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Abortion in Bosomtwe District, Ashanti, Ghana: a Case Control Study at St. Michael’s Hospital, Jachie – Pramso
(2009-07-12) Momo Lokko, Christiana Naa
Strategies for preventing unsafe abortion have been unyielding as a result of which many women die and develop complications from unsafe abortion including those resulting in induced abortion ending up as incomplete abortion. There is increase in incidence of death due to abortion at Bosomtwe district. This study was an un-matched case-control study with the objective of assessing the specific differences in the socio-demographic, economic and reproductive health characteristic of incomplete abortion clients (cases) and normal delivery clients (controls) attending St. Michael’s Hospital, Bosomtwe district. A comparative analysis of 61 cases and 129 controls revealed that, there is no significant difference in their age (p=0.61), marital status (p=0.11), educational level (p=0.63) and their religious background (p=0.61). There was also no difference in their occupation (p=0.52), income earned (p=0.96) and partners employment status (p=0.40). There was a statistical difference in the reproductive history between the groups in terms of the number of children (p=0.000), age of last child (p=0.000), and number pregnancies lost (p=0.000). Cases were 12.7 times more likely to have had abortion; 19.0 times more likely to have attempted to stop the index pregnancy; and 6 times more likely to have self induced the index pregnancy as a means of termination as compared to controls. It is recommended that stakeholders, especially the district health directorate should use specific predictors for incomplete abortion among women to educate and encourage them to live a healthy reproductive life.
Acceptance of HIV Counselling & Testing Among Pregnant Women in the Kumasi Metropolis
(2008-07-13) Sakyi, Kwofie Gabriel
In Ghana, as in most parts of Africa, south of the Sahara, HIV/AIDS account for a lot of mortality and morbidity in children. Children born to infected mothers acquire infection and progress to clinical diseases. This mother-to-child-Transmission (MTCT), accounts for most of the cases in children less than 15 years. To help address this problem, the Ghana National Policy on HIV/AIDS and STIs has come out with strategies that include the use of routine Counseling and Testing (CT) as a tool for the prevention of MTCT (PMTCT). The main objective of this study was to determine the level of acceptance of this routine HIV CT, as well as factors associated with acceptance among pregnant women in Kumasi Metropolis. The study was a descriptive cross-sectional type, with structured questionnaire as the data collection tool served on 200 pregnant women attending Antenatal Clinic (ANC) in the Kumasi Metropolis. The sampling frame was pregnant women attending ANC at the three hospitals in the metropolis. The 200 ANC attendants were selected by a systematic random sampling technique. Findings include a high level of acceptance, with 87.5% of respondents accepting to undergo HIV testing either before or after counseling. The effects of socio-demographic characteristics on acceptance of HIV CT were not statistically significant. The knowledge level of pregnant women on HIV/AIDS and Prevention of mother to Child transmission (PMTCT) significantly affected HIV CT acceptance (p = 0.000): Those with adequate knowledge levels were twenty four times more likely to accept HIV CT than those with inadequate knowledge levels. Seeking Spousal permission did not significantly affect acceptance (p= 0.86). However, spousal involvement significantly encouraged HIV CT (p = 0.04) Given the high, level of acceptance which is consistent with high acceptance levels in some African studies, the existing strategy of routine HIV CT, as a tool for PMTCT of HIV, should be sustained, and if possible improved upon.
