Ghana Health Service Research Articles

Situational Analysis on the Impact of Perinatal Deaths Among Bereaved Families in Ghana.

Background: Annually, about 5.9 million perinatal deaths occur worldwide, leaving millions bereaved due to stillbirths or early neonatal deaths. The highest burden of stillbirths (97%) and newborn deaths (98%) occurs in lower- and middle-income countries, with the majority occurring in Sub-Saharan African countries. Method: This cross-sectional qualitative study was conducted to identify existing policies and protocols to support bereaved families, explore the needs of bereaved families, and to also assess the impact of perinatal death on families in Ghana. All in-depth interviews were audio-recorded, transcribed verbatim and analyzed thematically. The results were presented in narratives and supported with illustrative quotes from respondents. Results: In all, 42 in-depth interviews were conducted with 10 (23.8%) from the Northern belt (Upper East), 11 (26.2%) from the middle belt (Ashanti) and 21 (50.0%) from the Southern belt (Greater Accra). The study revealed that practicing health professionals and other stakeholders within the health service delivery chain were not aware of protocols, written guidelines or written documents to initiate counseling at the facility in the event of a mother losing a child. Most of the respondents did not know what to do in the event that a mother loses a baby during delivery or immediately after. Respondents were in favor of having a policy or guidelines which will help them to counsel families who go through perinatal bereavement. Respondents were of the view that it is important for families who experience perinatal grief to be supported. Conclusion: All staff who meet the pregnant mother during her pre-and-post-delivery stages should be trained on the use of guidelines or policies. There is the need to have a policy, train and equip health staff to ensure that families experiencing perinatal grief are provided with effective counseling. Ghana Health Service should consider training and recruiting professional counselors who will support the health staff in dealing with perinatal grief.

Ghana health service performance appraisal system: a cross-sectional study on practices and perceptions among employees in the Bono East Region of Ghana, West Africa.

the fulcrum of every organization lies in the productivity of its employees. Consequently, organizations have adopted a policy of fostering an organizational culture that promotes employee development, resulting in the consistent use of performance evaluation systems particularly, performance appraisals (PA). Nonetheless, the issue of concern for several organizations is whether PA will truly be an adequate tool for maximizing employee´s performance. Here is where it becomes important to gauge the perceptions and practices of Ghana Health Service (GHS) employees in the Bono East Region of Ghana, West Africa, towards these performance appraisal systems (PAS). the study used an institutional-based cross-sectional study. Using simple random sampling, 375 health workers were recruited using a structured questionnaire. Data was analyzed using Stata. Bivariate and multivariate logistic regression analysis was performed and p-value less than 0.05 was considered statistical significance. the study revealed that the majority of the respondents (86.7%) had completed the performance appraisal form. Out of which 47.7% complete and submit PA every year, followed by those who complete and submit during promotion time (24.3%), every half year (15.1%) and anytime (12.9%). The key determinants of PA completion include; increasing age (AOR=2.24, 95% CI: 1.08-4.62), male staff (AOR=2.38, 95% CI: 1.16-4.91), permanent GHS employees (AOR=2.9, 95% CI: 1.07-7.86), respondents who had worked for 3 to 7 years (AOR=5.53, 95% CI: 2.48-12.36) and those with over 7 years working experience (AOR=20.80, 95% CI: 5.43-79.74). the study identified that the majority of the respondents completed PA, but quite an encouraging number of them do not complete PA at the required period as expected. Age, male staff, permanent employment, and increasing years of experience were the significant predictors of PA completion. Continuous professional development for GHS staff on PAS is required. The GHS human resource division should organize stakeholders´ engagement with facilities managers and employees on the PAS to inform all managers and employees on what is required from everyone.

