Browsing by Author "Yawson, A."

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Adherence to the recommended timing of focused antenatal care in the Accra Metropolitan Area, Ghana
(Pan African Medical Journal (PAMJ), 2019-06-18) Asah-Opoku, K.; Ameme, D.K.; Yawson, A.; Guure, C.B.; Aduama, D.E.M.; Mumuni, K.; Samba, A.; Maya, E.T.
Introduction: the proportion of antenatal attendants in Ghana who had at least four antenatal visits increased from 78% in 2008 to 87% in 2014. However, it is not known whether these visits followed the recommended timing of focused antenatal clinic attendance in Ghana. We sought to assess the adherence to the clinic schedule and its determinants in the Accra Metropolis. Methods: a cross-sectional study was conducted. Face-to-face interviews were conducted with postpartum women. Multiple logistic regression was used in the analysis of determinants of adherence to the recommended timing of clinic attendance. A p-value of <0.05 was considered statistically significant. Results: among 446 focused antenatal care clinic attendants, 378 (84.8%) had four or more visits. Among these, 101 (26.7%) adhered to the recommended clinic schedule. Women who adhered were more likely to have had education up to Junior High School [AOR=3.31, 95%CI (1.03-10.61)] or Senior High School [AOR=4.47, 95%CI (1.14-17.51)], or have history of abortion [(AOR=3.36, 95%CI (1.69-7.96)]. For every week increase in gestational age at booking at the antenatal clinic, respondents were 34% less likely to complete all four antenatal visits at the recommended times. [(AOR=0.66, 95% (0.60-0.73)]. Conclusion: majority of women receiving focused antenatal care in the Accra Metropolis have four or more visits but only about a quarter of them adhered to the recommended clinic schedule. Having high school education, history of abortion and early initiation of antenatal care were predictors of adherence to clinic schedule. Women should be educated on early initiation of antenatal care to enhance adherence.
Availability of HIV services along the continuum of HIV testing, care and treatment in Ghana
(BMC health services research, 2018-09) Ayisi Addo, S.; Abdulai, M.; Yawson, A.; Baddoo, A.N.; Zhao, J.; Workneh, N.; Okae, I.; Wiah, E.
Background Ghana has been providing HIV and AIDS services since the identification of the first case in 1986 and added highly active antiretroviral therapy to its comprehensive care in 2003.This study aimed at assessing availability of HIV services along the continuum of HIV care in Ghana. Method A cross sectional study was conducted among 172 (87%) of the total 197 ART canters in Ghana. Data was collected by self-administered questionnaire and analysed using STATA version 13. Results Of the 172 health facilities surveyed, 165 (96%) were offering HIV testing Services (HTS) during the survey period. More than 90% of the surveyed facilities reported to offer Anti-Retroviral Treatment (ART), patient counselling, TB screening and Prevention of Mother to Child Transmission (PMTCT) services. Viral load and Early Infant Diagnosis (EID) and laboratory testing services were reported at 10 (5.8%) and 23 (13.4%) respectively. HIV testing services (HTS), PMTCT, ART, patient counselling and opportunistic infections (OI) prophylaxis services were offered at all Tertiary and Regional hospitals surveyed. EID sample collection and testing services was reported at 2 out of 27 (7.4%) of the Health Centre and/or clinics in Ghana. The common adherence assessment methodology being implemented varied by facilities which included: asking patients if they took their drugs 154 (89.5%), pill counting 131 (76.2%), use of follow-up visit 79(45.9%) and use of CD4 counts, viral loads and clinical manifestation 76 (44.2%). Challenges encountered by facilities included shortage of test reagents and drugs 122 (71%), 111 (65%) respectively and patient compliance 101 (59%). Conclusion This study showed ART services to be available in most facilities. Methods used to assess patients adherence varied across facilities. Shortage of test reagents and drugs, EID sample collection and testing were major challenges. A standardised approach to assessing patient’s adherence is recommended. Measures should be put in place to ensure availability of HIV commodities at all levels.
