Services In Ghana Research Articles

Utilisation of Skilled Delivery in Ghana: A Systematic Review

Background: Access to a doctor, nurse, or a midwife during childbirth is key to the global effort to reduce maternal mortality ratios. Ghana has recorded significant improvements in maternal care over the past three decades. However, despite many policies aimed at improving health care for pregnant women such as the free maternal care policy, many Ghanaian women still deliver without a skilled birth attendant present. This systematic review, therefore, sought to identify the various factors affecting utilisation of skilled birth attendance in Ghana. Methods: PubMed Central, African Journals Online (AJOL), CINAHL Plus with Full Text (EBSCO), and Science Direct were searched for studies from January 2010 to December 2020. A broad range of search terms was used. Studies included had diverse designs, were conducted among Ghanaian pregnant women, and had skilled delivery as an outcome of interest. The quality of studies was assessed. Due to the diversity of types of studies included in this systematic review (including qualitative, descriptive, and evaluative studies that ranged from simple bivariate analyses to complex multivariate modelling), a meta-analysis was neither possible nor appropriate. We, therefore, conducted a narrative synthesis of the search findings. Results: Twenty-four (24) studies met our inclusion criteria for this review. Included studies comprised sixteen (16) cross-sectional studies and eight (8) qualitative studies. The sample size of the included studies cumulatively was 86,998 participants. The emerging themes were: health system factors (10); maternal and family factors (5); and sociodemographic factors (9). Conclusion: In general, health system factors; maternal and family factors; and sociodemographic factors were found to influence skilled delivery services in Ghana. Therefore, in order to ensure that there is a skilled birth attendant present at every birth, efforts should aim at addressing social and cultural factors which have been identified as key determinants to utilisation of skilled delivery in Ghana.

Evaluating farmers\u2019 perception toward the effectiveness of agricultural extension services in Ghana and Zambia

BackgroundIn this study, we present the current situation and the role of agricultural extension services for farmers and indicates the potential solutions for the optimum effectiveness of these services. Thus, we investigate the vital determinants influencing the farmers’ attitudes toward using agricultural extension services in Ghana and Zambia.MethodsIn this study, we used a mixed-method research analysis of data from a household survey of 240 farmers and 8 key informant interviews in the Upper West Region of Ghana and the Southern Province of Zambia.ResultsThe significant factors affecting the association of agricultural extension officers with farmers are regular meetings, demand for services and productivity, and the adoption rate of technology. Notably, approaches based on information communication technology indicators include owning cell phones; further, having radio access significantly affects agricultural practices. However, the role of gender, access to credit, and owning a television would influence food safety and nutrition.ConclusionsUnderstanding the critical determinants will provide potential solutions to national agricultural research institutes, private research entities, and policymakers to scale-up the effectiveness of agricultural extension services, particularly in Ghana and Zambia.

Pooled procurement programme: efficiency and challenges in medicinal health care – perspectives from National Catholic Health Service in Ghana

Abstract Objective This article explores the efficiency and the challenges of the pooled procurement programme (PPP) among National Catholic Health Service (NCHS) members using the stakeholder theory. Method This article used the qualitative research approach relying on a multiple case study design to conduct 20 in-depth interviews with respondents working within the health facilities and the secretariat of the NCHS. Key findings This article established that the PPP improved accessibility, quality, availability and ensured solidarity between the health facilities within the NCHS. This ensured efficient PPP management in the health facilities. Although a 30% reduction in the average cost of medicines was achieved in the first 3 years of the programme’s inception, prompt payment of the National Health Insurance Scheme (NHIS) could further drive down costs of medicines. Notwithstanding, there were other teething challenges such as inadequate consultation between the health facilities and the secretariat, inadequate physical structures, poor internet accessibility and inadequate coverage of the PPP. Conclusion The article contributes to medicine health services research literature in the context of using the PPP in Ghana in procuring medicines. This article suggests that monitoring and evaluation of the procurement procedures in the health facilities are critical in guaranteeing compliance with the pooled procurement guidelines by participating healthcare providers.

Delivery of Preconception Counselling Services: The Snags of Health Care Service Providers.

