Browsing by Author "Otupiri, E."

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    District inequities in household child survival practices in the Upper West Region of Ghana
    (2012-06-19) Otupiri, E.
    Worldwide, too many children under-five die needlessly but the greatest burden is in sub-Saharan Africa where in 2008, one-in-seven children died before the fifth birthday. Evidence shows that a set of 23 effective interventions could reduce child mortality by 66% if delivered at universal coverage (99%). Four of these interventions are capable of reducing the burden remarkably at universal coverage; three of these interventions do not require contact with the formal health sector. The children who are in greatest need of these life-saving practices do not get them. In Ghana, the worst place to live as a child under-five for the last two decades has been the Upper west Region; the 2008 GDHS reported a burden of 191 per 1000 live births for the region. Even though data on coverage of household practices for child survival growth and development are available at the regional level, the same cannot be said for data at the district and sub-district levels. Data at lower levels are poor, inconsistent and unreliable. National and regional data mask significant inequities within regions. We sought to determine whether the then eight districts in the Upper West Region differ in terms of the uptake of the four core household practices evidenced to be capable of reducing the under-five mortality burden by up to 41% even in resource-constrained settings such as the Upper West Region; the region is one of the poorest in Ghana. Additionally, we were interested in differences across the districts with reference to specific cofactors. We collected data from 2400 households (300 per district) using the methodology described by UNICEF in the 2005 Multiple-indicator Cluster Survey manual. The outcome variables were the four core household practices – exclusive breastfeeding, appropriate complementary feeding, insecticide bed net use and oral rehydration salt for diarrhoea management – which together at universal coverage could considerably reduce under-five deaths. The cofactors we studied included: child characteristics (age, sex); maternal characteristics (age, level of education, ability to read and write English); husband characteristics (age, level of education, ability to read and write English) and household wealth. In the Upper West Region, the overall prevalence of the four-core household practices was: exclusive breastfeeding (23%), appropriate complementary feeding (22%), insecticide bed net use (68%) and oral rehydration salt (47%). Even after multivariate adjustment, statistically significant district differentials were observed for all outcome variables (p≤0.05). With reference to the cofactors studied the following relationships were observed even after multivariate adjustment: wealthy mothers were significantly less likely to have initiated breastfeeding within an hour of delivery (AOR=0.85, p-value≤0.001, 95%CI: 0.77-0.93); a mother’s ability to read and write English and her husband’s age were significantly associated with appropriate complementary feeding (AOR=2.22, p-value ≤0.01, 95%CI: 1.35-3.56 and AOR=1.31, p-value≤0.01, 95%CI:1.09-1.57 respectively); children under-five from wealthy homes were less likely to have slept under an insecticide-treated bed net the night preceding the survey (AOR=0.78, p-value ≤0.001, 95%CI: 0.72-0.85) and a mother’s age, her husband’s age and ability to read and write English, and household wealth were significant predictors of a mother’s ability to correctly prepare ORS. The study indicates important district inequities across the Upper West Region. Interventions should be evidence-based emphasizing district level differentials and recognizing the paradoxical effect of wealth. Further research could emphasize the cofactors studied, cultural practices, access to and utilization of health care facilities and family planning.
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    Farmer drug use in the Kumasi poultry industry
    (2000) Otupiri, E.
    The grouping of large numbers of poultry in small areas and the intensive management of such systems exert a lot of stress on the birds. This renders the birds susceptible to diseases. Even though drugs on their own are not sufficient to guarantee good health, no meaningful poultry can exist without drugs. As a result of their addition to poultry feed or their use to treat infections, poultry drugs may be present in poultry tissues consumed as food. The risk associated with chemical residues in food consumed by the public has increased in developing countries alongside the adoption of poultry technology from developed countries. In Ghana, poultry production is fairly well organized and has specialized and integrated into industrial complexes. Several private farms located mainly in the pen-urban areas of Kumasi, Accra and Cape Coats dominate the modern poultry sector. In 1987, it was estimated that this sector produced 58,000 eggs and 6,500 tons of meat. Commercial poultry is an important economic activity in and around Kumasi. Routine data from drug houses and the Animal Health Service indicate that the Kumasi poultry industry consumes a large amount of drugs. Some of these drugs may have strong residual effects and constitute a public health hazard. The problem is non-compliance of poultry farmers in the use of these drugs. Do farmers respect the dosage, route of administration and particularly the withdrawal period recommended for these drugs? The logistic cycle for drug management consists of four main functions namely, selection, procurement, distribution and use. Drug use in poultry is influenced by the prescriber, the dispenser and the farmer whose compliance is being questioned. Non-adherence to recommended withdrawal times would lead to residues in poultry and poultry products. Drug use problems are solved through a combination of regulations, management and education. This study was designed to assess the extent of compliance by farmers in drug use with the view to discussing the associated health risks to the consumer. The study was cross sectional. Qualitative and quantitative methods were used to assess the extent of farmer compliance. The study population comprised health professionals, veterinarians, veterinary drug houses and poultry farmers. Non-structured interviews were held with the health professionals, veterinarians and the drug houses. Person-to-person interviews were held with the farmers. This study showed that drugs are available from legal and illegal sources. The level of drug use is high. The most important finding was that farmers do not comply with withdrawal period requirements. Farmers are aware of the harmful effects in humans caused by drug residues. The study recommends that animal health outreach services should be provided to support farmers and to monitor on-farm drug use. There is the need to regularize the importation, sale and use of poultry drugs. Farmers would welcome health education sessions on drug use. Finally, the study recommends that further studies be undertaken to measure the actual levels of residue in poultry and poultry products as per WHO/FAQ standards.