Effects of Supply Chain Visibility on Supply Chain Performance in Ghana Health Service: The Case of Kumasi Metro Health Directorate

The integration of supply chain visibility has become very necessary in today’s corporate world. For quality health delivery system to be realised, the critical role of supply chain management cannot be overlooked. This study, which is more of quantitative study examined the effects of supply chain visibility on supply chain performance of Ghana health service. The study used Kumasi Metro Health Directorate as the case study and employed questionnaire to collect data. Both descriptive and inferential statistics were utilized to analyze the data gathered from the study area. Additionally, mean and standard deviation as well as frequencies and percentages were the main descriptive statistics used. Regression analysis was conducted to establish the effect of SCV on SCP. It was revealed that most respondents have a fair idea of the strategies being used to implement supply chain visibility in Kumasi Metro Health directorate. The study identified exchanging or sharing of information, use of asset status knowledge and improved electronic dissemination as SCV measures employed at Kumasi Metro Health Directorate. The findings also revealed that technological constraints, lack of synergy between automated systems and manual operations, inconsistencies in the flow of data between stakeholders, lack of communication between staff and management and budget constraint were noted as some of the bottlenecks that impede the smooth implementation of SCV in the Kumasi Metro Health Directorate. It was also found that Supply Chain Visibility has a positive effect on the supply chain performance of Kumasi Metro Health directorate. It is therefore recommended that Kumasi Metro Health directorate adopt effective networking programs as the basis for enhancing supply chain efficiency and performance.

Clinical presentation and persistent symptoms in patients at a post-COVID-19 clinic in Ghana.

on March 11th, 2020, the World Health Organization recognized COVID-19 as a pandemic. By March 31st, 2021, the Ghana Health Service had recorded a cumulative 90,782 positive cases and 748 deaths in the country. Despite the significant resources and efforts being put into containing and treating individuals with COVID-19, there is a lack of information within sub-Saharan Africa on clinical presentations and factors associated with experiencing persistent symptoms of COVID-19. in this retrospective study, we collected data obtained from patients with COVID-19 who were discharged from the post-COVID-19 clinic at the Ga East Municipal Hospital, Ghana, between April 1st, 2020, and March 31st, 2021, to assess clinical presentations and identify predictors of COVID-19 symptoms that persist beyond 14 days from the onset of the symptom. of the 253 patients who experienced symptoms of COVID-19, 81 (32.0%) experienced symptoms that persisted beyond 14 days. Cough (64.0%), headache (38.7%), and chest pain (28.1%) were the most common symptoms. After adjusting for covariates, the odds of patients presenting with COVID-19 symptoms that persist beyond 14 days are 98% higher among patients who experienced chest pain compared to those who did not and 2% increased for each additional year of their age. patient´s age and experiencing chest pain were significant predictors of symptoms that persist beyond 14 days. The findings of our study highlight the need to continue to monitor and care for individuals with identified predictors of experiencing persistent symptoms of COVID-19.

Determinants of tuberculosis treatment support costs to the treatment supporters in rural Ghana.

The Ghana Health Service has been implementing the Directly Observed Therapy Short Course (DOTS) strategy for decades now, to cure and reduce the transmission of tuberculosis. DOTS strategy requires TB patients and their treatment supporters to make multiple clinic visits in the course of treatment, and this may place financial burden on treatment supporters with low socio-economic status. However, the determinants of tuberculosis treatment support costs to treatment supporters are unknown in Ghana. This study determined the costs associated with treatment support to the treatment supporters in Bono Region, Ghana. In a cross-sectional study using cost-of-illness approach, 385 treatment supporters were selected and interviewed. A validated questionnaire for the direct and indirect costs incurred was used. Descriptive statistics and bivariate techniques were used for data analysis. Averagely, each treatment supporter spent GHS 122.4 (US$ 21.1) on treatment support activities per month, which is about 19% of their monthly income. The findings also revealed that highest level of education, household size, monthly income and district of residence were significant predictors of the direct costs. On the other hand, gender of the respondents, highest level of education, ethnicity, household size, income level and relationship with patient were some of the factors that significantly influenced the indirect costs. The significance levels were set at a 95% confidence interval and p < 0.05. The study concludes that the estimated cost associated with assisting tuberculosis patients with treatment is significant to treatment supporters. If these costs are not mitigated, they have the tendency of affecting the socio-economic status and welfare of individuals assisting tuberculosis patients with treatment.