Common risk factors for chronic non-communicable diseases among older adults in china, ghana, mexico, india, russia and south africa: The study on global AGEing and adult health (SAGE) wave 1
(BioMed Central Ltd., 2015) Wu, F.; Guo, Y.; Chatterji, S.; Zheng, Y.; Naidoo, N.; Jiang, Y.; Biritwum, R.; Yawson, A.; Minicuci, N.; Salinas-Rodriguez, A.; Manrique-Espinoza, B.; Maximova, T.; Peltzer, K.
Background: Behavioral risk factors such as tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol are known and modifiable contributors to a number of NCDs and health mediators. The purpose of this paper is to describe the distribution of main risk factors for NCDs by socioeconomic status (SES) among adults aged 50 years and older within a country and compare these risk factors across six lower- And upper-middle income countries. Methods: The study population in this paper draw from SAGE Wave 1 and consisted of adults aged 50-plus from China (N=13,157), Ghana (N=4,305), India (N=6,560), Mexico (N=2,318), the Russian Federation (N=3,938) and South Africa (N=3,836). Seven main common risk factors for NCDs were identified: daily tobacco use, frequent heavy drinking, low level physical activity, insufficient vegetable and fruit intake, high risk waist-hip ratio, obesity and hypertension. Multiple risk factors were also calculated by summing all these risk factors. Results: The prevalence of daily tobacco use ranged from 7.7% (Ghana) to 46.9% (India), frequent heavy drinker was the highest in China (6.3%) and lowest in India (0.2%), and the highest prevalence of low physical activity was in South Africa (59.7%). The highest prevalence of respondents with high waist-to-hip ratio risk was 84.5% in Mexico, and the prevalence of self-reported hypertension ranging from 33% (India) to 78% (South Africa). Obesity was more common in South Africa, the Russia Federation and Mexico (45.2%, 36% and 28.6%, respectively) compared with China, India and Ghana (15.3%, 9.7% and 6.4%, respectively). China, Ghana and India had a higher prevalence of respondents with multiple risk factors than Mexico, the Russia Federation and South Africa. The occurrence of three and four risk factors was more prevalent in Mexico, the Russia Federation and South Africa. Conclusion: There were substantial variations across countries and settings, even between upper-middle income countries and lower-middle income countries. The baseline information on the magnitude of the problem of risk factors provided by this study can help countries and health policymakers to set up interventions addressing the global non-communicable disease epidemic.
Corporate Governance and Restructuring Activities Following Completed Bids
(Corporate Governance: An International Review, 2011-01) Abor, J.; Graham, M.; Yawson, A.
Manuscript Type: EmpiricalResearch Question/Issue: We examine the extent to which effective corporate governance impacts three restructuring choices following completed acquisitions - significant adjustment to workforce; sale of subsidiaries; and further acquisitions. We also investigate the relative firm performance in the post-restructuring period for the three respective options examined.Research Findings/Insights: Based on a sample of 649 US firms between the period 1991 and 2009, we find support for the assertion that corporate governance impacts layoffs and further acquisitions. We, however, find no evidence to support a measurable governance effect on divestiture likelihood. In examining the post-acquisition performance following restructuring, we find no significant difference in performance between acquirers that made further acquisitions and those that did not. There is evidence, however, suggesting that acquirers who laid off workers and those that divested assets performed significantly poorer relative to a comparable group of acquirers.Theoretical/Academic Implications: This study adds to the empirical literature on the relation between governance and restructuring choices. We provide evidence on the impact of governance on restructuring choices that has not been documented in the academic literature. An implication of this study is that performance in post-restructuring period would not necessarily be enhanced even when governance exerts positive influences on restructuring choice.Practitioner/Policy Implications: Our empirical results demonstrate the relative importance of corporate governance in organizational strategic choices. This study offers insights to stakeholders interested in enhancing governance structures to influence restructuring decisions following completed bids. © 2010 Blackwell Publishing Ltd.
Domestic banking sector development and cross border mergers and acquisitions in Africa
(2012) Agbloyor, E.K.; Abor, J.; Adjasi, C.K.D.; Yawson, A.
Recently, economists have started taking a closer look at cross border mergers and acquisitions (M&As) due to its phenomenal rise in the past two decades. This study investigates the relation between banking sector development and cross M&As in Africa. Our sample consists of 11 African countries with data covering the period, 1993–2008. We use a Baltagi panel instrumental variable Error Component Two Stage Least Squares (EC2SLS) estimator with the Baltagi-Chang estimators of the variance components to deal with endogeneity. The results of the study indicate that banking sector development promotes cross border M&A activity in Africa. We also document evidence suggesting that cross border M&A activity drives banking sector development in Africa. Overall, our evidence suggests a two-way causation between banking sector development and cross border M&As.
