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Search Results: 1 - 10 of 19220 matches for " Richard Adanu "
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It’s for the Greater Good: Perspectives on Maltreatment during Labor and Delivery in Rural Ghana  [PDF]
Jamila Yakubu, Dana Benyas, Sarah Vandy Emil, Ebenezer Amekah, Richard Adanu, Cheryl A. Moyer
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.47057

Aim: Encouraging women to deliver in facility settings is one strategy to improve maternal and neonatal outcomes in the developing world. However, in much of sub-Saharan Africa, fewer than half of pregnant women deliver in health facilities. Fear of maltreatment during labor and delivery has been shown to be one barrier to facility delivery, yet previous studies have focused solely on reports from women, rarely seeking insights from practicing midwives. Method: All seven practicing midwives from a rural hospital in Ghana and ten pregnant women seeking antenatal care from the same hospital were recruited to participate in in-depth interviews regarding their perceptions of care during labor and delivery. A semi-structured interview tool and qualitative field interviewing approach were utilized. All interviews were audio taped, transcribed, and analyzed using NVivo 9.0. Results: Respondents described situations that precipitate abuse during facility deliveries, yet not all abuse was seen as acceptable. Two overarching themes emerged: 1) The interaction between midwives and their patients is analogous to a mother/daughter relationship, including both a knowledge imbalance and the need for disciplinary action when necessary; and 2) Midwives feel a strong sense of responsibility for the delivery outcomes and as a result, they will do whatever it takes to deliver a live baby to a healthy mother. Hitting, yelling, and neglecting women were reported as common occurrences in the labor and delivery ward. However, each was undertaken to encourage women to do what was needed to deliver safely. Conclusion: These findings suggest that the issue of patient maltreatment in low-resource labor and delivery settings is complex and may be undertaken in what is perceived to be the laboring woman’s best interest. The exploration of alternative strategies to facilitate labor and delivery is warranted, as well as the provision of adequate support and resources for practicing midwives in rural settings.

Detary Practices and Nutrient Intakes of Pregnant Women in Accra, Ghana
Alice Koryo-Dabrah,Christina A. Nti,Richard Adanu
Current Research Journal of Biological Sciences , 2012,
Abstract: The aim of the study was to assess potential changes in dietary habits during pregnancy, nutrient intakes of pregnant women and the effect of socio-demographic factors on nutrient intakes of pregnant women. The research design was cross-sectional. A systematic random sampling technique was used to recruit 279 pregnant women from the antenatal clinic of the Korle-Bu Teaching Hospital and Osu Maternity Home in Accra. In-depth interviews were performed to assess perceptions and attitudes regarding food consumption and dietary habits during pregnancy. In addition, an interactive 24-h recall repeated for three days was used to obtain data on food and nutrient intakes of the women. Information on foods consumed was converted into quantitative data of nutrients using Ghana Food Composition Tables and FOOD PROCESSOR PLUS Software. Data were analyzed using the Statistical Package for Social Sciences (SPSS, 17). The mean energy, vitamin B12, folate, iron and zinc intakes were found to be inadequate compared with the Recommended Intakes. There was also a significant difference (p<0.001) in the mean intake of protein across the different trimesters. On the average protein, fat and carbohydrate contributed 13.2, 34.7 and 52.1%, respectively to total calories. Significant differences were observed between educational level and mean intake of protein (p<0.001), as well as income levels and mean intake of protein (p<0.001) and zinc (p<0.02). Surprisingly women with larger household size had high intake of energy and nutrients. Most of the women (67.7%) reported food craving, 57.3% practiced pica and 48.8% reported dietary restrictions during pregnancy. However no significant difference was found in nutrient intakes between women who reported food craving, food avoidance and pica and women who did not. In conclusion, pregnant women in the study had lower intake of energy and nutrients compared with the RNI. Food craving and aversion as well as pica practice are common dietary practices among pregnant women in the study. Protein and zinc are associated with income and educational levels of the pregnant women in the study. It is recommended that more attention should be focused on nutrition education and intervention programs during pregnancy as well as dietary approaches such as fortification of foods to increase both macronutrient and micronutrient intakes.
