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Local Business Climate in Ghana – Insights for Policy Direction  [cached]
Mavis Serwah Benneh Mensah
International Journal of Business and Management , 2012, DOI: 10.5539/ijbm.v7n2p17
Abstract: This study provides insights for enhancing the business climate in Ghana. The primary objective of the study was to identify the most relevant binding constraint(s) on the activities of micro, small and medium-sized enterprises (MSMEs) in the manufacturing sector of Sunyani Municipality and Berekum District of Ghana. Accordingly, a survey of 85 manufacturing MSMEs was conducted. In spite of energy crisis in Ghana at the time of research, the most relevant binding constraints to the enterprises surveyed were poor access to technology including technological support services, and poor access to market (which will be discussed in subsequent paper). The findings contradict policy focus on addressing governance and regulatory bottlenecks, and inadequate physical infrastructure. This underscores the importance of local business climate surveys in addition to national surveys in establishing the right policy focus for enhancing the business climate of localities within a country.
Breast Self-Examination and breast cancer awareness in women in developing countries: a survey of women in Buea, Cameroon
Mary Atanga Suh, Julius Atashili, Eunice Fuh, Vivian Eta
BMC Research Notes , 2012, DOI: 10.1186/1756-0500-5-627
Abstract: A cross-sectional survey was conducted in a volunteer sample of 120 consenting women in Buea, Cameroon. Data were collected using a structured questionnaire self-administered by study participants.The sample was fairly educated with close to three quarters (70.83%) having completed high school. Nearly three quarters (74.17%) of participants had previously heard about BSE, however as many as 40% had never done a BSE. Although 95% of participants believed that breast cancer could be prevented, only 36.67% recognized breast examination as a prevention method. A substantial 13.33% thought that breast cancer could be prevented with a vaccine while 45% thought that dieting or exercising would prevent breast cancer. Similarly, 70% of participants thought that breast cancer could be treated, with 35.83% thinking that it could be treated medically while 34.17% thought it could be treated traditionally or spiritually.The practice of BSE while perceived as being important is not frequent in these women in Buea, Cameroon. Health education campaigns are imperative to elucidate the public on the causes, risk factors and prevention of breast cancer. Further studies need to explore what interventions could be best used to improve the uptake and practice of BSE.Breast cancer is the second cause of cancer worldwide and the fifth cause of cancer mortality [1]. It is estimated that the prevalence of breast cancer in women aged 15 and over in sub-Saharan Africa was 23.5 per 100,000 women in 2008 [2]. During the same period an estimated 35,427 women died from breast cancer - a crude mortality rate of 12.8 per 100.000 women [3]. In Cameroon the crude annual incidence of breast cancer is estimated at 19.3 per 100,000 women with a mortality of 10.7 per 100,000 women [3].Prevention remains the cornerstone of the fight against breast cancer worldwide. Although some prevention methods have been proposed, many remain inaccessible to women in developing countries who, ironically, given the limit
Enhancing Buruli ulcer control in Ghana through social interventions: a case study from the Obom sub-district
Collins K Ahorlu, Eric Koka, Dorothy Yeboah-Manu, Isaac Lamptey, Edwin Ampadu
BMC Public Health , 2013, DOI: 10.1186/1471-2458-13-59
Abstract: This was a qualitative study using in-depth interviews to generate information to ascertain the benefit or otherwise of the intervention implemented. Clinical records of patients to generate data to determine the feasibility and effectiveness of social interventions in the fight against Buruli ulcer was examined. In all, 56 in-depth interviews (28 at baseline and 28 at evaluation) were conducted for this report.At full implementation, treatment default and dropout reduced significantly from 58.8% and 52.9% at baseline to 1.5% and 1.5% respectively. The number of early case detection went up significantly. Affected families were happy with social interventions such as provision of transportation and breakfast to patients on daily basis. Families were happy with the outpatient services provided under the intervention where no patient was admitted into the hospital.The study showed that with a little more investment in early case detection, diagnosis and treatment, coupled with free transportation and breakfast for patients, most of the cases could be treated effectively with the available antibiotics to avoid disability and complications from the disease.Buruli ulcer (BU) was identified about a century ago, and it is generally referred to as a re-emerging disease particularly in West Africa, including Ghana where the prevalence in some villages is higher than tuberculosis [1]. The worst affected age group in this endemic region is mainly children aged 15 years and below. The disease begins typically as a painless nodule under the skin at the site of a trauma. In some geographical areas the first manifestation is a papule rather than the firm, painless nodule. If not treated early, the nodule gradually enlarges and erodes through the skin surface, leaving a well-demarcated ulcer with a necrotic slough in the base and widely undermined edges, the hallmark of the disease. Prolong delay, might lead to bone involvement, functional disabilities such as amputation of limbs a