Educational status and beliefs regarding non-communicable diseases among children in Ghana
(BioMed Central, 2016) Badasu, D.M.; Atobra, D.; Adzei, F.; Abuosi, A.; Yawson, A.; Anarfi, J.
Background: Increasing prevalence of non-communicable diseases (NCDs) has been observed in Ghana as in other developing countries. Past research focused on NCDs among adults. Recent researches, however, provide evidence on NCDs among children in many countries, including Ghana. Beliefs about the cause of NCDs among children may be determined by the socioeconomic status of parents and care givers. This paper examines the relationship between educational status of parents and/or care givers of children with NCDs on admission and their beliefs regarding NCDs among children. Methods: A total of 225 parents and/or care givers of children with NCDS hospitalized in seven hospitals in three regions (Greater Accra, Ashanti and Volta) were selected for the study. Statistical techniques, including the chi-square and multinomial logistic regression, were used for the data analysis. Results: Educational status is a predictor of care giver’s belief about whether enemies can cause NCDs among children or not. This is the only belief with which all the educational categories have significant relationship. Also, post-secondary/polytechnic (p-value =0.029) and university (p-value = 0.009) levels of education are both predictors of care givers being undecided about the belief that NCDs among children can be caused by enemies, when background characteristics are controlled for. Significant relationship is found between only some educational categories regarding the other types of beliefs and NCDs among children. For example, those with Middle/Juniour Secondary School (JSS)/Juniour High School (JHS) education are significantly undecided about the belief that the sin of parents can cause NCDs among children. Conclusions: Education is more of a predictor of the belief that enemies can cause NCDs among children than the other types of beliefs. Some categories of ethnicity, residential status and age have significant relationship with the beliefs when background characteristics of the parents and/or care givers were controlled for.
Exploring the causality links between financial markets and foreign direct investment in Africa
(2013) Agbloyor, E.K.; Abor, J.; Adjasi, C.K.D.; Yawson, A.
This paper sets out to explore the causality links between financial markets and foreign direct investment (FDI) in Africa. We use proxies for the banking sector and stock market to capture financial market development. We run separate estimations for the banking and stock market samples. Therefore, the sample size differs based on the sample being estimated. The banking sample is made up of 42 countries, whilst the stock market sample is made up of 16 countries. We use data covering the period 1970–2007 for the bank sample whilst for the stock market sample we use data covering the period 1990–2007. We use a 2SLS panel instrumental variable approach to obviate simultaneous causality bias. Our results suggest that a more advanced banking system can lead to more FDI flows. Also higher FDI flows can lead to the development of the domestic banking system. Countries with better-developed stock markets are likely to attract more FDI. We also find that FDI flows can lead to the development of the domestic stock market. Our results imply significant complementarities and feedback between financial markets and FDI in Africa.
Exploring the Causality Links between Financial Markets and Foreign Direct Investment in Africa
(2013) Agbloyor, E.K.; Abor, J.; Adjasi, C.K.D.; Yawson, A.
This paper sets out to explore the causality links between financial markets and foreign direct investment (FDI) in Africa. We use proxies for the banking sector and stock market to capture financial market development. We run separate estimations for the banking and stock market samples. Therefore, the sample size differs based on the sample being estimated. The banking sample is made up of 42 countries, whilst the stock market sample is made up of 16 countries. We use data covering the period 1970–2007 for the bank sample whilst for the stock market sample we use data covering the period 1990–2007. We use a 2SLS panel instrumental variable approach to obviate simultaneous causality bias. Our results suggest that a more advanced banking system can lead to more FDI flows. Also higher FDI flows can lead to the development of the domestic banking system. Countries with better-developed stock markets are likely to attract more FDI. We also find that FDI flows can lead to the development of the domestic stock market. Our results imply significant complementarities and feedback between financial markets and FDI in Africa.
Exploring the Causality Links between Financial Markets and Foreign Direct Investment in Africa
(2013) Agbloyor, E.; Abor, J.; Adjasi, C.; Yawson, A.
