Background: Access to healthcare is crucial for health equity and outcomes, especially in resourc... more Background: Access to healthcare is crucial for health equity and outcomes, especially in resource-limited rural areas. Despite expansion efforts, access disparities persist, impacting rural well-being. Assessing spatial accessibility to primary and secondary healthcare is essential for identifying underserved areas and guiding effective resource allocation and intervention strategies. Objective: This study aims to evaluate the geographic access to healthcare services in a rural district of Ghana using Geographic Information Systems (GIS) and spatial analysis techniques. Methods: Utilizing Geographic Information Systems (GIS) 3.28.6, spatial data including health facility locations, settlements, road networks, and population data were analysed. Buffer and distance to the nearest hub analyses were conducted to assess healthcare accessibility to all ten (10) healthcare facilities in the district. Travel time analysis was performed using specified travel speeds for various modes of transportation. Chi-square tests were employed to evaluate the associations between settlement characteristics and access to primary and secondary healthcare services. Results: Approximately 40% of the health facilities were located in Akumadan, the district capital. Primary healthcare accessibility within a 3km radius covered 35% of settlements and 59% of the population, while secondary healthcare, within a 5km radius, was accessible to only 11.3% of settlements and 27.2% of the population. The mean distance to health centres was 4.35±2.72 km and to hospitals was 10.35±5.77 km. Mean walking times were 87±54.6 minutes to health centres and 209.2±117.0 minutes to hospitals. By motorized transport, travel times were up to 24 minutes to health centres and 55 minutes to hospitals; by bicycle, up to 37 minutes to health centres and 190 minutes to hospitals. Chi-Square Tests revealed significant associations between settlement type and both primary (χ²(1, N=80) = 30.77, p <.001) and secondary (χ²(1, N=80) = 15.93, p <.001) healthcare access, as well as between population level and healthcare access. Proximity to health facilities (primary χ²(1, N=80) = 21.26, p <.001; secondary χ²(1, N=80) = 5.48, p =.019) and transportation accessibility (primary χ²(1, N=80) = 9.13, p =.003; secondary χ²(1, N=80) = 12.13, p <.001) were significantly associated with healthcare access. Conclusion: This study unveils substantial disparities in healthcare accessibility, characterized by uneven distribution of facilities and remote distances. Challenges include limited infrastructure and geographic isolation. Addressing these requires enhanced infrastructure, transport networks, expanding outreach services, and equitable policy reforms to promote health equity.
Aim: Pregnancy complications significantly affect health, making timely antenatal care (ANC) esse... more Aim: Pregnancy complications significantly affect health, making timely antenatal care (ANC) essential for early detection and skilled delivery. Despite WHO guidelines, some pregnant women in Ghana's Offinso North District delay their first ANC visit. This study explored intrapersonal and interpersonal factors contributing to this delay. Methods: Conducted from October 2021 to March 2022, this institutional cross-sectional study collected data from 397 pregnant women through a structured questionnaire. Descriptive and inferential statistical analyses were conducted with SPSS version 20. Results: Approximately 47% of pregnant women booked their antenatal care late. Key personal reasons hindering early ANC initiation included financial constraints, busy schedules, and insufficient knowledge about early ANC. Interpersonal barriers included pregnant women's difficulty in initiating antenatal care (ANC) on their own, inadequate support from partners and family, and a lack of information about the importance of ANC in the media. Lower educational attainment (AOR = 1.86, 95% CI [1.13, 3.08], p = 0.016), lower income levels (AOR = 2.42, 95% CI [1.00, 5.85], p = 0.049), lack of knowledge about early ANC (AOR = 0.59, 95% CI [0.36, 0.99], p = 0.045) and busy schedules (AOR = 0.09, 95% CI [0.05, 0.17], p < 0.001) were significant predictors of late ANC initiation. Conclusion: The study identifies a high prevalence of delayed antenatal care (ANC), primarily linked to educational and income levels, with financial constraints, demanding schedules, and insufficient knowledge as major contributing factors. Recommendations: To improve early antenatal care (ANC) uptake and health outcomes, targeted interventions such as financial support and ongoing health education through outreach are crucial. Future research should evaluate the long-term effects of these interventions and explore additional support mechanisms.
Journal of Health and Environmental Research, 2022
Water, Sanitation and Hygiene (WASH) implementation are paramount in reducing healthcare-associat... more Water, Sanitation and Hygiene (WASH) implementation are paramount in reducing healthcare-associated infections through Infection Prevention and Control (IPC) practices in healthcare facilities. This study assessed the Water, Sanitation, and Hygiene status in selected urban healthcare facilities. This assessment employed onsite observations and structured interviews using pre-defined Water and Sanitation for Health Facility improvement tool (WASH FIT) indicators. Hand hygiene had the highest assessed indicators meeting the required standards (70%) followed by the Water domain with 64%. Facility environment, cleanliness and disinfection had about 62% of its indicators meeting standards. Only 20.8% of indicators assessed on healthcare waste met standards with about 38% failing to meet standards. Sanitation had 30% of its indicators meeting standards. The management domain had the least indicators meeting standards (4.5%) with over 50% of indicators not meeting the standards. There is an urgent need for the supply of sanitation and healthcare waste logistics to healthcare facilities assessed and a paradigm shift in the area of management focusing on orientations of other healthcare professionals on WASH. Furthermore, the delegation of WASH implementation activities to healthcare professionals is key to ensuring effective implementation. Water quality assessment should be prioritized in future studies.
