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Dive into the research topics where Emmanuel Nakua is active.

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Featured researches published by Emmanuel Nakua.


BMC Medical Education | 2013

Factors that influence midwifery students in Ghana when deciding where to practice: a discrete choice experiment

Peter Ageyi-Baffour; Sarah Rominski; Emmanuel Nakua; Mawuli Gyakobo; Jody R. Lori

BackgroundMal-distribution of the health workforce with a strong bias for urban living is a major constraint to expanding midwifery services in Ghana. According to the UN Millennium Development Goals (MDG) report, the high risk of dying in pregnancy or childbirth continues in Africa. Maternal death is currently estimated at 350 per 100,000, partially a reflection of the low rates of professional support during birth. Many women in rural areas of Ghana give birth alone or with a non-skilled attendant. Midwives are key healthcare providers in achieving the MDGs, specifically in reducing maternal mortality by three-quarters and reducing by two-thirds the under 5 child mortality rate by 2015.MethodsThis quantitative research study used a computerized structured survey containing a discrete choice experiment (DCE) to quantify the importance of different incentives and policies to encourage service to deprived, rural and remote areas by upper-year midwifery students following graduation. Using a hierarchical Bayes procedure we estimated individual and mean utility parameters for two hundred and ninety eight third year midwifery students from two of the largest midwifery training schools in Ghana.ResultsMidwifery students in our sample identified: 1) study leave after two years of rural service; 2) an advanced work environment with reliable electricity, appropriate technology and a constant drug supply; and 3) superior housing (2 bedroom, 1 bathroom, kitchen, living room, not shared) as the top three motivating factors to accept a rural posting.ConclusionAddressing the motivating factors for rural postings among midwifery students who are about to graduate and enter the workforce could significantly contribute to the current mal-distribution of the health workforce.


Injury Prevention | 2015

Incidence, characteristics and risk factors for household and neighbourhood injury among young children in semiurban Ghana: a population-based household survey

Adam Gyedu; Emmanuel Nakua; Easmon Otupiri; Charles Mock; Beth E. Ebel

Background There are few population-based studies on household child injury in African countries. Objectives To determine the incidence, characteristics and risk factors of household and neighbourhood injury among children in semiurban communities in Kumasi, Ghana. Methods We conducted a cross-sectional population-weighted survey of 200 randomly selected caregivers of children under 18, representing 6801 households. Caregivers were interviewed about moderate to severe childhood injuries occurring within the past 6 months, for which the child staying home from school or activity, and/or required medical care. Multivariable logistic regression was used to identify factors associated with injury risk. Results Annual injury incidence was 593.5 injuries per 1000 children. Common causes of injury were falls (315.7 injuries per 1000 children), followed by cuts/lacerations and burns. Most injuries (93.8%) were of moderate severity. Children whose caregivers were hourly workers (AOR=1.97; 95% CI 1.06 to 3.68) had increased odds of sustaining an injury compared to those of unemployed caregivers. Girls had decreased odds of injury (AOR=0.59; 95% CI 0.39 to 0.91). Cooking outdoors (AOR=0.45; 95% CI 0.27 to 0.76) and presence of cabinet/cupboards (AOR=0.41; 95% CI 0.24 to 0.70) in the house were protective. Among children under 5 years of age, living in uncompleted accommodation was associated with higher odds of injury compared with living in a rented single room (AOR=3.67; 95% CI 1.17 to 11.48). Conclusions The incidence of household and neighbourhood child injury is high in semiurban Kumasi. We identified several novel injury risk factors (hourly work, younger children) and protective factors (cooking outdoors, presence of cabinet/cupboards). These data may identify priorities for household injury prevention.


Health Policy and Planning | 2016

When the baby remains there for a long time, it is going to die so you have to hit her small for the baby to come out: justification of disrespectful and abusive care during childbirth among midwifery students in Ghana

Sarah Rominski; Jody R. Lori; Emmanuel Nakua; Veronica Millicent Dzomeku; Cheryl A. Moyer

