Research Articles
Permanent URI for this communityhttp://197.255.125.131:4000/handle/123456789/22010
A research article reports the results of original research, assesses its contribution to the body of knowledge in a given area, and is published in a peer-reviewed scholarly journal. The faculty publications through published and on-going articles/researches are captured in this community
Browse
86 results
Search Results
Item Socio-economic differences in cost of pregnancy-related health services in the peri-urban Accra, Ghana(Journal of Public Health, 2014) Aikins, M.; Aryeetey, R.; Dako-Gyeke, P.; et al.Background Financial and physical barriers are known to limit access to maternal health services in developing countries. These limitations are often compounded by the low socio-economic status of women. This study examined socio-economic differences in health services costs incurred by pregnant women. Methods A cross-sectional cost survey of 300 women who had delivered a live birth in the last 12 months was undertaken. Results Majority of the women were aged between 20 and 39 years. About 63% of the women claimed they were registrants of the National Health Insurance Scheme (NHIS). However, only 64% of them provided valid NHIS identification cards. There were relatively more insured women in the rich quintiles (44%) compared with insured women in the poor quintiles (33%). Generally, women who were in the rich quintile incurred the highest average medical and non-medical costs, spent the highest time before service provision, and lost the highest average incomes. Conclusions Women's socio-economic differences play a critical role in access to health services. We recommend that awareness campaigns on the NHIS must be intensified. The Ghana Health Services through its Community-based Health Planning Service should carefully structure its home visits to cover education on pregnancy-related health services.Item Pathways Utilized For Antenatal Health Seeking Among Women In The Ga East District, Ghana(Ghana Medical Journal, 2015) Aryeetey, R.N.O.; Aikins, M.; Dako-Gyeke, P.; Adongo, P.B.Background: Ghana’s maternal mortality ratio has been declining over the last two decades but at a rather slow pace. Poor access to effective maternity care is identified as one of the key challenges of maternity care. The current study mapped out the pathways to pregnancy care seeking among urban-dwelling adult women in a peri-urban district located in the Greater Accra region of Ghana. Methods: A total of 300 women who had a live birth in the last 12 months participated in a community-based survey. They answered questions on care-seeking behavior related to their last pregnancy. A multivariate A logistic regression model was used to identify factors associated with multiple care-seeking behavior. Results: Almost all women in the survey (98%) reported accessing skilled antenatal care (ANC) from a bio-medical provider, although 35% began ANC later than the first trimester. About 45% of women simultaneously utilized both ANC and alternative care providers (ACP) including traditional birth attendants, herbalists, and spiritualists. A complex pathway to antenatal care seeking behavior involving shuttling between providers was observed. Controlling for household wealth, household size, and age, seeking care from multiple providers concurrently were associated with residence in Kwabenya sub-district OR=2.13 (95% CI: 1.28, 3.55) and previous abortion OR=2.08 (95% CI: 1.11, 3.91) Conclusions: Urban-dwelling women in Ga East Dis trict seek antenatal care concurrently from multiple sources. Health system interventions must seek ways to integrate alternative care providers into the existing biomedical health care system.Item An Exploratory Study of Physical Activity and Over Weighti Two Senior High Schools in The Accra Metropolis(GHANA MEDICAL JOURNAL, 2013) Nyawornota, V.K.; Aryeetey, R.; Bosomprah, S.; Aikins, M.Background: Overweight and physical inactivity are major risk factors for non-communicable diseases. However, little evidence on physical activity, and overweight exists to support intervention in specific sub-populations including adolescents in low-income settings like Ghana. This study aimed at estimating overweight and determining the pattern and level of physical activity among senior high school students in the Accra Metropolis. Methods: A cross-sectional study was conducted in the Accra Metropolis, among senior high school students, ages 15 to 19 years. Participants were selected using a two-stage cluster sampling technique. Structured ques tionnaire and anthropometric measurement were em ployed to gather information for the study. Students were considered as overweight if their Body Mass In dex (BMI) ≥ +1SD, and obese if BMI ≥ +2SD. Results: Out of 444 students, 17% were classified as engaging in low level physical activity, 49% in moder ate activity, and 34% in high level of physical activity. Much of the activity in boys was recreational while among girls, was due to domestic chores. The preva lence of overweight