This paper sets out to explore the causality links between financial markets and foreign direct investment (FDI) in Africa. We use proxies for the banking sector and stock market to capture financial market development. We run separate estimations for the banking and stock market samples. Therefore, the sample size differs based on the sample being estimated. The banking sample is made up of 42 countries, whilst the stock market sample is made up of 16 countries. We use data covering the period 1970–2007 for the bank sample whilst for the stock market sample we use data covering the period 1990–2007. We use a 2SLS panel instrumental variable approach to obviate simultaneous causality bias. Our results suggest that a more advanced banking system can lead to more FDI flows. Also higher FDI flows can lead to the development of the domestic banking system. Countries with better-developed stock markets are likely to attract more FDI. We also find that FDI flows can lead to the development of the domestic stock market. Our results imply significant complementarities and feedback between financial markets and FDI in Africa.
Factors influencing unmet need for family planning among Ghanaian married/union women: a multinomial mixed effects logistic regression modelling approach
(Archives of Public Health, 2019-03) Guure, C.; Maya, E.T.; Dery, S.; Da-Costa Vrom, B.; Alotaibi, R.M.; Rezk, H.R.; Yawson, A.
Background Unmet need for family planning is high (30%) in Ghana. Reducing unmet need for family planning will reduce the high levels of unintended pregnancies, unsafe abortions, maternal and neonatal morbidity and mortality. The purpose of this study was to examine factors that are associated with unmet need for family planning to help scale up the uptake of family planning services in Ghana. Methods This cross sectional descriptive and inferential study involved secondary data analysis of women in the reproductive age (15–49 years) from the Ghana Demographic and Health Survey 2014 data. The outcome variable was unmet need for family planning which was categorized into three as no unmet need, unmet need for limiting and unmet need for spacing. Chi-squared test statistic and bivariate multilevel multinomial mixed effects logistic regression model were used to determine significant variables which were included for the multivariable multilevel multinomial mixed effects logistic regression model. All significant variables (p < 0.05) based on the bivariate analysis were included in the multinomial mixed effects logistic regression model via model building approach. Results Women who fear contraceptive side effects were about 2.94 (95% CI, 2.28, 3.80) and 2.58 (95% CI, 2.05, 3.24) times more likely to have an unmet need for limiting and spacing respectively compared to those who do not fear side effects. Respondents’ age was a very significant predictor of unmet need for family planning. There was very high predictive probability among 45–49 year group (0.86) compared to the 15–19 year group (0.02) for limiting. The marginal predictive probability for spacing changed significantly from 0.74 to 0.04 as age changed from 15 to 19 to 45–49 years. Infrequent sexual intercourse, opposition from partners, socio-economic (wealth index, respondents educational level, respondents and partner’s occupation) and cultural (religion and ethnicity) were all significant determinants of both unmet need for limiting and spacing. Conclusions This study reveals that fear of side effect, infrequent sex, age, ethnicity, partner’s education and region were the most highly significant predictors of both limiting and spacing. These factors must be considered in trying to meet the unmet need for family planning. Electronic supplementary material The online version of this article (10.1186/s13690-019-0340-6) contains supplementary material, which is available to authorized users.
Impact evaluation of the free maternal healthcare policy on the risk of neonatal and infant deaths in four sub-Saharan African countries: a quasi-experimental design with propensity score Kernel matching and difference in differences analysis
(BMJ Open, 2020-03-19) Dwomoh, D.; Agyabeng, K.; Agbeshie, K.; Incoom, G.; Nortey, P.; Yawson, A.; Bosomprah, S.
