Eric Badu

Attitudes of health service providers: the perspective of Persons with Disabilities in the Kumasi Metropolis of Ghana

Introduction Awareness of disability issues has gained considerable interest by advocacy groups in recent years. However, it is uncertain whether attitudes and perceptions of all service providers and society have adjusted accordingly towards the health care of people with disabilities. This study sought to examine the attitudes of health providers from the perspective of people with disabilities in the Kumasi Metropolis. Methods A cross-sectional study using semi-structured questionnaires was conducted with people with disabilities (with physical, hearing and visual impairments,) in the Kumasi Metropolis. The study used a multi-stage sampling involving cluster and simple random sampling to select 255 respondents split amongst the following five clusters of communities; Oforikrom, Subin, Asewase, Tafo and Asokwa. Data were analysed using STATA 14 and presented in descriptive and inferential statistics. Results The study found that 71% of the respondents faced some form of discrimination including the use of derogatory remarks, frustration and unavailable required services on the basis of their disability, the type of services they need and the location. Women were 3.89 times more likely to face discrimination; Adjusted odds ratio (AOR) = 3.89 (95% confidence interval [CI]; 1.41, 10.76), and visually impaired was more likely to be discriminated at the facility compared with physical disability; AOR = 5.05 (95% CI; 1.44, 17.65). However, respondents with some educational qualification and those who stayed with their family members were less likely to face discrimination; AOR = 0.08 (95% CI; 0.01, 0.39). Conclusion The study recommends the provision of in-service training for service providers to update their knowledge on disability issues and improve access to services for people with disabilities.

Access to employment in Kenya: the voices of persons with disabilities

Abstract Introduction: Unemployment is one of the major challenges facing persons with disabilities worldwide. Persons with disabilities experience significantly high rates of unemployment compared with the general population, and are often employed in low-paid jobs. This could indicate a missing link in identifying employment opportunities and impeding factors to the opportunities. This study examined access to employment opportunities for persons with disabilities in the Nairobi County in Kenya. Method: An exploratory study design, using qualitative methods, was conducted with three categories of persons with disabilities: the physically disabled, the visually impaired, and the hearing impaired. A convenient sampling was used to recruit 30 participants from five constituencies in Embakasi in the Nairobi County. Findings: The study found that access to employment for persons with disabilities in the study area was limited. Factors responsible for the high unemployment include inaccessible information on employment, negative attitudes, inaccessible physical environment, low educational attainment of persons with disabilities, and ineffective legislation on employment. Conclusion: The lack of employment opportunities for persons with disabilities in Kenya suggests that poverty reduction among persons with disabilities will be difficult. Therefore, efforts should be made through implementation of effective policies to remove barriers hindering access to employment for persons with disabilities in Kenya.

Lives of persons with disabilities in Cameroon after CRPD: voices of persons with disabilities in the Buea Municipality in Cameroon

Abstract Introduction: The Convention on the Rights of Persons with Disabilities (CRPD) has been touted as a major breakthrough towards achieving equal rights for persons with disabilities. The promulgation of the convention provided clear guidelines for signatory countries to revise their legislation as well as to formulate policies that will take into consideration the needs of persons with disabilities. As Cameroon is a signatory to the convention, it is expected that disability-friendly policies have been implemented to enhance the living conditions of persons with disabilities. This study examined, from the perspectives of participants, the life experiences of persons with disabilities in the Buea Municipality 7 years after Cameroon signed the CRPD. Methods: The study adopted a qualitative method, involving focus-group discussions with 36 participants from three disability groups: hearing impaired, visually impaired, and physically impaired. Findings: The study found that persons with disabilities in the Buea Municipality faced many challenges in their daily endeavors. These challenges are a result of a lack of inclusive policies, leading to their exclusion from social and economic activities such as education, employment, and healthcare. Conclusion: Although the study is limited in scope, the findings suggest that persons with disabilities in the Buea Municipality were yet to benefit from the CRPD. It is, therefore, suggested that the government of Cameroon should formulate inclusive policies to address the numerous challenges facing persons with disabilities in the Buea Municipality.

Impact of maternal weight on pregnancy outcomes: a systematic review

Purpose The nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome. The increasing prevalence of maternal overweight and obesity worldwide has become a problem of concern among public health professionals. The purpose of this paper is to review the evidence regarding the impact of maternal weight on pregnancy outcomes to facilitate the provision of evidence-based information to pregnant women during antenatal clinics in Ghana. Design/methodology/approach A search was conducted in PubMed, PLOS ONE, Cochrane, Embase and bibliographies for all studies on maternal weight and pregnancy outcomes published from January 2000 to May 2013. The key words used for the search were: “pre-pregnancy BMI”, “gestational weight gain”, “maternal weight”, “pregnancy outcomes” and “birth outcomes”. Findings The search yielded 113 papers; out of these, 35 studies were included in the review after exclusion of duplicates and irrelevant papers. Excluded papers included animal studies and human studies that did not meet inclusion criteria. Research limitations/implications The review only considered papers published from 2000 to 2013 and might have left out other important papers published before 2000 and after 2013. Practical implications The origins of the studies included in the review suggest paucity of studies on maternal weight and pregnancy outcomes in developing countries where there is a double burden of malnutrition. There is the need for more studies to be initiated in this area. Social implications Results of this review have revealed that the extremes of maternal weight prior to and during pregnancy increase the risk of maternal and fetal complications. Originality/value This paper provides evidential information on the impact of maternal weight on pregnancy outcomes for counseling during antenatal clinics.

Households Sociodemographic Profile as Predictors of Health Insurance Uptake and Service Utilization: A Cross-Sectional Study in a Municipality of Ghana

Introduction. Attempts to use health insurance in Low and Middle Income Countries (LMICs) are recognized as a powerful tool in achieving Universal Health Coverage (UHC). However, continuous enrolment onto health insurance schemes and utilization of healthcare in these countries remain problematic due to varying factors. Empirical evidence on the influence of household sociodemographic factors on enrolment and subsequent utilization of healthcare is rare. This paper sought to examine how household profile influences the National Health Insurance Scheme (NHIS) status and use of healthcare in a municipality of Ghana. Methods. A cross-sectional design with quantitative methods was conducted among a total of 380 respondents, selected through a multistage cluster sampling. Data were collected using a semistructured questionnaire. Data were analysed using descriptive and multiple logistics regression at 95% CI using STATA 14. Results. Overall, 57.9% of respondents were males, and average age was 34 years. Households’ profiles such as age, gender, education, marital status, ethnicity, and religion were key predictors of NHIS active membership. Compared with other age groups, 38–47 years (AOR 0.06) and 58 years and above (AOR = 0.01), widow, divorced families, Muslims, and minority ethnic groups were less likely to have NHIS active membership. However, females (AOR = 3.92), married couples (AOR = 48.9), and people educated at tertiary level consistently had their NHIS active. Proximate factors such as education, marital status, place of residence, and NHIS status were predictors of healthcare utilization. Conclusion. The study concludes that households’ proximate factors influence the uptake of NHIS policy and subsequent utilization of healthcare. Vulnerable population such as elderly, minority ethnic, and religious groups were less likely to renew their NHIS policy. The NHIS policy should revise the exemption bracket to wholly cover vulnerable groups such as minority ethnic and religious groups and elderly people at retiring age of 60 years.