International Journal of Multidisciplinary Studies and Innovative Research, 2024
Access to maternal healthcare services is crucial in reducing maternal mortality rates, particul... more Access to maternal healthcare services is crucial in reducing maternal mortality rates, particularly in rural areas of developing countries like Ghana. The National Health Insurance Scheme (NHIS) in Ghana offers free maternal healthcare services to registered pregnant women, yet uptake remains low in rural districts. Understanding the socio-demographic factors influencing NHIS registration among pregnant women is essential for targeted interventions to improve maternal health outcomes. A cross-sectional study was conducted in Offinso North District of Ghana, involving 397 pregnant women accessing antenatal care services. A structured questionnaire was administered to collect socio-demographic data and information on NHIS registration status. Data were analyzed using descriptive statistics and logistic regression to determine factors associated with NHIS registration. The prevalence of National Health Insurance Scheme (NHIS) registration among the interviewed pregnant women was exceptionally high, reaching 98%, with approximately 87% maintaining active NHIS membership. The NHIS registration exhibited statistically significant associations with marital status (χ2=7.20; p=0.01). Moreover, the maintenance of active NHIS membership was significantly associated with various demographic factors, including age (χ2=5.00; p=0.03), educational level (χ2=8.77; p=0.00), marital status (χ2=5.38; p=0.02), and gestational age of pregnancy (χ2=5.84; p=0.02). Married respondents demonstrated a twofold likelihood of NHIS registration compared to their unmarried counterparts (AOR=2.05, [95%CI (1.53-39.69)], p=0.013). Conversely, respondents aged over 19 years were 0.5 times less likely to maintain active NHIS membership compared to teenage respondents (AOR=0.95, [95%CI (1.00-6.667)], p=0.050). Notably, respondents in their 35th week of pregnancy exhibited twice the likelihood of maintaining active NHIS membership compared to those with pregnancies below 35 weeks (AOR=2.08, [95%CI (1.03-61.80)], p=0.047). Socio-demographic factors such as age, education level, marital status, and gestational age of pregnancy significantly influenced active membership of National Health Insurance for free maternal healthcare among pregnant women in rural Ghana. These findings underscore the importance of targeted interventions to address socio-demographic disparities and enhance NHIS registration among pregnant women, ultimately improving maternal and child health outcomes in rural Ghana.
Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countrie... more Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countries to aid in achieving universal coverage with diagnostic testing, antimalarial treatment and malaria surveillance systems strengthening. This study, therefore, analyzed reported malaria data in the DHIMS2 database to assess the adherence of the ‘Test’, ‘Treat’ and ‘Track’ strategy in a rural district. Method: This was a retrospective cross-sectional descriptive analysis of reported OPD malaria secondary data from January 2016 to December 2020 to evaluate adherence to T3 policy in a district in Ghana. Reported DHIMS2 data by eight health facilities were extracted and analyzed to ascertain the test and treat component whilst an observational checklist was used to assess the track component of the policy. The analysis outcomes were presented on frequency tables and a chart. Findings: The overall testing rates for all ages, children under five years and pregnant women were 79.1%, 79.7% and 9...
International Journal of Research and Innovation in Social Science (IJRISS), 2022
Health care managers in urban settings have a greater advantage over their rural counterparts whe... more Health care managers in urban settings have a greater advantage over their rural counterparts when it comes to the needed essential training and logistics such as access to constant information technology and communication media to ensure effective health information management among health facilities. This assumption perceived health care managers in urban settings to have adequate knowledge and practice of health information management compared to their rural counterparts. This study, compared means scores of knowledge and practice of health information management among rural and urban health care managers in 67 conveniently selected government health facilities from 1st February to 10th March 2022 in the Ashanti region of Ghana. The study consisted of 37 (55.2%) urban and 30 (44.8%) rural managers of government health facilities (N= 67). Adequate health information management knowledge levels for rural and urban settings were 36.7% and 34.3% respectively. The level of adherence to good health information management practices for rural and urban were 53.3% and 43.2% respectively. The study revealed no statistical difference in the mean scores for knowledge t(65) =-0.08, p = 0.94 and practice t(65) =-0.59, p = 0.56 of health information management between rural and urban settings. Continuous capacity building tailored to health information management is paramount to ensure adequate knowledge and practice to improve health information practice among health facility managers in both rural and urban settings.
Journal of Health and Environmental Research, 2022
A proper health information management system goes a long way to effectively influence data-drive... more A proper health information management system goes a long way to effectively influence data-driven decision making to improve health delivery. Despite dedicating enormous resources to adequately manage health information in the health systems, health facility managers who are the main custodians of this information at the facility levels pay little or no attention to the management of this information. This study therefore aimed at assessing the knowledge, attitude and practice of health information management among health facility managers in government health facilities. An institutional-based descriptive cross-sectional study was conducted from 1st February to 10th March 2022 in 68 purposively selected government health facilities in the Ashanti Region of Ghana. A pretested researcher-administered structured questionnaire was used to elicit quantitative data from health facility managers. Epi Info version 7 and STATA version 13 were used for data entry, cleaning and analysis respectively. Univariate descriptive statistics were computed. Fisher’s exact Binary logistic regression analysis was done to identify factors influencing knowledge, attitude and practice levels. An odd ratio at a 95% confidence level was used to describe the strength of the association. The overall adequate knowledge score was 34.3% with a mean score of 9.09±0.97. Good attitude and practice scores were 41.8% and 47.8% with mean scores of 3.01±1.04 and 6.22±2.60 respectively. Adequate knowledge among respondents who were 30 years and above was 10 times more compared to respondents whose ages were below the 30 years (95%CI (10.00,4.53.45), p = 0.016). Respondents who had worked for 5 years or more were more likely to have adequate knowledge of health information management compared to the respondents who have worked for less than 5 years (COR = 4.96 [95%CI (1.20,29.83)], p = 0.022). Sex, educational level, and respondents’ specialty were not statistically significant with the health information management knowledge level. All socio-demographics used in the multivariate analysis were not statistically significant with attitude and practice level of health information management among respondents. Knowledge, attitude and practice level of health information management were found to be very poor among health facility managers. Capacity building tailored towards health facility managers would help ensure effective supervision and monitoring of routine health information management. Future research would be needed to explore the reason behind the poor level of health managers’ knowledge, attitude and practice of health information management.