Objective Despite the huge financial investment in the free maternal healthcare policy (FMHCP) by the Governments of Ghana and Burkina Faso, no study has quantified the impact of FMHCP on the relative reduction in neonatal and infant mortality rates using a more rigorous matching procedure with the difference in differences (DID) analysis. This study used several rounds of publicly available population-based complex survey data to determine the impact of FMHCP on neonatal and infant mortality rates in these two countries. Design A quasi-experimental study to evaluate the FMHCP implemented in Burkina Faso and Ghana between 2007 and 2014. Setting Demographic and health surveys and maternal health surveys conducted between 2000 and 2014 in Ghana, Burkina Faso, Nigeria and Zambia. Participants Children born 5 years preceding the survey in Ghana, Burkina Faso, Nigeria and Zambia. Primary outcome measures Neonatal and infant mortality rates. Results The Propensity Score Kernel Matching coupled with DID analysis with modified Poisson showed that the FMHCP was associated with a 45% reduction in the risk of neonatal mortality rate in Ghana and Burkina Faso compared with Nigeria and Zambia (adjusted relative risk (aRR)=0.55, 95% CI: 0.40 to 0.76, p<0.001). In addition, infant mortality rate has reduced significantly in both Ghana and Burkina Faso by approximately 54% after full implementation of FMHCP compared with Nigeria and Zambia (aRR=0.46, 95% CI: 0.36 to 0.59, p<0.001). Conclusion The FMHCP had a significant impact and still remains relevant in achieving Sustainable Development Goal 3 and could provide lessons for other sub-Saharan countries in the design and implementation of a similar policy.
Investigating parents/caregivers financial burden of care for children with non-communicable diseases in Ghana
(2015-11-16) Abuosi, A.A.; Adzei, F.A.; Anarfi, J.; Badasu, D.M.; Atobrah, D.; Yawson, A.
Abstract Background The introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS. Methods We conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers. Results The study found that over 30 % of parents/caregivers spend more than Gh¢50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40 % of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children. Conclusions Even though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs, parents/caregivers still face significant financial burden in the care of their wards. Stakeholders in health care delivery should therefore ensure that all children with NCDs including those excluded from the NHIS should be covered by NHIS. A special effort focusing on identifying children with NCDs within the lower income groups, especially from rural areas, in order to exempt them from any form of payment for their health care is recommended.
Investigating parents/caregivers financial burden of care for children with noncommunicable diseases in Ghana
(BMC Pediatrics, 2015-11) Abuosi, A.A.; Adzei, F.A.; Anarfi, J.; Badasu, D.M.; Atobrah, D.; Yawson, A.
Background: The introduction of the Ghana national health insurance scheme (NHIS) has led to progressive and significant increase in utilization of health services. However, the financial burden of caring for children with non-communicable diseases (NCDs) under the dispensation of the NHIS, especially during hospitalization, is less researched. This paper therefore sought to assess the financial burden parents/caregivers face in caring for children hospitalized with NCDs in Ghana, in the era of the Ghana NHIS. Methods: We conducted a cross-sectional survey of 225 parents or caregivers of children with NCDS hospitalized in three hospitals. Convenience sampling was used to select those whose children were discharged from hospital after hospitalization. Descriptive statistics such as frequencies and chi-square and logistic regression were used in data analysis. The main outcome variable was financial burden of care, proxied by cost of hospitalization. The independent variable included socio-economic and other indicators such as age, sex, income levels and financial difficulties faced by parents/caregivers. Results: The study found that over 30 % of parents/caregivers spend more than Gh¢50 (25$) as cost of treatment of children hospitalized with NCDs; and over 40 % of parents/caregivers also face financial difficulties in providing health care to their wards. It was also found that even though many children hospitalized with NCDs have been covered by the NHIS, and that the NHIS indeed, provides significant financial relief to parents in the care of children with NCDs, children who are insured still pay out-of-pocket for health care, in spite of their insurance status. It was also found that there is less support from relatives and friends in the care of children hospitalized with NCDs, thus exacerbating parents/caregivers financial burden of caring for the children. Conclusions: Even though health insurance has proven to be of significant relief to the financial burden of caring for children with NCDs, parents/caregivers still face significant financial burden in the care of their wards. Stakeholders in health care delivery should therefore ensure that all children with NCDs including those excluded from the NHIS should be covered by NHIS. A special effort focusing on identifying children with NCDs within the lower income groups, especially from rural areas, in order to exempt them from any form of payment for their health care is recommended.
Investigation on children with acute non-communicable diseases and their caregivers in developing countries
(Elsevier, 2016) Abuosi, A.; Badasu, D.M.; Adzei, F.A.; Atobrah, D.; Yawson, A.