Health-Seeking Behavior of Diabetic and Hypertensive Patients in Rural Communities of Ghana

Background: This study examined the health-seeking behaviors of patients with diabetes and hypertension in rural communities in Ghana. In Ghana, most studies on diabetes and hypertension are clinically oriented. However, medical-sociological truism suggests that attitudes towards health and illnesses, such as hypertension and diabetes, have a social-cultural perspective.&#x0D; Method: This study adopted a qualitative approach where twenty (20) participants who were either diabetic, hypertensive, or both were interviewed.&#x0D; Results: One of the study's significant findings was that diabetics/hypertensives use only orthodox hospitals to treat their conditions. Another finding was that the problems and challenges diabetics and hypertensives face include financial difficulties, social isolation, and stigmatization.&#x0D; Conclusion: Recommendations were made based on these findings. For instance, the registered traditional medicine practitioners should collaborate with the Ghana Health Service to intensify education on the importance of using certified traditional medicines in the treatment and management of diabetes and hypertension and provide customer-age-factor services at the various health facilities for persons with chronic diseases such as diabetics and hypertension.

Epidemiology of influenza in Ghana, 2011 to 2019.

Influenza virus is an important contributor to acute respiratory illnesses and is estimated to cause up to 650,000 respiratory deaths each year. Ghana recorded influenza viruses as far back as 1918 when the Spanish influenza pandemic led to the death of >100,000 people in a population of 4 million at the time. An outbreak of highly pathogenic avian influenza A(H5N1) among poultry in Ghana in 2007, led to the establishment of virological surveillance for influenza-like illness (ILI) by the Noguchi Memorial Institute for Medical Research (NMIMR). This surveillance system, supported by the U.S. Naval Medical Research Unit-No. 3 (NAMRU-3) and the Ghana Health Service (GHS), monitors circulating influenza strains and activity to better understand the epidemiology of influenza in Ghana. We present here the results of this surveillance system from 2011 to 2019. As part of the Integrated Disease Surveillance and Response (IDSR) system of the GHS under the Ministry of Health (MOH), oropharyngeal and nasopharyngeal swabs were collected from patients who met a modified World Health Organization (WHO) case definition for ILI or severe acute respiratory illness (SARI) through a sentinel surveillance system in the country. Samples were transported to the National Influenza Centre (NIC) at the NMIMR and tested for influenza virus using protocols defined by the United States Centers for Disease Control and Prevention (CDC). Selected isolates were sent to the WHO collaborating centre in the United Kingdom for further antigenic characterization. From 2011 to 2019, the NIC tested a total of 21,747 ILI samples and 3,429 SARI samples. Influenza positivity rates were highest in the 5-14 year old group for both ILI (20.8%) and SARI (23.8%). Compared to females, more males were seen at the health facilities for ILI and SARI symptoms with a statistically significant difference in influenza positive ILI (15% vs 13.2%, p <0.001). In terms of absolute numbers, more cases were seen at the health centres during the wet seasons (April to October) compared to the dry seasons (November to March) in Ghana. This study presents 9 years of surveillance data from outpatient and inpatient setting on influenza activity as well as the influenza A subtypes and B lineages that drive the activity. This presents useful information for influenza vaccine selection and administration. Ghana's unique influenza activity patterns also present a challenge in predicting when an outbreak could occur.

