Browsing by Author "Letsa, T."
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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 Factors associated with syphilis screening uptake among pregnant women in health facilities in Brong Ahafo Region of Ghana(2015-03-18) Punguyire, D.; Mahama, E.; Letsa, T.; Akweongo, P.; Sarfo, B.Abstract Background Congenital syphilis is a consequence of undiagnosed, untreated, or inadequately treated maternal syphilis and results in serious adverse outcomes. It is easily diagnosed and in Ghana it is treated at points of care free; yet most pregnant women attending antenatal clinic (ANC) in Ghana are not screened. This study identified some factors influencing syphilis screening uptake at medical facilities during pregnancy in the Brong Ahafo Region of Ghana. Method A cross-sectional study was conducted in two districts in Brong Ahafo Region of Ghana. All the health facilities in the selected districts that run antenatal services were assessed on their preparedness to screen syphilis for pregnant women. Interviews were conducted among 390 pregnant women attending ANC at five hospitals in the two districts to identify individual and community level barriers to syphilis screening. Results In all 37 health facilities conducted antennal clinics in the two districts in 2013, 75.7% of the health facilities were public; Techiman had the higher number of health facilities (64.9%), test kits were available in only 29.7% of the health facilities and 43.2% of 37 health facilities were conducting syphilis screening. Majority of the pregnant women (57.7%) were within the age range of 20–29 years, 53.1% were in their third trimester, 32.6% in second trimester and 14.3% were in the first trimester. Syphilis screening was 52.4% among 37 health facilities. Among 390 pregnant women who participated in the study syphilis screening was 21.1%. At the health facility level, screening was significantly associated with the type of hospital (whether private or public), availability of test kits, and trained personnel, such as doctors/midwives and syphilis education. At the individual level, attending a public hospital (OR=5.49; 95% CI=1.71-17.65), willingness to request screening (OR=2.72; 95% CI=1.09-5.88), and being in the third trimester of pregnancy (OR=16.47; 95% CI=2.02-132.81) were significantly associated with syphilis screening uptake. Conclusion Despite government’s free screening policy for syphilis among pregnant women, the coverage of antenatal screening is still low. Training of lower level health workers and regular supply of logistics are crucial for the success of the syphilis prevention programme.Item HIV Status Disclosure and Quality of Life of People Living with HIV/AIDS in the Ho Municipality, Ghana(Advances in Public Health, 2022) Agbeko, A.; Owusu, R.; Alhassan, Y.; Letsa, T.; Axame, W.K.; Ogum-Alangea, D.Background. Quality of life (QoL) and HIV/AIDS serostatus disclosure are vital HIV outcome indicators. Tis study examined factors associated with QoL, HIV status disclosure, and the relationship between QoL and disclosure among people living with HIV (PLWHIV) at the Ho Teaching Hospital. Methods. We conducted a hospital-based cross-sectional survey among 311 PLWHIV. Te World Health Organization WHOQOL-HIV BREF questionnaire was used to measure QoL. A semistructured questionnaire was used to gather information on socio-demographics and HIV serostatus disclosure. Multivariate logistic and multiple linear regressions were used to determine predictors of HIV serostatus disclosure and QoL in six domains, respectively. Results. Overall, 88.7% of participants disclosed their HIV status to a significant relation. Te majority (98.1%) presented with good QoL, high (83.3%) among participants who disclosed their HIV seropositive status. Patients on antiretroviral therapy (ART) for more than a year were 8.64 times more likely to disclose their HIV status as compared to those on ART for less than a year (AOR = 8.64 (95% CI: 2.00–37.27), p 0.004). Increasing years on ART (β = 0.37) and being employed (β = 1.31) positively predicted good QoL in the physical domain, whereas higher educational level positively predicted good QoL in the social domain (β = 0.66). QoL was not associated with HIV serostatus disclosure. Conclusion. HIV status disclosure was high. Increasing years on ART increased the odds of disclosure. Although there was no significant relationship between QoL and disclosure, good QoL was high among those who disclosed their HIV status. Increasing years on ART, higher education, and being employed predicted good QoL.Item Pneumococcal meningitis outbreak and associated factors in six districts of Brong Ahafo region, Ghana, 2016(BioMed Central Ltd., 2018) Letsa, T.; Noora, C.L.; Kuma, G.K.; Asiedu, E.; Kye-Duodu, G.; Afari, E.; Kuffour, O.A.; Opare, J.; Nyarko, K.M.; Ameme, D.K.; Bachan, E.G.; Issah, K.; Aseidu-Bekoe, F.; Aikins, M.Background: Meningitis, a disease of the Central Nervous System is described as inflammation of the covering of the brain and spinal cord (meninges). It is characterised by fever, severe headache, nausea, vomiting, stiff neck, photophobia, altered consciousness, convulsion/seizures and coma. In December, 2015, twelve suspected cases of meningitis were reported in Tain district in Brong Ahafo region (BAR). Subsequently, dozens of suspected cases were hospitalized in five district hospitals in BAR. We investigated to determine the magnitude, causative agent and risk factors for the disease transmission. Methods: A community-based 1:2 case-control study (with 126 individuals) was conducted form 10/12/15 to 26/4/16 in 27 districts of Brong-Ahafo Region, Ghana. We defined suspected meningitis cases as people presenting with sudden headache and fevers (Temp> 38.0 °C) in combination with one of the following signs: neck stiffness, altered consciousness, convulsions, bulging fontanelle (infants) and other meningeal signs. Controls were selected from the same neighbourhood and defined as individuals with no overt meningitis signs/symptoms. We collected CSF samples and performed serological testing using Pastorex-Meningitis-Kit and culture for bacterial isolation. Moreover, structured questionnaires were used to collect data on socio-demographics, living conditions, health status and other risk factors. We conducted univariate data analysis and logistic regressions to study disease-exposure associations using Stata 15. Results: A total of 969 suspected cases with 85 deaths (CFR = 9.0%) were recorded between December, 2015 and March, 2016. Majority, 55.9% (542/969) were females aged between 10 months-74 years (median 20 years, IQR; 14-34). Of the 969 cases, 141 were confirmed by Laboratory test with Streptococcus pneumoniae identified as the causative agent. Cases were reported in 20 districts but 6 of these districts reported cases above threshold levels. The outbreak peaked in week 6 with 178 cases. Overall attack rate (AR) was 235.0/100,000 population. District specific ARs were; Tain; 143.6/100,000, Wenchi; 110.0/100,000, Techiman; 46.6/100,000, Jaman North; 382.3/100,000 and Nkoranza South; 86.4/100,000. Female and male specific ARs were 251.3/100,000 and 214.5/100,000 respectively. Age group 10-19 years were most affected 33.8% (317/940). We identified sore throat [aOR = 5.2, 95% (CI 1.1-26.1)] and alcohol use [aOR = 9.1, 95%(CI 1.4-55.7)] as factors associated with the disease transmission. Conclusion: Meningitis outbreak due to Streptococcus pneumoniae was established in BAR. Upper respiratory tract infection and alcohol use were associated with the outbreak. Mass campaigns on healthy living habits, signs and symptoms of meningitis as well as the need for early reporting were some of the control measures instituted. Moreover, we recommend Pneumococcal vaccination in BAR to prevent future outbreaks. © 2018 The Author(s).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