Despite global attention, high levels of maternal mortality continue to plague many low- and middle-income settings. One important way to improve the care of women in labour is to increase the proportion of women who deliver in a health facility. However, due to poor quality of care, including being disrespected and abused, women are reluctant to come to facilities for delivery care. The current study sought to examine disrespectful and abusive treatment towards labouring women from the perspective of midwifery students who were within months of graduation. For this study, we conducted focus groups with final year midwifery students at 15 public midwifery training colleges in all 10 of Ghana’s regions. Focus group discussions were recorded and transcribed. A multi-disciplinary team of researchers from the US and Ghana analysed the qualitative data. Key MessagesMidwifery students in Ghana’s public midwifery schools report witnessing and participating in many forms of disrespect and abuse during deliveries as part of their education. While they are clear as to why respectful care is important and necessary, they are able to justify and explain reasons for disrespectful and abusive care. This poor treatment of labouring women was explicitly and tacitly supported by these students’ teachers and preceptors.All study materials and methods were reviewed and approved by the Ghana Health Service Ethical Review Committee, the Kwame Nkrumah University of Science and Technology Committee on Publication and Human Ethics, and the University of Michigan Institutional Review Board.This research was made possible through a grant from the African Studies Center, University of Michigan. While students were able to talk at length as to why respectful care is important, they were also able to recount times when they both witnessed and participated in disrespectful and abusive treatment of labouring women. The themes which emerged from these data are: 1) rationalization of disrespectful and abusive care; 2) the culture of blame and; 3) no alternative to disrespect and abuse. Although midwifery students in Ghana’s public midwifery schools highlight the importance of providing high-quality, patient-centred respectful care, they also report many forms of disrespect and abuse during childbirth. Without better quality care, including making care more humane, the use of facility-based maternity services in Ghana is likely not to improve. This study provides an important starting point for educators, researchers, and policy makers to re-think how the next generation of healthcare providers needs to be prepared to provide high-quality, respectful care to women during labour and delivery in low-resource settings.


Journal of Public Health Dentistry | 2015

Prevalence and geographic distribution of edentulism among older Ghanaians

Sandra Hewlett; Benedict Nl Calys-Tagoe; Alfred E. Yawson; Phyllis Dako-Gyeke; Emmanuel Nakua; Gloria Folson; Akosua N. Baddo; George Mensah; Nadia Minicuci; Paul Kowal; Richard B. Biritwum

OBJECTIVES Edentulism has important health implications for aging individuals and is used as an indicator of the oral health of a population. Its distribution is unequal within populations, with the greatest burden on disadvantaged and socially marginalized populations. With an increasing older adult population in Ghana, its burden may increase; however, there is no nationwide information on edentulism in Ghana. Focusing on adults 50 years and older, this study assessed the prevalence of edentulism among older Ghanaians and its distribution across the country. METHODS Secondary analysis of WHOs Study on global AGEing and adult health (SAGE) Wave 1 in Ghana was conducted using self-reported edentulism as the dependent variable. RESULTS The overall prevalence was 2.8%, varying by sex (men had lower rates; OR = 0.67, 95% CI = 0.47-0.97); by location, being more prevalent in urban areas (3.6%) and the Western Region (4.7%); by education levels (rates were higher among those with no formal education; OR = 1.626, 95% CI = 1.111-2.380); and by marital status (those living without a partner had higher rates; OR = 1.980, 95% CI =1.366-2.870). On multivariate logistic regression, the variables positively associated with edentulism were older age (OR = 0.945) and urban residence (OR = 0.582). Living in the Brong Ahafo (OR = 3.138), Central (OR = 2.172), Eastern (OR = 2.257), or Volta regions (OR = 3.333) was negatively associated with edentulism. CONCLUSION Edentulism is unequally distributed across Ghana. Future aged cohorts are likely to follow the same patterns of geographic and social disadvantage if needed interventions are not carried out. This study provides nationwide data to assist service planning.


Ultrasound | 2016

The effectiveness of intrapartum ultrasonography in assessing cervical dilatation, head station and position: A systematic review and meta-analysis

Yaw Amo Wiafe; Bill Whitehead; Heather Venables; Emmanuel Nakua

The objective of this review was to assess the effectiveness of intrapartum ultrasonography in measuring cervical dilatation, head station and position. Electronic literature searches were carried out of MEDLINE, CINAHL, and Web of Knowledge, plus manual reference list checks of all relevant articles. All published prospective studies comparing intrapartum ultrasonography with digital VE in the determination of cervical dilatation, head station and position were then evaluated for the success rate and level of agreement between ultrasonography and digital VE. Ultrasonography had higher success rate than digital VE in the determination of fetal head position, with a statistically significant difference in the first stage of labour. Second, although the successful determination of cervical dilatation was in favour of digital VE, the difference was not statistically significant. In addition, there was high agreement between ultrasound and digital VE findings on cervical dilatation. Lastly, a significant but moderate correlation between digital VE and ultrasound methods was found in the assessment of fetal head station. However, no meta-analysis could be done for the fetal head station due to the methodological differences between ultrasound anatomical landmarks and that of digital VE. The findings suggest that ultrasonography is superior to digital VE in the assessment of fetal head position, but has moderate correlation with digital VE in the assessment of head station. It also showed high agreement with digital VE in the assessment of cervical dilatation with no statistically significant difference in terms of success rate.


