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Adong JW, Adjei DN, Adokiya MN, Agyemang C. Impact of hospital-community diabetes management intervention in Central Region, Ghana: A retrospective study. Diabetes Res Clin Pract 2024; 213:111762. [PMID: 38944249 DOI: 10.1016/j.diabres.2024.111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE Effective diabetes management remains suboptimal in low-resourced countries including Ghana. We determined the effectiveness of hospital-community link diabetes management intervention on glycaemic control and other outcomes. METHODS A retrospective study design, using secondary data from the Ghana-Netherlands for Health Foundation diabetes programme. The z-test was used for proportions, to compare parameters between baseline (2017) and endpoint (2022). The Friedman test was used to assess changes in blood glucose levels, and the multivariable Logistic regression to identify factors associated with blood glucose control. RESULTS Analyses of 251 clinical records showed decline in median blood glucose levels across six years from 8.8 mmol/L (7.2-12.9) in 2017 to 6.5 mmol/L (5.7-7.2) (p = 0.001) in 2022, recording 43 % increase in patients attaining glycaemic control in 2022 (p = 0.001). The Friedman test showed significant reduction in glucose levels (χ2 = 319.2, p = 0.001), with an effect size of 0.25 using the Kendall test. The logistic regression analyses revealed that patients on metformin and Glibenclamide combination were more likely to achieve glycaemic control than those on metformin monotherapy (adjusted OR = 7.30, 95 % CI 2.31-23.01, p = 0.001). CONCLUSION The intervention achieved significant reduction in blood glucose levels. Patients with diabetes benefit from the hospital-community link diabetes management intervention regarding glycaemic control.
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Affiliation(s)
| | - David Nana Adjei
- School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Ghana
| | | | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Obeng FY, Amponsah SK, Ofori EK, Afriyie DK. Medication errors at a diabetes management center in a resource-poor setting. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2024:JRS230062. [PMID: 38788093 DOI: 10.3233/jrs-230062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Abstract
BACKGROUND Medication errors are known to cause adverse drug reactions, hospital admissions and mortality. In most resource-poor settings, medication errors occur but are undocumented. OBJECTIVE This study sought to investigate medication errors in a diabetic clinic at Komfo Anokye Teaching Hospital (KATH), Ghana. METHODS The research combined both qualitative and quantitative data collection methods. The quantitative aspect involved retrospectively reviewing patient folders over two years (1st January 2019 to 31st December 2021). Patients' folders were reviewed to identify possible medication errors. The qualitative arm explored underlying factors and experiences related to medication errors through interviews with healthcare workers. Ten healthcare professionals at KATH were interviewed using an interview guide. RESULTS A total of 264 patients' folders were retrieved. The majority (23.11%) of the patients were between 18 and 25 y.o., and there were more females (52.27%) than males. About 60% of the patients had diabetes and hypertension comorbidity. The overall prevalence of medication errors was 18.18%. The most prevalent type of medication error identified was wrong drug formulation (n = 19, 39.58%). About 47.92% of the medication errors resulted in adverse events and this was predominantly caused by antidiabetic drugs (47.83%) and anti-hypertensive drugs (34.78%). Patients in the age category of 26-35 y.o. [aOR: 0.31, CI: 0.11-0.90] had reduced odds of medication errors whilst patients with comorbidity of diabetes and hypertension [aOR: 5.95, CI: 2.43-14.60] had an increased odds of medication errors. Large patient population, low staff numbers and inadequate knowledge of drugs by healthcare workers were factors that contributed to medication errors. CONCLUSION Medication errors was moderately high in this diabetic clinic, and the errors led to a number of adverse events. Age, diabetes and hypertension comorbidity, large patient population, low staff numbers, and inadequate knowledge about drugs were identified as factors that influenced medication errors.
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Affiliation(s)
- Frank Yaw Obeng
- Department of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Seth Kwabena Amponsah
- Department of Medical Pharmacology, University of Ghana Medical School, Accra, Ghana
| | - Emmanuel Kwaku Ofori
- Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana
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Owusu MF, Adu J, Dortey BA, Gyamfi S, Martin-Yeboah E. Exploring health promotion efforts for non-communicable disease prevention and control in Ghana. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002408. [PMID: 37747848 PMCID: PMC10519596 DOI: 10.1371/journal.pgph.0002408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/27/2023] [Indexed: 09/27/2023]
Abstract
Noncommunicable diseases (NCDs) are a growing public health challenge in Ghana. Health promotion can provide useful avenues to reduce the incidence of NCDs in the country. We used the Ottawa Framework to assess health promotion efforts for the prevention and control of NCDs in Ghana. Data were collected using key informant interviews and documentary sources. A content analysis approach was adopted for data analysis using Nvivo 11 Software. We found a strong policy framework for NCD prevention in Ghana with the ratification of several international protocols and resolutions and the development of national and specific NCD-related policies. Implementation of these policies, however, remains achallenge due to limited resources and the overconcentration on communicable diseases. Attempts have been made to create a supportive environment through increased access to NCD services but there are serious challenges. Respondents believe the current environment does not support healthy eating and promotes unhealthy use of alcohol. The Community-based Health Planning and Services (CHPS) program engenders community participation in health but has been affected by inadequate resources. Personal skills and education programs on NCDs are erratic and confined to a few municipalities. We also found that NCD services in Ghana continue to be clinical and less preventative. These findings have far-reaching implications for practice and require health planners in Ghana to pay equal attention in terms of budgetary allocations and other resources to both NCDs and communicable diseases.