Access and coverage of healthcare among health staff in the Sunyani Municipality: Implications for the realization of universal health coverage
(NOVEMER, 2019) Abu, Juliet;
Universal Health Coverage seeks to ensure that everybody has access to quality healthcare without financial challenges. It is one of the global strategies towards the realization of the Sustainable Development Goals. Countries therefore need to track progress of universal health coverage not just across the national population but within different groups (e.g. by occupation, income level, sex, age, place of residence, migrant status and ethnic origin). The role of health workers in the realization of the universal health coverage cannot be overemphasized. Health workers are vulnerable to varying risks inherent in their profession, as they are exposed to infections, injuries, stress, violence, allergies, contact diseases and many others). There is a dearth of knowledge on access and coverage of healthcare among health staff who are the forefront of the effort at the realization of universal health coverage. It is this regard that access and coverage of health care among health Workers was investigated. The main objective of the study was to assess the access and coverage of healthcare among health Workers in the Sunyani Municipal. An analytic study type using a cross-sectional design was carried out in the Sunyani municipal. Data was collected using self-administered questionnaires, structured interview guide and subjected to univariate, bivariate and multivariate regression analysis. The study found that 52% of health staff had a degree,66% of health staff had worked for a period less than 5years, 57.1% monthly income was 1,500 Ghana cedis and above and 90% had a valid National Health Insurance Scheme card. Out of the four access and coverage areas the Occupational Health and Safety policy addresses, 71.5% of health staff were assisted during referral, 63.5% supported to access specialist care while 54.1% of health staff did not benefit from the health staffvi screening and 55.6% did not benefit from free Hepatitis B vaccination due to financial challenges as alluded to by Health Managers. Physical access and availability to healthcare by Health staff was highly encouraging as 95.9% of health staff had healthcare always available to them when needed and 83.2% of health staff usually visited the hospital, health centre or community Health Planning and Service Compound when ill. In terms of access to healthcare there was a significant association between income (p=0.017) and possession of valid National Health Insurance Scheme card (p=0.006). Coverage wise, 62% of health staff were moderately satisfied with their volume of healthcare needed and there was a significant association between income status (p=0.006) of health staff and quality of healthcare provided to them. A multivariate regression analysis indicated a highly significant association between volume of care health staff received (p=0.001), quality of Healthcare provided (p=0.001) and health staff healthcare needs satisfaction. The study concludes though health staffs of the Sunyani Municipal moderately accessed their needed health care and received moderate volume of their expected healthcare, one needed to be financially sound to access and obtained optimal healthcare needed. This study recommends effective implementation of the OHS policy and institution of special health package for health staff regardless of their income status to ensure health staffs are universally covered.
Access and use of e-books among students in Senior High Schools: a case study of schools in Kumasi Metropolis
(November, 2016) Boachie, Joyce
Electronic books or e-books have been in existence for a considerable number of years. E-books are now common and very popular with people who wish to read one or many books. Unearthing and the thus understanding of challenges hindering students’ access to and use of e-book is important for effective planning and implementation of policies for the successful integration of e-books in the education curriculum. The study seeks to explore access to and the use of e-books among Senior High School students in the Kumasi Metropolis and the associated challenges and problems they do encounter in this quest. A survey study comprising an admixture of quantitative and qualitative methodologies was designed to elicit participants (students) response on the use of e-books. A total sample of 283 students were selected from five senior high schools in the Kumasi Metropolis to constitute the sample size for the study. Structured questionnaires were employed to elicit information relevant to the objectives of the study. Frequencies and percentages of the variables were computed and described to ascertain the responses of the participants. The study discovered that majority of the high school students surveyed, had varying knowledge of e-books but its usage and thus accessibility was the exclusive privilege of a relatively few due to a litany of factors the prime among which is lack of access. It was found out that students used e-books for the purposes of enhancing personal development, self-inspiration, education, information, as well as for academic development. Mitigating against the effective use of e-books were factors like lack of time, prohibition to use certain devices by school authorities, non-affordability of the reading device and preference for printed books as the prime reasons for not patronizing e-books. The study then concludes that Senior High School students in the Kumasi Metropolis read e-books albeit limited to non-academic related purposes like entertainment and general information seeking via the mobile phone which is the primary medium of access. The study therefore recommends to the Ghana Education Service to institute policies to encourage and improve access and use of e-books among Senior High School students by unleashing its untapped potentials for enhanced academic work by properly integrating it into the educational curriculum.
Access to credit from Non-Bank Financial Institutions (NBFIs) by Small and Medium Scale Enterprises (SMEs) in Kumasi Metropolis
(July, 2015) Darko, Richard
Access to credit for Small and Medium Scale Enterprises (SMEs) in Kumasi Metropolis in the Ashanti Region of the Republic of Ghana, is one of the thorny issues as far as growth and development of SMEs is concerned. This study is meant to highlight on how SMEs could reasonably access credit from financial institutions. It also gives an expose on credit delivery processes of Non-Bank Financial Institutions (NBFIs) to economically support SMEs. The study received responses from 329 owners of SMEs, three (3) NBFIs, National Board for Small Scale Industries (NBSSI) and experts in credit delivery processes and SMEs activities. Questionnaire was used to gather primary data for the study through cross-sectional survey design. Secondary data from literature review of the study supported questionnaire administered to collect data from respondents. The study used tables, percentages and Microsoft Excel to produce bar graphs for data presentation, analysis and discussion. The study identified inadequate SMEs funding, non-formalization of SMEs credit from friends and family members, cash lien, collateral security, insider loan fraud, high interest rates, misclassification of borrowers of credit and credit repayment periods as challenges of SMEs access to credit and credit delivery processes of NBFIs. The study called for the establishment of SMEs Development Fund (SMEDEF), formalization of SMEs credit from friends and family members, proper administration of collateral security for loans, proper classification of borrowers in credit delivery, effective management of cash lien, competitive interest rates on loans, flexible credit repayment periods, restrictions on insider loan fraud and SMEs capacity building to streamline credit delivery in SMEs and NBFIs operations.
