Browsing by Author "Welbeck, J."

Now showing 1 - 8 of 8

The determinants of anti-money laundering compliance among the Financial Action Task Force (FATF) member states
(Journal of Financial Regulation and Compliance, 2018-07) Mekpor, E.S.; Aboagye, A.; Welbeck, J.
Purpose This paper aims to compute a measure for anti-money laundering/counter-financing of terrorism (AML/CFT) compliance and investigate its determinants. Design/methodology/approach Using the Financial Action Task Force (FATF) recommendations and assigning weights to them, the study computes a measure for AML compliance. Further, the determinants of AML compliance were investigated using ordinary least squares (OLS) data of 155 countries between 2004 and 2016. Findings The findings suggest that AML compliance have slightly improved over the years. Further, the OLS regression results show that technology, regulatory quality, bank concentration, trade openness and financial intelligence center significantly determined and improved AML compliance. Practical implications From the findings, it is evident that countries that wish to improve the AML compliance should focus more on technology, regulatory quality, structure of the banking sector, size of the economy and institution of financial intelligence center so as to enhance AML compliance. Originality/value To the best of the author’s knowledge, this paper reveals a first AML/CFT compliance index that measures the cross-country level of AML/CFT compliance from the year 2004 to 2016. Subsequently, this paper adopted an OLS econometric model to identify the key determinants of AML/CFT compliance among member states of FATF.
Factors affecting the survival of the "at risk" newborn at Korle Bu Teaching Hospital, Accra, Ghana.
(2003-01) Welbeck, J.; Biritwum, R.B.; Mensah, G.
High risk pregnancies continue to be associated with high perinatal mortality and morbidity in developing countries. Korle Bu Teaching Hospital is no exception with a perinatal mortality rate of 98.7/1000 births. Multiple factors resulting in this include the high risk nature of the pregnancies resulting in increased incidence of premature deliveries and asphyxiated babies, the delay in transfer of the sick neonate as well as the inadequate mode of transfer. The type of delivery other than the spontaneous vaginal route also affects the outcome, though the relationship was not statistically significant. Logistic regression analysis showed that maturity, birthweight and time from birth to admission to NICU were the most significant factors associated with the survival of the neonate. Proper foetal surveillance both in the antenatal period and during labour cannot be over emphasized and the mere presence of a paediatrician at these high risk deliveries may make a difference. Also, increased vigilance in the special care offered will help reduce mortality.
Implementing newborn screening for sickle cell disease in Korle Bu Teaching Hospital, Accra: Results and lessons learned
(Wiley, 2021) Segbefia, C.I.; Goka, B.; Welbeck, J.; Amegan-Aho, K.; Dwuma-Badu, D.; Rao, S.; Salifu, N.; Salifu, N.; Oppong, S.A.; Odei, E.; Ohene-Frempong, K.; Odame, I.
Early diagnosis of sickle cell disease (SCD) through newborn screening (NBS) is a cost-effective intervention, which reduces morbidity and mortality. In sub-Saharan Africa (SSA) where disease burden is greatest, there are no universal NBS programs and few institutions have the capacity to conduct NBS. We determined the feasibility and challenges of implementing NBS for SCD in Ghana's largest public hospital. The SCD NBS program at Korle Bu Teaching Hospital (KBTH) is a multiyear partnership between the hospital and the SickKids Center for Global Child Health, Toronto, being implemented in phases. The 13-month demonstration phase (June 2017–July 2018) and phase one (November 2018–December 2019) focused on staff training and the feasibility of universal screening of babies born in KBTH. During the demonstration phase, 115 public health nurses and midwives acquired competency in heel stick for dried blood spot sampling. Out of 9990 newborns, 4427 babies (44.3%) were screened, of which 79 (1.8%) were identified with presumptive SCD (P-SCD). Major challenges identified included inadequate nursing staff to perform screening, shortage of screening supplies, and delays in receiving screening results. Strategies to overcome some of the challenges were incorporated into phase one, resulting in increased screening coverage to 83.7%. Implementing NBS for SCD in KBTH presented challenges with implications on achieving and sustaining universal NBS in KBTH and other settings in SSA. Specific steps addressing these challenges comprehensively will help build on the modest initial gains, moving closer toward a sustainable national NBS program.
Incidence and management of malaria in two communities of different socio-economic level, in Accra, Ghana.
(Routledge, part of the Taylor & Francis Group, 2000-12-01) Biritwum, R.B.; Welbeck, J.; Barnish, G.