The Pan African medical journal | 2016

Triage capabilities of medical trainees in Ghana using the South African triage scale: An opportunity to improve emergency care

Adam Gyedu; Kwabena Agbedinu; Mohammed Dalwai; Maxwell Osei-Ampofo; Emmanuel Nakua; Rockefeller Oteng; Barclay T. Stewart

Introduction The incidence of emergency conditions is increasing worldwide, particularly in low- and middle-income countries (LMICs). However, triage and emergency care training has not been prioritized in LMICs. We aimed to assess the reliability and validity of the South African Triage Scale (SATS) when used by providers not specifically trained in SATS, as well as to compare triage capabilities between senior medical students and senior house officers to examine the effectiveness of our curriculum for house officer training with regards to triage. Methods Sixty each of senior medical students and senior house officers who had not undergone specific triage or SATS training were asked to triage 25 previously validated emergency vignettes using the SATS. Estimates of reliability and validity were calculated. Additionally, over- and under-triage, as well as triage performance between the medical students and house officers was assessed against a reference standard. Results Fifty-nine senior medical students (98% response rate) and 43 senior house officers (72% response rate) completed the survey (84% response rate overall). A total of 2,550 triage assignments were included in the analysis (59 medical student and 43 house officer triage assignments for 25 vignettes each; 1,475 and 1,075 triage assignments, respectively). Inter-rater reliability was moderate (quadratically weighted κ 0.59 and 0.60 for medical students and house officers, respectively). Triage using SATS performed by these groups had low sensitivity (medical students: 54%, 95% CI 49–59; house officers: 55%, 95% CI 48–60) and moderate specificity (medical students: 84%, 95% CI 82 - 89; house officers: 84%, 95% CI 82 - 97). Both groups under-triaged most ‘emergency’ level vignette patients (i.e. SATS Red; 80 and 82% for medical students and house officers, respectively). There was no difference between the groups for any metric. Conclusion Although the SATS has proven utility in a number of different settings in LMICs, its success relies on its use by trained providers. Given the large and growing burden of emergency conditions, training current and future emergency care providers in triage is imperative.


Burns | 2016

Prevalence of preventable household risk factors for childhood burn injury in semi-urban Ghana: A population-based survey

Adam Gyedu; Barclay T. Stewart; Charles Mock; Easmon Otupiri; Emmanuel Nakua; Beth E. Ebel

OBJECTIVE Childhood burns are a leading cause of injury in low- and middle-income countries; most of which are preventable. We aimed to describe the prevalence of household risk factors for childhood burn injury (CBI) in semi-urban Ghana to inform prevention strategies for this growing population. METHODS We conducted a population-based survey of 200 households in a semi-urban community in Ghana. Households were randomly selected from a list of 6520 households with children aged <18 years. Caregivers were interviewed about CBI within the past 6 months and potentially modifiable household risk factors. RESULTS Of 6520 households, 3856 used charcoal for cooking (59%) and 3267 cooked indoors (50%). In 4544 households (70%), the stove/cooking surface was within reach of children under-five (i.e., <1m). Higher household wealth quintiles (OR 0.95; 95%CI 0.61-1.49) and increasing age (OR 0.82; 95%CI 0.68-0.99) were associated with lower odds of CBI. Living in uncompleted accommodation (OR 11.29; 95%CI 1.48-86.18 vs rented room) and cooking outside the house (OR 1.13; 95%CI 0.60-2.14 vs cooking indoors) were also predictive of CBI. CONCLUSIONS This study identified a high prevalence of CBI risk factors in semi-urban households that may benefit from targeted community-based prevention initiatives.


British Journal of Surgery | 2016

Assessment of risk of peripheral vascular disease and vascular care capacity in low- and middle-income countries.