Access to justice and inmates at Kumasi central prison
(2021-06-14) Akoto, Alexandria A.;
The study explores how inmates at the Kumasi Central Prison access justice. Purposely, the study seeks to outline the reasons for delay in access to justice for the inmates at the Kumasi prison. To examine the extent to which inmates access justice whiles at the Prison, and identify the various challenges they faced at the prisons. We collect data from a survey administered to 230 respondents from key technical persons and some selected inmates at the Kumasi Central Prisons. The study found out that factors such as few judges and magistrates available to adjudicate the massive backlogs of court cases, and lack of transparency of court document processing and publication of court decisions are the reasons for the delays. The study further found out that majority of the inmates were denied access to legal advice and service, and some of the inmates also expressed total ignorance so far as access to justice. We therefore, conclude that access to justice or legal representation is very difficult in the prison, and that many accused persons go through trial without being represented by a legal practitioner. The researcher therefore recommends a Legal Aid Policy that shall promote speedy access to justice, reformative programmes such as skills training for prisoners, a social protection and support programmes that could help for effective reintegration of remand prisoners into society, and the establishment of a remand home to avoid the mingling of remand prisoners with convicted prisoners.
Access to Microfinance and Performance of Small and Medium Scale Enterprises in Ghana: A Case of Selected SMEs in the Kumasi Metropolis”
(SEPTEMBER 2016) Antwi, Bernard Owusu
The underlying focus of the study was to investigate the impact of services provided by the microfinance institutions on the profitability of small- and medium-scale enterprises that access those services. Employing cross sectional data gathered through the administration of structured questionnaire, the Ordinary Least Squares estimation technique was adopted. On the basis of MFIs services enjoyed by the SMEs in the Kumasi Metropolis, a number of respondents indicated that they have the opportunity to save, invest, and access loan facilities from the MFIs. However, it was made known to the researcher that not much advisory support is received from the MFIs. The results from the OLS estimation revealed that percentage of loans granted outright to the SMEs, cash collateral security required by the MFIs, interest charged on loans and the period of time allowed for the repayment of loans secured are the loan terms that critically influence the profitability of SMEs in the metropolis. On the contrary, the length of time taken to access loans, the grace period permitted by the MFIs, and cost of labour do not have any power in determining the profitability of the SMEs at the various margins of error adopted by the study. The researcher therefore recommends regularly monitoring of loans advanced to Small and Medium Scale Enterprises. The researcher also recommends that Microfinance institutions can partner enterprise development agencies to increase the advisory support rendered to Small and Medium Scale Enterprises.
Access to water and financial implications of groundwater development in Dodowa, Ghana.
(May 2016) Adjei, Seth Allabo
Global urban population growth has led to an increase in the difficulties in urban water provision. This population growth and urbanization which is rampant in the Sub- Saharan Africa has led to the rapid expansion of slums and informal settlements in the urban centers. Access to drinking water in these urban informal settlements of developing countries has being a challenge. The use of groundwater has hence evolved as a major source of urban water supply. In Ghana, Dodowa is one of the peri-urban communities where groundwater is widely used in addition to utility supplies and hence the research in Dodowa gives a true picture of water supply situation and domestic groundwater use within the urban poor. This study therefore focused on determining access to water supply, its cost implication to consumers and also to assess the financial implications of groundwater development in Dodowa. The methodology adopted was household surveys where a total of 300 households were interviewed to access all the necessary data such as socio-economic status of the consumers, access to water, cost and consumption. In addition, water point inventory was conducted where financial data such as capital cost, operation and maintenance cost and replacement costs of various water points was obtained. The results revealed a variety of water points in Dodowa which include utility pipe public taps, utility piped into buildings, motorized boreholes, hand/foot pump boreholes, hand-dug wells, water tankers and vendors. It was found that groundwater is widely used than all other sources of water supply in Dodowa. As much as 78% of all households use groundwater; only that most consumers of the groundwater sources find the water to be salty and hence they do not patronize it as a main source of supply. The financial analysis revealed that managing a utility public tap as well as motorized borehole fetches good returns with short payback periods (1 year 9 months and 2 years, 3 months respectively) and hence was found to be a profitable business for private water point operators. It was also found that the lowest income group rather pays more for water (0.84 Ghana Cedis/Capita/Day) while the highest income earning group pays less (0.36 Ghana Cedis/Capita/Day). Sachet water was also found to be in high demand (96.3% of all households purchase and use it) and a major contributor to high household water expenditure (it forms 72% of the average household water expenditure).