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Affiliation(s)
- Mark Fordjour Owusu
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| | - Joseph Adu
- Department of Health and Rehabilitation Sciences, Western University, Ontario-Canada
| | | | - Sebastian Gyamfi
- Lawson Health Research Institute, London, Ontario, Canada and Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
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Amu H, Brinsley TY, Kwafo FO, Amu S, Bain LE. Improving investment in chronic disease care in Sub-Saharan Africa is crucial for the achievement of SDG 3.4: application of the chronic care model. Arch Public Health 2023; 81:169. [PMID: 37710333 PMCID: PMC10500797 DOI: 10.1186/s13690-023-01181-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
Over 41 million people die of chronic non-communicable diseases (CNCDs) each year, accounting for 71% of all global deaths. The burden of CNCD is specifically a problem in sub-Saharan Africa (SSA) since CNCDs are largely a leading major cause of mortality in the sub-region. While the disease burden and mortality from chronic non-communicable diseases (CNCDs) have reached an epidemic threshold in sub-Saharan Africa (SSA), health systems, policy-makers and individuals still consider CNCDs to be uncommon and, therefore, do not give its management the required attention. In sub-Saharan Africa (SSA), effectively addressing the growing burden of CNCDs will require comprehensive measures that incorporate both curative and preventive interventions, towards achieving the Sustainable Development Goal (SDG) 3.4 target of reducing by one-third premature mortality from CNCDs through prevention and treatment and the promotion of mental health and well-being by the year 2030. In this commentary, we adopt the Chronic Care Model (CCM) to discuss how improved investment in Chronic Disease Care is crucial in achieving the SDG target in SSA. At the health systems level of the CCM, we propose that countries in SSA should increase the proportion of their annual budgets allocated to health in line with the Abuja Declaration of 2001. Social health insurance should also be adopted by all countries and effectively implemented. At the community level, we propose intensified community-based health education, the formation of peer support groups and the implementation of community-based policies that promote healthy eating and physical activity.
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Affiliation(s)
- Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Theodora Yayra Brinsley
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
| | - Frank Oppong Kwafo
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Selasi Amu
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Luchuo Engelbert Bain
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, Auckland Park, South Africa
- International Development Research Centre, IDRC, Ottawa, Canada
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Dowou RK, Amu H, Saah FI, Arthur LE, Dotse PAN, Bain LE. Management of chronic non-communicable diseases in Ghana: a qualitative study of patients' coping strategies and the role of caregivers. BMC Health Serv Res 2023; 23:371. [PMID: 37072851 PMCID: PMC10111065 DOI: 10.1186/s12913-023-09398-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/13/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Chronic Non-Communicable Diseases (CNCDs) has become a major cause of mortality and disability globally. We explored the coping strategies adopted by CNCD patients and the roles of caregivers in the management of CNCDs in Ghana. METHODS This was a qualitative study that adopted an exploratory design. The study was carried out at the Volta Regional Hospital. Purposive convenience sampling procedures were used to sample patients and caregivers. Data for the study were collected using in-depth interview guides. Data were collected among 25 CNCDs patients and 8 caregivers and analysed thematically using ATLAS.ti. RESULTS Patients adopted a variety of strategies to cope with their condition. These strategies were emotion-oriented coping, task-oriented coping, and avoidance-oriented coping. Family members were the main caregivers, who provided social and financial support for patients. Financial challenges, inadequate family support, poor attitudes of health workers, delays at the health facility, unavailability of drugs at the facility, and patients' non-adherence to the medical advice were major challenges that militated against caregivers' efforts in supporting patients in the management of their CNCDs. CONCLUSION We found that patients adopted various strategies to cope with their conditions. The roles of the caregivers in supporting patients in the management practices were identified as very important as they contribute immensely to the financial and social support for the patients in their management of CNCDs. It is crucial that health professionals actively involve caregivers in every aspect of the day-to-day management of CNCDs as these caregivers spend more time with these patients and understand them better.