Listening to Women’s Voices: The Quality of Care of Women Experiencing Severe Maternal Morbidity, in Accra, Ghana
?zge Tun?alp, Michelle J. Hindin, Kwame Adu-Bonsaffoh, Richard Adanu
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0044536
Abstract: Background Women who survive severe obstetric complications can provide insight into risk factors and potential strategies for prevention of maternal morbidity as well as maternal mortality. We interviewed 32 women, in an urban facility in Ghana, who had experienced severe morbidity defined using a standardized WHO near-miss definition and identification criteria. Women provided personal accounts of their experiences of severe maternal morbidity and perceptions of the care they received. Methods and Findings The study took place in a referral facility in urban Accra, and semi-structured interviews were conducted with women who had either a maternal near miss (n = 17) or a potentially life-threatening complication (n = 15). The most common themes surrounding the traumatic delivery were the fear of dying and concern over the potential (or actual) loss of the baby. For many women, the loss of a baby negatively influenced how they viewed and coped with this experience. Women’s perceptions of the quality of the care highlighted several key factors such as the importance of information, good communication and attitudes, and availability of human (i.e., more doctors) and physical resources (i.e., more beds, water) at the facility. Conclusions Our results suggest that experiences of women with severe maternal morbidity may inform different aspects of quality improvement in the facilities, which in turn have a positive impact on future health seeking behavior, service utilization and reduction in maternal morbidity and mortality.
Measuring Coverage in MNCH: Validating Women’s Self-Report of Emergency Cesarean Sections in Ghana and the Dominican Republic
?zge Tun?alp, Cynthia Stanton, Arachu Castro, Richard Adanu, Marilyn Heymann, Kwame Adu-Bonsaffoh, Samantha R. Lattof, Ann Blanc, Ana Langer
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0060761
Abstract: Background Cesarean section is the only surgery for which we have nearly global population-based data. However, few surveys provide additional data related to cesarean sections. Given weaknesses in many health information systems, health planners in developing countries will likely rely on nationally representative surveys for the foreseeable future. The objective is to validate self-reported data on the emergency status of cesarean sections among women delivering in teaching hospitals in the capitals of two contrasting countries: Accra, Ghana and Santo Domingo, Dominican Republic (DR). Methods and Findings This study compares hospital-based data, considered the reference standard, against women’s self-report for two definitions of emergency cesarean section based on the timing of the decision to operate and the timing of the cesarean section relative to onset of labor. Hospital data were abstracted from individual medical records, and hospital discharge interviews were conducted with women who had undergone cesarean section in two hospitals. The study assessed sensitivity, specificity, and positive predictive value of responses to questions regarding emergency versus non-emergency cesarean section and estimated the percent of emergency cesarean sections that would be obtained from a survey, given the observed prevalence, sensitivity, and specificity from this study. Hospital data were matched with exit interviews for 659 women delivered via cesarean section for Ghana and 1,531 for the Dominican Republic. In Ghana and the Dominican Republic, sensitivity and specificity for emergency cesarean section defined by decision time were 79% and 82%, and 50% and 80%, respectively. The validity of emergency cesarean defined by operation time showed less favorable results than decision time in Ghana and slightly more favorable results in the Dominican Republic. Conclusions Questions used in this study to identify emergency cesarean section are promising but insufficient to promote for inclusion in international survey questionnaires. Additional studies which confirm the accuracy of key facility-based indicators in advance of data collection and which use a longer recall period are warranted.