Background: There is scanty data on the usage and safety of herbal medicines in pregnancy and bre... more Background: There is scanty data on the usage and safety of herbal medicines in pregnancy and breast feeding. Though they may be efficacious on account of their long experience of usage, effects of these herbal preparations and the extent of usage in pregnancy and breastfeeding are not known. There were anecdotal claims of herbal medicine usage in pregnancy in Offinso North District. Objective: To determine the prevalence and the pattern of herbal medicine usage among pregnant women attending ANC in all the health facilities in Offinso North District and to determine the level of awareness of healthcare givers about these herbal medicines. Design: Cross-sectional study. Method: A standardized structured questionnaire was administered to pregnant women attending antenatal clinics in the Offinso North district. Results: Age of respondents ranged from 15-49 years among which 25 (6.5%) took herbal medicines through varying routes of administration. High usage was found amongst those married and also with no formal and basic education and a median age of 25 years. Awareness of orthodox health practitioners about these herbal medicines was scanty. Conclusions: The study emphasized the use of herbal medicines particularly through some unconventional mode of preparations by pregnant women in Offinso North. Orthodox practitioners' awareness of their usage was found to be inadequate, highlighting an urgent need for health care practitioners and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during antenatal care.
International Journal of Scientific Research and Management
Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect... more Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect the quality of decision and interventions. This study sought to assess the quality of routine neonatal mortalities and stillbirth records in health facilities and propose interventions to improve the data quality gaps. Method: Descriptive cross-sectional study was employed. This study was carried out at three (3) purposively selected health facilities in Offinso North district. Stillbirths and neonatal deaths recorded in registers from 2015 to 2017, were recounted and compared with monthly aggregated data and District Health Information Management System 2 (DHIMS 2) data using a self-developed Excel Data Quality Assessment Tool (DQS). An observational checklist was used to collect primary data on completeness and availability. Accuracy ratio (verification factor), discrepancy rate, percentage availability and completeness of stillbirths and neonatal mortality data were computed using t...
International Journal of Scientific Research and Management, 2022
Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect... more Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect the quality of decision and interventions. This study sought to assess the quality of routine neonatal mortalities and stillbirth records in health facilities and propose interventions to improve the data quality gaps. Method: Descriptive cross-sectional study was employed. This study was carried out at three (3) purposively selected health facilities in Offinso North district. Stillbirths and neonatal deaths recorded in registers from 2015 to 2017, were recounted and compared with monthly aggregated data and District Health Information Management System 2 (DHIMS 2) data using a self-developed Excel Data Quality Assessment Tool (DQS). An observational checklist was used to collect primary data on completeness and availability. Accuracy ratio (verification factor), discrepancy rate, percentage availability and completeness of stillbirths and neonatal mortality data were computed using t...
International Journal of Scientific Development and Research, 2022
Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countrie... more Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countries to aid in achieving universal coverage with diagnostic testing, antimalarial treatment and malaria surveillance systems strengthening. This study, therefore, analyzed reported malaria data in the DHIMS2 database to assess the adherence of the ‘Test’, ‘Treat’ and ‘Track’ strategy in a rural district. Method: This was a retrospective cross-sectional descriptive analysis of reported OPD malaria secondary data from January 2016 to December 2020 to evaluate adherence to T3 policy in a district in Ghana. Reported DHIMS2 data by eight health facilities were extracted and analyzed to ascertain the test and treat component whilst an observational checklist was used to assess the track component of the policy. The analysis outcomes were presented on frequency tables and a chart. Findings: The overall testing rates for all ages, children under five years and pregnant women were 79.1%, 79.7% and 97.1% respectively. Presumptuous treatment among children under five years and pregnant women was 29.5% and 6.2%. Over 11% of clients were prescribed antimalarial though malaria test results proved they were negative. There was no documented evidence of malaria surveillance, though malaria data were duly reported in DHIMS2. Conclusion: Adherence to the ‘Test’ policy was consistently encouraging especially among children under five years and pregnant women. The facilities compliance with the ‘Treat’ policy was marginally low with a poor tracking malaria surveillance system.
Background: Access to healthcare is crucial for health equity and outcomes, especially in resourc... more Background: Access to healthcare is crucial for health equity and outcomes, especially in resource-limited rural areas. Despite expansion efforts, access disparities persist, impacting rural well-being. Assessing spatial accessibility to primary and secondary healthcare is essential for identifying underserved areas and guiding effective resource allocation and intervention strategies. Objective: This study aims to evaluate the geographic access to healthcare services in a rural district of Ghana using Geographic Information Systems (GIS) and spatial analysis techniques. Methods: Utilizing Geographic Information Systems (GIS) 3.28.6, spatial data including health facility locations, settlements, road networks, and population data were analysed. Buffer and distance to the nearest hub analyses were conducted to assess healthcare accessibility to all ten (10) healthcare facilities in the district. Travel time analysis was performed using specified travel speeds for various modes of transportation. Chi-square tests were employed to evaluate the associations between settlement characteristics and access to primary and secondary healthcare services. Results: Approximately 40% of the health facilities were located in Akumadan, the district capital. Primary healthcare accessibility within a 3km radius covered 35% of settlements and 59% of the population, while secondary healthcare, within a 5km radius, was accessible to only 11.3% of settlements and 27.2% of the population. The mean distance to health centres was 4.35±2.72 km and to hospitals was 10.35±5.77 km. Mean walking times were 87±54.6 minutes to health centres and 209.2±117.0 minutes to hospitals. By motorized transport, travel times were up to 24 minutes to health centres and 55 minutes to hospitals; by bicycle, up to 37 minutes to health centres and 190 minutes to hospitals. Chi-Square Tests revealed significant associations between settlement type and both primary (χ²(1, N=80) = 30.77, p <.001) and secondary (χ²(1, N=80) = 15.93, p <.001) healthcare access, as well as between population level and healthcare access. Proximity to health facilities (primary χ²(1, N=80) = 21.26, p <.001; secondary χ²(1, N=80) = 5.48, p =.019) and transportation accessibility (primary χ²(1, N=80) = 9.13, p =.003; secondary χ²(1, N=80) = 12.13, p <.001) were significantly associated with healthcare access. Conclusion: This study unveils substantial disparities in healthcare accessibility, characterized by uneven distribution of facilities and remote distances. Challenges include limited infrastructure and geographic isolation. Addressing these requires enhanced infrastructure, transport networks, expanding outreach services, and equitable policy reforms to promote health equity.