Accessing the role and impact of the KNUST CECAST in the cultural development of Ghana
(December, 2009.) Aikins-Bekoe, Emmanuella
This thesis seeks to assess the role of the KNUST Centre for Cultural and African Studies in the preservation and development of Ghanaian culture, find out its impact on the KNUST community, identify the challenges faced by the Centre and offer some recommendations to solve these problems. This work has examined the various definitions of culture, its components and characteristics, the culture of Ghana, under which the researcher looked at the land, its people, their religion and artforms. It also studied the types of development and assessment, the changes that have occurred in Ghanaian culture and the role of culture in national development; in terms of creating jobs and promoting tourism attraction. Data was collected using questionnaires and interviews. A survey conducted with 200 people, to find out their views about the KNUST Centre for Cultural and African Studies and its impact on their lives, revealed that 17.5 percent of respondents had been on campus for two years but did not know about the Centre, 20 percent of those who knew, had no idea that courses in Sound Engineering, Keyboard skills, Acting techniques and Sight Singing could be accessed there, and 84 percent of the respondents believed that the Centre had broadened their knowledge about Ghanaian cultural practices. The report gives a brief history of the KNUST Centre for Cultural and African Studies, its staff and their roles, collaborations, learning and skill acquisition at the Centre, and the Centre’s most crucial needs. It was found out that the Centre has helped to preserve and develop Ghanaian culture, through the teaching of students about their cultural values and that of others. This report offers some recommendations in the last chapter which can help to improve upon the Centre’s services if they are adopted by the authorities of the University.
Accumulation of Copper from Application of Copper-Based Fungicides and its Relationship with Soil Chemical Properties and Microbial Biomass in Bibiani-Anhwiaso-Bekwai District of Ghana
(SEPTEMBER, 2016) Kakutey, Kingsford
Black pod disease is a major cause of yield loss in cocoa production worldwide and the disease is mostly controlled by copper-based fungicides. However, prolong usage of these fungicides might have negative impact on soil fauna and other soil chemical properties. Ghana Cocoa Board continues to assist farmers to spray their cocoa farms with copper-based fungicides. This study was conducted in selected cocoa farms and uncultivated forests close to these farms which have never been sprayed with fungicides as reference. The study was to investigate the extent of accumulation of copper from the application of copper-based fungicides and its relationship with soil chemical properties and microbial biomass in three communities namely Akaasu, Kyeikrom and Tuntum in Bibiani-Anhwiaso-Bekwai District. Soil samples were collected at two distinct depths, 0-15 cm and 15-30 cm. The fresh soil samples were divided into two. One was immediately sieved through 4 mm mesh and stored at 4 0C for the soil microbial test. The other half was air dried, sieved through a 2 mm mesh and stored in plastic bags for the chemical analysis. Results showed that Tuntum cocoa plantation recorded the highest concentration of total copper (286.54 mgkg-1) while Akaasu cocoa plantation recorded the least total copper concentration of (215.63 mgkg-1). Extractable and total copper vary significantly (P < 0.05) in both top and sub soils of the cocoa plantations from their respective reference values. However, soil pH, nitrogen and organic matter from soils of the cocoa plantations did not vary significantly (P > 0.05) from their reference soils. Results from correlation analysis revealed that extractable and total copper in both the top and sub soils correlated negatively with the levels of organic matter. The relationship between extractable and total copper with microbial biomass were also negatively correlated but not significant (P > 0.05) from the regression analysis in all the study locations. The findings have also shown that the concentrations of copper in the soils of cocoa plantations have not reached their critical levels.