OP51 Improving Childhood Cancer Management And Financing In Ghana: Results From Stakeholder Mapping and Analysis

IntroductionCoverage of childhood cancer treatment under the Ghanaian National Health Insurance Scheme (NHIS) has been a policy discussion recently. To improve priority setting, Ghana introduced and used health technology assessment (HTA) processes to guide the resource allocation. To understand the role of stakeholders throughout the HTA lifecycle and for this decision, a stakeholder mapping and engagement was undertaken. We share our results of this mapping and analysis for improving management and financing of childhood cancers in Ghana.MethodsWe used two main approaches; first, we undertook a systematic policy documents and literature review of stakeholders relevant in childhood cancer management and financing in Ghana. This was followed by a stakeholder engagement workshop of key stakeholders from the Ministry of Health, Ghana Health Service (GHS), National Health Insurance Authority (NHIA), academia, non-governmental organizations (NGOs), private sector, teaching hospitals, patient groups, and civil society organizations. Participation was done in-person and virtual. Questions were moderated using a focus group discussion approach where responses were recorded. Data were analysed using synthesis and development of themes. Mapping of stakeholders was done using Mendelow’s power-interest grid.ResultsThe mapping identified eight key stakeholders in different roles: policy makers (Ministry of Health), payer (NHIA), healthcare providers (teaching hospitals, GHS, private hospitals), pharmaceutical companies, patient group (Ghana Parents Association for Childhood Cancers), and advocacy group (NGOs). Analysis showed that power and interest are concentrated with Ministry of Health and NHIA primarily because of control over resources. Also, while healthcare providers, patient groups, and advocacy groups have high interest, their power ranges from low to moderate. Further analysis of data from the workshop revealed that inability to pay for high cost of treatment leads to treatment abandonment. Payment for treatment was mainly out-of-pocket and by donation from philanthropist.ConclusionsThere was a strong will from stakeholders to extend coverage of the NHIS to childhood cancers in Ghana. Stakeholder engagement is a powerful tool and should be an integral part of every HTA process.

Pattern and outcomes of medical malpractice cases in Ghana: a systematic content analysis.

Medical malpractice complaints are apparently on the rise in Ghana. Though it has been suggested that medico-legal training programmes should emphasise the kinds of legal problems that healthcare staff encounter most frequently in practice, no comprehensive study currently analyses the pattern and outcomes of existing case laws. Systematic content analysis. Medical malpractice case laws sourced from Ghanaian legal repositories, media platforms and other grey literature sources. Nine case laws were retained. Most of the cases (n=7) involved negligence. Emerging patterns of cases are complex, including patients' access to their medical records, practising without a license/ out of scope, refusal to treat, and the development of complications following surgical interventions. Obstetrics & Gynaecology, Surgery, and Paediatrics were the main clinical specialties involved in the malpractice cases identified. The pattern of the cases suggests that all medical specialties are potentially at risk, although most of the cases emerged from Obstetrics & Gynaecology, Surgery, and Paediatrics. Medico-legal training for healthcare staff should emphasise the duty of care and adherence to the Ghana Health Service Patient Charter. None declared.

Contraceptive use among female head porters: implications for health policy and programming in Ghana

ObjectiveDespite the growing literature on the barriers to contraceptives use among women, the perspective of female head porters has not been exhaustively researched. Using Bronfenbrenner's socio-ecological theory, we explore the factors that influence the contraceptive decision-making of migrant female head porters in the Kumasi Metropolis and the implications for health policy and planning. MethodologyA case study of female head porters in the Kumasi Metropolis was conducted. We employed a qualitative approach in the collection and analysis of the data. A combination of cluster, purposive, and convenience sampling procedures was used to select 48 migrant female head porters to participate in semi-structured in-depth interviews. The data collected were analyzed using the thematic analytical framework. ResultsWe found the main barriers to the uptake of contraception among the head porters to include high cost of contraceptives, perceived side effects associated with contraceptive use, and the disapproval of a male sexual partners. ConclusionThe findings indicate that head porters' contraceptive decision-making is largely influenced by their social and economic circumstances. To address these, we recommend a carefully tailored approach, starting with a free National Health Insurance Scheme (NHIS) enrollment policy for all head porters in the country. There is also the need for the Ghana Health Service, and NGOs in health to work together to create effective awareness among female head porters on the benefits and misconceptions of contraception by incorporating culturally appropriate education that would facilitate the adoption of positive attitudes towards contraception. Additionally, NGOs in health in collaboration with the health facilities should initiate a process that encourages joint reproductive health decision-making among partners which recognises the added value of men's participation. We argue that men's active participation in contraception decision-making could potentially address their scepticism towards uptake.