Purpose: This study investigates the difficulties the health care service providers encounter in the quest of rendering preconception counselling services in Ghana.
 Methodology: The study employed descriptive survey design with the use of both qualitative and quantitative research approaches using questionnaire as the main tool. The study employed simple random sampling to sampled 135 out of 675 health care service providers from 23 health facilities in the Bole District of the Savanna Region in Ghana. The quantitative data obtained for the study was analysed using Statistical Package for Social Solution (SPSS) whilst the qualitative data were subjected to descriptive and narrative discussion.
 Findings: The study revealed that, health care practitioners need continuous training programme. It also became clear that, there no any clear national guideline or policy on preconception counselling in Ghana. It came to light that, the healthcare service providers face a lot of difficulties to capture women of child bearing age to offer them the services. Inadequate knowledge and expertise to effectively offer the preconception counselling services was also identified as a challenge.
 Recommendations: The study therefore recommend that the Ministry of Health and Ghana Health Service should come out with a clear policy guideline on preconception counselling and also provide an intensive training for the health care professionals. The health care providers should also be provided with the needed resources to embark on sensitisation and advocacy campaigns to create the awareness for women of childbearing age to appreciate the need for preconception and genetic carrier risk counselling.

Surveying and mapping breast cancer services in Ghana: a cross-sectional pilot study in the Eastern Region

ObjectivesDefine the services available for the care of breast cancer at hospitals in the Eastern Region of Ghana, identify areas of the region with limited access to care through geospatial...

Towards Financial Sustainability: Beneficiaries’ Perception and Performance of Community Water Supply Services in Ghana

Revenue mobilization is critical for community-managed water systems to overcome financial constraints and to achieve financial sustainability. Using data from beneficiaries of a community managed water supply system in Ghana, we employed descriptive statistics, chi-square, perception index and document review of the system’s financial reports to assess beneficiaries’ views and perception on revenue mobilization for operations and maintenance, system expansion as well as sustainability of the project. The results showed that revenue mobilization for sustainability of operations and maintenance is significantly influenced by water connection type and religion while marital status, age and income of beneficiaries determine sustainability of the project’s expansion. The findings further revealed a significant relationship between sustainability of replacement of the project’s accessories and water connection type as well as gender, marital status, age and income of beneficiaries. The average perception index of 3.2 showed that beneficiaries perceived revenue mobilization as very good for replacing the water system’s accessories. Revenue mobilization is able to support the water system’s expansion to help meet the increasing water demands. In addition, with an average perception index of 3.6, the beneficiaries’ perception was that revenue was enough to fund operations and maintenance. Furthermore, the document review of the system’s financial reports confirmed beneficiaries’ perception of sufficiency of revenue for operations and maintenance. Finally, we found weaknesses in revenue mobilization with over 40% of bills in arrears, mostly from private users. To build resilience to the financial crisis with enhanced innovations, the study recommends the institution of effective debt recovery strategies such as the provision of pre-paid metering for private users, adoption of a public standpipe pay-as-you-fetch system as well as the introduction of smart tap technology for public standpipes in community-managed water supply systems.

Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study

BackgroundHuman Papillomavirus (HPV) infection is the main etiological factor for pre-invasive and invasive cervical cancer. HPV type-specific vaccination is being widely recommended to control the burden of disease, but the genotype-specific distribution of HPV may vary in different countries. The aim of the study was to determine the prevalence and distribution of HPV genotypes among women attending reproductive health services in Ghana, their associated risk factors, and to assess the potential coverage of identified HPV genotypes by three licensed vaccines among these women.MethodWomen presenting for reproductive health services in two regional hospitals in Accra and Kumasi from October 2014 to March 2015 were conveniently recruited into the study (n = 317). HPV-DNA detection and genotype identification were carried out by a nested multiplex PCR assay that combines degenerate E6/E7 consensus primers and type-specific primers for the detection and typing of eighteen HPV genotypes. Cytology was performed to screen women for cervical cancer lesions. Risk factors for HPV infection were analyzed by logistic regression. Statistical significance was accepted for p < 0.05.ResultsThe age of study participants ranged from 21 to 76 years. Among women positive for HPV, 35.0% were infected with high-risk HPV, 14.5% with probable high-risk HPV, and 17.0% with low-risk HPV. The prevalence of HPV 16/18 was 8.2%, HPV 6/11/16/18 was 9.1% and HPV 6/11/16/18/31/33/45/52/58 was 28.4%. The most prevalent among HR-HPV were types 52 (18.3%) and 58 (8.8%). HPV positivity may be associated with educational background (p < 0.001), age at first pregnancy (p = 0.028), and age at coitarche (p = 0.016).ConclusionsOur study revealed a high prevalence of HR-HPV infection among women. The high prevalence of HR HPV indicates that multivalent vaccines will be useful for controlling HPV burden in general population contexts. The distribution of HPVs in this population suggests that of the three currently available vaccines the nonavalent vaccine, which protects against seven HPV types in addition to HPV 16 and 18, has the highest coverage of HPV infections among Ghanaian women. Healthcare officials planning to reduce the transmission of HPV and cervical cancer must consider the coverage of the nonavalent vaccine as an advantage.

A social media strategy for academic libraries

This study was carried out to analyse strategies regarding the use of social media for academic library services in Ghana. The research design was quantitative and adopted the survey approach. Questionnaires served as the main data collection instrument. The study population comprised of one hundred and ten library staff from public and private universities in Ghana. As indicated by the study results, the library staff agreed that there was a need for a well-formulated social media strategy to help academic libraries identify the most appropriate social media tools, establish contact with targeted audience, and increase engagement rates to enable an effective and efficient distribution of its resources and services. The results also indicated that the academic libraries, however, seem to neglect these strategies which could drive patrons' use of such platforms. Recommendations therefore suggest the need to implement social media plans and policies, user engagement, social media update, and dedicated staff with the requisite skills in the use of social media platforms for library services delivery.

Assessing the Effectiveness of E-Government Services in Ghana

The adoption and implantation of electronic government service are on the rise as government services to citizens through electronic means has increased. However, assessing the effectiveness of e-government systems is still limited in the literature. This study sort to evaluate the effectiveness and benefits of information systems (E-registrar) at the Registrar General Department (RGD) in Ghana, using the updated DeLone and McLean IS Success Model. Via the purposive sampling technique, data for the study were collected from 102 staff of RGD and analyzed following the Partial Least Squares Structural Equation Modelling (PLS-SEM) technique. The results of the study indicate that Service Quality, System Quality, and Information Quality positively influence System Usage and User Satisfaction. Also, System Usage and User Satisfaction positively influence the Net Benefits derived from the E-Registrar system. The findings provide a relevant recommendation to policymakers and management of organizations when it comes to information systems implementation.

What alternative and innovative domestic methods of healthcare financing can be explored to fix the current claims reimbursement challenges by the National Health Insurance Scheme of Ghana? Perspectives of health managers

BackgroundLow-and-middle -income countries (LMICs), to achieve sustainable universal health coverage (UHC) governments are implementing local and sustainable methods of healthcare financing. However, in Ghana, there is limited evidence on these local methods for healthcare financing to inform policy. This study aimed at exploring health managers views on alternative domestic and sustainable methods of healthcare financing for UHC under the National Health Insurance Scheme (NHIS).MethodsA qualitative study using in-depth interviews with 16 health facility managers were held. The health facilities and participants were selected using convenience and purposive sampling methods. A written consent was obtained from participants prior to participation in the interview. Data was transcribed verbatim and analyzed using thematic framework approach.ResultsHealth managers across all the health facilities mentioned delayed and erratic claims reimbursement to health facilities as the main challenge. Participants attributed the main reason to lack of funds by the National Health Insurance Authority (NHIA). They said the delayed and irregular payments has been a challenge to efficient delivery of quality healthcare to clients. That in some instances they have been compelled to demand cash or out-of-pocket payment from insured clients or insurance card bearers to be able to render needed healthcare services to them. Participants think that to ensure regular reimbursement of claims to the health facilities by the NHIA, the managers think alternative local sources of funding need to be explored to fill the funding gap. To put in place this, they suggested the need to start levying special taxes on natural resources such as crude oil and gas, gold, bauxite, cocoa, mobile money transfers, airtime and increasing the proportion of levies on the existing Value Added Tax (VAT).ConclusionThe study provides important insights into potential innovative alternative domestic sources for raising additional funds to finance healthcare services in Ghana. Despite the potential of these sources, it is important for governments and health policy makers in Ghana and other LMICs who are working towards implementing innovative local methods using special levies on mobile communication services and natural resources to finance their UHC, to implement those that best suit their economies to ensure equity for better health.