Two adjacent communities of differing socio-economic levels were selected, in Accra, Ghana, for the study of the home management of malaria. The youngest child in each selected household, each of which had a child aged < 5 years, was recruited for weekly follow-up, following informed consent. Malaria was the most common condition reported by the 'caregivers' (mothers of the subjects and others caring for the subjects) in each community, with 2.0 episodes of clinical malaria/child during the 9-month study. Most (89%) of the caregivers in the better-off community had been educated beyond primary-school level, but 55% of the caregivers in the poorer community had either received no formal education or only primary-school education. This difference was also reflected by the educational facilities provided to the children studied: 52% of the those in the better-off community attended nurseries, kindergartens or creches, compared with 8% of the children investigated in the poorer community. The proportion of caregivers who purchased drugs without prescription or used left-over drugs to treat clinical malaria in the children was higher in the poorer community (82% v. 53%), and a child from the poorer community was less likely to have been taken to a clinic or hospital to be treated for malaria than a child from the better-off community (27% v. 42%). During the follow-up period two children died, one from each community. Treatment of malaria in young children is likely to be less effective in the poorer community, where a lack of economic access to health services was demonstrated.
“The Mother Beyond Delivery”: The Midwife and Maternal Mental Health
(2018-03-27) Adjorlolo, S.; Welbeck, J.
Mental illness is a major contributor to maternal morbidity and mortality, globally. Health professionals, specifically midwives’ have significant roles to play in reducing maternal mortality to less than 70 per 100,000 live births by 2030, particularly in developing and resource constraint countries, as envisioned by the Sustainable Development Goal (SDG) 3. Consequently, following a systematic and integrated literature review, this presentation critically examines midwives involvement in promoting maternal mental health, such as identifying women at risk, assessing and referring women appropriately in Ghana and beyond. Also, in view of calls to integrate mental health into general maternal health care, the presentation examines how midwives’ can be empowered, taking into consideration sociocultural dynamics and mental illness, to screen and deliver evidenced-based, low-cost interventions through routine maternal health and reproductive care services, or make appropriate psychiatric care referrals. Midwives’ are highly skilled in developing relationships with childbearing women and their families, a privileged position that affords a unique opportunity to enhance and promote maternal mental health to contribute to the attainment of SDG 3.
The selection and use of essential medicines
(World Health Organization - Technical Report Series, 2012) Abdel-Aleem, H.; Bero, L.A.; Cheraghali, A.M.; Cranswick, N.; Fernandopulle, R.; Gray, A.; Hoppu, K.; Kearns, G.L.; Ofori-Adjei, D.; Wannmacher, L.; Zaidi, A.; Raymond, A.S.; Welbeck, J.; Nielsen, H.; Ahmed, K.U.; Porrás, A.; Kertesz, D.; Annan, E.A.; Ondari, C.; Hill, S.; Ridge, A.; Renevier, M.
The 18th Meeting of the WHO Expert Committee on the Selection and Use of Essential Medicines took place in Accra, Ghana on 21-25 March 2011. This was the first meeting of the Committee held outside of Geneva. The purpose of the meeting was to review and update the WHO Model List of Essential Medicines (EML) as well as the WHO Model List of Essential Medicines for Children (EMLc). The Expert Committee Members and Temporary Advisers who participated in the meeting are listed in the report, together with their declarations of interest. In accordance with its approved procedures (http://apps.who.int/gb/archive/pdf- files/EB109/eeb1098.pdf) the Expert Committee evaluated the scientific evidence on the comparative effectiveness, safety and cost-effectiveness of medicines to update the WHO Model List of Essential Medicines and the Model List of Essential Medicines for Children. The Expert Committee: approved the addition of 16 new medicines to the EML; approved the deletion of 13 medicines from the EML; approved n indications for 4 medicines already listed on the EML; approved the addition of a new dosage form or strength for 4 medicines already on the EML; rejected 9 applications for the addition of a medicine to EML; approved the addition of 16 new medicines to the EMLc; approved the deletion of 15 medicines from the EMLc; rejected 3 applications for the addition of a new medicine to the EMLc. Some of the main recommendations made, in order of their appearance on the Model List, were: Section 6: addition of artesunate + amodiaquine combination tablet for the treatment of malaria in adults and children, in line with current WHO treatment guidelines. In making its decision, the 2011 Committee reviewed the latest clinical evidence and the information about licensing in several countries of the fixed-dose combination tablet. The Committee noted, however, that appropriate doses of both medicines can also be achieved using combinations of the mono-component products, including co-blistered presentations. Section 10: addition of tranexamic acid injection for the treatment of adult patients with trauma and significant risk of ongoing haemorrhage. On the basis of the results of a very large trial of the use of tranexamic acid specifically for trauma patients - including those who have been in road traffic accidents, the Committee concluded that there is sufficient evidence to support the proposal that listing tranexamic acid may contribute to a reduction in this cause of death. Section 18.5: addition of glucagon injection, 1 mg/ml to treat acute severe hypoglycaemia in patients with diabetes, to support efforts in many countries to ensure appropriate treatment of the increasing number of patients with diabetes. The