Utilisation of antenatal care and skilled delivery services among mothers in Nanton District of Northern Ghana: a mixed-method study protocol

IntroductionMaternal morbidity and mortality are a global phenomenon with devastating effects on low-income and middle-income countries among which sub-Saharan Africa (SSA) is the hardest hit. Low utilisation of maternal health...

Incidence and determinants of maternal sepsis in Ghana in the midst of a pandemic

BackgroundDespite being preventable, maternal sepsis continues to be a significant cause of death and morbidity, killing one in every four pregnant women globally. In Ghana, clinicians have observed that maternal sepsis is increasingly becoming a major contributor to maternal mortality. The lack of a consensus definition for maternal sepsis before 2017 created a gap in determining global and country-specific burden of maternal sepsis and its risk factors. This study determined the incidence and risk factors of clinically proven maternal sepsis in Ghana.MethodsWe conducted a prospective cohort study among 1476 randomly selected pregnant women in six health facilities in Ghana, from January to September 2020. Data were collected using primary data collection tools and reviewing the client’s charts. We estimated the incidence rate of maternal sepsis per 1,000 pregnant women per person-week. Poisson regression model and the cox-proportional hazard regression model estimators were used to assess risk factors associated with the incidence of maternal sepsis at a 5% significance level.ResultsThe overall incidence rate of maternal sepsis was 1.52 [95% CI: 1.20–1.96] per 1000 person-weeks. The majority of the participants entered the study at 10–13 weeks of gestation. The study participants' median body mass index score was 26.4 kgm−2 [22.9—30.1 kgm−2]. The risk of maternal sepsis was 4 times higher among women who developed urinary tract infection after delivery compared to those who did not (aHR: 4.38, 95% CI: 1.58–12.18, p < 0.05). Among those who developed caesarean section wound infection after delivery, the risk of maternal sepsis was 3 times higher compared to their counterparts (aHR: 3.77, 95% CI: 0.92–15.54, p < 0.05). Among pregnant women who showed any symptoms 14 days prior to exit from the study, the risk was significantly higher among pregnant women with a single symptom (aHR: 6.1, 95% CI: 2.42–15.21, p < 0.001) and those with two or more symptoms (aHR: 17.0, 95% CI: 4.19–69.00, p < 0.001).ConclusionsOur findings show a low incidence of maternal sepsis in Ghana compared to most Low and Middle-Income Countries. Nonetheless, Maternal sepsis remains an important contributor to the overall maternal mortality burden. It is essential clinicians pay more attention to ensure early and prompt diagnosis. Factors significantly predicting maternal sepsis in Ghana were additional maternal morbidity, urinary tract infections, dysuria, and multiple symptoms. We recommend that Ghana Health Service should institute a surveillance system for maternal sepsis as a monthly reportable disease.

Socio-demographic factors associated with medication adherence among People Living with HIV in the Kumasi Metropolis, Ghana

BackgroundMedication adherence is important to the survival of People Living with HIV (PLHIV) globally. Although, HIV viral load is reduced by antiretroviral therapy (ART), the number of people on ART continues to rise in Ghana. In the Kumasi Metropolis, Ghana, we looked at the socio-demographic factors associated with medication adherence among PLHIV.MethodsA quantitative study involving 420 PLHIV who sought healthcare at the Kumasi South Regional Hospital was conducted utilizing a cross-sectional study design. We employed a structured questionnaire to collect data on medication adherence using the eight-item Morisky Medication Adherence Scale (MMAS) and socio-demographic factors that influence medication adherence. The data were analysed using Stata 14.2. Frequencies and percentages were used to present the descriptive data. The association between socio-demographic factors and medication adherence among PLHIV was investigated using both univariate and multivariate analyses.ResultsMore than half (53.10%) of PLHIV adhered to ART. Place of residence was significantly established to be influencing medication adherence among PLHIV. PLHIV who were residing in urban centers (aOR = 3.61; CI = 2.24–5.82) were more likely to adhere to medication as compared to those who resided in rural areas.ConclusionSlightly more than half of PLHIV took their medicines as prescribed. Government and Policymakers such as the Ghana AIDS Commission, Ministry of Health, and Ghana Health Service should incorporate socio-demographic factors such as place of residence while creating and executing medication adherence initiatives to evaluate HIV management regimen for PLHIV.