Application of Earth Observation Technology to Site Selection and Development of Ecotourism Management Plans in Rural Ghana
Selase Kofi Adanu,Foster Kwami Mensah,Sesime Kofi Adanu,Dziwornu Kwami Adanu
ISRN Forestry , 2013, DOI: 10.1155/2013/924506
Application of Earth Observation Technology to Site Selection and Development of Ecotourism Management Plans in Rural Ghana
Selase Kofi Adanu,Foster Kwami Mensah,Sesime Kofi Adanu,Dziwornu Kwami Adanu,Kabila Abass
ISRN Forestry , 2013, DOI: 10.1155/2013/924506
Abstract: Production of development plans is vital for sustainable ecotourism development given the increasing competition for land to satisfy various human needs including agriculture, timber, and wood energy. Such human activities cause rapid destruction of wildlife habitat and loss of indigenous tree species. To enhance sustainable use of the flora and fauna to promote rural tourism in Ghana, seven eco-tourism sites have been surveyed to produce data for management plans to be developed for these sites. The survey focused on the status of flora and fauna at the sites, infrastructure, cultural dynamics, cross-border issues, and revenue mobilization. Key findings indicate lack of infrastructure at the sites and substantial loss of forest cover over seventeen years covered by the survey. 1. Background Ecotourism is becoming a leading world industry especially in developing countries so far as provision of employment opportunities is concerned [1, 2]. Expansion in this sector has brought to the fore the role of ecotourism in poverty alleviation in developing countries [3–7]. Even though ecotourism is expanding, lack of adequate planning and management of sites poses a challenge to sustainable ecotourism. For example, failure to plan and introduce encroachment buffers in tourism development around the Bohorok river in Indonesia resulted in encroachment of the ecotourist sites by housing development [8]. Nature based tourism involves the enjoyment of wildlife and plants at undeveloped natural areas [9]. Sustaining benefit flows is however heavily dependent on proper planning and management of tourism sites. This calls for the development and implementation of comprehensive plans. Such plans must provide management with detailed site-specific guidelines to tourism development and respond to pressure on tourism infrastructure and the environment [10]. In addition to the existence of pristine forests and diverse wildlife, some sites in Ghana are also characterized by the presence of cultural resources like missionary buildings, slave markets, and caves. Development plans in Ghana therefore require an integrated approach that accounts for such cultural resources and involve private-public sector partnerships, interagency coordination, and community involvement. Unfortunately, the history of tourism management in Ghana reveals the absence of any comprehensive tourism development plan. Tourism resource management in Ghana has followed a very unsystematic approach that involves occasional short-term studies and implementation of programs that are incoherent and ineffective
Optimism/pessimism and health-related quality of life during pregnancy across three continents: a matched cohort study in China, Ghana, and the United States
Cheryl A Moyer, Huixia Yang, Yao Kwawukume, Anu Gupta, YuChun Zhu, Isaac Koranteng, Yasmin Elsayed, YuMei Wei, Jonathan Greene, Cecilia Calhoun, Geraldine Ekpo, Megan Beems, Megan Ryan, Richard Adanu, Frank Anderson
BMC Pregnancy and Childbirth , 2009, DOI: 10.1186/1471-2393-9-39
Abstract: Three samples of pregnant women in their final trimester were recruited from China, Ghana, and the United States (U.S.). Participants completed a survey that included the Life Orientation Test - Revised (LOT-R, an optimism/pessimism measure), the Short Form 12 (SF-12, a quality of life measure), and questions addressing health and demographic factors. A three-country set was created for analysis by matching women on age, gestational age at enrollment, and number of previous pregnancies. Anovas with post-hoc pairwise comparisons were used to compare results across the cohorts. Multivariate regression analysis was used to create a model to identify those variables most strongly associated with optimism/pessimism.LOT-R scores varied significantly across cultures in these samples, with Ghanaian pregnant women being the most optimistic and least pessimistic and Chinese pregnant women being the least optimistic overall and the least pessimistic in subscale analysis. Four key variables predicted approximately 20% of the variance in overall optimism scores: country of origin (p = .006), working for money (p = .05); level of education (p = .002), and ever being treated for emotional issues with medication (p < .001). Quality of life scores also varied by country in these samples, with the most pronounced difference occurring in the vitality measure. U.S. pregnant women reported far lower vitality scores than both Chinese and Ghanaian pregnant women in our sample.This research raises important questions regarding what it is about country of origin that so strongly influences optimism/pessimism among pregnant women. Further research is warranted exploring underlying conceptualization of optimism/pessimism and health related quality of life across countries.The psychosocial constructs of optimism and pessimism have been under study for several decades. Optimism is associated with more active coping strategies, lower levels of psychological distress [1-5], health-enhancing behav
Risk Factors for Buruli Ulcer in Ghana—A Case Control Study in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region
