Research Articles
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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
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Item Impact of COVID-19 lockdown measures on mother and child health – the case of Ghana(BMC Public Health, 2024) Koka, E.; Asante-Poku, A.; Siam, M.; et al.Background The lockdown measures in response to the coronavirus disease (COVID-19) have led to a wide range of unintended consequences for women and children. Until the outbreak of COVID-19, attention was on reducing maternal and infant mortality due to pregnancy and delivery complications. The aim of this study was to interrogate the impact of lockdown measures on women and children in two contrasting districts in Ghana – Krobo Odumase and Ayawaso West Wuogon. Methods This study adopted the mixed-method approach using both qualitative and quantitative data. The qualitative study relied on two data collection methods to explore the impacts of COVID-19 control measures on women and children in Ghana. These were: Focus Group Discussions (FGDs; n=12) and Key Informant Interviews (KIIs; n=18). The study complemented the qualitative data with survey data - household surveys (n=78) which were used to support the nutrition and school closure data; and policy data gathered from government websites consisting of government responses to COVID-19. The qualitative data was analysed using the thematic approach with codes generated apriori with the NVIVO software. The quantitative data used percentages and frequencies. Results Engagements with participants in the study revealed that the lockdown measures implemented in Ghana had consequences on child and maternal health, and the health care system as a whole. Our study revealed, for example, that there was a decrease in antenatal and postnatal attendance in hospitals. Childhood vaccinations also came to a halt. Obesity and malnutrition were found to be common among children depending on the location of our study participants (urban and rural areas respectively). Our study also revealed that TB, Malaria and HIV treatment seeking reduced due to the fear of going to health facilities since those ailments manifest similar symptoms as COVID 19. Conclusion Government responded to COVID-19 using different strategies however the policy response resulted in both intended and unintended consequences especially for women and children in Ghana. It is recommended that national policy directions should ensure the continuous provision of child and maternal healthcare services which are essential health services during lockdowns.Item Global research priorities on COVID-19 for maternal, newborn, child and adolescent health(Journal of Global Health, 2021) Ahmed, N.; Aryeetey, R.; Abdellatif, M.; et al.Background This research prioritization aimed to identify major research gaps in maternal, newborn, child, and adolescent health (MNCAH) to help mitigate the direct and indirect effects of the COVID-19 pandemic. Methods We adapted the Child Health and Nutrition Research Initiative methodology. We defined scope, domains, themes, and scoring criteria. We approached diverse global experts via email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/ health systems area. We curated the research ideas as research questions (RQs) and sent them to the consenting experts for scoring via the online link. For each RQ, the research priority score (RPS) was calculated as an average of individual criterion scores and ranked based on RPS in each area. Results We identified the top-ranked 10 RQs in each maternal, newborn, and child and adolescent health and 5 in the cross-cutting/health systems area. In maternal health, indirect effects on care, measures to improve care, health risks and outcomes, and preventing and managing SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health, clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode of transmission, and interventions to prevent transmission were the focus. For child and adolescent health, top-ranked RQs were indirect effects on care, clinical status, and outcomes, interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educational institute-related RQs. The cross-cutting RQs were the effects of the pandemic on the availability, access, care-seeking, and utilization of MNCAH services and potential solutions. Conclusions We call on partners, including governments, non-governmental organizations, research institutes, and donors, to address this urgent research agenda.Item Harnessing the tenets of health promotion and wise reasoning in managing the COVID-19 pandemic in Ghana and similar contexts(African Geographical Review, 2022) Kutor, S.K.; Ablo, A.D.; Annan-Aggrey, E.; et al.The emergence of COVID-19 in December 2019 produced new geographic spaces characterized by physical and social distancing with concomitant surprises. In Ghana, management of the first and second waves of the pandemic garnered mixed reactions from the populace. Against these perspectives, this commentary explored the critical role of health promotion and wise reasoning tenets in dealing with the COVID-19 pandemic in Ghana, specifically through the following eight principles: intellectual humility; acknowledging uncertainty and change; perspective-taking of different viewpoints; integration of diverse