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The Effect of Plant Water Potential on Nitrogen Fixation of Soybeans
(University of Ghana, 1975-06) Azu, J.N.; Tanner. J.W; University of Ghana, College of Health Sciences School of Public Health
Field experiments at two sites, Elora and Arkell,were conducted to investigate the effect of plant water potential on the nitrogen fixation of two soybean cultivars, Vansoy and Anoka. The treatments were Vansoy and Anoka both under irrigated and non-irrigated conditions. The acetylene reduction technique was employed to estimate nitrogen fixation of nodules and measurements of plant water potential were made using the pressure chamber technique. Nitrogen fixation and plant water potential measurements were made at various stages during the entire growing period of the soybeans, and the results showed that water stress which was related to low plant water potential caused a reduction in nodule numbers, fresh weight and dry weight. There was evidence that moderate moisture stress mainly affected the amount of nodule tissue formed and not nitrogen fixing efficiency whereas severe stress led to reduction in both nodule mass and efficiency of fixation. The total seasonal amount of nitrogen fixed by Vansoy and Anoka was reduced substantially by water stress while high plant water potential resulting from irrigation led to large amounts of nitrogen fixed. Regression analysis of nitrogen fixed with plant water potential indicated that reduction in plant water potential was accompanied by reduction in the amount of nitrogen fixed, thus showing a relationship between plant water potential and nitrogen fixation. Irrigation substantially increased seed yields of Vansoy and Anoka at Arkell, but there was no significant increase in either variety at Elora.
Evaluation of Childhood Immunization Coverage in Jasikan District
(University of Ghana, 1995) Ntumy, R.; Antwi, P.; Biritwum, R.B.; University of Ghana, College of Health Sciences, School of Public Health
This is a study of the evaluation of the Expanded Programme on Immunization Coverage in the Jasikan District of the Volta Region of Ghana between October and December, 1995 with particular attention to childhood immunization coverage. This was a cross-sectional study using the WHO 30-7 cluster sampling method. The sample population were 219 children aged 12-23 months and their mothers. The primary objective of the study was to assess the childhood immunization coverage in the Jasikan District. In the study population 48.4 per cent of the children were fully immunized, 49.3 per cent partially and 2.3 per cent non immunized. The individual valid vaccine coverage was 83.1 per cent for BCG, 75 per cent for DPT3, 75.8 per cent for OPV3 and 67.1 per cent for measles. The drop out rate for DPT1-DPT3 was 8.2 per cent whilst that of BCG-measles was 18.3 per c e n t. Of the 182 children who had BCG recorded on their Road to Health cards, 4.4 per cent did not have the BCG scars. The completion of immunization schedules by one year among the 219 children was positively associated (P<0.005) with mothers’ parity being less than five children and mothers’ ability to mention at least two of the vaccine-preventable diseases. Formal education and place of delivery however, did not show any association with the completion of childhood immunization by one year. The recommendations given include: to issue Road to Health card to all children at birth in both government and private health facilities. ensure that BCG is administered to the newly born before discharging them from health facilities. intensification of home visits to trace defaulters so as to reduce drop-out rates, intensification of EPI health education at all places of contact and not necessarily only at child welfare clinics.
An Appraisal of Intersectoral Collaboration on PHC in the Asante-Akim North District
(University of Ghana, 1995) Afenyadu, G.Y.; Nyarko, E.; Ashitey, G. A.
An appraisal of intersectoral collaboration on PHC in the Asante-Akim North District in October 1995 revealed that though PHC is high amongst the developmental priorities of the Assembly, there is hardly any effort to coordinate the activities of the various sectors engaged in the promotion of PHC. Despite much common ground for collaboration, horizontal linkages amongst the decentralised departments engaged in PHC. Activities remain weak or nonexistent. An analytical framework adapted from the work of Susan Rifkin and others on “Measuring Participation” was used to describe the extent of Intersectoral collaboration in the district. The extent of Intersectoral collaboration can be described as limited. The subcommittees established for the purpose of preparing short, medium, and long term plans on PHC for the District Assembly have been unable to perform this role adequately. The members of these subcommittees have not been prepared (through training) for their new roles. Consequently, they have been found to lack the capacity to prepare district health development and promotion plans and to advocate for their implementation as envisaged by Local government law, Act 462. The DHMT has ceased to be multi sectoral because its past relationships with other health related sectors were found to be unfruitful The team perceives the other sectors as not committed to intersectoral health activities and therefore unwilling to commit their resources to such activities. In view of the fact that donor funded joint action plans were smoothly and effectively implemented, it is believed that the implementation of composite budgeting may facilitate the implementation of intersectoral PHC activities in the future. A training programme for the Assembly members elected to the subcommittees and the staff of the Assembly is advocated to strengthen their capacity to perform their expected roles. A “neutral” forum created and supported by the Assembly for coordinating the activities of all health related sectors is also advocated to further strengthen intersectoral collaboration in the district.