Accuracy of Urine Microalbumin and Serum Uric Acid in the diagnosis of Preeclampsia
(APRIL, 2015 ) Kankam-Agyiri, Mabel
Preeclampsia (PE), a multisystemic disorder of pregnancy characterized by proteinuria and hypertension after 20 weeks of gestation, is one of the leading causes of maternal morbidity and mortality worldwide. Its aetiology is not fully understood though several studies attribute it to a widespread endothelial dysfunction originating from the placenta. The increasing prevalence of PE coupled with the need to identify and institutionalize more sensitive diagnostic tools has necessitated this study. This study sought to evaluate the diagnostic accuracy of urine microalbumin and serum uric acid as early markers of preeclampsia among Ghanaian women attending antenatal care at the Komfo Anokye Teaching Hospital (KATH). This case-control study was conducted among pregnant women at the Obstetrics and Gynaecology (O&G) department of the KATH, Kumasi-Ghana from October 2011 to May 2012. A total of 146 participants were recruited for this study. Written informed consent was obtained from the participants, and information on socio-demographic characteristics, medical history and previous obstetric history were obtained through medical records of the eligible participants. Blood pressure and anthropometrics were measured according to standard procedure; urine samples were collected for estimation of spot urine protein and microalbuminuria; and venous blood sample was taken for biochemical analysis and platelet count. The percentage of married participants with preeclampsia was significantly lower than the controls (p=0.004). More control participants had formal education compared to the participants with preelampsia (p=0.008), however, more preelamptics had informal education compared to the controls (p=0.004). The prevalence of abortion and blood pressure were higher in the preelamptics than the controls. Serum uric acid and hepatic enzymes (ALT and AST)] and urine microalbumin (p=0.005) were significantly elevated in the preeclamptic participants compared to the controls. The mean platelets count and serum albumin levels were however lower in the preelamptics than the controls (p>0.001). A significant positive linear correlation was observed between spot urine protein and urine microalbumin (r=0.324, p=0.006). A negative linear correlation was observed between uric acid and spot urine micro albumin (r=0.033, p=0.786). A urinary micro albumin value of 75.45 mg/g was identified as the best threshold to 2 detect a spot urine protein of > +2 with a sensitivity of 92.7% and a specificity of 80.0%, PPV of 81.03% and NPV of 33.3%. Area under the curve = 0.835; asymptomatic p-value of 0.0001 at 95% CI (0.678-0.991). In contrast, serum uric acid level of 263.5 mg/g was identified as the best cut-off point to detect a spot urine protein of > +2 with sensitivity and specificity of 89.1% and 33.3% respectively (PPV of 77.2% and NPV) of 20.8%. Area under the curve = 0.552; asymptotic p-value of 0.538 at 95% CI (0.364-0.740). Urine levels of microalbumin, as a measure of proteinuria are elevated in preeclamptics and can be used in place of spot macro protein estimation to diagnose preeclampsia especially in the early stages.
Acid Mine Drainage: Effect of acid mine drainage on water and soil resources within the Bogoso/Prestea Mine Resource. (Bogoso Concessional Area)
(FEBURARY, 2009) Afriyie – Debrah, Charles
Heavy metals contamination (As, Fe, Cu, Zn, Mn and Cd) and other physico-chemical changes (pH, temperature, EC, DO, alkalinity, S042-, free CN) in underground and surface water, and carbonate carbon and sulphate sulfur in soil samples due to the effect of acid mine drainage (AMD) were assessed around Golden Star Resource Mine (Bogoso concession). Underground and surface water samples were collected from seven different sites and soil samples from three different sites within Golden Star Resources Mine (Bogoso concession) between November, 2006 and April, 2007. Atomic Absorption Spectrometry (AAS) was used to determine the heavy metal concentrations whilst the physico-chemical parameters were determined using standard methods. Average total levels of arsenic, iron, copper, zinc, manganese and cadmium were 0.0313, 3.7675, 0.0518, 0.0382, 0.8102 and 0.008 (mg/l) and average dissolved levels were 0.0104, 0.6737, 0.0356, 0.0256, 0.6998 and < 0.005 (mg/l) in surface water respectively. In underground water, average total levels of arsenic, iron, copper, zinc, manganese and cadmium were 0.0058, 5.8220, 0.1676, 0.0339, 0.2521 and 0.0065 (mg/l) whilst average dissolved levels were 0.0050, 4.3496, 0.1219, 0.0215, 0.2239 and 0.006 (mg/l) respectively. Iron and manganese levels in surface and underground waters exceeded Ghana Environmental Protection Agency standards for mining effluent. Differences in pH, temperature, E.C, alkalinity, S042-, iron, Cu, Zn and Mn levels in the seven water samples were statistically significant (p ≤ 0.05). Surface water samples recorded values of EC and S042- ions higher than in underground water samples which exceeded acceptable limits. Carbon and sulfur in soil samples varied from 0.1922 to 1.8247 % and 0.0237 to 1.5830 % respectively. The results of the study showed high impact of AMD on water quality in Bogoso mining area. This effect could be attributed to the release of metals as a result of oxidation of metal-bearing sulphides in the mine dumps and pits at the selected sampling sites. The study showed that addition of lime as a treatment option has not been effective. Hence new conventional methods should be considered in the treatment of acidic water (AMD) in the mining area.