Objective To investigate children with acute non-communicable diseases (NCDs) and their caregivers in developing countries. Methods A cross-sectional survey was conducted in three out of the ten regions of Ghana. A total of 1 540 caregivers/parents of children with NCDs were interviewed. Data was analysed with the aid of IBM SPSS version 20. Statistical techniques used in the analysis included frequencies, means, SD and factor analysis. Findings were analysed according to the major themes of the study. Results Caregivers indicated that the incidence of NCDs among children is on the increase. They also believed that enemies can cause diseases in children. Caregivers tend to seek treatment in hospitals/clinics rather than from traditional or herbal medicine. However, they complement biomedical treatment with prayers for healing/deliverance. It was also found that NCDs have a negative effect on the physical and mental development of children as well as their school performance; and caring for children with NCDs also poses material, emotional and financial burden to caregivers. Conclusions Serious attention needs to be given to the development and implementation of policies to better the lot of children with NCDs. Conscious efforts need to be made to encourage and assist the caregivers with necessary resources to cater for their children's educational and health needs in particular.
Knowledge and Willingness to Donate Kidneys for Transplantation in Ghana: A Cross-Sectional Survey
(Transplantation Proceedings, 2020-05-10) Boima, V.; Ganu, V.; Yorke, E.; Dey, D.; Amissah-Arthur, M.B.; Agyabeng, K.; Yawson, A.; Lartey, M.; Mate-Kole, C.C.
Background. The main treatment modalities for chronic kidney disease (CKD) are dialysis and kidney transplantation. While kidney transplantation provides better survival and quality of life outcomes, it is a new treatment option in Ghana. Finding kidney donors for transplant may be a major challenge due to varied views of the public. Methods. This cross-sectional study was carried out in 5 purposively selected communities in the Greater Accra region in Ghana. Structured questionnaires and standardized instruments were used to assess sociodemographic characteristics, spirituality, and perception of kidney transplantation. Results. The mean age of the 480 participants was 29.60 10.65 years. The proportion of men was 51%. The average score for knowledge of participants on kidney donation was 4.8 2.6. The level of spirituality score was 25.4 3.89. Approximately 48%(231/480) of participants were willing to donate a kidney while still alive. Willingness to donate when dead was 72% (344/480). Willingness to donate a kidney when deadwas significantly lower among the participants in the older age groups.High level of knowledge about kidney transplantation, being employed, basic formal education, and never married were associated with willingness to donate kidney (P < .05). Conclusion. Our results suggest that participants have a low level of knowledge regarding kidney transplantation, while about two-thirds are willing to donate only after death. Continuous public education is key to raise public awareness of the need for kidney transplants. This will support the Ministry of Health in their efforts to institute a kidney transplant program in Ghana.
Modern contraceptive use among women of reproductive age in Ghana: analysis of the 2003–2014 Ghana Demographic and Health Surveys
(BMC Women's Health, 2018-08) Aviisah, P.A.; Dery, S.; Atsu, B.K.; Yawson, A.; Alotaibi, R.M.; Rezk, H.R.; Guure, C.
Background Contraceptives are used in family planning to space or limit pregnancies and are categorized into modern and traditional methods. The modern methods have been proven to be more scientifically effective at preventing unwanted pregnancies than the traditional methods. With data from three (3)-different Demographic and Health Surveys, the aim of this study is to assess the trends and identify factors that consistently influence modern contraceptives’ use among women of the reproductive age group in Ghana. Methods The study used secondary data from the 2003, 2008, and 2014 Ghana Demographic Health Surveys (GDHS). The trends of determinants of modern contraceptives use among women of reproductive age in Ghana were determined. A bivariate approach was used to select significant predictors. The Cox proportional hazards model analysis was employed via a multilevel modelling approach. Results Out of the total respondents of 2229, 2356, and 4469, 18.75%, 15.75% and 21.53% were modern contraceptives users for 2003, 2008 and 2014 respectively. The multiple cox proportional hazards model analysis identified place of residence and the educational level of a woman as strong predictors of modern contraceptives use in Ghana. Modern contraceptive use is increasing among rural residence. Women who are in formal occupations (professional, clerical, services) are more likely to use modern contraceptives than their colleagues in less formal occupations (manual, agricultural, sales). Conclusion This study highlights the trends of determinants on modern contraceptive use in Ghana from 2003 to 2014. The most persistent determinants of modern contraceptive use in Ghana during this time period are place of residence and a woman’s educational level. Women working in Agriculture and Sales are the least users of modern contraceptives in Ghana over the period.