Factors associated with COVID-19 knowledge among Ghanaians: A national survey.

Adequate knowledge about COVID-19 in a population may be relevant in the fight to control its spread among the populace. Thus, the aim of this study was to assess the factors associated with real knowledge of COVID-19 among Ghanaians to promote effective dissemination of appropriate information aimed at containing the spread. A cross-sectional online survey and computer assisted telephone interviews (CATI) was conducted among Ghanaians aged 18 years and above across the 260 districts of Ghana. The survey assessed the level of knowledge of COVID-19 and its associated factors and compared differences between perceived and real knowledge. One district health promotion officer per district was trained for the data collection. Participants were recruited via use of phone directories of both organized and non-organized local district groups. Phone calls were made to randomly selected phone contacts to schedule options for participation in the study. We used multivariable logistic regression to investigate the associated factors of COVID-19 knowledge among respondents. Of the 2,721 participants who completed the survey, the majority (99.3%) were aware of the existence of the COVID-19 outbreak, had good knowledge on infection prevention (87.0%) and rated their knowledge about COVID-19 as good (81.7%). Factors associated with COVID-19 knowledge were: age ≥56 years (aOR = 0.5; CI: 0.3-0.8; p = 0.002), tertiary education (aOR = 1.8; CI: 1.2-2.6; p = 0.003), residing in Greater Accra region (aOR = 2.0; CI: 1.1-3.6; p = 0.019), not infected with the novel coronavirus (aOR = 1.5; Cl: 1.0-2.1; p = 0.045), knowing an infected person (aOR = 3.5; CI = 1.5-7.9; p = 0.003), good practice of effective preventive measures (aOR = 1.2: Cl: 1.1-1.5: 0.008), not misinformed (aOR = 0.7; Cl: 0.5-0.9; 0.015), and perceiving spreading speed of the virus as slow (aOR = 0.7; Cl: 0.5-0.9; 0.007). The study found good knowledge regarding COVID-19, control measures, and preventive strategies. The Ghana Health Service should continuously provide accurate information to educate the media and citizens to prevent misinformation, which is vital in stopping the spread of the COVID-19 virus.

Operation and sustainability of Water, Sanitation and Hygiene (WASH) in schools: Evidence from a vulnerable and deprived area in Ghana

Abstract: Safe and adequate water supply and sanitation in schools are pre-requisites for the right to basic education for school children and the achievement of goal 4 and 6 of the Sustainable Development Goals. Nonetheless, Water, Sanitation and Hygiene (WASH) in schools is fraught with inadequacy of toilet and handwashing facilities, and poor sustainability mechanisms that threaten its success. This paper, therefore, assesses the operation and sustainability of WASH in schools in the Nabdam District of Ghana. Adopting a qualitative approach, thirty-seven semi-structured interviews were held to capture the understanding and experiences of students, head teachers, health officers, officials of the Ghana Health Service and District Education Directorate on the phenomena. Fifteen focus group discussions were further held with students in the basic schools. The findings indicate that WASH is poorly managed even though the schools studied had some established WASH facilities. WASH in the schools was bedeviled with challenges such as inadequate toilets and handwashing facilities, poor funding and ineffective WASH committees. The WASH committees lacked the capacity to raise funds and carry out their duties in accordance with the WASH implementation guidelines. The study recommends that the Ghana Education Service organizes periodic capacity building programs for WASH committees to address this shortcoming. The Ministry of Education should support basic schools in districts in their efforts to provide WASH facilities and fund WASH activities. The study also calls for the formation of student WASH clubs and sanitation brigades to promote the operation and sustainability of WASH in schools.

