Ishmael D. Norman

A review of Ghana's 2009–2013 integrated strategic response plan for pandemic influenza: illustrative study of the perceived adequacy of preparedness for the pandemic influenza of sub-Sahara Africa

Objectives To review the National Integrated Strategic Plan for Pandemic Influenza for 2009–2013 and assess whether it is in congruence with the nations emergency preparedness status. Method The authors examined the National Plan ‘as is’ and evaluated it against the ‘State and Local Pandemic Influenza Planning Checklist’ of the Department of Health and Human Services and the Centers for Disease Control and Prevention. The authors matched the activities in the National Plan apropos the national emergency response capabilities. From the legal framework, published studies and other grey literature on the thematic areas of the Plan, the authors developed key items found in response programmes and drew a 5-point Likert-type scale for assessment. The authors analysed the results in relation to WHOs framework for hospital emergency preparedness, and conducted two-sample non-parametric Wilcoxon rank sum (Mann–Whitney) tests. Results/discussion The result showed that Ghanas health emergency preparedness is in disarray. About 75% of the health facilities lack emergency preparedness plans, surge capacity planning, triage for mass event and mutual aid agreements. Conclusions The authors concluded that the Plan is incongruent with Ghanas public health emergency preparedness. The evaluation is important for Ghana and the subregion.

Assessing the ownership, usage and knowledge of Insecticide Treated Nets (ITNS) in malaria prevention in the Hohoe Municipality, Ghana

Introduction Malaria remains one of the top five killer diseases in sub-Saharan Africa (SSA) and its burden is skewed towards pregnant women and children under five. Insecticide Treated Bed-Net (ITN) usage is considered one of the most cost-effective, preventive interventions against malaria. This study sought to assess ownership, usage, effectiveness, knowledge, access and availability of ITNs among mothers with children under five in the Hohoe municipality. Methods In August 2010 a cross-sectional survey was carried out in 30 communities, selected using the WHO 30 cluster sampling technique. In the selected communities, mothers/caregivers with children under five years were selected using the snowball method. Data were collected through questionnaires and direct observation of ITN. Descriptive statistics was used to analyse the data collected. Results A total of 450 mothers/caregivers were interviewed and their mean age was 30 ± 7 years. ITN ownership was 81.3%, and usage was 66.4%. The majority (97.8%) of the mothers/caregivers said ITNs were effective for malaria prevention. Awareness about ITNs was high (98.7%) and the majority (52.9%) had heard about ITNs from Reproductive and Child Health (RCH) Clinic and antenatal care ANC clinic (33.6%). Over 60% of the ITNs were acquired through free distribution at RCH clinics, clinic and home distribution during mass immunization sessions. The majority of the mothers/caregivers (78.6%) knew the signs and symptoms of malaria, what causes malaria (82.2%) and who is most at risk (90%). Conclusion Behaviour change communication strategies on ITN use may need to be further targeted to ensure full use of available ITNs.

Facilitators and barriers to modern contraception use among reproductive-aged women living in sub-Saharan Africa: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE The main objective of this qualitative review is to synthesize the best available evidence on facilitators and barriers of modern contraception use among reproductive-aged (15-49 years) women living in sub-Saharan Africa [SSA].The specific review questions are.

Earthquake hoax in Ghana: exploration of the Cry Wolf hypothesis

This paper investigated the belief of the news of impending earthquake from any source in the context of the Cry Wolf hypothesis as well as the belief of the news of any other imminent disaster from any source. We were also interested in the correlation between preparedness, risk perception and antecedents. This explorative study consisted of interviews, literature and Internet reviews. Sampling was of a simple random nature. Stratification was carried out by sex and residence type. The sample size of (N=400), consisted of 195 males and 205 Females. Further stratification was based on residential classification used by the municipalities. The study revealed that a person would believe news of an impending earthquake from any source, (64.4%) and a model significance of (P=0.000). It also showed that a person would believe news of any other impending disaster from any source, (73.1%) and a significance of (P=0.003). There is association between background, risk perception and preparedness. Emergency preparedness is weak. Earthquake awareness needs to be re-enforced. There is a critical need for public education of earthquake preparedness. The authors recommend developing emergency response program for earthquakes, standard operating procedures for a national risk communication through all media including instant bulk messaging.

Geophagia: A cultural-nutrition health-seeking behaviour with no redeeming psycho-social qualities

Aim: We investigated if Geophagia is restricted to only pregnant and lactating women in Ghana. We also investigated if the key driver of Geophagia is poverty and other socio-cultural factors. Methods: This analysis was part of a broader national study of resilience among the population of Ghana (N=2,000). Regional comparisons were made possible due to the stratified and random selection of representations that were similar in characteristics such as being urban or rural, ethnicity, religion and gender. Results: It was found that Geophagia was present among both females and males and was not restricted to pregnant and lactating women. Geophagia was not driven by poverty or the lack of formal education or the presence of gainful employment. Geophagia was practiced by both urban and rural residents irrespective of religious proclivities and devotion. The assertion that Geophagia was an instinctive primordial response to gastro-intestinal disturbances was not sustained by the data in this study, although the literature review suggested such in calves and lambs. Conclusion: In order to address the potential health threats posed by Geophagia, the key cultural drivers need to be studied and understood. We also need to appreciate the shocks and stresses that create such desires. It is not a case of mental illness and it cannot be concluded that Geophagia is driven by a psychiatric disorder. This paper would be disseminated to inform policy in Ghana and beyond.

The Delaying of Workmen’s Compensation in Ghana: Review Article

Background: There are many bottlenecks in the administration of claims for compensation by injured employees. These include delays in processing claims, getting physicians to conduct examination of claimant’s injuries and to attest that the injury occurred in the course of employment. This could be further delayed by legal challenges to degree of disability provided by the examining physician. Objective: We investigated whether the design of workmen’s compensation legislation is defective because it places a burden on the physician to determine the degree of disability. We also investigated whether administrative modalities for the settlement of disability claims, contribute to delays. We considered the ethical and legal issues in the role of the physician as a healer and a claims adjuster. Method: This study consisted of literature and documentary review of the national and international legislation on workmen’s compensation legislation and disability claims. We also conducted Key Informant Interviews as collaborating data to the literature review. We also reviewed both public and private sector claims in three consecutive years from 2008 through 2010 as the basis of analysis. Result: The study identified many problems in the Physician-claimant relationship, such as the administration and management of compensations and benefits. The 1987 law provides little guidelines to the physician on how to assess disability. This contributes to low claims settlement and backlog of cases of injured employees due to legal challenges. Conclusion: There is the need to harmonize current safety legislation such as the Factories, Offices and Shops Act, 1970, (ACT 328), the Mining Regulations, 1970, (LI 665), the Radiation Protection Instrument, 1993, (LI 1559), and the Workmen’s Compensation Act 1987 (PNDC 187). These should be administered by one entity for efficiency and scaling.