YabaniAssessment of Noise Induced Hearing Impairment n a Cement Factory
(University of Ghana, 1995) Yabani, J.B.K.; Quainoo, A.B.; University of Ghana, College of Health Sciences, School of Public Health
ABSTRACT OBJECTIVE: GENERAL:- To assess the prevalence of occupational cement factory. SPECIFIC: (1) To measure the noise levels at different sections in the factory (2) To compare the prevalence of hearing impairment among workers of different age-groups. (3) To compare the prevalence of hearing impairment among workers with different lengths of exposure. (4) To determine whether the speech frequency range of those workers with hearing impairment is affected. DESIGN: Cross sectional study SETTING: Cement factory with a captured population of 308 workers. PARTICIPANTS: One hundred workers were selected at random from three hundred and eight workers. The selected workers were interviewed to discover other risk factors contributing to hearing loss. A recent auroscopic examination report was examined to rule out any ongoing ear infection. The workers then underwent audiometric assessment with a wide range qualitone Model WRB 6097 Diagnostic Audiometer calibrated according to American National Standard Institute (ANSI) 1969 standard. MAIN OUTCOME MEASURES: Noise levels at different locations in the factory were measured and prevalence of Noise-induced hearing loss assessed. RESULTS: The worst areas of toxic noise was the production section where noise levels ranged between 80 dBA and 108 dBA(decibels -Aweighted). Even though noise levels in the engineering section was below the threshold limit value, most of the workers from this section carry out maintenance work for long hours in the production section. Forty-two (42%) out of the 100 workers selected showed definite noise-induced hearing impairment, whilst 15 (15%) workers were strongly suspected of having noise-induced hearing impairment, 38 workers (38%) had good hearing acuity whilst 5 (5%) had excellent hearing acuity. Out of 42 workers who were forty years of age and below, 10 workers (23.8%) showed noise-induced hearing impairment, whilst out of 58 workers who were above forty years of age, 32 workers (55.2%) showed hearing impairment. Hearing normally declines with age. The effect of aging and noise exposure are additive, consequently the prevalence of noise induced hearing loss increases with age. Eleven workers (35.5%) of the 31 workers who had had noise exposure for up to five years showed noise induced hearing impairment (NIHI), for exposure between 6 and 10 years, 3 workers (23%) of 13 workers showed NIHI, for the exposure period 11-15 years, 6 workers (28.6%) out of 21 workers exhibited NIHI, and for those with exposure period 16 years and above, 22 (62.9%) out of 35 workers exhibited N.I.H.I. For the first 10 years of exposure to noise, 14 workers (31.8%) out of 44 workers exhibited N.I.H.I, whilst 28 workers (50%) out of 56 workers who had more than 10 years exposure exhibited NIHI, therefore the prevalence of noise induced hearing impairment increases with increasing length of noise exposure. Out of the 42 workers who had noise-induced hearing impairment, 37 of them (88.1%) had no problem engaging in normal conversation. Only 5 of the workers (11.9%) showed signs of mild defect in the speech frequency range. LIMITATIONS: Unavailability of pre employment baseline audiometric data. RECOMMENDATIONS: To Government (1) Government should update existing legislations and provide statutory regulations and code of practices for control of noise in industries. (2) The Government agency in charge of he should establish an occupational health service which could be integrated into the primary health care delivery service. (3) The Workmen's Compensation Scheme operated by the Labour Department is unsatisfactory, it should be updated to cover all occupational diseases. To Management (1) A hearing conservation programme should be set up in the industry. (2) Management should make sure that pre-employment medical examination are conducted for their workers followed by routine periodic examinations. (3) Management should organise regular meetings to discuss occupational health and safety problems with trade unions and supervisors. (4) Management should team up with managements of other factories to set up a well equipped occupational health service which will cater for their occupational health needs with a full or part time industrial physician. To Trade Unions (1) They should hold regular educational seminars on occupational health and safety for workers. (2) Whilst they make sure that management provides the necessary protective equipment, they should monitor to ensure that protective devices are worn always by workers and also ensure that newly employed workers undergo preemployment audiometric assessment.
Cutaneous Ulcers in Primary School Children in The South Tongu District Of The Volta Region
(University of Ghana, 1995-12) Adjetey, N.A.; Obuobi, A.A.D.; Laing, E.; University of Ghana, College of Health Sciences, School of Public Health
The South Tongu District Health Administration has observed that skin diseases and ulcers have been featuring prominently in their top ten diseases reported at the OPD. Indeed for the past two years they ranked second among the various diseases reported and available records showed that the trend in 1995 may not be any different. The nature and magnitude of the problem of ulcers is not known to the health authorities since the cases of ulcers cannot be disaggregated from other skin disease with which they are grouped on the reporting forms currently in use. It is therefore important to find out the prevalence of ulcers in the district and their characteristics such as the types of ulcers that are predominant, who are affected and what kinds of treatment are applied on them. This would give an insight to the problem and what intervention measures to undertake. This study was undertaken to investigate the prevalence of ulcers among primary school children, compare the prevalence among school children living within 1.5km of the Volta river to that of school children living further away from the river and to describe the characteristics of the ulcers. The results would serve as a basis for a more extensive study on the ulcers in the district.