A. Gyedu; Barclay T. Stewart; Emmanuel Nakua; R. Quansah; P. Donkor; Charles Mock; M. Hardy; K. H. Yangni-Angate

This study aimed to describe national peripheral vascular disease (PVD) risk and health burden, and vascular care capacity in Ghana. The gap between PVD burden and vascular care capacity in low‐ and middle‐income countries was defined, and capacity improvement priorities were identified.


BMC Women's Health | 2014

Severe morbidities associated with induced abortions among misoprostol users and non-users in a tertiary public hospital in Ghana.

Francis J M K Damalie; Edward Tieru Dassah; Emmanuel Morhe; Emmanuel Nakua; Harry Tagbor; Henry S. Opare-Addo

BackgroundMisoprostol has become a popular over the counter self-administered abortifacient in Ghana. This study aimed to compare the socio-demographic characteristics and clinical complications associated with misoprostol and non-misoprostol induced abortions among patients admitted to a tertiary public health facility in Ghana.MethodsThis was a cross sectional study conducted at the gynaecological ward of Komfo Anokye Teaching Hospital (KATH), over a four-month period using a structured pre-tested questionnaire. Data were analysed using Chi-square, Fisher’s exact and student t-tests. Factors associated with severe morbidity were examined using Poisson regression with robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.05 was considered statistically significant.ResultsOverall, 126 misoprostol users and 126 misoprostol non-users were recruited into the study. About 71% of the clients had self-induced abortions. Misoprostol users were more likely to be younger (p < 0.001), single (p < 0.001), nulliparous (p = 0.001), of higher educational background (p = 0.001), and unemployed (p < 0.001), than misoprostol non-users. Misoprostol users were more likely than non-users to undergo termination of pregnancy because they wanted to continue schooling (p < 0.001) or were not earning regular income to support a family (p = 0.001). Overall, 182 (72.2%) of the women (79.4% misoprostol users vs. 65.1% misoprostol non-users; p = 0.01) suffered severe morbidity. Nulliparous women (adjusted RR, 1.28; 95% CI, 1.08-1.52) and those who had induced abortion after 12 weeks’ gestation (adjusted RR, 1.36; 95% CI, 1.18-1.57) were at increased risks of experiencing severe morbidity. The association between mode of abortion induction and severe morbidity was not statistically significant (p = 0.06).ConclusionSelf-induced abortions using misoprostol is a common practice among women in this study; nearly three quarters of them suffered severe morbidity. Nonetheless, severe morbidity among misoprostol users and non-users did not differ significantly but was directly related to the gestational age at which the induced abortions occurred. Health education on the dangers of self-induced abortions and appropriate use of medication abortion could help reduce complications associated with induced abortions in Ghana.


African Journal of Disability | 2017

Wheelchair accessibility to public buildings in the Kumasi metropolis, Ghana

Cosmos Yarfi; Evans Y.K. Ashigbi; Emmanuel Nakua

Background Accessibility implies making public places accessible to every individual, irrespective of his or her disability or special need, ensuring the integration of the wheelchair user into the society and thereby granting them the capability of participating in activities of daily living and ensuring equality in daily life. Objective This study was carried out to assess the accessibility of the physical infrastructures (public buildings) in the Kumasi metropolis to wheelchairs after the passage of the Ghanaian Disability Law (Act 716, 2006). Methods Eighty-four public buildings housing education facilities, health facilities, ministries, departments and agencies, sports and recreation, religious groups and banks were assessed. The routes, entrances, height of steps, grade of ramps, sinks, entrance to washrooms, toilets, urinals, automated teller machines and tellers’ counters were measured and computed. Results Out of a total of 84 buildings assessed, only 34 (40.5%) of the buildings, 52.3% of the entrances and 87.4% of the routes of the buildings were accessible to wheelchair users. A total of 25% (13 out of 52) of the public buildings with more than one floor were fitted with elevators to connect the different levels of floors. Conclusion The results of this study show that public buildings in the Kumasi metropolis are not wheelchair accessible. An important observation made during this study was that there is an intention to improve accessibility when buildings are being constructed or renovated, but there are no laid down guidelines as how to make the buildings accessible for wheelchair users.

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Peter Agyei-Baffour

Kwame Nkrumah University of Science and Technology

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Easmon Otupiri

Kwame Nkrumah University of Science and Technology

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Ellis Owusu-Dabo

Kwame Nkrumah University of Science and Technology

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Veronica Millicent Dzomeku

Kwame Nkrumah University of Science and Technology

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Adam Gyedu

Kwame Nkrumah University of Science and Technology

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Charles Mock

University of Washington

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