Aim: Pregnancy complications significantly affect health, making timely antenatal care (ANC) esse... more Aim: Pregnancy complications significantly affect health, making timely antenatal care (ANC) essential for early detection and skilled delivery. Despite WHO guidelines, some pregnant women in Ghana's Offinso North District delay their first ANC visit. This study explored intrapersonal and interpersonal factors contributing to this delay. Methods: Conducted from October 2021 to March 2022, this institutional cross-sectional study collected data from 397 pregnant women through a structured questionnaire. Descriptive and inferential statistical analyses were conducted with SPSS version 20. Results: Approximately 47% of pregnant women booked their antenatal care late. Key personal reasons hindering early ANC initiation included financial constraints, busy schedules, and insufficient knowledge about early ANC. Interpersonal barriers included pregnant women's difficulty in initiating antenatal care (ANC) on their own, inadequate support from partners and family, and a lack of information about the importance of ANC in the media. Lower educational attainment (AOR = 1.86, 95% CI [1.13, 3.08], p = 0.016), lower income levels (AOR = 2.42, 95% CI [1.00, 5.85], p = 0.049), lack of knowledge about early ANC (AOR = 0.59, 95% CI [0.36, 0.99], p = 0.045) and busy schedules (AOR = 0.09, 95% CI [0.05, 0.17], p < 0.001) were significant predictors of late ANC initiation. Conclusion: The study identifies a high prevalence of delayed antenatal care (ANC), primarily linked to educational and income levels, with financial constraints, demanding schedules, and insufficient knowledge as major contributing factors. Recommendations: To improve early antenatal care (ANC) uptake and health outcomes, targeted interventions such as financial support and ongoing health education through outreach are crucial. Future research should evaluate the long-term effects of these interventions and explore additional support mechanisms.
Journal of Health and Environmental Research, 2022
Water, Sanitation and Hygiene (WASH) implementation are paramount in reducing healthcare-associat... more Water, Sanitation and Hygiene (WASH) implementation are paramount in reducing healthcare-associated infections through Infection Prevention and Control (IPC) practices in healthcare facilities. This study assessed the Water, Sanitation, and Hygiene status in selected urban healthcare facilities. This assessment employed onsite observations and structured interviews using pre-defined Water and Sanitation for Health Facility improvement tool (WASH FIT) indicators. Hand hygiene had the highest assessed indicators meeting the required standards (70%) followed by the Water domain with 64%. Facility environment, cleanliness and disinfection had about 62% of its indicators meeting standards. Only 20.8% of indicators assessed on healthcare waste met standards with about 38% failing to meet standards. Sanitation had 30% of its indicators meeting standards. The management domain had the least indicators meeting standards (4.5%) with over 50% of indicators not meeting the standards. There is an urgent need for the supply of sanitation and healthcare waste logistics to healthcare facilities assessed and a paradigm shift in the area of management focusing on orientations of other healthcare professionals on WASH. Furthermore, the delegation of WASH implementation activities to healthcare professionals is key to ensuring effective implementation. Water quality assessment should be prioritized in future studies.
International Journal of Multidisciplinary Studies and Innovative Research, 2024
Access to maternal healthcare services is crucial in reducing maternal mortality rates, particul... more Access to maternal healthcare services is crucial in reducing maternal mortality rates, particularly in rural areas of developing countries like Ghana. The National Health Insurance Scheme (NHIS) in Ghana offers free maternal healthcare services to registered pregnant women, yet uptake remains low in rural districts. Understanding the socio-demographic factors influencing NHIS registration among pregnant women is essential for targeted interventions to improve maternal health outcomes. A cross-sectional study was conducted in Offinso North District of Ghana, involving 397 pregnant women accessing antenatal care services. A structured questionnaire was administered to collect socio-demographic data and information on NHIS registration status. Data were analyzed using descriptive statistics and logistic regression to determine factors associated with NHIS registration. The prevalence of National Health Insurance Scheme (NHIS) registration among the interviewed pregnant women was exceptionally high, reaching 98%, with approximately 87% maintaining active NHIS membership. The NHIS registration exhibited statistically significant associations with marital status (χ2=7.20; p=0.01). Moreover, the maintenance of active NHIS membership was significantly associated with various demographic factors, including age (χ2=5.00; p=0.03), educational level (χ2=8.77; p=0.00), marital status (χ2=5.38; p=0.02), and gestational age of pregnancy (χ2=5.84; p=0.02). Married respondents demonstrated a twofold likelihood of NHIS registration compared to their unmarried counterparts (AOR=2.05, [95%CI (1.53-39.69)], p=0.013). Conversely, respondents aged over 19 years were 0.5 times less likely to maintain active NHIS membership compared to teenage respondents (AOR=0.95, [95%CI (1.00-6.667)], p=0.050). Notably, respondents in their 35th week of pregnancy exhibited twice the likelihood of maintaining active NHIS membership compared to those with pregnancies below 35 weeks (AOR=2.08, [95%CI (1.03-61.80)], p=0.047). Socio-demographic factors such as age, education level, marital status, and gestational age of pregnancy significantly influenced active membership of National Health Insurance for free maternal healthcare among pregnant women in rural Ghana. These findings underscore the importance of targeted interventions to address socio-demographic disparities and enhance NHIS registration among pregnant women, ultimately improving maternal and child health outcomes in rural Ghana.
Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countrie... more Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countries to aid in achieving universal coverage with diagnostic testing, antimalarial treatment and malaria surveillance systems strengthening. This study, therefore, analyzed reported malaria data in the DHIMS2 database to assess the adherence of the ‘Test’, ‘Treat’ and ‘Track’ strategy in a rural district. Method: This was a retrospective cross-sectional descriptive analysis of reported OPD malaria secondary data from January 2016 to December 2020 to evaluate adherence to T3 policy in a district in Ghana. Reported DHIMS2 data by eight health facilities were extracted and analyzed to ascertain the test and treat component whilst an observational checklist was used to assess the track component of the policy. The analysis outcomes were presented on frequency tables and a chart. Findings: The overall testing rates for all ages, children under five years and pregnant women were 79.1%, 79.7% and 9...
International Journal of Research and Innovation in Social Science (IJRISS), 2022
Health care managers in urban settings have a greater advantage over their rural counterparts whe... more Health care managers in urban settings have a greater advantage over their rural counterparts when it comes to the needed essential training and logistics such as access to constant information technology and communication media to ensure effective health information management among health facilities. This assumption perceived health care managers in urban settings to have adequate knowledge and practice of health information management compared to their rural counterparts. This study, compared means scores of knowledge and practice of health information management among rural and urban health care managers in 67 conveniently selected government health facilities from 1st February to 10th March 2022 in the Ashanti region of Ghana. The study consisted of 37 (55.2%) urban and 30 (44.8%) rural managers of government health facilities (N= 67). Adequate health information management knowledge levels for rural and urban settings were 36.7% and 34.3% respectively. The level of adherence to good health information management practices for rural and urban were 53.3% and 43.2% respectively. The study revealed no statistical difference in the mean scores for knowledge t(65) =-0.08, p = 0.94 and practice t(65) =-0.59, p = 0.56 of health information management between rural and urban settings. Continuous capacity building tailored to health information management is paramount to ensure adequate knowledge and practice to improve health information practice among health facility managers in both rural and urban settings.
Journal of Health and Environmental Research, 2022
A proper health information management system goes a long way to effectively influence data-drive... more A proper health information management system goes a long way to effectively influence data-driven decision making to improve health delivery. Despite dedicating enormous resources to adequately manage health information in the health systems, health facility managers who are the main custodians of this information at the facility levels pay little or no attention to the management of this information. This study therefore aimed at assessing the knowledge, attitude and practice of health information management among health facility managers in government health facilities. An institutional-based descriptive cross-sectional study was conducted from 1st February to 10th March 2022 in 68 purposively selected government health facilities in the Ashanti Region of Ghana. A pretested researcher-administered structured questionnaire was used to elicit quantitative data from health facility managers. Epi Info version 7 and STATA version 13 were used for data entry, cleaning and analysis respectively. Univariate descriptive statistics were computed. Fisher’s exact Binary logistic regression analysis was done to identify factors influencing knowledge, attitude and practice levels. An odd ratio at a 95% confidence level was used to describe the strength of the association. The overall adequate knowledge score was 34.3% with a mean score of 9.09±0.97. Good attitude and practice scores were 41.8% and 47.8% with mean scores of 3.01±1.04 and 6.22±2.60 respectively. Adequate knowledge among respondents who were 30 years and above was 10 times more compared to respondents whose ages were below the 30 years (95%CI (10.00,4.53.45), p = 0.016). Respondents who had worked for 5 years or more were more likely to have adequate knowledge of health information management compared to the respondents who have worked for less than 5 years (COR = 4.96 [95%CI (1.20,29.83)], p = 0.022). Sex, educational level, and respondents’ specialty were not statistically significant with the health information management knowledge level. All socio-demographics used in the multivariate analysis were not statistically significant with attitude and practice level of health information management among respondents. Knowledge, attitude and practice level of health information management were found to be very poor among health facility managers. Capacity building tailored towards health facility managers would help ensure effective supervision and monitoring of routine health information management. Future research would be needed to explore the reason behind the poor level of health managers’ knowledge, attitude and practice of health information management.
Background: There is scanty data on the usage and safety of herbal medicines in pregnancy and bre... more Background: There is scanty data on the usage and safety of herbal medicines in pregnancy and breast feeding. Though they may be efficacious on account of their long experience of usage, effects of these herbal preparations and the extent of usage in pregnancy and breastfeeding are not known. There were anecdotal claims of herbal medicine usage in pregnancy in Offinso North District. Objective: To determine the prevalence and the pattern of herbal medicine usage among pregnant women attending ANC in all the health facilities in Offinso North District and to determine the level of awareness of healthcare givers about these herbal medicines. Design: Cross-sectional study. Method: A standardized structured questionnaire was administered to pregnant women attending antenatal clinics in the Offinso North district. Results: Age of respondents ranged from 15-49 years among which 25 (6.5%) took herbal medicines through varying routes of administration. High usage was found amongst those married and also with no formal and basic education and a median age of 25 years. Awareness of orthodox health practitioners about these herbal medicines was scanty. Conclusions: The study emphasized the use of herbal medicines particularly through some unconventional mode of preparations by pregnant women in Offinso North. Orthodox practitioners' awareness of their usage was found to be inadequate, highlighting an urgent need for health care practitioners and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during antenatal care.