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Affiliation(s)
- Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Science, Hohoe, Ghana.
| | - Hubert Amu
- Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Farrukh Ishaque Saah
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Lordina Ewurabena Arthur
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Priscilla Aku Nuna Dotse
- Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Science, Hohoe, Ghana
| | - Luchuo Engelbert Bain
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Auckland Park, Johannesburg, South Africa
- International Development Research Centre, IDRC, Ottawa, Canada
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Sambah F, Malau-Aduli BS, Seidu AA, Malau-Aduli AEO, Emeto TI. Ghana's Adherence to PASCAR's 10-Point Action Plan towards Hypertension Control: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1425. [PMID: 36674181 PMCID: PMC9859290 DOI: 10.3390/ijerph20021425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
The continuous increase in the prevalence of hypertension in Ghana has led to various interventions aimed at controlling the disease burden. Nonetheless, these interventions have yielded poor health outcomes. Subsequently, the Pan-African Society of Cardiology (PASCAR), established a 10-point action plan for inclusion in policies to aid control of hypertension. This scoping review assessed the adherence of health policies to the 10-point action plan towards hypertension control/reduction in Ghana. Eight health policies met the inclusion criteria and were assessed. The programme evaluation and policy design framework were used for synthesis and analysis of extracted data. Overall, there was poor adherence to hypertension control observed in the policies. Specifically, there were low levels of integrating hypertension control/reduction measures, a poor task-sharing approach, and poor financial resource allocations to tackle hypertension control/reduction in most of the policies. There was also low support for research to produce evidence to guide future interventions. For Ghana to achieve the global target of reducing hypertension by the year 2025, its health policies must adhere to evidence-based interventions in hypertension management/control. The study recommends a follow-up study among hypertension patients and healthcare professionals to evaluate the factors militating against hypertension management/control in Ghana.
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Affiliation(s)
- Francis Sambah
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- Department of Sports and Exercise Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast P.O. Box UC 182, Ghana
| | - Bunmi S. Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Aduli E. O. Malau-Aduli
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
| | - Theophilus I. Emeto
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
- World Health Organization Collaborating Center for Vector-Borne and Neglected Tropical Diseases, James Cook University, Townsville, QLD 4811, Australia
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Kretchy IA, Okoibhole LO, Sanuade OA, Jennings H, Strachan DL, Blandford A, Agyei F, Asante P, Todowede O, Kushitor M, Adjaye-Gbewonyo K, Arhinful D, Baatiema L, Dankyi E, Grijalva-Eternod CS, Fottrell EF, de-Graft Aikins A. Scoping review of community health participatory research projects in Ghana. Glob Health Action 2022; 15:2122304. [DOI: 10.1080/16549716.2022.2122304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Legon, Ghana
| | | | - Olutobi Adekunle Sanuade
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, USA
| | - Hannah Jennings
- Department of Health Sciences, University of York and Hull York Medical School, York, UK
| | - Daniel Ll Strachan
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | - Ann Blandford
- Department of Computer Science, UCLIC, University College London, London, UK
| | - Francis Agyei
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Paapa Asante
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Olamide Todowede
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Mawuli Kushitor
- Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Kafui Adjaye-Gbewonyo
- Faculty of Education, Health and Human Sciences, University of Greenwich, London, UK
| | - Daniel Arhinful
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Leonard Baatiema
- Department of Health Policy, School of Public Health, Planning and ManagementUniversity of Ghana, Legon, Ghana
| | - Ernestina Dankyi
- Centre for Social Policy Studies, University of Ghana, Legon, Ghana
| | - Carlos S. Grijalva-Eternod
- Institute for Global Health, University College London, London, UK
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
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How Can “Community Voices” from Qualitative Research Illuminate Our Understanding of the Implementation of the SDGs? A Scoping Review. SUSTAINABILITY 2022. [DOI: 10.3390/su14042136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In 2015, the United Nations committed to 17 Sustainable Development Goals (SDGs) to drive global development policy and practice. Six years into the implementation of the 15-year agenda, the SDGs are subject to extensive monitoring and research at the national, regional, and global levels using quantitative data sets. In contrast, this scoping review considered the contribution of qualitative research studies published in 2021, utilizing data collected from local, place-based community participants. Qualitative research with community participants connects global policy with place-based experience, thus potentially offering a valuable perspective on SDG implementation. Searches were carried out using the Scopus database to identify studies that explicitly linked their aims and objectives to the SDGs. Fifty-four papers met the criteria for inclusion in the review and were charted, mapped, and analysed. For the majority of studies, data collection was carried out in lower-middle income and low-income countries. The “voices” of community participants highlight tensions and challenges affecting the implementation of the SDGs. Reviewing this body of research as a whole identified opportunities to strengthen future qualitative research that will further illuminate progress towards the SDGs.
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