Assessing health system factors affecting access and delivery of IPTp-SP and ITN to pregnant women attending ANC clinics in Ghana

IntroductionMalaria interventions including use of Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment (IPTp-SP) and distribution of Insecticide Treated Nets (ITNs) have been implemented through ante-natal clinic (ANC) services in Ghana. Yet, the high ANC attendance is not commensurate with the uptake of these interventions, with missed opportunities to deliver the interventions. This study sought to assess the health system factors affecting access and delivery of IPTp-SP and ITN as defined by the Ghana Malaria Policy Guideline to eligible pregnant women attending ANC clinic sessions.MethodsA quantitative cross-sectional study was conducted in the Volta Region of Ghana, with data collected across three levels of health care delivery facilities, including hospitals, health centres and Community-Based Health Planning Service (CHPS) compounds. Data collection included structured observation checklists to document the communication and interaction between the ANC health staff and pregnant women. Additionally, structured questionnaires were used to elicit information on cadre, trainings attended, knowledge and delivery practices of health workers on IPTp-SP and ITN. Stata 16 was used for data analysis, and a defined delivery algorithm was used to compute appropriate and inappropriate delivery practices, using the Ghana policy directive as a guide. Predictors of appropriate delivery were determined using logistic regression analysis.ResultsApproximately 97% of the 680 ANC observations had complete information for analysis. Of these, 78% (511/657) were eligible for IPTp-SP after excluding women who have less than 16 weeks of gestation, G6PD deficient, malaria positive and have taken 5 doses of IPTp-SP prior to day of observation. Appropriate delivery of IPTp-SP was 76% (390/511). Despite the availability of SP, 15% (75/511) of all eligible women were not offered the medication and 37% (44/119) of inappropriate delivery was recorded during periods of stock out. ITNs were appropriately delivered to 59% (139) out of 237 eligible women. Thirty-two percent (77/237) of eligible women, mostly continuing ANC clients, were not given ITN despite stock availability.ConclusionsIPTp-SP was appropriately delivered to most of the eligible pregnant women compared to ITN. While stock out of both intervention could account for inappropriate delivery, despite stock availability, IPTp-SP and ITN were not delivered to some eligible women.

DRIVERS, INHIBITORS AND IMPLICATIONS OF EFFECTIVE COMPLAINT MANAGEMENT AMONG HEALTHCARE INSTITUTION IN AN EMERGING ECONOMY: A CASE OF THE UNIVERSITY OF GHANA HOSPITAL.

Purpose: Complaint Management (CM) is significant in improving the quality of healthcare service delivery. There is a dearth of knowledge regarding CM in healthcare service in Ghana. This paper aims at exploring the drivers, inhibitors, implications and influence of leadership on effective CM in healthcare service delivery.&#x0D; Methodology: A qualitative methodology was used. Data were collected through in-depth semi-structured interviews with 20 purposively selected informants. Data were transcribed and analysed thematically.&#x0D; Findings: The evidence suggests that there are some notable drivers, inhibitors, and implications of CM in healthcare service delivery. The study found that customer complaint, customer satisfaction, customer feedback, customer loyalty, customer retention, quality assurance, competitive advantage, compensation, culture, and speedy recovery are the drivers to effective CM in healthcare service delivery. However, regarding the factors that inhibit effective CM in healthcare service delivery, the study found insufficient skilled personnel, inadequate technology, lack of infrastructure, inadequate resources/funds and lack of oversight responsibility or control, lack of accountability, unresponsiveness, and unacceptance of mistakes/complaint. The study provides insight that effective CM has significant implications on customer satisfaction, customer loyalty, customer retention/commitment, institutional reputation/image, organisational performance, profitability, and good staff attitude. The results of the research corroborate the perception that leadership style influences the effectiveness of CM in healthcare service delivery.&#x0D; Recommendation: The study strongly recommend the establishment of CM department with the requisite logistics and accessories to promote effective handling of complaint. Additionally, it endorses training programmes on building strategies to enhance effective CM which will go a long way toward allowing service providers to form strong emotional bonds with their patients. The focus of such a program should be on instilling in frontline staff who deal with disgruntled/dissatisfied customers the necessity of adopting the study's findings into their complaint handling process.