Poor knowledge and awareness of human papillomavirus and cervical cancer among adult females in rural Ghana

Cervical cancer (CC) continues to be a global burden, and a disease of public health interest, especially in low- and middle-income countries. This study explored the knowledge and awareness of human papillomavirus (HPV) infection and CC and the risk-behavioural characteristics of an adult female population in rural Ghana. A total of 274 women, aged 21 years and above were recruited through multi-stage sampling. A questionnaire was used to obtain data on their socio-demographic and socio-economic characteristics and assess their knowledge and awareness of HPV and CC through face-to-face interviews. In all, 187 (68.2%) participants had poor knowledge of HPV and CC with 87 (31.8%) having good knowledge. Only 18.2% and 48.9% of them had prior awareness of HPV infection and CC, respectively. Their primary source of information was the broadcast media (TV and Radio stations) (60.1%). Regarding risky lifestyle behaviours, the mean age at sexual debut was 18.52 ± 2.39 years, 82.8% have had more than one lifetime sexual partner, 81.0% were multiparous with 51.5% using oral contraceptives. Women with higher educational attainment (cOR = 0.41; 95%CI = 0.20-0.81), monthly income (cOR = 0.31; 95%CI = 0.10-1.02), and lifetime sexual partners (aOR = 0.46; 95%CI = 0.21-1.00) were less likely to have poor CC and HPV knowledge compared to their counterparts. In conclusion, adult females in the rural population have limited knowledge and awareness of HPV infection and CC with low CC screening. Intensive educational campaigns should be organised and spearheaded on multiple platforms by the Ghana Health Service and civil societies to sensitise and educate women, in the rural parts of the country, on CC and its related preventive measures.

Marburg virus in Ghana: A public health threat to Ghanaians and to Africans

AbstractThe Marburg virus disease (MVD) outbreak in Ghana and the re‐emergence of other infectious diseases in Africa require a unified effort to fight these highly infectious health threats. Although no new cases have been reported after the three MVD confirmed cases, Ghana Health Service (GHS), and Health Authorities of neighbouring countries are on the alert to identify any new cases and deal with them at the earliest. Public health measures, however, inadequate, are in place in Ghana. Varied challenges remain in the fight against these outbreaks. All known public health measures must be brought to bear in the fight. African governments must resource the African Centre for Diseases Control and Prevention, in its efforts to augment the various country‐level health services in the fight against the threats. African governments, citizens, development partners, and foreign governments must commit to fighting these diseases before they turn into pandemics.

Strengthening surveillance in Ghana against public health emergencies of international concern

Among western African countries, the Republic of Ghana has maintained an economic growth rate of 5% since the 1980s and is now categorized as a middle-income country. However, as with other developing countries, Ghana still has challenges in the effective implementation of surveillance for infectious diseases. Facing public health emergencies of international concern (PHEIC), it is crucial to establish a reliable sample transportation system to the referral laboratory. Previously, surveillance capacity in Ghana was limited based on Integrated Disease Surveillance and Response, and therefore the “Surveillance and Laboratory Support for Emerging Pathogens of Public Health Importance in Ghana (SLEP)” was introduced to strengthen diarrhea surveillance. The SLEP project started with a sentinel diarrhea survey supported by SATREPS/JICA in collaboration with National Public Health Reference Laboratory (NHPRL) and Noguchi Memorial Institute of Medicine (NMIMR). The base-line survey revealed the limited capacity to detect diarrhea pathogens and to transfer samples from health centers to NHPRL. The involvement of private clinic/hospital facilities into the surveillance network is also crucial to strengthen surveillance in Ghana. The strong and interactive relationship between the two top referral laboratories, NHPRL under the Ministry of Health NMIMR and under the Ministry of Education, enables Ghana Health Services and is critical for the rapid response against PHEIC. In future, we hope that the outcome of the SLEP surveillance project could contribute to building a surveillance network with more timely investigation and transfer of samples to referral labs.