Ernest Kenu ,Kofi Mensah Nyarko,Linda Seefeld,Vincent Ganu,Michael K?ser,Margaret Lartey,Benedict Nii Laryea Calys-Tagoe,Kwodwo Koram,Richard Adanu,Oliver Razum,Edwin Afari,Fred N. Binka
PLOS Neglected Tropical Diseases , 2014, DOI: 10.1371/journal.pntd.0003279
Abstract: Background Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. Its exact mode of transmission is not known. Previous studies have identified demographic, socio-economic, health and hygiene as well as environment related risk factors. We investigated whether the same factors pertain in Suhum-Kraboa-Coaltar (SKC) and Akuapem South (AS) Districts in Ghana which previously were not endemic for BU. Methods We conducted a case control study. A case of BU was defined as any person aged 2 years or more who resided in study area (SKC or AS District) diagnosed according to the WHO clinical case definition for BU and matched with age- (+/?5 years), gender-, and community controls. A structured questionnaire on host, demographic, environmental, and behavioural factors was administered to participants. Results A total of 113 cases and 113 community controls were interviewed. Multivariate conditional logistic regression analysis identified presence of wetland in the neighborhood (OR = 3.9, 95% CI = 1.9–8.2), insect bites in water/mud (OR = 5.7, 95% CI = 2.5–13.1), use of adhesive when injured (OR = 2.7, 95% CI = 1.1–6.8), and washing in the Densu river (OR = 2.3, 95% CI = 1.1–4.96) as risk factors associated with BU. Rubbing an injured area with alcohol (OR = 0.21, 95% CI = 0.008–0.57) and wearing long sleeves for farming (OR = 0.29, 95% CI = 0.14–0.62) showed protection against BU. Conclusion This study identified the presence of wetland, insect bites in water, use of adhesive when injured, and washing in the river as risk factors for BU; and covering limbs during farming as well as use of alcohol after insect bites as protective factors against BU in Ghana. Until paths of transmission are unraveled, control strategies in BU endemic areas should focus on these known risk factors.
The health of adult women in Accra, Ghana: Self-reporting and objective assessments 2008-2009
R Darko, RM Adanu, RB Duda, N Douptcheva, AG Hill
Ghana Medical Journal , 2012,
Abstract: Objectives: The study provides a full description of the state of women’s health in Accra, Ghana using selfreported as well as objective health measures. Using data from the Women’s Health Survey of Accra, Wave 2 (WHSA-2), the authors a) examine the consistency of the objective measures of health status (anthropometry and blood pressures) with self-report measures, including the Short Form 36 indices for 8 separate domains of health; and b) describe the main socio-economic differentials in morbidity. Methods: Cross-sectional household survey with field measurements. 2814 women aged 18 and over were interviewed and measured in their homes in late 2008 and early 2009. The physical measurements included height, weight, waist and hip measurement and 3 or more measures of resting blood pressure. Results: Using the 8 domains of self-reported health captured by the Short Form 36 instrument, we find that physical health worsens more sharply with age than mental health. Social class differentials are narrow in the younger cohorts but widen amongst the elderly. The physical measurements reveal unhealthy levels of obesity and hypertension, worsening steadily with rising age. Age and the wealth of the household influence women’s health more than their individual characteristics such as education. Conclusions: Younger women appear to be in good health with steady declines in physical and mental health with age. The major threat to women’s health appears to be the rising levels of obesity and hypertension with mean BMIs for all women over age 45 in excess of 30, producing elevated blood pressures and associated high risks of heart attacks and stroke rising sharply amongst the elderly.
Sexual and reproductive health in Accra, Ghana
RM Adanu, J Seffah, JK Anarfi, N Lince, K Blanchard
Ghana Medical Journal , 2012,
Abstract: Objective: To describe sexual and reproductive health among women in Accra and explore the burden of sexual and reproductive ill health among this urban population. Design: Cross-sectional study. Methods: We analysed data from the WHSA-II (n=2814), a cross-sectional household survey on women’s health, and supplemental data from an in-depth survey (n=400), focus groups discussions (n=22) and in-depth interviews (n=20) conducted among a subsample of women which focused specifically on reproductive health issues. Results: Modern contraceptive use was uncommon. More than one third of women reported ever using abstinence; condoms, injectables and the pill were the most commonly reported modern methods ever used. The total fertility rate among this sample of women was just 2.5 births. We found a considerable burden of sexual and reproductive ill health; one in ten women reported menstrual irregularities and almost one quarter of women reported symptoms of a Sexually Transmitted Infection (STI) or Reproductive Tract Infection (RTI) in the past 6 months. Focus group results and indepth interviews reveal misperceptions about contraception side-effects and a lack of information. Conclusion: In urban Ghana, modern contraceptive use is low and a significant proportion of women experience reproductive ill health (defined here as menstrual irregularity or RTI, UTI, STI symptoms). Increased access to information, products and services about for preventive care and contraception could improve reproductive health. More research on healthy sexuality and the impact of reproductive ill health on sexual experience is needed.
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