International Journal of Scientific Research and Management
Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect... more Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect the quality of decision and interventions. This study sought to assess the quality of routine neonatal mortalities and stillbirth records in health facilities and propose interventions to improve the data quality gaps. Method: Descriptive cross-sectional study was employed. This study was carried out at three (3) purposively selected health facilities in Offinso North district. Stillbirths and neonatal deaths recorded in registers from 2015 to 2017, were recounted and compared with monthly aggregated data and District Health Information Management System 2 (DHIMS 2) data using a self-developed Excel Data Quality Assessment Tool (DQS). An observational checklist was used to collect primary data on completeness and availability. Accuracy ratio (verification factor), discrepancy rate, percentage availability and completeness of stillbirths and neonatal mortality data were computed using t...
International Journal of Scientific Research and Management, 2022
Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect... more Background: Stillbirths and neonatal deaths when poorly documented or collated, negatively affect the quality of decision and interventions. This study sought to assess the quality of routine neonatal mortalities and stillbirth records in health facilities and propose interventions to improve the data quality gaps. Method: Descriptive cross-sectional study was employed. This study was carried out at three (3) purposively selected health facilities in Offinso North district. Stillbirths and neonatal deaths recorded in registers from 2015 to 2017, were recounted and compared with monthly aggregated data and District Health Information Management System 2 (DHIMS 2) data using a self-developed Excel Data Quality Assessment Tool (DQS). An observational checklist was used to collect primary data on completeness and availability. Accuracy ratio (verification factor), discrepancy rate, percentage availability and completeness of stillbirths and neonatal mortality data were computed using t...
International Journal of Scientific Development and Research, 2022
Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countrie... more Background: The WHO in 2012 recommended the T3 (Test, Treat and Track) policy in endemic countries to aid in achieving universal coverage with diagnostic testing, antimalarial treatment and malaria surveillance systems strengthening. This study, therefore, analyzed reported malaria data in the DHIMS2 database to assess the adherence of the ‘Test’, ‘Treat’ and ‘Track’ strategy in a rural district. Method: This was a retrospective cross-sectional descriptive analysis of reported OPD malaria secondary data from January 2016 to December 2020 to evaluate adherence to T3 policy in a district in Ghana. Reported DHIMS2 data by eight health facilities were extracted and analyzed to ascertain the test and treat component whilst an observational checklist was used to assess the track component of the policy. The analysis outcomes were presented on frequency tables and a chart. Findings: The overall testing rates for all ages, children under five years and pregnant women were 79.1%, 79.7% and 97.1% respectively. Presumptuous treatment among children under five years and pregnant women was 29.5% and 6.2%. Over 11% of clients were prescribed antimalarial though malaria test results proved they were negative. There was no documented evidence of malaria surveillance, though malaria data were duly reported in DHIMS2. Conclusion: Adherence to the ‘Test’ policy was consistently encouraging especially among children under five years and pregnant women. The facilities compliance with the ‘Treat’ policy was marginally low with a poor tracking malaria surveillance system.
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Papers by Richmond Bediako Nsiah
expansion efforts, access disparities persist, impacting rural well-being. Assessing spatial accessibility to primary and secondary
healthcare is essential for identifying underserved areas and guiding effective resource allocation and intervention strategies.
Objective: This study aims to evaluate the geographic access to healthcare services in a rural district of Ghana using Geographic Information Systems (GIS) and spatial analysis techniques. Methods: Utilizing Geographic Information Systems (GIS) 3.28.6, spatial data including health facility locations, settlements, road networks, and population data were analysed. Buffer and distance to the nearest hub analyses were conducted to assess healthcare accessibility to all ten (10) healthcare facilities in the district. Travel time analysis was performed using specified travel speeds for various modes of transportation. Chi-square tests were employed to evaluate the associations between settlement characteristics and access to primary and secondary healthcare services. Results: Approximately 40% of the health facilities were located in Akumadan, the district capital. Primary healthcare accessibility within a 3km radius covered 35% of settlements and 59% of the population, while secondary healthcare, within a 5km radius, was accessible to only 11.3% of settlements and 27.2% of the population. The mean distance to health centres was 4.35±2.72 km and to hospitals was 10.35±5.77 km. Mean walking times were 87±54.6 minutes to health centres and 209.2±117.0 minutes to hospitals. By motorized transport, travel times were up to 24 minutes to health centres and 55 minutes to hospitals; by bicycle, up to 37 minutes to health centres and 190 minutes to hospitals. Chi-Square Tests revealed significant associations between settlement type and both primary (χ²(1, N=80) = 30.77, p <.001) and secondary (χ²(1, N=80) = 15.93, p <.001) healthcare access, as well as between population level and healthcare access. Proximity to health facilities (primary χ²(1, N=80) = 21.26, p <.001; secondary χ²(1, N=80) = 5.48, p =.019) and transportation accessibility (primary χ²(1, N=80) = 9.13, p =.003; secondary χ²(1, N=80) = 12.13, p <.001) were significantly associated with healthcare access. Conclusion: This study unveils substantial disparities in healthcare accessibility, characterized by uneven distribution of facilities and remote distances. Challenges include limited infrastructure and geographic isolation. Addressing these requires enhanced infrastructure, transport networks, expanding outreach services, and equitable policy reforms to promote health equity.
infections through Infection Prevention and Control (IPC) practices in healthcare facilities. This study assessed the Water,
Sanitation, and Hygiene status in selected urban healthcare facilities. This assessment employed onsite observations and
structured interviews using pre-defined Water and Sanitation for Health Facility improvement tool (WASH FIT) indicators.
Hand hygiene had the highest assessed indicators meeting the required standards (70%) followed by the Water domain with 64%.