The challenges of developing an instrument to assess health provider motivation at primary care level in rural Burkina Faso, Ghana, and Tanzania
Helen Prytherch,Melkidezek T. Leshabari,Christiane Wiskow,Gifty A. Aninanya
Global Health Action , 2012, DOI: 10.3402/gha.v5i0.19120
Abstract: Background: The quality of health care depends on the competence and motivation of the health workers that provide it. In the West, several tools exist to measure worker motivation, and some have been applied to the health sector. However, none have been validated for use in sub-Saharan Africa. The complexity of such tools has also led to concerns about their application at primary care level. Objective: To develop a common instrument to monitor any changes in maternal and neonatal health (MNH) care provider motivation resulting from the introduction of pilot interventions in rural, primary level facilities in Ghana, Burkina Faso, and Tanzania. Design: Initially, a conceptual framework was developed. Based upon this, a literature review and preliminary qualitative research, an English-language instrument was developed and validated in an iterative process with experts from the three countries involved. The instrument was then piloted in Ghana. Reliability testing and exploratory factor analysis were used to produce a final, parsimonious version. Results and discussion: This paper describes the actual process of developing the instrument. Consequently, the concepts and items that did not perform well psychometrically at pre-test are first presented and discussed. The final version of the instrument, which comprises 42 items for self-assessment and eight for peer-assessment, is then shown. This is followed by a presentation and discussion of the findings from first use of the instrument with MNH providers from 12 rural, primary level facilities in each of the three countries. Conclusions: It is possible to undertake work of this nature at primary health care level, particularly if the instruments are kept as straightforward as possible and well introduced. However, their development requires very lengthy preparatory periods. The effort needed to adapt such instruments for use in different countries within the region of sub-Saharan Africa should not be underestimated.
Sanitary Pad Interventions for Girls' Education in Ghana: A Pilot Study  [PDF]
Paul Montgomery, Caitlin R. Ryus, Catherine S. Dolan, Sue Dopson, Linda M. Scott
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0048274
Abstract: Background Increased education of girls in developing contexts is associated with a number of important positive health, social, and economic outcomes for a community. The event of menarche tends to coincide with girls' transitions from primary to secondary education and may constitute a barrier for continued school attendance and performance. Following the MRC Framework for Complex Interventions, a pilot controlled study was conducted in Ghana to assess the role of sanitary pads in girls' education. Methods A sample of 120 schoolgirls between the ages of 12 and 18 from four villages in Ghana participated in a non-randomized trial of sanitary pad provision with education. The trial had three levels of treatment: provision of pads with puberty education; puberty education alone; or control (no pads or education). The primary outcome was school attendance. Results After 3 months, providing pads with education significantly improved attendance among participants, (lambda 0.824, F = 3.760, p<.001). After 5 months, puberty education alone improved attendance to a similar level (M = 91.26, SD = 7.82) as sites where pads were provided with puberty education (Rural M = 89.74, SD = 9.34; Periurban M = 90.54, SD = 17.37), all of which were higher than control (M = 84.48, SD = 12.39). The total improvement through pads with education intervention after 5 months was a 9% increase in attendance. After 3 months, providing pads with education significantly improved attendance among participants. The changes in attendance at the end of the trial, after 5 months, were found to be significant by site over time. With puberty education alone resulting in a similar attendance level. Conclusion This pilot study demonstrated promising results of a low-cost, rapid-return intervention for girls' education in a developing context. Given the considerable development needs of poorer countries and the potential of young women there, these results suggest that a large-scale cluster randomized trial is warranted. Trial Registration Pan African Clinical Trials Registry PACTR201202000361337
A cost-effectiveness analysis of provider interventions to improve health worker practice in providing treatment for uncomplicated malaria in Cameroon: a study protocol for a randomized controlled trial
Virginia Wiseman, Lindsay J Mangham, Bonnie Cundill, Olivia A Achonduh, Akindeh Nji, Abanda Njei, Clare Chandler, Wilfred F Mbacham