An Exploratory Study into the Usefulness of the District Health Annual Report to the DHMT* in the Management of the District Health System
(University of Ghana, 1995-12) Arde-Acquah, A.A.; Ofosu-Amaah, S.; Dzatse, Z.K.M.; University of Ghana, College of Health Sciences, School of Public Health
For a developing country like Ghana, which has chosen the PHC strategy to achieve health for all by 2000 AD, the management of the district health system is understandably of vital importance. The government's support of its health policy is shown in its decentralization moves on the past few years. In 1995, not only personnel, but now, the financial administration has been brought to the district level. Health managers and teams therefore now bear the responsibility of managing the district health system. To do this successfully, information generation as well as its use in the widest sense is very essential. It is necessary to find out if this realization is present, for indeed a lot of data and information is commonly being already generated in the health system.
Service Utilization at the Kintampo Health Centre: Implication for Policy Formulation
(University of Ghana, 1996) Blay, D.; Enyimayew, N.; Senah, K.; University of Ghana,College of Health Sciences,School of Public Health
Service Utilization at the Kintampo Health Centre: Implication for Policy Formulation. From the early 1980s utilization at outpatient services at government health facilities declined considerably, of which the Kintampo Health Centre was a typical example. The main focus of this study was therefore, to find out the factors that influence utilization at the Kintampo Health Centre. The study was descriptive. Questionnaire and available routinely collected data from health institutions were used. Sampling was purposive and adults above 19 years were interviewed. The findings show that, the following factors influence utilization of services: - Proximity - Presence of competent doctor - Availability of drugs - Facilities such as operating theatre - Cost - Attitude of health providers and - Clean environment The result of the study imply that, the demand for health care in rural health centres, such as the one at Kintampo, can be significantly increased if, technically competent and courteous personnel such as medical doctors, with facilities to work with in a very clean environment are available.
A Survey of Prescribing Patterns in the Wassa West District of Ghana with Special Reference to Antibiotics
(University of Ghana, 1996-01) Bosu, W.K.; Laing, E.; Obuobi, A.A.D.; University of Ghana, College of Health Sciences, School of Public Health
Study title: A survey of prescribing patterns in the Wassa West district of Ghana with special reference to antibiotics. Statement of the problem: The availability, affordability and rational use of drugs constitute a fundamental indicator of quality of health care delivery. Ghana has spent up to 40% of its recurrent budget to ensure the availability of. drugs in the health system. However, irrational prescribing has led to a wastage in drugs supply. 4 - •' < . - - \ & J . In the Wassa West district, several obstacles to rational prescribing exist: These include the lack of an active programme to promote rational prescribing, the lack of objective information to guide prescribers in their practice in the face of an increasing array of new drugs and the aggressive promotional activities of drug companies. A previous rapid qualitative assessment of the pharmaceutical system in the district indicated that there were inappropriate prescribing practices. The absence of relevant, objective and measurable indicators limited the usefulness of the findings of the study as a basis for the evaluation of any interventions instituted to improve the prescribing practices. This study provides the requisite baseline measures of prescribing patterns in the district and identifies areas for targeted interventions. Main objective: To describe and compare the patterns of drug prescribing in government health facilities in the Wassa West district with a view to developing strategies to improve prescribing practices. Place of study: Seven government health facilities located at Tarkwa, Nsuaem, Simpa, Dompim, Bogoso, Huni Valley and Prestea Himan. Study type: The study was cross-sectional comparative in type. Methodology: Retrospective prescribing data covering a one year period from June 1994 to June 1995 were obtained from 700 outpatients' clinical record cards, 100 from each of 7 government health facilities in the district. At the district hospital, prospective data from 100 outpatient prescriptions were also collected because of a relatively large number of incomplete data from the retrospective records. A one-day prevalence survey of prescribing patterns for 45 inpatients at the district hospital was also undertaken. Finally, the type of prescribers and the availability of the national Essential Drugs List (EDL) manual and some common drugs in all 7 health facilities were determined. Findings and conclusions: • irrational prescribing is both serious and widespread in the Wassa West district • prescribing patterns differed significantly between the health facilities. Bogoso and Himan had the worst prescribing indicators • prescribing patterns in the health centres were worse than those in the district hospital perhaps a reflection of the lower cadre of prescribers and a relative lack of diagnostic facilities • treatment records were poorly kept, at the district hospital as a result of a heavy workload • there was an average of 4 prescribers comprising combinations of medical officers, medical assistants, nurses and technical officers in each facility • the number of drugs prescribed per patient ranged from 0-13 with a mean of 4.6 • 80.0% and 57.9% of patients were treated with one or more injectable drugs and antibiotics respectively. The preference for injections was influenced by patient demand as well as by clinical and financial considerations. Antibiotics were commonly prescribed for malaria, respiratory infections and soft tissue infections. • 64.6% of all drugs were prescribed by their generic names; 97.1% were on the national Essential Drugs List. The use of essential drags was favoured by procurement from a central Regional Medical Store. Prescription by non-generic names was due to a concern that chemical sellers were not familiar with the generic names and may therefore not be able to dispense the right drugs • there were inappropriate treatment practices. About 87% and 41% of patients with malaria were treated with an injection chloroquine and antibiotics respectively. This was attributed to the lack of refresher training for prescribers in management of some common conditions • the national EDL manual was not available at any of the facilities surveyed owing to a general national shortage of the manuals • except for drugs for skin diseases, drags for the treatment of common diseases were generally