Department of Population, Family and Reproductive Health

Permanent URI for this collectionhttp://197.255.125.131:4000/handle/123456789/24380

Browse

Search Results

Now showing 1 - 10 of 104
  • Item
    Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub-Saharan African adolescents aged 10-19 years: cross-sectional study.
    (Tropical Medicine and International Health, 2020-01-25) Manu, A.; Nyundo, A.; Regan, M.; Ismail, A.; Chukwu, A.; Dessie, Y.; Njau, T.; Kaaya, S.F.; Smith, F.M.C.
    OBJECTIVE: This study aimed to determine the burden of depression, suicidal ideation and suicidal behaviour amongst adolescents at sites in six sub-Saharan African countries and examine associated risk and protective factors. METHODS: Household-based cross-sectional study involving male and female adolescents ages 10-19 years. A total of 7,662 adolescents from eight sites in six countries participated in the survey. Three sites were urban: Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria); five were rural: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). Log-binomials models were used to estimate relative risks and confidence intervals for factors associated with depression and suicidal behaviour. This was supplemented using log-Poisson models as needed. RESULTS: The prevalence of suicidal behaviour over the last 12 months ranged between 1.2% and 12.4% in the eight sites. Depressive symptoms and suicidal ideation/behaviours were associated with older age, female sex, food insecurity, poor access to health care and substance use. Depression was strongly associated with increased risk of suicidal behaviour at two sites where the multivariate model converged: Harar, Ethiopia (RR = 3.5, 95% CI 1.8, 7.0, P < 0.05) and Ibadan, Nigeria (RR = 3.7, 95% CI 2.2, 6.3, P < 0.0001). CONCLUSIONS: Depressive symptoms and suicidal behaviour are common amongst sub-Saharan African adolescents at these 8 sites. Most factors associated with depressive symptoms are modifiable and preventable. Routine screening for depressive symptoms in services frequented by adolescents in these and similar communities would be crucial in early detection and prompt intervention.
  • Item
    Reproductive autonomy and pregnancy decision-making among young Ghanaian women
    (Global Public Health, 2019-10-25) Manu, A.; Loll, D.; Fleming, P.J.; Morhe, E.; Stephenson, R.; King, E.J.
    Decision-making regarding the outcome of a pregnancy may include participation of the woman herself, her sexual partner, parents, family, and/or community. This paper examines who had the most say in the outcome of young Ghanaian women’s last pregnancy and whether this correlated with her level of reproductive autonomy (RA). We analysed cross-sectional data from 380 previously pregnant young women in urban Ghana. We measured communication and decision-making RA using modified scales ranging from 3 (low RA) to 12 (high RA). We tested unadjusted associations between the RA sub-scales and who made the pregnancy decision (self, partner, both together, or someone else) and used multinomial regression models to understand these associations when controlling for sociodemographic, reproductive history, and social context variables. In final models, a one-point increase in decision-making RA was associated with an adjusted relative risk ratio of 0.79 (95% CI: 0.66–0.93; p = 0.006) of partner having the most say as compared to the woman having the most say. The communication RA scale was not associated. Programmes that increase RA may be effective in increasing women’s rights to execute decisions about reproductive health and outcomes. Future research should explore this notion and the role of pregnancy disclosure in this relationship.
  • Item
    Suicide in ghana: How could the community-based health planning and service (chps) effectively contribute to its prevention?
    (Iran J Public Health, 2019-11) Aikins, M.; Assan, A.; Takian, A.
    Suicide and suicide attempts are significant global public health challenge. Among the most com-mon means of suicide worldwide are pesticide self-poisoning, hanging and firearm use. Regard-ing methods of suicide, studies have identified strong association between suicidal behavior and mental disorders –especially depression and alco-hol use disorders. Further, many suicide cases happen spontaneously due to inabilities to handle life stress which emerge from financial difficul-ties, break-ups from relationships, chronic pain and illness or loss
  • Item
    Reproductive Autonomy and Modern Contraceptive Use at Last Sex Among Young Women in Ghana
    (Guttmacher Institute, 2019-08-25) Manu, A.; Loll, D.; Fleming, P.J.; Morhe, E.; Stephenson, R.; King, E.J.; Hall, K.S.