A qualitative study of evidence-based therapeutic process in mental health services in Ghana\u2013 context-mechanisms-outcomes

BackgroundEvidence-based clinical practice is an inherent component of mental health professional practice in developed countries. However, little is known about professional perspectives of evidence-based practice in mental in developing countries such as Ghana. This paper describes the processes involved in the delivery of best practice in Ghana. The paper reports on a realistic evaluation of mental health nurses and allied health professionals’ views on the evidence-based therapeutic process in Ghana.MethodsA purposive sample of 30 mental health professionals (MHPs) was recruited to participate in semi-structured, in-depth interviews. Thematic analysis was used to analyse the data. A program theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis.ResultsThe thematic analysis identified two contexts, mechanism and outcome configurations (themes): 1) technical competency stimulates evidence-based mental health services, and 2) therapeutic relationship building ensures effective interaction. The study demonstrates that contextual factors (technical competencies and therapeutic relationship building) together with mechanisms (intentional and unintentional) help to promote quality in mental health service provision. However, contextual factors such as a lack of sign language interpreters yielded unintended outcomes including barriers to communication with providers for consumers with hearing impairment and those from linguistic minority backgrounds.ConclusionGovernment stakeholders and policymakers should prioritise policies, periodic monitoring and adequate financial incentives to support the mechanisms that promote technical competence in MHPs and the building of therapeutic relationship.

Transition Preparation and Satisfaction of Care Among Adolescents and Young Adults With Sickle Cell Disease at the Ghana Institute of Clinical Genetics.

Expanding services in Ghana for people with sickle cell disease is expected to increase childhood survival and need for transition to adult care. Little is known about patient transition experiences in sub-Saharan Africa. We sought to understand those experiences of adolescents and young adults at an adult sickle cell clinic in Accra, Ghana. Individuals 13 to 22 years of age receiving sickle cell care at the Ghana Institute of Clinical Genetics were interviewed to recall their advance preparation and early experiences in adult sickle cell clinic. Mean age of the 100 participants interviewed was 17.9±2.9 years, 65% female. Most had hemoglobin SS (77%) or hemoglobin SC (20%). Twenty-nine participants recalled pretransition preparation; 93% of them (27) had received care at Korle Bu Pediatric Sickle Cell Clinic. Among the remaining 71 who did not recall advance preparation, 54% (34) had received pediatric care at that clinic (P<0.001). More in the group recalling preparation had positive feelings about needing to transition care compared with those not recollecting preparation (55% vs. 32%, P=0.04). Our results suggest that pretransition preparation may ease the peritransition experience. Conduct and evaluation of a program for transitioning into adult sickle cell care in Ghana may facilitate the transfer process.

Indicators for commuter’s satisfaction and usage of high occupancy public bus transport service in Ghana

High occupancy public bus transport services in some countries have gradually dropped due to its less competitive service performance. This has resulted in deteriorating the sustainability of the transportation system especially in developing countries such as Ghana. The study mainly aims to identify the perception and expectation of service quality factors related to commuters’ satisfaction and usage of bus services in Ghana. Using two approaches, a sample of 816 public bus users completed a questionnaire on perception and expectation measures at terminals in six regional capitals in Ghana. The result of the preliminary analysis shows that in the gap analysis, there is a wide gap between commuters’ expectations and perception of Public Bus Transport (PBT) service quality attributes. The “path model” revealed that affordability and availability were the most significant service quality attributes related to perceived commuters’ satisfaction. With the expectation model, availability, security and reliability were the most significant service quality attributes related to passengers' expected satisfaction. The coefficient between satisfaction and usage of bus transport, and the variance explained in these variables (satisfaction and usage) by the expectation model is stronger compared to the perception model. This explains that passengers’ satisfaction and usage of PBT would be enhanced when transport operators provide services that accommodate the expectations of service required by passengers. The interventions suggested will stimulate passengers’ satisfaction, promote sustainable mobility, reduce energy consumption, and emissions.