available in the facilities • in relation to the severity of illness, drugs for inpatients of the district hospital were greater in number, more expensive and more frequently administered parenterally than those for outpatients. Recommendations: Policy makers: The urgent development, proclamation and promotion of a national drugs policy backed by the relevant legislation should provide a framework for the improvement of prescribing practices and for the entire pharmaceutical sector. The national Essential Drugs Programme should be reactivated and given the necessary legal backing. Funding should be provided for the regular revision and widespread marketing of the EDL manual. Training institutions'. Training institutions should prepare medical officers and medical assistants for the "real-world" practice of prescribing under negative pressures by adopting a problem-based teaching of therapeutics in place of the traditional approach of merely transferring knowledge about the action of drugs in the treatment of diseases. Regional Health Administration'. The regional health authorities should obtain copies of the EDL manual for distribution to the districts, ensure availability of essential drugs in the Regional Medical Store, organise training .as well as assist districts to prepare appropriate treatment guidelines for common diseases. i District Health Administration'. • The district health authorities should establish a District Medical Store to supply drugs to and monitor the consumption patterns of all health facilities. • a District Drugs and Therapeutics Committee should be formed to promote rational prescribing in the district • there should be regular in-service training for prescribers in which the management of common diseases, polypharmacy and the over-use of injections and antibiotics will be discouraged. Funding for training could be obtained from the district's quarterly financial allocation and donor agencies • training should be followed up with a programme of regular supervision of medical assistants and nurses by the medical officers at the district hospital • training of chemical sellers to correctly interpret prescriptions should favour generic prescribing • the district should undertake further studies on the nature and extent of prevailing prescribing influences. Regular assessment of prescribing practices for government as well as mines and private clinics will be necessary. Patients and communities'. Posters on the walls of clinics should be provided to educate public on the effects of patients' demands for certain drugs as well as educate the public on the dangers of self-medication, The appropriate use of drugs should be incorporated into the district's intersectoral social mobilisation programme.
Essential Obstetric Care- A Comprehensive Coverage Evaluation in Adansi-East District, Ghana
(University of Ghana, 1997) Kyei-Faried, S.; Enyimayew, N.; Amuah, E.; University of Ghana,College of Health Sciences,School of Public Health
A comprehensive coverage evaluation of essential obstetric care was carried out at the district referral point and the sub-districts’ first points of contact in the Adansi-East District, Ashanti Region. The evaluation tool consisted of measuring the coverage of essential care availability, access, utilization, adequacy and effectiveness. The essential care variables that were assessed were labour monitoring by partography, performance of obstetric surgery and the treatment of non-surgical obstetric complications. Interviews were conducted among district health managers, service providers, trained traditional birth attendants and women who delivered 12 months prior to the study, to identify factors causing bottlenecks in the coverage. The effectiveness coverage of each essential obstetric care variable was found to be very low, below 5%. This was mainly due to bottlenecks at resource availability and service utilization at the district and sub-district levels. There was also a bottleneck at access coverage at the district level for all the variables. The low availability coverage was due to lack of ..:Information and training in the use of essential care resources, absence of resident midwives and lack of rooms to treat cases. The low utilization was as a result of the inability of the facilities to effectively treat obstetric complications. Most women with obstetric complications therefore use facilities outside the district. To improve the effectiveness coverage of essential obstetric care, it is recommended that the District Health Team reallocates midwives, ensures the provision of a minimal package of essential resources in each facility, provides life-saving skills training for essential care providers and strengthens its collaboration with the communities.
Is the Sub-District Concept Working? A Study of the Subdistrict Health System in the Ho District
(University of Ghana, 1997) Senaya, L.K.; Ofosu-Amaah, S.; Pappoe, M.; University of Ghana,College of Health Sciences,School of Public Health
The Primary Health Care in Ghana which started as far back as 1978 is based on the three tier structure namely the District; subdistrict and community levels. The Subdistrict level is to act as a link between the District level and the Community level. However, the subdistrict level was recognised as a weak link in translating policies into significant health impact by the Ministry of Health, (MOH). In an attempt to address these problems, subdistrict health systems were formed in the country to provide essential health services within defined catchment areas. The subdistrict concept has been operating for over three years. This study aimed at determining whether the concept is working in the Ho District. The general objectives were to verify whether the subdistrict health system is working in the Ho district and to identify factors adversely affecting the system and suggest solutions. A descriptive study was conducted using both qualitative and quantitative methods. Data was collected using a checklist, a questionnaire, an interview guide, a discussion guide and available health information in the district. The study revealed that almost all SDHTs were not functioning as a team. The support systems needed to create the enabling environment for improved health service deliver}' at the subdistrict level was weak. Consequently, the subdistrict activities were not meeting the expected outputs recommended by the subdistrict working Group of MOH. On the basis of these findings, it is recommended that the SDHTs should be reconstituted to reflect the basic composition of an SDHT. Also, SDHT should be trained after needs assessment have been done by the DHMT. It is very important that the support systems of r the SDHTs are evaluated for the necessary action to be taken to improve health service delivery. SDHTs should also play the key role of involving communities in health programmes by supporting and working closely with community structures like VHCs and IMCs.