Acrylamide Exposure and Risks in Most Frequently Consumed Foods in a Total Diet Study
(2018-10-31) Siaw, Michelle Oppong
The neurotoxic and carcinogenic nature of acrylamide, coupled with the recent emphasis of the “probable carcinogenic” status of acrylamide is a cause for concern requiring further studies. The objective of this study was to determine the carcinogenic and neurotoxic risks associated with the consumption of frequently consumed foods in a Total Diet Study (TDS). From a selection of 80 frequently consumed foods, the acrylamide concentrations in the foods were purified by the QuEChERS method of extraction and purification, and the concentrations of acrylamide were determined using the HPLC. Acrylamide was detected in 82% of all the foods analyzed, and the levels ranged from 1.33×10-3 ± 1.89 to 14.39×10-3 ± 6.33 mg/g. The probabilistic approach was used to model the chronic exposures using the Monte Carlo simulation of the Palisade @Risk software. The mean, 50th and 95th percentile values for acrylamide exposures were in the range of 1.56×10-3 to 1.88×10-2, 3.21×10-4 to 5.85×10-3 and 6.16×10-3 to 8.32×10-2 mg/kg bw/day respectively. The mean and 95th percentile values for the margins of exposure (MOE) for the risk of tumorigenesis and neurotoxicity were below the thresholds, hence posing significant public health concern. Generally, the lifetime cancer risks of male consumers were higher compared to that of the female consumers. The median and 95th percentile consumers presented unacceptable risk, since their lifetime cancer risks were greater than the de minimus (10-6). The elements that imparted the most on the overall lifetime cancer risk of the consumers were the exposure duration and the concentration of acrylamide in the foods. To lower these lifetime cancer risks, mitigation studies can thus, be mounted in order to help lower the concentrations of acrylamide in the foods.
Activities of untrained artists and their effects on advertising in the Kumasi Metropolis.
(August, 2009.) Markwei, Magdalene Martekor
Art is a necessity in advertising but most Ghanaians do not really appreciate the significance of art in an advertisement. For this reason they use untrained artists for their advertisements, who end up producing poor advertisements. The people within the Kumasi metropolis patronize the services of untrained artists because of low fees. As a result, untrained artists are gradually taking over the advertising industry in Kumasi. In this study, the descriptive method of qualitative study was used to undertake the research. After the research, the researcher found out that the works of untrained artists affect advertising because their works reduce the high standards of advertising. This, however, denies clients from getting the full benefit of advertising. Also, after criticising, appreciating and documenting the works of untrained artists, it was realized that most of their works had poor creative concepts poor layout and illustration. This thesis finally recommends that perodic and less expensive courses and Awards Night should be organised for the untrained artists in Kumasi so that they can learn and be motivatied to produce good advertisement for their clients.
Actuarial Applications of Hierarchical Modeling to Health Insurance Claims
(October 22, 2015) Atta-Mensah, Michael
This study demonstrates actuarial applications that can be performed on the Health insurance claims in the country. To achieve this, data from the CPC scheme in Accra of the NHIA in the year 2013 was employed for the study. this consisted of facility type, number of claims submitted(in-patient and out-patient) and amount submitted (in-patient,out-patient,drugs and services charges). A hierarchical model allowing for frequency, claim type and severity amount to be jointly modeled was used. Based on this hierarchical model, we proceeded to estimate premium values under various conditions, however due to lack of information from the insurer most of these estimates could not be stated categorically. Applications of the study was also made to the Value-at-Risk theory. This fact not withstanding, a case has been made for the consideration of the hierarchical modeling approach to be considered as the means of analyzing health insurance claims since this model takes into consideration not only the loss (severity) amount submitted but also considers most especially factors integral to the planning and budgeting of the insurer, and these are, the frequency and type of claim. The hierarchical modeling approach thus provided further insight which previously was overlooked.