Committee also recommended that careful attention be paid to the cost of procuring glucagon and noted that based on the experience with other highcost medicines, such as the antiretrovirals, inclusion in the EML may help reduce prices. Section 22.1: addition of misoprostol tablet, 200 micrograms for the prevention of postpartum haemorrhage, where oxytocin is not available or cannot be safely used. WHO guidelines currently recommend that in situations where there is no other treatment available, misoprostol can be used to prevent and treat postpartum haemorrhage due to uterine atony. New evidence submitted to the Committee shows that misoprostol can be safely administered to women to prevent postpartum haemorrhage by traditional birth attendants or assistants trained to use the product at home deliveries. Misoprostol should not, however, be used to treat haemorrhage unless there is no other option available (see below). Moreover, if it is available, oxytocin is recommended as it is more effective and cheaper. Other medicines that were added to the Model List are: isoflurane, propofol, midazolam, clarithromycin, miltefosine, paclitaxel and docetaxel, bisoprolol, terbinafine cream/ointment, mupirocin cream/ointment, and atracurium. The Expert Committee did not approve the following proposals for addition of medicines on the basis of the evidence submitted: ether, gatifloxacin, a fixed-dose combination of isoniazid + pyridoxine + sulfamethoxazole + trimethoprim (because there is no marketed product), etravirine, darunavir, raltegravir, dihydroartemisinin + piperaquine, pyronaridine + artesunate, loperamide and misoprostol tablet for treatment of postpartum haemorrhage. The Expert Committee also assessed a review of the comparative effectiveness and cost-effectiveness of analogue insulins compared to recombinant human insulin. The products considered were: insulin glargine, insulin detemir, insulin aspart, insulin lispro, and insulin glulisine. The Committee noted that while many of the comparative trials find a statistically significant difference between analogue insulins and standard recombinant human insulin for some effects on blood glucose measurements, there is no evidence of a clinically significant difference in most outcomes. The Committee concluded that insulin analogues currently offer no significant clinical advantage over recombinant human insulin and there is still concern about possible long-term adverse effects. A summary of reasons for all changes to the List is in Section 1 of the report. All applications and documents considered by the Committee will remain available on the web site for the meeting at: http://www.who.int/selection-medicines/ committees/expert/18/en/index.html.
Treating burkitt's lymphoma in Malawi, Cameroon, and Ghana.
(2008-06) Hesseling, P.B.; Molyneux, E.; Tchintseme, F.; Welbeck, J.; McCormick, P.; Pritchard-Jones, K.; Wagner, H.P.
The Special Report: International published in the April issue of The Lancet Oncology, raised valid concerns about the issue of treating childhood Burkitt's lymphoma in Kenya and Uganda.1 These same concerns were voiced by delegates from 13 African countries at the first African Continental Conference of the International Society of Paediatric Oncology (SIOP) in Stellenbosch, South Africa, in 1994. At the end of this conference, a decision was made to develop effective and affordable treatment for African children with endemic Burkitt's lymphoma. At that time, over 90% event-free survival was being achieved in French children with sporadic Burkitt's lymphoma by use of short, but intensive, multidrug chemotherapeutic regimens adapted to initial tumour burden and response to chemotherapy.2 However, these Lymphome Malins de Burkitt (LMB) regimens included high doses of cyclophosphamide, doxorubicin, and methotrexate and needed a high level of supportive care. Thus, these regimens were clearly not feasible for the treatment of malnourished children with comorbidities in Africa. Hence, SIOP supported a study in Malawi, in which an overall 52% 1-year event-free survival was achieved for patients with St Jude stage I, II, or III endemic Burkitt's lymphoma, by use of a simplified LMB-like protocol. However, the cost of this treatment was too high and there were many toxic effects.3
Unveiling Midwives' Experiences of Newborn Health in Rural Birth Spaces in Southern Ghana
(2018-03-27) Ani-Amponsah, M.; Welbeck, J.
Midwives’ experiences of newborn care in rural communities have been minimally explored over the past two decades globally in spite of their rich experiences as frontline health workers in maternal and newborn health. In Ghana, the slow decline of neonatal mortality is shaped by inequitable health coverage, lapses in health care delivery, weak community engagement strategies and policy implementation challenges. Understanding the dynamic contextual factors that impact rural newborn health care delivery is critical to meeting the Sustainable Development Goal (SDG) 3.2 - i.e. reducing neonatal mortality to at least 12 per 1000 live births. The aim of this study was to explore and unveil the experiences of midwives involved with newborn health care in rural birth settings, Southern Ghana. Interpretive phenomenology that incorporates Heideggerian and African philosophy were used to explore the meanings embedded in the experiences of thirteen midwives who volunteered to participate in the study. Emerging themes were synthesized from the verbal transcripts, field notes, reflective journal and commentaries from two independent reviewers to produce rich narratives of the midwives’ embodied experiences. The study findings establish that maternal and neonatal care are delivered in health facilities, domiciliary settings and unpredictable spaces in rural communities where silent suffering occur. The knowledge generated in the study serves as basis for setting newborn health care delivery priorities, scaling up research-informed interventions, and refining policies to improve newborn health care delivery and midwifery practice in rural settings within Ghana.