Equity and access to maternal and child health services in Ghana a cross-sectional study

BackgroundInequities in the distribution of and access to maternal and child health care services is pervasive in Ghana. Understanding the drivers of inequity in maternal and child health (MCH) is important to achieving the universal health coverage component of the Sustainable Development Goals (SDGs) and poverty reduction in developing countries. However, there is increasing disparities in MCH services, especially in rural -urban, and income quintiles. The study aimed to examine the disparities in maternal and child health care services in Ghana for policy intervention.MethodsData for this study was extracted from the nationally representative Ghana Statistical Service (GSS) Multiple Indicator Cluster Survey (MICS) round 4, 2011. Respondents of this survey were women of reproductive age 15–49 years with a sample size of 10,627 households. The models were estimated using multivariate regression analysis together with concentration index (CI) and risk ratio (RR) to assess the distribution of MCH indicator groups across the household wealth index.ResultsThe results show that women with secondary school level and above were more likely to receive family planning, prenatal care, and delivery by a skilled health professional than those without formal education. Mothers with low level of educational attainment were 87% more likely to have their first pregnancy before the age of 20 years, and 78% were more likely to have children with under-five mortality, and 45% more likely to have children who had diarrhoea. teenage pregnancy (CI = − 0.133, RR =0.679), prenatal care by skilled health worker (CI = − 0.124, RR =0.713) under five mortality, child underweight, reported diarrhoea, and suspected pneumonia, though not statistically significant, were more concentrated in the poorer than in the richer households, The RR between the top and bottom quintiles ranged from 0.77 for child underweight to 0.82 for child wasting.ConclusionGeographic location, income status and formal education are key drivers of maternal and child health inequities in Ghana. Government can partner the private sector to implement health policies to address inequalities in MCH services through primary health care, and resource allocation skewed towards rural areas and the lower wealth quintile to bridge the inequality gaps and improve MCH outcomes. The government and the private sectors should prioritize female education, as that can improve maternal and child health.

To leave or retain? An interplay between quality digital banking services and customer satisfaction

PurposeIn this paper, the authors investigated the impact of quality digital banking services delivered during the COVID-19 pandemic on customers' satisfaction and retention intentions.Design/methodology/approachThis study combined constructs drawn from the E-S-QUAL and BSQ models to measure the impact of digital banking services on subscribers of digital banking services in Ghana. The study utilized structural equation modeling with partial least squares (PLS-SEM) to analyze 395 responses.FindingsResults revealed a significant direct effect between digital banking services satisfaction and customer retention decision. The results also revealed that digital banking services quality dimensions such as ease of use, efficiency, privacy/security and reliability impact customers' satisfaction and retention intentions.Research limitations/implicationsDigital banking service portfolios and their quality dimensions vary among banks. This offers an opportunity for banking institutions and other non-bank financial service providers to be wary of the impact of quality service delivery on customers' decisions. This paper makes significant theoretical contributions and practical implications on the relevance of quality digital banking services in customers' retention strategies for competitive advantage.Originality/valueThis study has underlined the significance of quality digital banking services in developing countries. The study underscored the need for banking and non-bank financial institutions to embrace the much-anticipated quality service demanded by customers and the need for continuous service improvement relative to the growing deployment of financial technologies.