Actuarial modeling of health insurance claim reserves using the chainladder
(NOVEMBER, 2019) Opoku, Genevieve;
The preparation for outstanding claims is one of the main factors of technical provisions of Insurance company’s liabilities. Minimising the digression of the true amount of reserves from its estimation is one of the major actuarial challenges. Though the NHIA request the use of Chain Ladder method amidst the various actuarial models for reserve, most health insurance companies default in settling their claims on time leading to the pullout of some healthcare service providers in providing services to customers under the defaulters’ schemes. This thesis summarizes the salient techniques typically used for the estimation of outstanding claims reserves in non-life insurance specifically health insurance, including those to estimate the claims development. This research goes for estimation of health claim reserves in Ghana utilizing Inflation-adjusted chain ladder, Mack chain ladder and Bootstrap chain ladder technique. Claim data on Nationwide Medical Insurance Co. Ltd for my examination ranges from January 2008 to December 2017. Results indicate the Inflation-adjusted Chain Ladder had a superior reserve estimate than that of Mack Chain ladder and Bootstrap Chain Ladder methods.
Acute chest syndrome in sickle cell disease: clinical presentation and pharmacological management
(AUGUST, 2016 ) Ansere, Afriyie Victor
Acute chest syndrome (ACS) is a common cause of hospitalization and mortality in sickle cell patients across the globe. There appears to be paucity of data concerning ACS and its pharmacological management in Ghana and Africa as a whole. This study was aimed at assessing the prevalence and clinical presentation of ACS, and its pharmacotherapy in children with Sickle Cell Disease (SCD) at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Method: The designs of the study was retrospective, in which medical records of the children 14 years and below with SCD and at least an episode of ACS were retrieved and assessed at the Sickle Cell Clinic of KATH. One hundred and seven cases among 1336 children with sickle cell disease met the criteria for inclusion in the study. The ages of the patients ranged from 8 months to 14 years with a mean of 5.7 ± 3.5 years. The prevalence of ACS was 8%, with a 2.2 episodes/ month rate of occurrence. Forty percent of the patients were between the ages of 5 to 9 years. Seventy five percent (n=80) presented with fever and 65% (n=70) presented with cough. Other symptoms like rhinorrhoea and irritability were common in younger patients (< 5 years), p = 0.012 and 0.001 respectively. Abdominal pain and chest pain occurred mostly in the older patients (≥ 5 years), p = 0.024 and < 0.001 respectively. Bacteria isolates were found in 12 of 79 cases (15.2%) that had blood culture information. Eighty four patients (80.7%) received cefuroxime and gentamicin dual therapy for empiric treatment of infection in ACS. The dose range of gentamicin used in the hospital was 3 to 9 mg/kg body weight as opposed to the recommended 5 to 7 mg/kg, as a single daily dose. The empiric antibiotic therapy for infections in ACS patients did not cover for atypical bacteria as recommended in standard guidelines. Forty seven patients received paracetamol alone for pain management and 47 received paracetamol and ibuprofen. Morphine was the preferred opioid prescribed, which is in line with recommendation by WHO guidelines for pain management in SCD patients. The prevalence of ACS was 8%. The majority of patients were between the ages 2 to 9 years. Fever and cough were among the common clinical symptoms presented. Other clinical features like rhinorrhoea, irritability, chest pain and abdominal pain varied with age. Treatment regimen for ACS in the hospital included pharmacotherapy for infections, pain management, hydration with IV fluids and blood transfusion in patients with severe anaemia. All of these were in conformity with standard guidelines and literature.
Adaptation and effects of social media in teaching and learning at the second cycle institution level in Ghana
(AUGUST, 2016 ) Dore-Natteh, Doris
The proliferation of social media platforms freely accessible online using cell mobile devices, PCs and the immense interest of this generation of students in such platforms to the detriment of their studies has cause for concern. As it is almost impossible to block students from engaging on these platforms, it therefore becomes imperative to find a way to make them use the social media for useful purposes. The primary reason for this study is to determine the feasibility of adapting the use of social media in teaching and learning; and to assess the effectiveness and efficiency of these media for instructional engagement by instructors and learners at the second cycle institution level in Ghana. In the course of the study, Facebook© and WhatsApp© were used to supplement traditional classroom instruction and the impacts on students' motivation, learning experience and performance were assessed. Qualitative Case Study research method was used for this study. Interviews conducted were transcribed and composed into three phases of sorting out subjective information as suggested by Strauss and Corbin (1998). The results of the study demonstrate positive results in the use of the social media (Facebook and WhatsApp) to augment classroom teaching and learning with respect to students’ motivation, learning experience and performance suggesting effectiveness and efficiency of the instructional blend. Implication of the results is that the findings can be utilized as a reference for educators and curriculum designers to find meaningful use of social media for teaching and learning in second cycle institutions in Ghana. The study however reveals some challenges such as affordance, access to mobiles devices and irregular power supply that need to be addressed in order not exacerbate the problem of digital divide.
