Browsing by Author "Moyer, C."
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Item Creating a charter of collaboration for international university partnerships: The elmina declaration for human resources for health(Academic Medicine, 2014-06) Anderson, F.; Donkor, P.; De Vries, R.; Appiah-Denkyira, E.; Dakpallah, G.F.; Rominski, S.; Hassinger, J.; Lou, A.; Kwansah, J.; Moyer, C.; Rana, G.K.; Lawson, A.; Ayettey, S.The potential of international academic partnerships to build global capacity is critical in efforts to improve health in poorer countries. Academic collaborations, however, are challenged by distance, communication issues, cultural differences, and historical context. The Collaborative Health Alliance for Reshaping Training, Education, and Research project (funded by the Bill and Melinda Gates Foundation and implemented through academic medicine and public health and governmental institutions in Michigan and Ghana) took a prospective approach to address these issues. The project had four objectives: to create a "charter for collaboration" (CFC), to improve data-driven policy making, to enhance health care provider education, and to increase research capacity. The goal of the CFC was to establish principles to guide the course of the technical work. All participants participated at an initial conference in Elmina, Ghana. Nine months later, the CFC had been revised and adopted. A qualitative investigation of the CFC's effects identified three themes: the CFC's unique value, the influence of the process of creating the CFC on patterns of communication, and the creation of a context for research and collaboration. Creating the CFC established a context in which implementing technical interventions became an opportunity for dialogue and developing a mutually beneficial partnership. To increase the likelihood that research results would be translated into policy reforms, the CFC made explicit the opportunities, potential problems, and institutional barriers to be overcome. The process of creating a CFC and the resulting document define a new standard in academic and governmental partnerships.Item Female autonomy and reported abortion-seeking in Ghana, West Africa(International Journal of Gynecology and Obstetrics, 2014-09) Rominski, S.D.; Gupta, M.; Aborigo, R.; Adongo, P.; Engman, C.; Hodgson, A.; Moyer, C.Objective To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision. Methods In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior. Results Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05). Conclusion Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services. © 2014 International Federation of Gynecology and Obstetrics.Item Pregnancy Related Causes of Deaths in Ghana: A 5-Year Retrospective Study(2013-12) Der, E. M.; Moyer, C.; Gyasi, R. K.; Akosa, A. B.; Tettey, J.; Akakpo, P. K.; Blankson, A.; Anim, J. T.Objective Data on maternal mortality varies by region and data source. Accurate local-level data are essential to appreciate its burden. This study uses autopsy results to assess maternal mortality causes in southern Ghana. Methods Autopsy log books of the Department of Pathology, Korle-Bu Teaching Hospital Mortuary were reviewed from 2004 through 2008 for pregnancy related deaths. Data were entered into a database and analyzed using SPSS statistical software (Version 19). Results Of 5,247 deaths among women aged 15–49, 12.1% (634) were pregnancy-related. Eighty one percent of pregnancy-related deaths (517) occurred in the community or within 24 hours of admission to a health facility and 18.5% (117) occurred in a health facility. Out of 634 pregnancy-related deaths, 79.5% (504) resulted from direct obstetric causes, including: haemorrhage (21.8%), abortion (20.8%), hypertensive disorders (19.4%), ectopic gestation (8.7%), uterine rupture (4.3%) and genital tract sepsis (2.5%). The remaining 20.5% (130) resulted from indirect obstetric causes, including: infections outside the genital tract, (9.2%), anemia (2.8%), sickle cell disease (2.7%), pulmonary embolism (1.9%) and disseminated intravascular coagulation (1.3%). The top five causes of maternal death were: haemorrhage (21.8%), abortion (20.7%), hypertensive disorders (19.4%), infections (9.1%) and ectopic gestation (8.7%). Conclusion Ghana continues to have persistently high levels of preventable causes of maternal deaths. Community based studies, on maternal mortality are urgently needed in Ghana, since our autopsy studies indicates that 81% of deaths recorded in this study occurred in the community or within 24 hours of admission to a health facility.Item Pregnancy Related Causes of Deaths in Ghana: A 5-Year Retrospective Study(Ghana medical journal, 2013-12) Der, E.M.; Moyer, C.; Gyasi, R.K.; Akosa, A.B.; Tettey, Y.; Akakpo, P.K.; Blankson, A.; Anim, J.T.Objective: Data on maternal mortality varies by region and data source. Accurate local-level data are essential to appreciate its burden. This study uses autopsy results to assess maternal mortality causes in southern Ghana. Method: Autopsy log books of the Department of Pa-thology, Korle-Bu Teaching Hospital Mortuary were reviewed from 2004 through 2008 for pregnancy relat-ed deaths. Data were entered into a database and ana-lyzed using SPSS statistical software (Version 19). Results: Of 5,247 deaths among women aged 15-49, 12.1% (634) were pregnancy-related. Eighty one per-cent of pregnancy-related deaths (517) occurred in the community or within 24 hours of admission to a health facility and 18.5% (117) occurred in a health facility. Out of 634 pregnancy-related deaths, 79.5% (504) re-sulted from direct obstetric causes, including: haemor-rhage (21.8%), abortion (20.8%), hypertensive disor-ders (19.4%), ectopic gestation (8.7%), uterine rupture (4.3%) and genital tract sepsis (2.5%). The remaining 20.5% (130) resulted from indirect obstetric causes, including: infections outside the genital tract, (9.2%), anemia (2.8%), sickle cell disease (2.7%), pulmonary embolism (1.9%) and disseminated intravascular coag-ulation (1.3%). The top five causes of maternal death were: haemorrhage (21.8%), abortion (20.7%), hyper-tensive disorders (19.4%), infections (9.1%) and ectop-ic gestation (8.7%). Conclusion: Ghana continues to have persistently high levels of preventable causes of maternal deaths. Com-munity based studies, on maternal mortality are urgent-ly needed in Ghana, since our autopsy studies indicates that 81% of deaths recorded in this study occurred in the community or within 24 hours of admission to a health facility.