perspectives; intersectorality; sustainability; empowerment and public health engagement; and equity. Our analyses demonstrate that wise reasoning and health promotion from Ghana’s political authorities are critical to ensuring citizens’ compliance with the several measures that require a change of behavior.Item Intimate Partner Violence against Men and Women in Nigeria during the COVID-19 Pandemic Lockdown: An Assessment of Prevalence and Forms(Journal of Community Medicine and Primary Health Care, 2024) Ezenwoko, A.Z.; Abubakar, A.U.; Udofia, E.A.; et al.Background: The control of the COVID-19 pandemic necessitated the use of stringent control measures such as lockdowns by many countries of the world. This predisposed people in relationships to intimate partner violence (IPV). This study aimed to assess the prevalence and forms of intimate partner violence against both men and women in Nigeria during the COVID-19 pandemic lockdown. Methods: We conducted a cross-sectional study among 538 respondents using an online electronic questionnaire which was circulated across the 36 states in Nigeria on social media platforms - nd Facebook, WhatsApp and Twitter. Data were collected from May 22 - July 27 2020 and descriptive analysis generated using IBM SPSS version 23. Results: The mean age ± standard deviation of respondents was 37.2± 8.0 years. The overall prevalence of IPV was 216 (40.2%). Eighty-six (44.8%) men reported experiencing IPV with sexual violence 54 (28.1%) being the most reported form followed by emotional 49 (25.5), nancial 20 (10.4%) and physical 18 (9.4%) violence. One hundred and thirty (37.6%) women experienced IPV during the lockdown period. The common forms of violence experienced by women were emotional 100 (28.9%), sexual 66 (19.1%), nancial 42 (12.1%) and physical 31 (9.0%) violence. Conclusion: The prevalence of IPV was higher in men than women. The most reported form of violence was sexual in men and emotional in women. This underscores the need for the Federal Government to put in place systems (such as helplines for counselling and legislation) to protect people who are in relationships from IPV.Item COVID-19, nutrition, and gender: An evidence-informed approach to gender-responsive policies and programs(Social Science & Medicine, 2022) Kalbarczyk, A.; Lartey, A.; Aberman, N.; et al.In addition to the direct health impacts of COVID-19, government and household mitigation measures have triggered negative indirect economic, educational, and food and health system impacts, hitting low- and middle-income countries the hardest and disproportionately affecting women and girls. We conducted a gender focused analysis on five critical and interwoven crises that have emerged because of the COVID-19 crisis and exacerbated malnutrition and food insecurity. These include restricted mobility and isolation; reduced income; food insecurity; reduced access to essential health and nutrition services; and school closures. Our approach included a theoretical gender analysis, targeted review of the literature, and a visual mapping of evidence-informed impact pathways. As data was identified to support the visualization of pathways, additions were made to codify the complex interrelations between the COVID-19-related crises and underlying gender relations. Our analysis and resultant evidence map illustrate how underlying inequitable norms, such as gendered unprotected jobs, reduced access to economic resources, decreased decision-making power, and unequal gendered division of labor, were exacerbated by the pandemic’s secondary containment efforts. Health and nutrition policies and interventions targeted to women and children fail to recognize and account for understanding and documentation of underlying gender norms, roles, and relations, which may deter successful outcomes. Analyzing the indirect effects of COVID-19 on women and girls offers a useful illustration of how underlying gender inequities can exacerbate health and nutrition outcomes in a crisis. This evidence-informed approach can be used to identify and advocate for more comprehensive upstream policies and programs that address underlying gender inequities.Item Implications of COVID-19 Innovations for Social Interaction: Provisional Insights From a Qualitative Study of Ghanaian Christian Leaders(Frontiers in Psychology, 2022) Adams, G.; Osei-Tutu, A.; Affram, A.A.; et al.Responses to the COVID-19 pandemic prompted people and institutions to turn to online virtual environments for a wide variety of social gatherings. In this perspectives article, we draw upon our previous work and interviews with Ghanaian Christian leaders to consider implications of this shift. Specifically, we propose that the shift from physical to virtual interactions mimic and amplify the neoliberal individualist experience of abstraction from place associated with Eurocentric modernity. On the positive side, the shift from physical and virtual environments liberates people to selectively pursue the most fulfilling interactions, free from constraints of physical distance. On the negative side, the move from physical to virtual space necessitates a shift from material care to tangible engagement with the local community to the psychologization of care and pursuit of emotional intimacy in relations of one’s choosing—a dynamic that further marginalizes people who are already