was 11.7%. Overweight preva lence was higher among female students (15.6%) com pared to 4.5% in males. Furthermore the risk of over weight was lower among students who engaged in high physical activity than those engaged in low activity. Overweight was independently associated with physi cal activity (p=0.01), sex (p=0.001) and age (p=0.01), after controlling for age sex and physical activity and diet. Conclusion: Majority of students in the study engaged in moderate to high physical activity. The prevalence of overweight was 11.7%. Physical activity was sig nificantly related to overweight among students in the study.Item Exploring barriers to accessing physiotherapy services for stroke patients at Tema general hospital, Ghana(Archives of Physiotherapy, 2017) Nketia-Kyere, M.; Aryeetey, G.C.; Nonvignon, J.; Aikins, M.Background: Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about barriers especially to physiotherapy services in Ghana. The objective of this study was to assess the barriers to physiotherapy services for stroke patients at Tema General Hospital (TGH). The individual/personal and health system barriers to physiotherapy services at TGH were determined. Method: A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers of respondents to physiotherapy services and were described using the Likert’s scale. Health system barriers were assessed using a self-structured questionnaire which had section under the following heading: human factors, physiotherapy modalities, physical barriers and material/equipment factors. The time spent waiting for physiotherapy and attitude of physiotherapist towards patients; physiotherapy modality such as electrotherapy, exercise therapy and massage therapy among others were some of the indices measured. Respondents’ adherence to Medication was assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression model was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance was set at p < 0.05. Results: The results showed that majority (76.3%) of the respondents had economic barrier as their main individual/ personal barrier to physiotherapy services. For medication adherence level, patients with low medication adherence level were about 21 times the odds of defaulting on accessing physiotherapy services five times or more as compared to those with medium adherence level (OR 20.63, 95% CI 8.96, 42.97). It was concluded in the study that individual/ personal barriers of stroke patients were the significant barriers to accessing physiotherapy services at Tema General Hospital.Item Responses to donor proliferation in Ghana’s health sector: a qualitative case study(Bull World Health Organ, 2015) Pallas, S.W.; Nonvignon, J.; Aikins, M.; Ruger, J.P.Objective To investigate how donors and government agencies responded to a proliferation of donors providing aid to Ghana’s health sector between 1995 and 2012. Methods We interviewed 39 key informants from donor agencies, central government and nongovernmental organizations in Accra. These respondents were purposively selected to provide local and international views from the three types of institutions. Data collected from the respondents were compared with relevant documentary materials – e.g. reports and media articles – collected during interviews and through online research. Findings Ghana’s response to donor proliferation included creation of a sector-wide approach, a shift to sector budget support, the institutionalization of a Health Sector Working Group and anticipation of donor withdrawal following the country’s change from low income to lower-middle income status. Key themes included the importance of leadership and political support, the internalization of norms for harmonization, alignment and ownership, tension between the different methods used to improve aid effectiveness, and a shift to a unidirectional accountability paradigm for health-sector performance. Conclusion In 1995–2012, the country’s central government and donors responded to donor proliferation in health-sector aid by promoting harmonization and alignment. This response was motivated by Ghana’s need for foreign aid, constraints on the capacity of governmental human resources and inefficiencies created by donor proliferation. Although this decreased the government’s transaction costs, it also increased the donors’ coordination costs and reduced the government’s negotiation options. Harmonization and alignment measures may have prompted donors to return to stand-alone projects to increase accountability and identification with beneficial impacts of projects.Item Routine medical and dental examinations: a case study of adults in Tema community 20 in Ghana(INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION, 2019-12-02) Agyemang, S.A.; Danquah, E.P.B.; Amon, S.; Aikins, M.Routine medical and dental examinations are important and effective measures in the prevention of diseases and promotion of good health. A cross-sectional quantitative study was conducted among adult residents in Community 20, Tema. The study randomly sampled 216 adults