Facility environment, cleanliness and disinfection had about 62% of its indicators meeting standards. Only 20.8% of indicators
assessed on healthcare waste met standards with about 38% failing to meet standards. Sanitation had 30% of its indicators
meeting standards. The management domain had the least indicators meeting standards (4.5%) with over 50% of indicators not
meeting the standards. There is an urgent need for the supply of sanitation and healthcare waste logistics to healthcare facilities
assessed and a paradigm shift in the area of management focusing on orientations of other healthcare professionals on WASH.
Furthermore, the delegation of WASH implementation activities to healthcare professionals is key to ensuring effective
implementation. Water quality assessment should be prioritized in future studies.
offers free maternal healthcare services to registered pregnant women, yet uptake remains low in rural districts. Understanding the socio-demographic factors influencing NHIS registration among pregnant
women is essential for targeted interventions to improve maternal health outcomes. A cross-sectional study was conducted in Offinso North District of Ghana, involving 397 pregnant women accessing antenatal care services. A structured questionnaire was administered to collect socio-demographic data and information on NHIS registration status. Data were analyzed using descriptive statistics and logistic regression to determine factors associated with NHIS registration. The prevalence of National Health Insurance Scheme (NHIS) registration among the interviewed pregnant women was exceptionally high, reaching 98%, with
approximately 87% maintaining active NHIS membership. The NHIS registration exhibited statistically significant associations with marital status (χ2=7.20; p=0.01). Moreover, the maintenance of active NHIS
membership was significantly associated with various demographic factors, including age (χ2=5.00; p=0.03), educational level (χ2=8.77; p=0.00), marital status (χ2=5.38; p=0.02), and gestational age of pregnancy (χ2=5.84; p=0.02). Married respondents demonstrated a twofold likelihood of NHIS registration compared
to their unmarried counterparts (AOR=2.05, [95%CI (1.53-39.69)], p=0.013). Conversely, respondents aged over 19 years were 0.5 times less likely to maintain active NHIS membership compared to teenage respondents (AOR=0.95, [95%CI (1.00-6.667)], p=0.050). Notably, respondents in their 35th week of pregnancy exhibited twice the likelihood of maintaining active NHIS membership compared to those with pregnancies below 35 weeks (AOR=2.08, [95%CI (1.03-61.80)], p=0.047). Socio-demographic factors such as age, education level, marital status, and gestational age of pregnancy significantly influenced active membership of National Health Insurance for free maternal healthcare among pregnant women in rural
Ghana. These findings underscore the importance of targeted interventions to address socio-demographic disparities and enhance NHIS registration among pregnant women, ultimately improving maternal and child health outcomes in rural Ghana.
making to improve health delivery. Despite dedicating enormous resources to adequately manage health information in the health
systems, health facility managers who are the main custodians of this information at the facility levels pay little or no attention to
the management of this information. This study therefore aimed at assessing the knowledge, attitude and practice of health
information management among health facility managers in government health facilities. An institutional-based descriptive
cross-sectional study was conducted from 1st February to 10th March 2022 in 68 purposively selected government health
facilities in the Ashanti Region of Ghana. A pretested researcher-administered structured questionnaire was used to elicit
quantitative data from health facility managers. Epi Info version 7 and STATA version 13 were used for data entry, cleaning and
analysis respectively. Univariate descriptive statistics were computed. Fisher’s exact Binary logistic regression analysis was
done to identify factors influencing knowledge, attitude and practice levels. An odd ratio at a 95% confidence level was used to
describe the strength of the association. The overall adequate knowledge score was 34.3% with a mean score of 9.09±0.97. Good
attitude and practice scores were 41.8% and 47.8% with mean scores of 3.01±1.04 and 6.22±2.60 respectively. Adequate
knowledge among respondents who were 30 years and above was 10 times more compared to respondents whose ages were
below the 30 years (95%CI (10.00,4.53.45), p = 0.016). Respondents who had worked for 5 years or more were more likely to
have adequate knowledge of health information management compared to the respondents who have worked for less than 5 years
(COR = 4.96 [95%CI (1.20,29.83)], p = 0.022). Sex, educational level, and respondents’ specialty were not statistically
significant with the health information management knowledge level. All socio-demographics used in the multivariate analysis
were not statistically significant with attitude and practice level of health information management among respondents.
Knowledge, attitude and practice level of health information management were found to be very poor among health facility
managers. Capacity building tailored towards health facility managers would help ensure effective supervision and monitoring of
routine health information management. Future research would be needed to explore the reason behind the poor level of health
managers’ knowledge, attitude and practice of health information management.
expansion efforts, access disparities persist, impacting rural well-being. Assessing spatial accessibility to primary and secondary
healthcare is essential for identifying underserved areas and guiding effective resource allocation and intervention strategies.
Objective: This study aims to evaluate the geographic access to healthcare services in a rural district of Ghana using Geographic Information Systems (GIS) and spatial analysis techniques. Methods: Utilizing Geographic Information Systems (GIS) 3.28.6, spatial data including health facility locations, settlements, road networks, and population data were analysed. Buffer and distance to the nearest hub analyses were conducted to assess healthcare accessibility to all ten (10) healthcare facilities in the district. Travel time analysis was performed using specified travel speeds for various modes of transportation. Chi-square tests were employed to evaluate the associations between settlement characteristics and access to primary and secondary healthcare services. Results: Approximately 40% of the health facilities were located in Akumadan, the district capital. Primary healthcare accessibility within a 3km radius covered 35% of settlements and 59% of the population, while secondary healthcare, within a 5km radius, was accessible to only 11.3% of settlements and 27.2% of the population. The mean distance to health centres was 4.35±2.72 km and to hospitals was 10.35±5.77 km. Mean walking times were 87±54.6 minutes to health centres and 209.2±117.0 minutes to hospitals. By motorized transport, travel times were up to 24 minutes to health centres and 55 minutes to hospitals; by bicycle, up to 37 minutes to health centres and 190 minutes to hospitals. Chi-Square Tests revealed significant associations between settlement type and both primary (χ²(1, N=80) = 30.77, p <.001) and secondary (χ²(1, N=80) = 15.93, p <.001) healthcare access, as well as between population level and healthcare access. Proximity to health facilities (primary χ²(1, N=80) = 21.26, p <.001; secondary χ²(1, N=80) = 5.48, p =.019) and transportation accessibility (primary χ²(1, N=80) = 9.13, p =.003; secondary χ²(1, N=80) = 12.13, p <.001) were significantly associated with healthcare access. Conclusion: This study unveils substantial disparities in healthcare accessibility, characterized by uneven distribution of facilities and remote distances. Challenges include limited infrastructure and geographic isolation. Addressing these requires enhanced infrastructure, transport networks, expanding outreach services, and equitable policy reforms to promote health equity.