Trials , 2012, DOI: 10.1186/1745-6215-13-4
Abstract: A 3-arm stratified, cluster randomized trial will be conducted to assess whether introducing RDTs with provider training (basic or enhanced) is more cost-effective than current practice without RDTs, and whether there is a difference in the cost effectiveness of the provider training interventions. The primary outcome is the proportion of patients attending facilities that report a fever or suspected malaria and receive treatment according to malaria guidelines. This will be measured by surveying patients (or caregivers) as they exit public and mission health facilities. Cost-effectiveness will be presented in terms of the primary outcome and a range of secondary outcomes, including changes in provider knowledge. Costs will be estimated from a societal and provider perspective using standard economic evaluation methodologies.ClinicalTrials.gov: NCT00981877Governments and donors all over Africa are searching for sustainable, affordable and cost-effective ways to improve the quality of malaria case management. Widespread deficiencies have been reported in the prescribing and counselling practices of providers (by which we mean health workers) responsible for treating febrile patients attending public and private facilities [1-8]. Similar problems have been reported in Cameroon where malaria accounts for 35%-40% of all deaths, 50% of morbidity among children under the age of five, 40%-45% of medical consultations and 30% of hospitalizations [9,10].Despite widespread availability of malaria testing using microscopy in public and private facilities in Cameroon and recent guidelines from the World Health Organization (WHO) recommending parasitological confirmation of suspected malaria cases in all patients before treatment where testing facilities are available [11], symptomatic diagnosis of malaria remains routine in more than 50% of consultations [12]. There is, however, increasing interest in scaling up the use of rapid diagnostic tests (RDTs) to expand access to paras
In vitro Anti-leishmanial Activity of Traditional Medicinal Plants from Cameroon and Ghana  [PDF]
D. Ndjonka,C. Agyare,K. Luersen,A. Hensel
International Journal of Pharmacology , 2010,
Abstract: The aim of the study was to screen selected traditional medicinal plants from Cameroon and Ghana for their in vitro anti-leishmanial activity. The ethanolic and aqueous extracts of the selected plants were assessed for their effect on the promastigote stage of Leishmania tarentolae. Parasites were incubated with different concentrations of the extracts and proliferation inhibitory effects were monitored after 24 h and 48 h. Preliminary phytochemical screenings were carried out on extracts of these plants. Among the plants investigated in this study, extracts from Steganotaenia araliacea, Anogeissus leiocarpus, Phyllanthus muellerianus and Hoslundia opposita affected the proliferation of L. tarentolae most potently. Growth inhibition was concentration-dependent with an IC50 after 48 h ranging between 0.41-0.68 mg mL-1. Preliminary phytochemical screenings were carried out on extracts revealing the presence of flavonoids, alkaloids, saponins, carbohydrates and tannins in the selected plants. This study reveals that S. araliacae, A. leiocarpus, P. muellerianus and H. opposita extracts could lead to an alternative application in the control of Leishmania infections.
Homosexuality in Ghana  [PDF]
I. D. Norman, B. Awiah, F. A. Norvivor, J. Komesuor, M. Kweku, F. N. Binka
Advances in Applied Sociology (AASoci) , 2016, DOI: 10.4236/aasoci.2016.61002
Abstract: Although homosexuality is a crime in Ghana, like many others in Africa, it is practiced in both the provincial towns and communities and in the major urban centres. Generally the society is reticent about discussing sex, yet the national society is as over-sexualized as those societies that openly discuss sex. This paper investigated the incidence and prevalence of homosexuality and lesbianism in Ghana. Assessment was done on association among psychosocial background, sexual attitudes and homosexuality, including the use of paraphernalia in the sexual lives of the people. This cross-sectional study consisted of questionnaire survey and documentary review on the internet. Respondents completed self-administered and anonymous survey with open-ended question about their sexuality and sexual preferences. The sample consisted of N = 1068 respondents. Sampling selection was of random, pre-stratified by gender and region, which was based on the population survey by the Ghana Statistical Service for 2009. We found that the national attitudes towards homosexuality in general were changing from ambivalence to focused activism and agitation against homosexuality on one hand and acceptance on the other hand. Homosexuality and lesbian practices are prevalent in all socio-economic classes and ages of society. The study revealed that pornography and other sex media were accepted as part of the sexual repertoire of Ghanaian society. The societal reticence about sexuality that exists among the population tends to distort sexual beliefs, and imposes fear and dishonesty in sexual identification. This situation may complicate interventions for sexually transmitted diseases, as well as sexual or mental health.