on the margins. The disruptions of the pandemic provide an opportunity to re-set social relations and to design ways of being that better promote sustainable collective well-being rather than fleeting personal fulfillment.Item Adjustments in purchasing arrangements to support the COVID-19 health sector response: evidence from eight middle-income countries(Health Policy and Planning, 2024) Parmar, D.; Mathauer, I.; Abuosi, A.A.; et al.The COVID-19 pandemic has triggered several changes in countries’ health purchasing arrangements to accompany the adjustments in service delivery in order to meet the urgent and additional demands for COVID-19-related services. However, evidence on how these adjustments have played out in low- and middle-income countries is scarce. This paper provides a synthesis of a multi-country study of the adjustments in purchasing arrangements for the COVID-19 health sector response in eight middle-income countries (Armenia, Cameroon, Ghana, Kenya, Nigeria, Philippines, Romania and Ukraine). We use secondary data assembled by country teams, as well as applied thematic analysis to examine the adjustments made to funding arrangements, benefits packages, provider payments, contracting, information management systems and governance arrangements as well as related implementation challenges. Our findings show that all countries in the study adjusted their health purchasing arrangements to varying degrees. While the majority of countries expanded their benefit packages and several adjusted payment methods to provide selected COVID-19 services, only half could provide these services free of charge. Many countries also streamlined their processes for contracting and accrediting health providers, thereby reducing administrative hurdles. In conclusion, it was important for the countries to adjust their health purchasing arrangements so that they could adequately respond to the COVID-19 pandemic, but in some countries financing challenges resulted in issues with equity and access. However, it is uncertain whether these adjustments can and will be sustained over time, even where they have potential to contribute to making purchasing more strategic to improve efficiency, quality and equitable access in the long run.Item Maintaining essential health services during COVID-19 in Ghana: a qualitative study(BMJ Global Health, 2024) Yeboah, I.; Dwomoh, D.; Ndejjo, R.; et al.Introduction Evidence suggests that non-pharmaceutical interventions such as lockdown policies, restriction of movement and physical distancing to control the novel COVID-19 contributed to the decline in utilisation of essential health services. We explored healthcare providers’ and policy-makers’ experiences of the barriers, interventions and response actions that contributed to ensuring the continuity of essential health services during the COVID-19 pandemic in Ghana to help inform future practice and policy. Methods We used a qualitative study approach. Data were analysed using thematic analysis. Thirty Four participants composed of 20 healthcare providers and 14 policy-makers who worked across regions with low and high recorded COVID-19 cases in Ghana during the COVID-19 pandemic were involved in this study. Results Participants reported that essential health services including maternal, reproductive and child health services, communicable and non-communicable disease care, and elective surgeries were disrupted during the COVID-19 pandemic. Barriers to the utilisation of essential services were constructed into three subthemes: (1) fear, (2) poor quality of care at the facility and (3) financial limitation. These barriers were mitigated with population based interventions underpinned by the socioecological model at the individual and interpersonal level (including psychosocial care for families and home visits), institutional and community levels (such as allocation of funds, training of health workers, public education, triage stations, provision of logistics, appointment scheduling, telemedicine and redeployment of health workers) and public policy level (tax relief packages, transportation arrangements and provision of incentives), which helped in maintaining essential health services during COVID-19. Conclusion Disruption of essential health services during COVID-19 in Ghana instigated population-based interventions which aided in expanding the populations’ continuous access to essential health services and strengthened health service delivery.Introduction Evidence suggests that non-pharmaceutical interventions such as lockdown policies, restriction of movement and physical distancing to control the novel COVID-19 contributed to the decline in utilisation of essential health services. We explored healthcare providers’ and policy-makers’ experiences of the barriers, interventions and response actions that contributed to ensuring the continuity of essential health services during the COVID-19 pandemic in Ghana to help inform future practice and policy. Methods We used a qualitative study approach. Data were analysed using thematic analysis. Thirty Four participants composed of 20 healthcare providers and 14 policy-makers who worked across regions with low and high recorded COVID-19 cases in Ghana during the COVID-19 pandemic were involved in this study. Results Participants reported that essential health