Obesity a Menace to the Health of Adults in Ghana: Epidemiology and Policy Implications
(2019-10-24) Yawson, A.
Introduction: Trends of obesity in low- and middle-income countries continue to increase. Obesity increases the risk of hypertension and other non-communicable diseases (NCDs) with all the related-health consequences worldwide and in Africa. Population level changes in body weight in Ghana over a ten-year period was assessed. Method: This analysis is based on data from SAGE Ghana Wave 0 (2003/2004) and SAGE Ghana Wave 2 (2014/2015) in over 3500 adults 18 years and older. Body mass index was used as the main outcome measure. Changes in population level prevalence of obesity over a decade were determined and risk predictors of obesity assessed. Results: Overall, prevalence of obesity in the adult population in Ghana has more than doubled within a decade (from 5.5% in 2004 to 13.4% in 2014). Obesity was higher in women than men (20.7% vs. 4.8%) and relatively higher among urban than rural dwellers (18.2% vs. 8.5%). The southern regions of Ghana had relatively higher levels of obesity (highest in the Greater Accra region, 16.1% in 2004 and 28.6% in 2014). In both sexes, prevalence of obesity was highest among those in their middle-ages (41-50 years), those with formal education (13.9%) and persons with sedentary lifestyles/ physically inactive (16.6%). Adults who consumed alcohol had high proportion of obesity in both 2004 and 2014. Generally, obese adults in Ghana had other co-morbid conditions (hypertension and diabetes) i.e. obese adults had significant higher levels of blood pressure. Conclusion: Obesity among adults in Ghana (18 years and older) has increased over two-folds in a decade. The analysis provides concrete evidence and need to intensify action across the country on the 2012 National Policy for the Prevention and Control of Chronic Non-Communicable Diseases in Ghana to shift the trajectory of factors contributing to the rise in NCDs and meet WHO’s NCD Target #7 to halt the rise in obesity and diabetes by 2025.
Post-licensure safety evaluation of dihydroartemisinin piperaquine in the three major ecological zones across Ghana
(Public Library of Science, 2017) Oduro, A.R.; Owusu-Agyei, S.; Gyapong, M.; Osei, I.; Adjei, A.; Yawson, A.; Sobe, E.; Baiden, R.; Adjuik, M.; Binka, F.
Background Uncommon and rare adverse events (AEs), with delayed onset may not be detected before new drugs are licensed and deployed. The present study examined the post licensure safety of dihydroartemisinin-piperaquine (DHP) as an additional treatment for malaria in Ghana. The relationship between the incidence of AEs, treatment completion rate, participant characteristics and concomitant medications are reported. Methods A study conducted from September 2013 to June 2014 in Navrongo, Kintampo and Dodowa health research centres in Ghana is presented. Participants had confirmed malaria and no known allergy to study drug. Patients provided informed consent and had their symptoms and results of their clinical examinations documented. Treatment with Eurartesim® (20/160mg dihydroartemisinin and 40/320mg piperaquine by Sigma-Tau Incorporated) was given, according to the body weight of patients. First treatment doses were under observation but the second and third doses were taken at home except in a sub-study involving a nested cohort. Patients were contacted at Day 5 (± 2 days) either on telephone or by a home visit to document any AEs experienced. Patients were asked to report to the study team any other AEs that occurred within 28 days post-treatment. All patients in the nested cohort had electrocardiogram (ECG). Findings A total of 4563 patients, 52.1% females and 48.2% <6 years completed the study. A total of 444 patients were enrolled into the nested cohort. About 33% had temperature ≥ 37.5°C at enrolment. Approximately 3.4% reported taking prior antimalarials, 19.4% other medications and 86% took at least one concomitant medication. Incidence of AEs was 7.6% includinginfections (4.6%), gastrointestinal disorders (1.0%) and local reactions at the site of venesection (0.5%). Others were respiratory disorders (0.4%) and nervous system disorders (0.3%). There were nine adverse events of special interest (AESI); itching/pruritus (7), dizziness (1), and skin lesions (1). Patients who took medications prior to enrolment had higher incidence of AEs compared with those without (9.3% vs. 6.1%; P<0.001). Statistically significant associations were found between the reported AEs and age of patients (P<0.001), their body mass index (BMI) (P< 0.001) and parasite densities (P< 0.001). Conclusion Dihydroartemisinin-Piperaquine was well tolerated with no serious safety concerns identified. Obesity and prior enrolment medication were among significant factors associated with increased AEs reporting.