A Community-Based Study of Factors Contributing to the Delayed Arrival of Women with Pregnancy related Complications to Health Care Facilities in the Assin District of Ghana
(University of Ghana, 1997) Tinkorang, E.K.; Antwi, P. A.S. A.; University of Ghana, College of Health Sciences, School of Public Health
ABSTRACT The study is a community-based study to determine the factors contributing to the delayed arrival of women with pregnancy-related complication to the health facilities in the Assin District of Ghana. The women with pregnancy-related complications in the district often arrive at the health facilities in the district so late, that this makes the outcome of the management poor with resultant high maternal and perinatal morbidity and mortality. The study aimed at finding the factors which significantly contribute to the delayed arrival and to make recommendation on how to improve the situation. The study is descriptive which used both structured questionnaire and focus group discussion to collect relevant data from five communities. The data were analysed using a computer software. The major findings of the study were: (i) The community and individuals had good knowledge on pregnancy and pregnancy-related complication. (ii) Most individuals and families prefer to visit hospital in event of a pregnancy complications. (iii) The majority of the women in the community lack access to funds in event of pregnancy and pregnancy-related complication and this contributes significantly to the delayed arrival. (iv) Problem of long distance between health facilities and the women's place of residence, long travel time due to poor roads, lack of transport and high cost of transport also contributes to the delayed arrival. Based on the findings of the study recommendation has been made to help improve the situation.
A Study of Community Participation in the Supplementary Feeding Programme in the Tamale Municipality
(University of Ghana, 1997) Opata, H.; Koram, K.A.; Laing, E.; University of Ghana, College of Health Sciences, School of Public Health
This is a study of community involvement in the Supplementary Feeding Programme of the Ministry of Health in the Tamale District of the Northern Region, Ghana, at the request of the Tamale Municipal Health Management Team. The Supplementary Feeding Programme involved the setting up of community feeding centres in poor communities in the Northern Region of Ghana. The main objective was to improve upon the nutritional status of pre-school children, pregnant and lactating women. It was envisaged that after three years of operation donor support was to be gradually withdrawn. In its place, community initiative and support were expected to have developed to a level that would sustain and expand the uses of the feeding centres. A descriptive study was carried out to assess the extent to which the communities with feeding centres have reacted in the direction of the programme goal of community involvement. The main focus was on observing changes in the set-up and management of the feeding centres. Another aspect of interest was the communities' resource input. This study was intended to serve as the basis from which further intervention could be modelled to foster community participation in health. It may also serve as a resource for studies on the under-lying reasons of the dynamics of community participation in Tamale. Findings of the study suggest that the communities have participated in the supplementary feeding programme to some extent. Even though some feeding centres have been in operation for relatively long periods community participation seems to be at the same level for all the communities. For community initiative and support for the feeding centers to develop towards the programme goal of self-sufficiency some changes will have to put in place. The programme settings will have to be modified so as to nurture further community participation.
Essential Obstetric Care: A Comprehensive Coverage Evaluation in Adansi-East District, Ghana.
(1997) Kyei-Faried, S.; University of Ghana, College of Health Sciences, School of Public Health
A.comprehensive coverage evaluation of essential obstetric care was carried out at the district referral point and the sub-districts’ first points of contact in the Adansi-East District, Ashanti Region. The evaluation tool consisted of measuring the coverage of essential care availability, access, utilization, adequacy and effectiveness. The essential care variables that were assessed were labour monitoring by partography, performance of obstetric surgery and the treatment of non-surgical obstetric complications. Interviews were conducted among district health managers, service providers, trained traditional birth attendants and women who delivered 12 months prior to the study, to identify factors causing bottlenecks in the coverage. The effectiveness coverage of each essential obstetric care variable was found to be very low, below 5%. This was mainly due to bottlenecks at resource availability and service utilization at the district and sub-district levels. There was also a bottleneck at access coverage at the district level for all the variables. The low availability coverage was due to lack of ..: . information and training in the use of essential care resources, absence of resident midwives and lack of rooms to treat cases. The low utilization was as a result of the inability of the facilities to effectively treat obstetric complications. Most women with obstetric complications therefore use facilities outside the district. To improve the effectiveness coverage of essential obstetric care, it is recommended that the District Health Team reallocates midwives, ensures the provision of a minimal package of essential resources in each facility, provides life-saving skills training for essential care providers and strengthens its collaboration with the communities.
