f w om e n in ch a rg e o f h o u s e h o ld co o k in g sa id io d a te d sa lt w a s a lw a y s av a ilab le w h en th ey w a n te d to b u y it. W ith the q u e s tio n o f a ffo rd a b ility , it w a s fo u n d th a t 3 6 .8% o f th e w om e n in ch a rg e o f h o u se h o ld co o k in g sa id it w a s n o t a ffo rd a b le . T h e io d in e te s t on the salt co n sum ed in the h o u s e h o ld s in d ic a ted h ow e v e r th a t o n ly 16% o f h o u s e h o ld s u se d io d a te d salt. Availability, cost and awareness were the main factors determining the usage o f iodated salt in the district.Item Estimates of the maternal mortality ratio in two districts of the Brong-Ahafo region, Ghana(Bulletin of the World Health Organization, 2001-02) Smith, J.B.; Fortney, J.A.; Wong, E.; Amatya, R.; Coleman, N.A.; De Graft Johnson, J.Objective To estimate the maternal mortality ratio (MMR) by the sisterhood method in two districts of the Brong-Ahafo region of Ghana, and to determine the impact of different assumptions and analytical decisions on these estimates. Methods indirect estimates of the MMR were calculated from data collected in 1995 by Family Health International (FHI) on 5202 women aged 15-49 years, using a household screen of randomly selected areas in the two districts. Other data from the nationally representative 1994 Ghana Infant, Child and Maternal Mortality Survey (ICMMS) and from the 1997 Kassena-Nankana District study were also used for comparison. Findings Based on the FHI data, the MMR was estimated to be 269 maternal deaths per 100 000 live births for both districts combined, a figure higher than ICMMS estimates. Biases during data collection may account for this difference, including the fact that biases underestimating mortality are more common than those overestimating it. Biases introduced during data analysis were also considered, but only the total fertility rate used to calculate the MMR seemed to affect the estimates significantly. Conclusions The results indicate that the sisterhood method is still being refined and the extent and impact of biases have only recently received attention. Users of this method should be aware of limitations when interpreting results. We recommend using confidence limits around estimates, both to dispel false impressions of precision and to reduce overinterpretation of data.Item Risk Factors for Non-Communicable Disease among the Adult Population in the Kassena-Nankana District. A Community-Based Survey.(University of Ghana, 2003) Mensa-Wilmot, Y.M.; Binka, F.; Coleman, N.A.; University of Ghana, College of Health Sciences, School of Public HealthA community-based survey of 2018 adults in the Kassena-Nankana District of the Upper East Region aged 15-64 years was carried out to assess the prevalence of certain risk factors of the non-communicable diseases; cardiovascular disease, diabetes, respiratory conditions and cancers. This survey was conducted in the month of June during the planting season for the major crops cultivated in the Kassena Nankana district. Tobacco use among the study population was determined to be 20.9%. Men mostly smoked cigarettes and hand rolled tobacco, generally initiating this practice between the ages of 15-30years. The women mostly chewed tobacco leaves and rubbed tobacco powder on their gums; a habit initiated generally after 35years of age. Alcohol consumption was relatively high among the study population (55.03%) and was prevalent between both sexes. Shea fruits were the only local fruits that were frequently consumed. Other local fruits were consumed by less than 15% of the population surveyed. The study population was physically active with 90% of the population engaging in daily vigorous physical exercise for at least an hour. The prevalence of obesity was evaluated using two indices; body mass index (BMI) and waist-hip ratio (WHpR). Evaluating the study population BMIs indicated an obesity level of 2.69% whilst a higher figure of 33.9% indicative of high central obesity was derived by the computation of the WHpR. A hypertension prevalence of 6.21% and 4.54% was found in the in the study population using systolic and diastolic cutoffs of 140mmHg and 90mmHg respectively. A more detailed study that will evaluate serum cholesterol levels and determine the prevalence of undiagnosed diabetes in the community is needed as its outcome would complement these findings.Item A Study of the Cost of Delivery Services and Its Role in Determining Utilization Patterns of Pregnant Women in the Kintampo District.(University of Ghana, 2000-09) Marfoh, J.K.; Tetteh, E.; Coleman, N.A.; University of Ghana, College of Health Sciences, School of Public HealthHaving a trained birth attendant at every delivery has been identified as the single most important way of reducing maternal mortality. However most women do not patronize supervised delivery services even where they are available. Among the reasons given for this state of affairs is the high cost of accessing the services. Supervised delivery in this district was estimated at 37% in 1998, which falls below the national figure of 44%. The actual cost to a woman for accessing this service, and the role cost plays in determining the utilization by women is not known in this district. This study which was undertaken in the Kintampo district of the Brong Ahafo region of Ghana from May to August 2000 was to investigate the cost of delivery to women utilizing the various options of delivery: delivery at home, delivery under the supervision of a TBA and having a supervised delivery. These costs were compared and their effect on the choice of services by the women investigated. Women who had delivered in the three months before the study were chosen from three settings representing good, moderate and poor access to Orthodox health care facilities for the survey. It was found out that it cost a woman four to six times more to have a supervised delivery than to deliver with a TBA or at home. The bulk of the cost was found to be for services and drugs. Women identified cost as a very important factor in influencing their decision on where to deliver and ranked it second only to the safety of their life and that of their babies. Most women indicated their preference for hospital delivery if cost were not a problem. It is recommended that to make supervised delivery an attractive option for women in the Kintampo district, service charges for supervised deliveries are reviewed downwards, delivery costs are subsidized and more staff are trained to supervise more deliveries.