Predictors and outcome of systemic lupus erythematosus (SLE) admission rates in a large teaching hospital in sub-Saharan Africa
(Lupus, 2018-02) Dzifa, D.; Boima, V.; Yorke, E.; Yawson, A.; Ganu, V.; Mate-Kole, C.
Although it was previously believed that systemic lupus erythematosus was uncommon among Africans, it has become increasingly apparent that the incidence is higher, and socioeconomic challenges such as physician shortages, poor medical facility access, and poor health literacy may worsen prognosis. This retrospective study examines characteristics and outcomes of hospitalized systemic lupus erythematosus patients over a two-year period and serves as a baseline for comparison for future studies to examine the outcomes with the provision of more dedicated care. There were 51 patient admissions over a two-year period, with a mean duration from start of illness to admission of approximately two years. Duration of admission ranged from one to 140 days with a mean period of 26.12 days (SD ± 26.6). There were 22 deaths (43.1% of admissions), which were mainly due to infections and renal complications. Factors associated with risk of death in regression analysis were: infections, fever, disease flare, musculoskeletal involvement, amenorrhea, depression, a clinical finding of hepatomegaly, and chest infection. Understanding the effect and outcome of systemic lupus erythematosus across different countries can elucidate the role of genetic, environmental, and other causative factors in the progression of the disease.
Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-incomecountries: results from the WHO Study on global AGEing and adult health (SAGE)
(BMC Medicine, 2015-06) Stewart Williams, J.; Kowal, P.; Hestekin, H.; O'Driscoll, T.; Peltzer, K.; Yawson, A.; Biritwum, R.; Maximova, T.; Salinas Rodríguez, A.; Manrique Espinoza, B.; Wu, F.; Arokiasamy, P.; Chatterji, S.
Background: In 2010 falls were responsible for approximately 80 % of disability stemming from unintentional injuries excluding traffic accidents in adults 50 years and over. Falls are becoming a major public health problem in low- and middle-income countries (LMICs) where populations are ageing rapidly. Methods: Nationally representative standardized data collected from adults aged 50 years and over participating in the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) Wave 1 in China, Ghana, India, Mexico, the Russian Federation and South Africa are analysed. The aims are to identify the prevalence of, and risk factors for, past-year fall-related injury and to assess associations between fall-related injury and disability. Regression methods are used to identify risk factors and association between fall-related injury and disability. Disability was measured using the WHO Disability Assessment Schedule Version 2.0 (WHODAS 2.0). Results: The prevalence of past-year fall-related injuries ranged from 6.6 % in India to 1.0 % in South Africa and was 4.0 % across the pooled countries. The proportion of all past-year injuries that were fall-related ranged from 73.3 % in the Russian Federation to 44.4 % in Ghana. Across the six countries this was 65.7 %. In the multivariable logistic regression, the odds of past-year fall-related injury were significantly higher for: women (OR: 1.27; 95 % CI: 0.99,1.62); respondents who lived in rural areas (OR: 1.36; 95 % CI: 1.06,1.75); those with depression (OR: 1.43; 95 % CI: 1.01,2.02); respondents who reported severe or extreme problems sleeping (OR: 1.54; 95 % CI: 1.15,2.08); and those who reported two or more (compared with no) chronic conditions (OR: 2.15; 95 % CI: 1.45,3.19). Poor cognition was also a significant risk factor for fall-related injury. The association between fall-related injury and the WHODAS measure of disability was highly significant ( P <0.0001) with some attenuation after adjusting for confounders. Reporting two or more chronic conditions (compared with none) was significantly associated with disability ( P <0.0001). Conclusions: The findings provide a platform for improving understanding of risk factors for falls in older adults in this group of LMICs. Clinicians and public health professionals in these countries must be made aware of the extent of this problem and the need to implement policies to reduce the risk of falls in older adults.