A Community-Based Study of Factors Contributing To the Delayed Arrival of Women with Pregnancy-Related Complications to Health Care Facilities in the Assin District of Ghana
(University of Ghana, 1997-06) Tinkorang, K.E.; Antwi, P.; Amoa, S.A; University of Ghana, College of Health Sciences, School of Public Health
The study is a community-based study to determine the factors contributing to the delayed arrival of women with pregnancy-related complication to the health facilities in the Assin District of Ghana. The women with pregnancy-related complications in the district often arrive at the health facilities in the district so late, that this makes the outcome of the management poor with resultant high maternal and perinatal morbidity and mortality. The study aimed at finding the factors which significantly contribute to the delayed arrival and to make recommendation on how to improve the situation. The study is descriptive which used both structured questionnaire and focus group discussion to collect relevant data from five communities. The data were analysed using a computer software. The major findings of the study were: (i) The community and individuals had good knowledge on pregnancy and pregnancy-related complication. (ii) Most individuals and families prefer to visit hospital in event of a pregnancy complications. (iii) The majority of the women in the community lack access to funds in event of pregnancy and pregnancy-related complication and this contributes significantly to the delayed arrival. (iv) Problem of long distance between health facilities and the women's place of residence, long travel time due to poor roads, lack of transport and high cost of transport also contributes to the delayed arrival. Based on the findings of the study recommendation has been made to improve the situation.
The Magnitude and Determinants of Teenage Pregnancy in the Cape Coast Municipality
(University of Ghana, 1997-06) Dagadu, F.; Nabila, J.S.; Biritwum, R.B.; University of Ghana, College of Health Sciences, School of Public Health
The purpose of this study was to determine the magnitude of teenage pregnancy and identify the factors that contribute to teenage pregnancy in the Cape Coast municipality. Women in the fertile age group (WIFA) who were obviously pregnant and those who had delivered within the last year (April 1996-April 1997) were enumerated through a household survey. Three hundred and two households were surveyed in 21 randomly selected communities based on the population size of the four sub districts in the municipality. Two hundred and twenty nine pregnant and twenty non pregnant teenagers were interviewed by means of a structured questionnaire. The results of the study indicated that the prevalence of teenage pregnancy was 47.3%. The mean age of the teenagers was 18.2 years with a standard deviation of ± 1.8. The basic determinants of teenage pregnancy were school dropouts, unemployment especially among a high number of JSS graduates, single parenthood and poverty. Others included search for financial gain by striking up sexual relationship with boyfriends who were between the ages of 20 to 23. Peer pressure was found to be a major contributing factor to teenage pregnancy. However, contact with tourists did not appear to play any role. Although the hypothesis revealed that there was no difference between education, socio economic background and knowledge in reproductive health, there was a significant difference in the number of pregnant friends among respondents. (P=0.01) Based on the findings it is recommended that teens’ clinic should be established as a priority to cater for the counseling needs of teenagers. Youth placement centres should be established with the collaborative efforts of the Cape Coast Municipal Assembly, Ministry of Youth and Sports, Ministry of Employment and Social Welfare and the Business Advisory Centre (BAC). Parents should also be advised to improve upon their income with the needed assistance from BAC, and together with religious leaders, take it upon themselves to instil good moral training and discipline in their wards. Lastly, the Municipal Assembly should adopt a policy on measures to deal with men who impregnate teenagers. With these strategies, it is hoped that teenage pregnancy will be reduced.
A Study on the Knowledge And Practices of Childhood Diarrhoeal Diseases Management Among Mothers in the Wa District, Upper West Region. Ghana
(University of Ghana, 1997-06) Owusu, E.; Quansah, G.A.; Obuobi, A.; University of Ghana, College of Health Sciences, School of Public Health
This study was undertaken in the Wa District of the Upper West region o f Ghana during the period o f 5th April to 15th May 1997 in six (6) sub-districts. The study was to answer the following question: “ What level o f knowledge do mothers in the Wa District have about diarrhoea, it’s causes, effects, appropriate home treatment and prevention, and what they practice during episodes o f diarrhoea among young children” There have been concerns expressed at the district and regional level sectors o f the Ministry o f Health about the high prevalence and incidence o f diarrhoeal diseases particularly among young children in the Wa district with high fatality rates despite efforts put in by the District Health Management Team to intensify health education activities in the district. Though there had been previous attempt to carry out a study to answer this question, the study was linked up to a nutritional survey carried out by the Nutrition Unit o f the Regional Health Administration and only concentrated on a few mothers who attended the nutrition rehabilitation center in the region. This study is therefore intended to provide further information on what mothers in the district know and practice about diarrhoeal diseases management for young children, with the view o f using the findings o f the study to assist the District Health Administration and other health -related agencies in the district and the region in programming appropriate health education and promotion strategies to reduce diarrhoeal- related diseases and improve promote the general health o f young children in the district. The study was conducted with the broad objective o f finding out what women in the Wa district know about childhood diarrhoeal diseases and what they practice to manage the disease during episodes. The specific objectives of the study are: 1) To determine the level of information that mothers in the study area have about diarrhoeal diseases. 2) To identify any gap between what the mothers know and what they are expected to know about diarrhoeal diseases in young children. 3) To find out the management practices that mothers adopt during diarrhoea episodes in young children. 