Browsing by Author "Dotse-Gborgbortsi, W."
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Item Characteristics of packaged water production facilities in Greater Accra, Ghana: implications for water safety and associated environmental impacts(Journal of Water, Sanitation and Hygiene for Development, 2020-02-04) Dzodzomenyo, M.; Semey, M.D.K.; Dotse-Gborgbortsi, W.; Wright, J.Packaged water (sold in bags or bottles) is widely consumed in many countries and is the main drinking-water source for most urban Ghanaian households. There are, however, few studies of packaged water production. This study aims to assess the source water, treatment, and manufacturing characteristics of sachet water (vended in 500 mL plastic bags), together with pointof- manufacture risks to hygienic production. A sample of 90 sachets was collected of brands sold in four neighbourhoods in Accra, Ghana, their packaging and physical characteristics recorded, and a risk score calculated from these. Production processes were observed at 60 associated sachet factories, producers interviewed, and surrounding neighbourhoods surveyed for contamination hazards. 80% of producers packaged groundwater from boreholes and all treated water via reverse osmosis. Almost all manufacturers (95%) reported site visits by regulators in the previous year and few risks to hygienic production were observed at factories. Sanitary risk scores were 9.2% higher at the seven factories never visited by a regulator, though this difference was not significant (t ¼ 1.81; p ¼ 0.07). This survey suggests most Ghanaian sachet water originates from groundwater and is comparatively safe, though a minority remains unregulated. Groundwater governance policy could support this industry in meeting Greater Accra’s growing water demand through the designation of protected municipal wellfields.Item The influence of distance and quality on utilisation of birthing services at health facilities in Eastern Region, Ghana(BMJ Global Health, 2020-01-09) Dwomoh, D.; Dotse-Gborgbortsi, W.; Alegana, V.; Hill, A.; Tatem, A.J.; Wright, J.Objectives Skilled birth attendance is the single most important intervention to reduce maternal mortality. However, studies have not used routinely collected health service birth data at named health facilities to understand the influence of distance and quality of care on childbirth service utilisation. Thus, this paper aims to quantify the influence of distance and quality of healthcare on utilisation of birthing services using routine health data in Eastern Region, Ghana. Methods We used a spatial interaction model (a model that predicts movement from one place to another) drawing on routine birth data, emergency obstetric care surveys, gridded estimates of number of pregnancies and health facility location. We compared travel distances by sociodemographic characteristics and mapped movement patterns. Results A kilometre increase in distance significantly reduced the prevalence rate of the number of women giving birth in health facilities by 6.7%. Although quality care increased the number of women giving birth in health facilities, its association was insignificant. Women travelled further than expected to give birth at facilities, on average journeying 4.7 km beyond the nearest facility with a recorded birth. Women in rural areas travelled 4 km more than urban women to reach a hospital. We also observed that 56% of women bypassed the nearest hospital to their community. Conclusion This analysis provides substantial opportunities for health planners and managers to understand further patterns of skilled birth service utilisation, and demonstrates the value of routine health data. Also, it provides evidence-based information for improving maternal health service provision by targeting specific communities and health facilities.Item Sachet water quality and product registration: A cross-sectional study in Accra, Ghana(Journal of Water and Health, 2018-05) Dzodzomenyo, M.; Fink, G.; Dotse-Gborgbortsi, W.; Wardrop, N.; Aryeetey, G.; Coleman, N.; Hill, A.; Wright, J.Objectives: To assess the extent to which packaged water producers follow product registration procedures and to assess the relationship between product registration and drinking water quality in Accra, Ghana. Methods: Following preliminary analysis of a national water quality survey, 118 packaged sachet water samples were collected by sampling all brands sold by 66 vendors. A sample of vendors were selected from two high income and two low-income areas of Accra, Ghana. Sachet packaging and labelling details were recorded and compared to a regulatory database to assess product registration. All samples were weighed and tested for faecal indicator bacteria and selected physico-chemical parameters. Results: Product registration numbers and brand names could be matched to regulatory records for 77 out of 118 sachets (65.2%). All samples tested were compliant with national water quality standards for faecal indicator bacteria and nitrate. Brand registration was not associated with any of the quality indicators considered Conclusion: The results of this study suggest that whilst a substantial proportion of sachet water is sold without formal product registration, the microbial quality of the unlicensed water is consistently high in Accra, Ghana. Further examination of regulatory enforcement and monitoring will be needed to ensure sustained high water quality over time.