services including maternal, reproductive and child health services, communicable and non-communicable disease care, and elective surgeries were disrupted during the COVID-19 pandemic. Barriers to the utilisation of essential services were constructed into three subthemes: (1) fear, (2) poor quality of care at the facility and (3) financial limitation. These barriers were mitigated with population based interventions underpinned by the socioecological model at the individual and interpersonal level (including psychosocial care for families and home visits), institutional and community levels (such as allocation of funds, training of health workers, public education, triage stations, provision of logistics, appointment scheduling, telemedicine and redeployment of health workers) and public policy level (tax relief packages, transportation arrangements and provision of incentives), which helped in maintaining essential health services during COVID-19. Conclusion Disruption of essential health services during COVID-19 in Ghana instigated population-based interventions which aided in expanding the populations’ continuous access to essential health services and strengthened health service delivery.Item Upper Airway Epithelial Tissue Transcriptome Analysis Reveals Immune Signatures Associated with COVID-19 Severity in Ghanaians(Journal of Immunology Research, 2024) Sandi, J.D.; Tapela, K.; Yeboah, J.A.; et al.The immunological signatures driving the severity of coronavirus disease 19 (COVID-19) in Ghanaians remain poorly understood. We performed bulk transcriptome sequencing of nasopharyngeal samples from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-infected Ghanaians with mild and severe COVID-19, as well as healthy controls to characterize immune signatures at the primary SARS-CoV-2 infection site and identify drivers of disease severity. Generally, a heightened antiviral response was observed in SARS-CoV-2-infected Ghanaians compared with uninfected controls. COVID-19 severity was associated with immune suppression, overexpression of proinflammatory cytokines, including CRNN, IL1A, S100A7, and IL23A, and activation of pathways involved in keratinocyte proliferation. SAMD9L was among the differentially regulated interferon-stimulated genes in our mild and severe disease cohorts, suggesting that it may play a critical role in SARS-CoV-2 pathogenesis. By comparing our data with a publicly available dataset from a non-African (Indian) population (GSE166530), an elevated expression of antiviral response-related genes was noted in COVID-19-infected Ghanaians. Overall, the study describes immune signatures driving COVID-19 severity in Ghanaians and identifies immune drivers that could serve as potential prognostic markers for future outbreaks or pandemics. It further provides important preliminary evidence suggesting differences in antiviral response at the upper respiratory interface in sub-Saharan Africans (Ghanaians) and non-Africans, which could be contributing to the differences in disease outcomes. Further studies using Larger datasets from different populations will expand on these findings.Item COVID-19 in patients presenting with malaria like symptoms at a primary healthcare facility in Accra, Ghana(COVID-19 in patients presenting with malaria-like symptoms at a primary healthcare in Ghana, 2024) Asamoah, I.; Adusei-Poku, M.; Turkson, A.; Mohkta, Q.; et al.Background Malaria is a common and severe public health problem in Ghana and is largely responsible for febrile symptoms presented at health facilities in the country. Other infectious diseases, including COVID-19, may mimic malaria due to their shared non-specific symptoms, such as fever and headache, thus leading to misdiagnosis. This study therefore investigated COVID-19 among patients presenting with malaria-like symptoms at Korle-Bu Polyclinic, Accra, Ghana. Methods This study enrolled 300 patients presenting with malaria-like symptoms aged 18 years. After consent was obtained from study patients, Two to three millilitres of whole blood, nasopharyngeal and oropharyngeal swab samples, were collected for screening of Plasmodium falciparum using malaria rapid diagnostic test, microscopy, nested PCR, and SARS-CoV-2 using SARS-CoV-2 antigen test and Real-time PCR, respectively. The plasma and whole blood were also used for COVID-19 antibody testing and full blood counts using a hematological analyzer. SARS-CoV-2 whole genome sequencing was performed using MinIon sequencing. Results The prevalence of malaria by microscopy, RDT and nested PCR were 2.3%, 2.3% and 2.7% respectively. The detection of SARS-CoV-2 by COVID-19 Rapid Antigen Test and Real-time PCR were 8.7% and 20%, respectively. The Delta variant was reported in 23 of 25 SARS-CoV-2 positives with CT values below 30. Headache was the most common syndrome presented by study participants (95%). comorbidities reported were hypertension,asthma and diabetes. One hundred and thirteen (37.8%) of the study participants had prior exposure to SARS-CoV-2 and (34/51) 66.7% of Astrazeneca-vaccinated patients had no IgG antibody. Conclusion It may be difficult to use clinical characteristics to distinguish between patients with COVID-19 having malaria-like symptoms. Detection of IgM using RDTs may be useful in predicting CT values for SARS-CoV-2 real-time PCR and therefore transmission.