4) To recommend appropriate health intervention strategies and programmes for implementation to reduce the high prevalence o f diarrhoeal diseases among young children in the district. The sample size for the study was 210 mothers o f the Wa district who have children up to two (2) years. A household survey was conducted to interview mothers who were selected by means o f simple random sampling technique. A structured questionnaire was used as data collection tool to obtain information from the mothers on diarrhoeal diseases. The main variables o f study were: 1). Knowledge about diarrhoeal diseases, causes, effects, treatment and prevention. 2). Diarrhoea Management practices concerning treatment, feeding, breastfeeding and prevention. 3). Sources of information on childhood diarrhoeal diseases. The major findings of the study were as follows: 1) Mothers in the study area could adequately describe childhood diarrhoea but have limited knowledge about the causes, effects and dangers of diarrhoeal diseases on the child. 2) A significant proportion o f mothers in the study area strongly believe that supernatural forces such as witches and evil spirits could cause childhood diarrhoea. 3) More than half o f the mothers treat the child with diarrhoea at home. Among the various home treatment practices they adopt include enema administration, administration of various kinds of drugs obtained from the local market and the administration o f herbal concoctions. 4) A greater number o f mothers are aware o f the value o f continued feeding and breastfeeding the child and adopt the practice during diarrhoeal episode. 5) Though many mothers have ever heard of Oral Rehydration Salt (sachets) as an effective treatment o f childhood diarrhoea, quite a number o f the mothers have never used it to treat their children. Based on the findings o f the study, the following recommendations are suggested for implementation. 1) Health Education and Promotion activities on diarrhoeal diseases in the study area should emphasize on teaching mothers about the “germ theory” o f disease causation, effects, dangers as well as appropriate home management practices and prevention o f diarrhoeal diseases. 2) The value of the use o f O.R.S should be emphasized for mothers to appreciate it’s use for treating their children with diarrhoea at home even before taking the child to a health facility. 3) Outreach Health services should be extended to those communities or villages in the study area which are far away from the existing health facilities, and during each outreach session, a brief teaching on childhood diarrhoea should be given to mothers by the health team. 4) Misconceptions and beliefs about diarrhoeal diseases that are strongly held by mothers in the study area should be disabused with correct and adequate information about diarrhoeal diseases. 5) O.R.T comers or centres should be established in all health centres in the district which could be used as training or teaching centres for mothers who use the health facilities. Where possible some of the mothers could be used as resource persons in O.R.T training for mothers. 6) Health personnel particularly, Community and Public Health Nurses who do home visiting, should use the opportunity to teach mothers in their own homes about diarrhoea and it’s appropriate home management. 7) Mothers’ Clubs should be formed in all communities/villages so that mothers could share together information and experiences on diarrhoea management practices and other child survival activities.
The Health and Environmental Implications of Small-Scale Gold Mining Operations in the Bolgatanga District
(University of Ghana, 1997-06) Obeng, E.A.; Batse, Z.K.M.; Quainoo, A.B.; University of Ghana, College of Health Sciences, School of Public Health
This was a descriptive cross-sectional study to ascertain the health and environmental implications of small-scale gold mining operations in the Bolgatanga District of the Upper East Region. Small-scale gold mining started actively in an area designated the Small-Scale Gold Mining Area about two (2) years ago. The three main types of gold mining operations were alluvial, colluvial and lode gold mining. Alluvial and colluvial gold mining involved both sexes but lode gold mining was the exclusive preserve of males. Whereas mercury was used in the processing of ore in colluvial and lode gold mining, alluvial gold mining did not require its use. Explosives, though prohibited were freely used in lode gold mining because gold was encased in granite buried several metres below ground level. The 40 underground lode gold miners, chosen conveniently and interviewed were multi-ethnic in nature with a non-indigenous (non-Upper East) to indigenous (Upper East) ratio of 3:2. They were relatively young with a mean age of 28.8 ± 5.8SD years. Forty five percent (45%) smoked tobacco, 50% drank alcohol and 37.5% drank alcohol and smoked tobacco. Two and a half percent (2.5%) admitted smoking marijuana. They described their working conditions as good but agreed that working in single pits without adequate ventilation could be suffocating. The common health complaints among them were headache and bodily pains, abdominal pain and diarrhoea, catarrh, cough and chest pains. Other ailments were seasonal. Cholera and Pneumonia were rife during the wet season whereas Cerebrospinal Meningitis, Chicken Pox and Measles were common during the dry season. Malaria, Sexually Transmitted Diseases (STDs), Scorpion and Snake Bites were also prevalent. The job-related injuries included lacerations and abrasions, foreign body in the eyes and falls in the pits. Cerebrospinal meningitis (CSM); Cholera, Snake bites, Inhalation of ‘Smoke’ (Carbon monoxide fumes), Cave-ins, Dynamite explosions and Falls into pits were mentioned as causes of death among miners. There was total disregard for the use of protective clothing during working hours. The reasons given were non-availability, non-affordability, suitability and a false sense of security. Almost everyone knew about the side effects of carbon monoxide (smoke) inhalation but 37.5%, 45% and 70% did not know of any side effects of dynamite, dust and mercury respectively. The environment was characterized by substandard housing, overcrowding, poor water and sanitation facilities, high noise levels and atmospheric pollution with dust, fumes from water-pumping machines and detonation of dynamite. Numerous rock and soil ‘waste’ dumps, land denuded of trees, shallow excavations and abandoned pits littered the environs of the small-scale gold mining area. Concerted actions by the stake-holders, i.e. the Government through the review of existing legislation, technical and financial support for small-scale gold miners; the District Assembly through the monitoring and evaluation of gold mining activities and the setting up of an Environmental Rehabilitation Fund, and lastly the willingness of both miners and the non-mining community to observe good health and environmental hygiene practices, are some of the ways required to make small scale gold mining operations both health and environment friendly.