    CONTEXT Variability in the conceptualization and measurement of women's empowerment has resulted in inconsistent findings regarding the relationships between empowerment and sexual and reproductive health outcomes. Reproductive autonomy—a specific measure of empowerment—and its role in modern contraceptive use have rarely been assessed in Sub-Saharan contexts. METHODS Survey data were collected from a sample of 325 urban Ghanaian women aged 15-24 recruited from health facilities and schools in Kumasi and Accra in March 2015. Bivariate and multivariable logistic regression analyses were used to examine associations between two adapted reproductive autonomy subscales—decision making and communication—and women's use of modern contraceptives at last sex, controlling for demographic, reproductive and social context (i.e., approval of and stigma toward adolescent sexual and reproductive health) covariates. RESULTS In multivariable analyses, reproductive autonomy decision making—but not reproductive autonomy communication—was positively associated with women's modern contraceptive use at last sex (odds ratio, 1.1); age, having been employed in the last seven days and living in Kumasi were also positively associated with modern contraceptive use (1.1-9.8), whereas ever having had a previous pregnancy was negatively associated with the outcome (0.3). Reproductive autonomy decision making remained positively associated with contraceptive use in a subsequent model that included social approval of adolescent sexual and reproductive health (1.1), but not in models that included stigma toward adolescent sexual and reproductive health. CONCLUSIONS The reproductive autonomy construct, and the decision-making subscale in particular, demonstrated relevance for family planning outcomes among young women in Ghana and may have utility in global settings. Future research should explore reproductive autonomy communication and the potential confounding effects of social context.
  • Item
    Plantains: Gluco-friendly usage
    (Journal Of Pakistan Medical Association, 2019-10) Lamptey, R.; Velayoudom, F.L.; Kake, A.; Uloko, E.A.; Rhedoor, A.J.; Kibirige, D.; Ndour, M.N.M.; Sobgnwi, E.; Kalra, S.
    Plantains are a staple food for a large proportion of the world's population. Rich sources of carbohydrates, they are considered taboo by most diabetes care providers. For persons living with diabetes, however, they are a preferred food item. This multi country authored article discusses the nutritional and culinary qualities of plantains. It discusses how to consume the fruit in a glucose-safe manner, by reducing the glycaemic load and total caloric load due to a low glycaemic index. Simple ways of modifying plantain preparation and serving are suggested, to help patients take this foodstuff without impacting glucose control.
  • Item
    State of Dietetics Practice in Ghana: A Nation-Wide Situational Analysis
    (Ghana Medical Journal, 2014-12) Aryeetey, R.N.O.; Boateng, L.; Sackey, D.
    Objective: Prevalence of obesity and related diseases has increased in Ghana. Dietitians have essential skills to prevent and manage dietary diseases. However, little is known about dietetic practice in Ghana. This paper describes the history and current state of dietetics practice in Ghana. Methods: A questionnaire was administered to 13 dietitians and six dietetic interns in February 2012. The questionnaire collected data on perceptions about dietetics practice, career progression, and challenges in dietetics practice in Ghana. Key informant interviews (KII) on history of dietetics in Ghana were also held with four retired dietitians, and two dietetics educators. Additional KII were conducted with the Chief dietitian, two officers of the Ghana Dietetic Association, and three other dietitians. Most KII were conducted faceto- face but a few were only possible via telephone. Some of the KII were audio-recorded, in addition to handwritten notes. Following transcription of audiorecorded interviews, all data were subjected to content analysis. Results: Dietetic practice in Ghana has evolved from low-skilled cadre (catering officers) offering hospitalbased meal services to the current era of available trained dietitians providing diet therapy in diverse settings. However, 80% of the 35 dietitians identified are working in Accra. In three regions of Ghana, there are no dietitians. There remain limited opportunities for continuous learning and professional career advancement. Additionally, there are many unqualified dietitians in practice. Conclusion: A huge unmet need for dietitians exists in all regions of Ghana, except Greater Accra. Bridging this gap is essential to increase access to dietetic care throughout Ghana.
  • Item
    Comparison of maternal health services and indicators in three districts of the Volta Region, Ghana
    (Ghana Medical Journal, 2016-09) Nam, E.W.; Zakaria, A.; Adams, F.; Jun, Y.S.; Adanu, R.
    Development Goal (MDG) 5 target. The Ghana Health Service and Ministry of Health have displayed a high commitment to the improvement of maternal health in the country. One of the most recent partnerships directed at this is with the Korea International Cooperation Agency. Methods: This study was conducted among women between ages 15 and 49 resident in Keta Municipal, Ketu North and Ketu South districts in the Volta Region of Ghana who were pregnant or who had children aged less than five. Ethical approval was obtained from the Ghana Health Service Ethical Review Committee. Data were collected using questionnaires, entered into Stata version 12 and analyzed using frequency distribution and assessment of means. Comparisons among districts were conducted using chi square test and one way analysis of variance (ANOVA). Results: The study covered 630 women whose mean age was 28.4 years. Almost all participants (99.1%) from Ketu North knew where to obtain family planning services. Use of modern contraception was highest in Ketu North with 31% of respondents using a modern method. Delivery in a health facility was highest in Keta Municipal (62.3%) with overall institutional delivery being 57.6%. Delivery by a skilled birth attendant (SBA) was also highest in Keta Municipal. Conclusion: Indicators used to assess maternal health services show a coverage of over 50% but we need to improve institutional delivery, use of modern contraception and education about danger signs in pregnancy
  • Item
    Clinic Visits and Cervical Cancer Screening in Accra
    (Ghana Medical Journal, 2010-06) Adanu, R.M.K.; Seffah, J.D.; Duda, R.; Darko, R.; Hill, A.; Anarfi, J.