Adaptation of the Broadloom for Pile Weaving
(September, 2010.) Agbo Jones B., Harry
The production of pile fabrics has been limited to the big textile establishments which make use of power and sophisticated looms that are capable of producing complex or intricate designs. This situation has been in existence since the development of the dobby and jacquard looms which scope has gone beyond the simple plain, twill and satin / sateen weaves to the production of complex or intricate designs. An adapted broadloom has been designed and constructed to increase the scope of the local industry. This project is therefore an attempt to adapt the broadloom such that it can be used for pile fabric production, thereby increasing the scope of the local textile industry and reducing the unemployment situation in the country. A sample has been produced, after the adaptation, as proof that the adapted loom is capable of producing such type of fabric. The whole process and mode of production of the sample have been explained and illustrated in the text. Pictures of the sample weave and the adapted loom have been provided in the report to substantiate the fact that, the broadloom can easily be adapted to suit that purpose.
Adapting the Design Concept of Water Closet for Chair Production
(March, 2019) Boakye, Christopher;
This research is about adapting the design concept of Water Closet for the production of three ‘Water Closet Chairs’ for siting only (not for defecation), to be used in our corridors. sitting rooms etc. in our built environment to help improve our sitting posture (vertebrae column) for good health and longer life expectancy. Background study by the researcher has revealed that in Ghana (particularly in the cities), aesthetically appealing, expensive and imported Water Closets have been hidden in our wash rooms inside homes, hotels, restaurants, schools and offices for one purpose; excretion. This deprives visitors (villagers who have never seen Water Closets before sit on very low-level stools and stones), that negatively affects their posture due to lack of good upholstery and international standard measurements. The aim of this research is to pursue creativity and innovation in the Clay and Ceramic industry by exposing the axiology and content oriented account of Water Closet seat in terms of elements and principles of design (colour, shape, visual and tactile texture) to visitors (especially villagers). The objectives of the research are to: integrate Nfensi clay and Mim Granite stones to improve on fragility and tensile strength in the construction of ’Water Closet Chair’. To design and construct additional two ‘Water Closet Chairs’ using Discarded Water Closet and Swivel chair parts as well as (Triplochiton scleroxylon) ‘Wawa’ wood sawdust; To expose the content oriented account of Water Closet seats to visitors. For the sake of gathering enough data for this study, the researcher activated both qualitative and quantitative (pragmatism) research designs as data collection instruments. This paved the way for the full use of descriptive and experimental research methods, purposive sampling techniques, interviews and observations as well as library and field research. Through this research, it has been found that local raw clay materials such as Nfensi clay and Mim Granite Stones could be mixed to form a strong clay body after firing and testing that can withstand tensile strength, improve on fragility for chair construction, capable of carrying human weight. This research has also demonstrated the possibility of integrating discarded Water Closet bowls, metals and Reclining Chair parts in the production of aesthetically appealing ‘Water Closet Chair’ with international standard measurements. The researcher would like to recommend that locally produced Water Closet for excretion from Saltpond Ceramics in Central Region of Ghana and other clay and earthenware producing industries should consider using this study, to further research into local materials such as Nfensi clay and Mim quarry stones (which are in abundant in Ashanti and Brong Ahafo regions of Ghana). Produce cheap Water Closets for excretion, siting, aesthetics etc. to help discourage importation of expensive Water Closet bowls and chairs from outside the country. This will further encourage employment by setting up more local Water Closet Chair producing industries through the recycling of discarded Water Closet bowls and Reclining Chairs that are dumped around our environment causing bleeding of mosquitoes, malaria and soil infertility. This at the same time will discourage wooden chair production, which depletes our forest that results to deforestation, drought, desertification and shortage of food in Ghana.

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