infections through Infection Prevention and Control (IPC) practices in healthcare facilities. This study assessed the Water,
Sanitation, and Hygiene status in selected urban healthcare facilities. This assessment employed onsite observations and
structured interviews using pre-defined Water and Sanitation for Health Facility improvement tool (WASH FIT) indicators.
Hand hygiene had the highest assessed indicators meeting the required standards (70%) followed by the Water domain with 64%.
Facility environment, cleanliness and disinfection had about 62% of its indicators meeting standards. Only 20.8% of indicators
assessed on healthcare waste met standards with about 38% failing to meet standards. Sanitation had 30% of its indicators
meeting standards. The management domain had the least indicators meeting standards (4.5%) with over 50% of indicators not
meeting the standards. There is an urgent need for the supply of sanitation and healthcare waste logistics to healthcare facilities
assessed and a paradigm shift in the area of management focusing on orientations of other healthcare professionals on WASH.
Furthermore, the delegation of WASH implementation activities to healthcare professionals is key to ensuring effective
implementation. Water quality assessment should be prioritized in future studies.
offers free maternal healthcare services to registered pregnant women, yet uptake remains low in rural districts. Understanding the socio-demographic factors influencing NHIS registration among pregnant
women is essential for targeted interventions to improve maternal health outcomes. A cross-sectional study was conducted in Offinso North District of Ghana, involving 397 pregnant women accessing antenatal care services. A structured questionnaire was administered to collect socio-demographic data and information on NHIS registration status. Data were analyzed using descriptive statistics and logistic regression to determine factors associated with NHIS registration. The prevalence of National Health Insurance Scheme (NHIS) registration among the interviewed pregnant women was exceptionally high, reaching 98%, with
approximately 87% maintaining active NHIS membership. The NHIS registration exhibited statistically significant associations with marital status (χ2=7.20; p=0.01). Moreover, the maintenance of active NHIS
membership was significantly associated with various demographic factors, including age (χ2=5.00; p=0.03), educational level (χ2=8.77; p=0.00), marital status (χ2=5.38; p=0.02), and gestational age of pregnancy (χ2=5.84; p=0.02). Married respondents demonstrated a twofold likelihood of NHIS registration compared
to their unmarried counterparts (AOR=2.05, [95%CI (1.53-39.69)], p=0.013). Conversely, respondents aged over 19 years were 0.5 times less likely to maintain active NHIS membership compared to teenage respondents (AOR=0.95, [95%CI (1.00-6.667)], p=0.050). Notably, respondents in their 35th week of pregnancy exhibited twice the likelihood of maintaining active NHIS membership compared to those with pregnancies below 35 weeks (AOR=2.08, [95%CI (1.03-61.80)], p=0.047). Socio-demographic factors such as age, education level, marital status, and gestational age of pregnancy significantly influenced active membership of National Health Insurance for free maternal healthcare among pregnant women in rural
Ghana. These findings underscore the importance of targeted interventions to address socio-demographic disparities and enhance NHIS registration among pregnant women, ultimately improving maternal and child health outcomes in rural Ghana.
making to improve health delivery. Despite dedicating enormous resources to adequately manage health information in the health
systems, health facility managers who are the main custodians of this information at the facility levels pay little or no attention to
the management of this information. This study therefore aimed at assessing the knowledge, attitude and practice of health
information management among health facility managers in government health facilities. An institutional-based descriptive
cross-sectional study was conducted from 1st February to 10th March 2022 in 68 purposively selected government health
facilities in the Ashanti Region of Ghana. A pretested researcher-administered structured questionnaire was used to elicit
quantitative data from health facility managers. Epi Info version 7 and STATA version 13 were used for data entry, cleaning and
analysis respectively. Univariate descriptive statistics were computed. Fisher’s exact Binary logistic regression analysis was
done to identify factors influencing knowledge, attitude and practice levels. An odd ratio at a 95% confidence level was used to
describe the strength of the association. The overall adequate knowledge score was 34.3% with a mean score of 9.09±0.97. Good
attitude and practice scores were 41.8% and 47.8% with mean scores of 3.01±1.04 and 6.22±2.60 respectively. Adequate
knowledge among respondents who were 30 years and above was 10 times more compared to respondents whose ages were
below the 30 years (95%CI (10.00,4.53.45), p = 0.016). Respondents who had worked for 5 years or more were more likely to
have adequate knowledge of health information management compared to the respondents who have worked for less than 5 years
(COR = 4.96 [95%CI (1.20,29.83)], p = 0.022). Sex, educational level, and respondents’ specialty were not statistically
significant with the health information management knowledge level. All socio-demographics used in the multivariate analysis
were not statistically significant with attitude and practice level of health information management among respondents.
Knowledge, attitude and practice level of health information management were found to be very poor among health facility
managers. Capacity building tailored towards health facility managers would help ensure effective supervision and monitoring of
routine health information management. Future research would be needed to explore the reason behind the poor level of health
managers’ knowledge, attitude and practice of health information management.