Childhood Anaemia: The Case of Dormaa District
(University of Ghana, 1997-06) Oduro, J.; Senah, K. A.; Avokey, F.; University of Ghana, College of Health Sciences, School of Public Health
The study was conducted out of concern of the District Health Management Team of Dormaa District to find a solution to the rising anaemia problem in children in the District. The study was conducted from the 28th January, 1997 to 16th May, 1997. The main objective of the research was to find the distribution, outcome and the determinants of anaemia in children in the Dormaa District. The specific objectives were to find the age and sex distribution of anaemia cases and mortality, the causes of anaemia and its age distribution and the knowledge, attitude and practices on anaemia among community members. The study design was a descriptive cross-sectional one. Data were collected and analysed from the records of 1141 anaemic children 0 – 5 years admitted or treated at the Dormaa Presbyterian Hospital (District Hospital), and the three main Health Centres in the District from 1993 to 1996. Data on the knowledge, attitude and practices on anaemia were also collected from 70 Traditional Birth Attendants and Herbalists through interviews using questionnaire. Seventeen focus group discussions were also organised to collect data from grandmothers, nursing mothers and health staff.
A Community-Based Study of Factors Contributing to the Delayed Arrival of Women with Pregnancy related Complications to Health Care Facilities in the Assin District of Ghana
(University of Ghana, 1997-06) Tinkorang, E.K.; Antwi, P.; Amoa, S.A.; University of Ghana, College of Health Sciences, School of Public Health.
The study is a community-based study to determine the factors contributing to the delayed arrival of women with pregnancy-related complication to the health facilities in the Assin District of Ghana. The women with pregnancy-related complications in the district often arrive at the health facilities in the district so late, that this makes the outcome of the management poor with resultant high maternal and perinatal morbidity and mortality. The study aimed at finding the factors which significantly contribute to the delayed arrival and to make recommendation on how to improve the situation. The study is descriptive which used both structured questionnaire and focus group discussion to collect relevant data from five communities. The data were analysed using a computer software. The major findings of the study were: (i) The community and individuals had good knowledge on pregnancy and pregnancy-related complication. (ii) Most individuals and families prefer to visit hospital in event of a pregnancy complications. (iii) The majority of the women in the community lack access to funds in event of pregnancy and pregnancy-related complication and this contributes significantly to the delayed arrival. (iv) Problem of long distance between health facilities and the women's place of residence, long travel time due to poor roads, lack of transport and high cost of transport also contributes to the delayed arrival. Based on the findings of the study recommendation has been made to i .p improve the situation.
A Study of STD Treatment seeking Behavior among Adolescent Students in Asuogyaman District Eastern Region
(University of Ghana, 1997-06) Yeboah, K. G.; Amoah, S. A.; Antwi, P; University of Ghana, College of Health Sciences, School of Public Health
A study to determine some factors that affected STD treatment seeking behaviour among adolescents students in Senior Secondary School was carried out in the Asuogyaman District of the Eastern Region of Ghana in May 1997. In all 62 students who had suffered STDs in the past were respondents to the questionnaire. Seventy one percent (71%) of respondents were males and 85.5% of respondents were aged between 17 and 20 years. 62% usually lived in a rural area. All respondents had some knowledge about STDs and each could mention at least one STD. Forty percent (40%) knew AIDS as an STD and 95% attributed STD’s to having sex with an infected individual. The study revealed that 93% of respondents perceived a hospital/clinic as the best source of STD treatment and yet only 3 4% actually sought treatment from a hospital/clinic during their STD episode. Some reasons for this apparent discrepancy were that of high charges, inconvenience in the use of hospital/clinic and the wish of the afflicted to conceal their identity to avoid embarrassment. Other sources of treatment used by the remaining 66% were self-medication, herbalists, nurse acquaintance, friends. Chemical shops were the most common source used by respondents. Majority of respondents (82%) perceived that STD treatment should be sought immediately symptoms were noticed. 77% and 79% respectively preferred specialized STD clinics and a laboratory service prior to treatment. Short waiting time drug availability and confidentiality were factors that affected use of various STD services. The findings from this study are consistent with the hypothesis that was made i.e. that treatment seeking behavior in STDs is both a function o f attitudes towards disease and sex and the issues of accessibility and quality of health care facilities that deal with STDs. The findings colloborate those in the literature review except for the place o f residence where the study found a preponderance of respondents who usually lived in a rural area [9, 22], It may be important to continue with efforts to demystify STDs and remove the stigma attached to it by constantly discussing them. Since only a third of the respondents actually used hospitals/clinics it may be useful to equip alternative care providers with requisite knowledge to effectively manage STDs. Quality o f care in hospitals/clinics need to be improved to attract more STD patients.

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