Comparison of adiposity anthropometric indices and their associations with visceral fat levels determined by bioelectrical impedance analysis among diabetic patients

Visceral fat (VF) and its effect on metabolic disorders have been extensively studied; nevertheless, there is a need for a simple and reliable index to equally assess VF in low-resource settings. This multihospital-based study was designed to compare the five adiposity anthropometric indices and their associations with VF levels determined by bioelectrical impedance analysis as the reference standard among diabetic patients. A pretested questionnaire was used to collect anthropometric, biochemical and hemodynamic data from 473 diabetic patients. Regression analysis was performed to determine the associations between the five adiposity anthropometric indices and VF levels. Receiver operating characteristic (ROC) curves were used to confirm the predictive capacities of the five adiposity anthropometric indices with VF levels. The waist-to-height ratio WHtR showed the greatest ROC value [area under the curve (AUC) = 0.745, p ˂0.001] in identifying diabetic patients with high VF levels compared to body mass index BMI [AUC = 0.584, p = 0.047], waist circumference WC [AUC = 0.723, p ˂0.001], hip circumference HC [AUC = 0.647, p ˂0.001] and waist-to-hip ratio WHR [AUC = 0.711, p ˂0.001]. Likewise, the regression analysis of WHtR and VF levels revealed the strongest association [unadjusted odds ratio (UOR) = 21.49, p < 0.001] compared to BMI [UOR = 6.77, p = 0.008], WC [UOR = 6.37, p < 0.001], HC [UOR = 5.93, p = 0.002] and WHR [UOR = 13.17, p < 0.001]. The optimal cut-off values to identify diabetic patients with high VF levels were > 0.5 for WHtR, > 25.7 kg/m2 for BMI, > 80.5 cm for WC, > 95.5 cm for HC and > 0.82 for WHR. WHtR was shown to have overpowered BMI, HC, WC and WHR in identifying diabetic patients with high VF levels. Therefore, the Ghana Health Service could recommend WHtR as a better diagnostic index for assessing VF levels due to its high predictive capacity.

Occupational Health and Safety Issues among Artisans in the Bibiani Municipality

This study sought to identify and document key issues affecting occupational health and safety among artisans in the informal sector in the Bibiani Municipality of the Western North Region of Ghana. To realize this objective, a descriptive cross-sectional study using the qualitative approach was employed. This was done after an ethical clearance had been obtained from the Ghana Health Service Ethics Committee and prior consent was sought from all participants and managers of the study sites. A total of fifteen artisans participated in the study. The artisans spanned three major categories namely: fabrication, construction, and auto mechanic. A semi-structured interview guide was used to obtain responses from the participants through in-depth interviews. Valuable notes were also made from observations during the interview process. Data from the interview were transcribed, coded, and analyzed thematically. Firstly, most respondents displayed adequate knowledge of the concept of occupational health and safety, especially in the area of hazard identification. Secondly, most of the respondents showed positive attitudes toward occupational health and safety. This was evident in their expressed prioritization of occupational safety among all other factors needed to be productive at work. Thirdly, the artisans exhibited an appreciable level of occupational safety practices. Each respondent used at least one PPE on a regular basis. Finally, it was observed that the emergency preparedness of the respondents in the area of first aid responses and fire outbreak management was inadequate. The findings showed that there is more room for improvement for the artisans in the informal sector with regard to their knowledge, attitudes, and utilization of safe practices. There must be regular training for artisans to help update their knowledge and practices on occupational health and safety issues. The district and municipal authorities together with the Environmental Protection Agency (EPA) must organize such training on a regular basis for artisans. Artisans must be strongly encouraged to join well-organized associations to make such training effective. There must be a national law targeting occupational health and safety issues for workers in the informal sector, with an enforcement regime visible at the local level. This will help improve compliance and minimize the incidents of workplace injuries and ill health.