Genotypic Diversity and Drug Susceptibility Patterns among M. tuberculosis Complex Isolates from South-Western Ghana  [PDF]
Dorothy Yeboah-Manu, Adwoa Asante-Poku, Thomas Bodmer, David Stucki, Kwadwo Koram, Frank Bonsu, Gerd Pluschke, Sebastien Gagneux
PLOS ONE , 2011, DOI: 10.1371/journal.pone.0021906
Abstract: Objective The aim of this study was to use spoligotyping and large sequence polymorphism (LSP) to study the population structure of M. tuberculosis complex (MTBC) isolates. Methods MTBC isolates were identified using standard biochemical procedures, IS6110 PCR, and large sequence polymorphisms. Isolates were further typed using spoligotyping, and the phenotypic drug susceptibility patterns were determined by the proportion method. Result One hundred and sixty-two isolates were characterised by LSP typing. Of these, 130 (80.25%) were identified as Mycobacterium tuberculosis sensu stricto (MTBss), with the Cameroon sub-lineage being dominant (N = 59/130, 45.38%). Thirty-two (19.75%) isolates were classified as Mycobacterium africanum type 1, and of these 26 (81.25%) were identified as West-Africa I, and 6 (18.75%) as West-Africa II. Spoligotyping sub-lineages identified among the MTBss included Haarlem (N = 15, 11.53%), Ghana (N = 22, 16.92%), Beijing (4, 3.08%), EAI (4, 3.08%), Uganda I (4, 3.08%), LAM (2, 1.54%), X (N = 1, 0.77%) and S (2, 1.54%). Nine isolates had SIT numbers with no identified sub-lineages while 17 had no SIT numbers. MTBss isolates were more likely to be resistant to streptomycin (p<0.008) and to any drug resistance (p<0.03) when compared to M. africanum. Conclusion This study demonstrated that overall 36.4% of TB in South-Western Ghana is caused by the Cameroon sub-lineage of MTBC and 20% by M. africanum type 1, including both the West-Africa 1 and West-Africa 2 lineages. The diversity of MTBC in Ghana should be considered when evaluating new TB vaccines.
The development of cardiac surgery in West Africa - the case of Ghana
F Edwin, M Tettey, E Aniteye, M Tamatey, L Sereboe, K Entsua-Mensah, D Kotei, K Baffoe-Gyan
Pan African Medical Journal , 2011,
Abstract: Abstract West Africa is one of the poorest regions of the world. The sixteen nations listed by the United Nations in this sub-region have some of the lowest gross domestic products in the world. Health care infrastructure is deficient in most of these countries. Cardiac surgery, with its heavy financial outlay is unavailable in many West African countries. These facts notwithstanding, some West African countries have a proud history of open heart surgery not very well known even in African health care circles. Many African health care givers are under the erroneous impression that the cardiovascular surgical landscape of West Africa is blank. However, documented reports of open-heart surgery in Ghana dates as far back as 1964 when surface cooling was used by Ghanaian surgeons to close atrial septal defects. Ghana’s National Cardiothoracic Center is still very active and is accredited by the West African College of Surgeons for the training of cardiothoracic surgeons. Reports from Nigeria indicate openheart surgery taking place from 1974. Cote D’Ivoire had reported on its first 300 open-heart cases by 1983. Senegal reported open-heart surgery from 1995 and still runs an active center. Cameroon started out in 2009 with work done by an Italian group that ultimately aims to train indigenous surgeons to run the program. This review traces the development and current state of cardiothoracic surgery in West Africa with Ghana’s National Cardiothoracic Center as the reference. It aims to dispel the notion that there are no major active cardiothoracic centers in the West African sub-region.
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