aged over 18 years. These participants were interviewed after informed consent was obtained. Sociodemographic factors associated with routine medical and dental examinations were determined using multivariable logistic regression analysis. Weighted mean was used to determine the level of perceived importance of medical and dental examination. A total of 68.1% and 31.9% of the adults have ever undergone routine medical and dental examination, respectively. Personal reasons constituted 35.4% for medical examination and 55.1% for dental examination. Medical and dental examinations encourage adults to be health conscious was ranked highest with a weighted mean of 3.78. Routine medical and dental examinations were higher among adults over 50 years, males, higher educated adults, higher income earners and the unmarried. Most of the adults indicated that medical and dental examinations were very important. Routine medical and dental examinations encourage adults to be health conscious. Routine medical and dental examinations were higher among adults over 50 years. Public health education programs should educate and encourage the general public especially among the younger population to undergo routine medical and dental examinations annuallyItem 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 lossItem Determinants of health insurance enrolment in Ghana: Evidence from three national household surveys(Health Policy and Planning, 2019-08-21) Aikins, M.; Salari, P.; Akweongo, P.; Tediosi, F.In 2003, Ghana implemented a National Health Insurance Scheme (NHIS) to move towards Universal Health Coverage. NHIS enrolment is mandatory for all Ghanaians, but the most recent estimates show that coverage stands under 40%. The evidence on the relationship between socio-economic characteristics and NHIS enrolment is mixed, and comes mainly from studies conducted in a few areas. Therefore, in this study we investigate the socio-economic determinants of NHIS enrolment using three recent national household surveys. We used data from the Ghanaian Demographic and Health Survey conducted in 2014, the Multiple Indicator Cluster Survey conducted in 2011 and the sixth wave of the Ghana Living Standard Survey conducted in 2012–13. Given the multilevel nature of the three databases, we use multilevel logistic regression models to estimate the probability of enrolment for women and men separately. We used three levels of analysis: geographical clusters, household and individual units. We found that education, wealth, marital status—and to some extent— age were positively associated with enrolment. Furthermore, we found that enrolment was correlated with the type of occupation. The analyses of three national household surveys highlight the challenges of understanding the complex dynamics of factors contributing to low NHIS enrolment rates. The results indicate that current policies aimed at identifying and subsidizing underprivileged population groups might insufficiently encourage health insurance enrolmentItem Suicide in Ghana: How Could the Community-Based Health Planning and Service (CHPS) Effectively Contribute to Its Prevention?(Iranian Journal of Public Health, 2019-11-04) 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 lossItem Knowledge and satisfaction of health insurance clients: a cross-sectional study in a tertiary hospital in Ghana(Journal of Public Health, 2019-11) Aikins, M.; Nsiah-Boateng, E.; Asenso-Boadi, F.; Andoh-Adjei, F.Aim This study assesses client knowledge of, and satisfaction with services under the National Health Insurance Scheme (NHIS) in a tertiary healthcare facility. Subject and methods A cross-sectional exit interview was conducted at the Korle-Bu Teaching Hospital in the Greater Accra region of Ghana. Respondents were classified into various groups based on the number of positive responses obtained for knowledge and satisfaction measures on a 5-point Likert scale. Descriptive statistics and multivariate logistic regression analyses were conducted to test and measure associations between client characteristics, their knowledge of the NHIS, and satisfaction with services. Results Two hundred and four clients participated in the study, representing a 97% response rate. Seventy-nine clients (39%) had more knowledge of the NHIS, 115 (56%) were more satisfied with NHIS services, and 200 (98%) were more satisfied with healthcare services. Factors including education and years of enrolment were significantly associated with more knowledge of the NHIS. Similarly, knowledge of the NHIS, number of living children, and years of enrolment strongly correlated with more satisfaction with NHIS services. However, being a returning patient was strongly related with less knowledge of the NHIS and less satisfaction with NHIS services. Conclusion Clients have less knowledge of the NHIS and are fairly satisfied with its services overall. However, they are more satisfied with healthcare provider services. More education and sensitization are necessary to increase knowledge and improve satisfaction and enrolment.