    Objective: To determine the factors that increase the chances of a woman in Accra having a Pap smear and whether women who have recently visited clinics have higher chances of having had Pap smears. Design: A cross-sectional study Methods: A representative sample of women in Accra, Ghana was interviewed and the clinical and demographic factors influencing cervical cancer screening was assessed. Results: Out of 1193 women with complete data, only 25 (2.1%) had ever had a Pap smear performed though 171 (14.3%) had their last outpatient clinic visit for either a gynaecological consultation or a regular check up. Simple logistic regression showed that a high educational level, high socioeconomic status and a history over the past month of postmenopausal or intermenstrual bleeding significantly increased the odds of ever having a pap smear. Neither monthly income nor last clinic visit for a gynaecological consultation or regular check up increased the odds of having a pap smear. Multiple logistic regression showed that a high educational level and experiencing postmenopausal or intermenstrual bleeding were the most important determinants of ever having a Pap smear. Conclusion: While we wait for a national program for cervical cancer screening, there is a need for clinicians to put more individual effort into ensuring that asymptomatic women are screened for cervical cancer.
  • Item
    Electronic Learning and Open Educational Resources in the Health Sciences in Ghana
    (Ghana medical journal, 2010-12) Adanu, R.M.K.; Adu-Sarkodie, Y.; Opare-Sem, O.; Nkyekyer, K.; Donkor, P.; Lawson, A.; Engleberg, N.C.
    Objectives: To determine whether a group of Ghanaian students are able to easily use electronic learning material and whether they perceive this method of learning as ac-ceptable. Setting: The University of Ghana Medical School (UGMS) and the School of Medical Sciences (SMS), Kwame Nkrumah University of Science and Technology (KNUST) Participants: One hundred and fifty third year medical students at SMS and nineteen fifth year medical students at UGMS Methods: Two e-learning materials were developed, one on the polymerase chain reaction and the other on total abdominal hysterectomy and these were distributed to selected medical students. Two weeks after the distribu-tion of the programmes, a one-page, self-administered questionnaire was distributed to the target groups of stu-dents at the two institutions. Results: Ninety three percent (139) of respondents at KNUST and 95% (18) at UG report having access to a computer for learning purposes. All of the UG students viewed the TAH programme; 82% (130) of the KNUST students viewed the PCR animations. All students who viewed the programmes at both institutions indicated that the e-learning pro-grammes were “more effective” in comparison to other methods of learning. Conclusion: Computer ownership or availability at both medical schools is sufficient to permit the distribution and viewing of e-learning materials by students and the medical students considered both programmes to be very helpful.
  • Item
    Financial Viability of District Mutual Health Insurance Schemes of Lawra and Sissala East Districts, Upper West Region, Ghana
    (Ghana Medical Journal, 2010-12) Yevutsey, S.K.; Aikins, M.
    Introduction: The National Health Insurance Act, passed in 2003 mandates the National Health Insurance Authority to, in conjunction with the district assemblies establish district mutual health insurance scheme (DMHIS) governed by semi-autonomous boards in all ten regions. Since its implementation, unsubstantiated reports indicate increasing health care and administra-tive costs of the various DMHIS across the country without any corresponding increase in the premium level. We sought to assess the financial viability of the DMHIS in Lawra (LDMHIS) and Sissala East (SEDMHIS) districts, Upper West Region of Ghana. Methods: Cost analysis of revenue and expenditure of LDMHIS and SEDMHIS from 2004 to 2007 was used to estimate the revenue, expenditure, administrative cost, expense, claims and combined ratios. Results: The scheme‟s major sources of revenue were funds from NHIA on behalf of exempted group and the formal sector employees and premium collected from the informal sector. Other sources of revenue were significant at the beginning and became almost negli-gible at the end of 2007. At the end of 2005, adminis-trative cost was higher than medical claims. By the end of 2007, it has reduced to 34.3% and 15.7% of the total expenditure of the SEDMHIS and LDMHIS respec-tively. The combined ratios decreased from 2.27 and 1.17 in 2005 to 0.74 and 0.95 in 2007 for SEDMHIS and LDMHIS respectively. Conclusion: Continuous NHIA support, increasing coverage of the scheme and a corresponding reduction in administrative cost would increase revenue. If this is sustained, the schemes could be financially viable in the long term.