Building and enhancing library services: Patrons’ awareness of, and engagement with social media in academic libraries in Ghana

This study sought to examine academic libraries’ patrons’ level of awareness of, and engagement with social media in the use of academic libraries services in Ghana. The study employed the cross-sectional survey whereby quantitative data were collected from a total of 417 respondents, who consisted of students and library staff from public, private and technical universities in Ghana. Findings indicated that the academic libraries have adopted and used a number of social media applications, with Facebook and instant messaging as the most popular and frequently used platforms, for the provision and access to library services and resources as well as for contacting the academic libraries. However, the level of awareness, extent of use, as well as the level of engagement with the platforms was low as social media tools adopted by the libraries were not prevalent among the library patrons. Recommendations and conclusions based on the research findings are offered in the paper. This study uses a cross-sectional survey, with the data being collected at a specific point in time. However, due to rapid technological change and trends, future research studies could consider longitudinal studies to investigate the adoption and use of social media in academic libraries across time and environment. The analysis of social media use for academic library services from both the library staff and library patrons’ perspectives will inform decisions on how to improve the use of such platforms for effective and efficient library services delivery and access.

Patients satisfaction with healthcare delivery in Ghana

BackgroundThe service industry has been an evolving sector and a great concern to providers ensuring continuously that clients’ satisfaction is met. Hence, the importance of patient satisfaction in the healthcare sector. This study focused on the satisfaction of women with the delivery of health services in Ghana and aims to be different from other studies which has focused on patient satisfaction with urban and rural health services, regional health services and health insurance. Our study examines the percentages of satisfaction with the multiple outcomes defined and identifies the key health system and demographic related factors associated with women satisfaction.MethodsThis study used data from the 2014 Ghana Demographic and Health Survey and a total of 12,831 households were systematically selected with reproductive women aged 15–49 years eligible for interview. Data for this study was analysed quantitatively using descriptive statistics, chi square and regression analysis. A total of 3648 women were included in this study and the final analysis thus involved a weighted sample of 3507 women. Satisfaction indicators were put together into SERVQUAL dimensions in the study and reliability test run using Cronbach Alpha (α). All data analyses were carried out in STATA 13.0. The adjusted odds ratios (AOR) with their corresponding 95% confidence intervals (CI) were calculated.ResultsAnalysis showed that independently, education and religion were significantly associated with service reliability, overall satisfaction and responsiveness. Payment option was also associated with responsiveness and tangibility dimensions. Furthermore, place of residence was independently associated with responsiveness, tangibility and overall satisfaction. Finally, maternal age, region, provider friendly, ease of getting care and opening hours were all independently associated with reliability, responsiveness, tangibility and overall service satisfaction at the multivariable level.ConclusionsDimensions of service quality which focus on patient-centered atmosphere and efficient service delivery system should be integrated and strengthened by hospital management in order to increase patient satisfaction. Key maternal characteristics and health system related factors were revealed to have positive association with patient satisfaction with health services delivery and this cannot be ignored by health care managers in ensuring that systems are improved for better health care.

Measuring Disability in Consumers of mental health services - psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in Ghana.

The World Health Disability Assessment Scale (WHODAS-2.0) has widely been accepted as the standard measure of disability. However, psychometric testing is mostly performed in developed countries. This paper aims to assess the psychometric properties (reliability, validity) of the WHODAS-2.0 among consumers of mental health services in Ghana. Two translators (expert in English language and Akan language) performed forward and backward translation of the WHODAS-2.0 from English language to Ghanaian language (Twi). A total of 510 consumers of mental health services were recruited consecutively to complete the WHODAS-2.0 using RedCAP. Confirmatory factor analysis was used to analyse the data. All domains in the 6-factor solutions had excellent internal consistency (ω=0.90-0.98), sufficient convergent validity and had satisfactory discriminant validity except for domain on participation. The CFA model confirmed that the data had a good model fit, CFI=0.97, TLI=0.96, RMESA=0.05, RMR=0.03; NFI=0.94; χ2 =1243.8, df=529, P<0.001. Although the WHODAS 2.0 had satisfactory psychometric properties and was thus considered to be a reliable and valid measure for assessing disability and level of functioning in consumers of mental health services, researchers and clinicians should re-consider items within the participation domain. Also, practitioners are encouraged to integrate the WHODAS-2.0 into the collection of data on clinical outcomes, as well as, collecting data on government social protection intervention programmes for consumers.