Availability of low vision services and barriers to their provision and uptake in Ghana: practitioners’ perspectives

Background: Provision and uptake of low vision services are essential. Objective: To assess the availability of low vision services and barriers to their provision and uptake in the Ashanti and Brong Ahafo regions of Ghana from the perspective of eye care practitioners. Methods: A descriptive, quantitative, cross-sectional study design using semi-structured questionnaires was used to collect information from eye care practitioners selected from 58 eye care facilities in the Ashanti and Brong Ahafo regions of Ghana. Results: Forty-four eye care practitioners from Ashanti region and 10 from Brong Ahafo region responded to the question- naire. Seventeen (34%) of the 50 eye care facilities who reported having patients seeking low vision services in their facilities provided such services. Lack of low vision devices (94.4%) and equipment (87%) were reported to be the main barriers to the provision of low vision services. Major barriers to low vision services uptake were lack of awareness (88.7%), high cost (70.4%) and social unacceptability of low vision assistive devices (59.3%). Conclusion: Lack of adequate low vision services and barriers to their provision and uptake impact negatively on efforts to prevent visual impairment and blindness in Ghana. Keywords: Low vision services; provision; barriers.

The Rhetoric and Farmers’ Lived Realities of the Green Revolution in Africa: Case Study of the Brong Ahafo Region in Ghana

This paper presents a political ecological analysis of the drivers and impacts of Green Revolution technologies – including improved seeds, chemical fertiliser and other agrochemicals – in the Brong Ahafo Region of Ghana. We identify national government, foreign investment and philanthro-capital as key drivers in shaping both narratives and uptake of Green Revolution technologies at the local level. Drawing from interviews and focus groups, our findings demonstrate that Green Revolution technologies deliver a range of negative local-level socio-ecological impacts, including increasing the overall costs of production, as well as exacerbating poverty and inequality amongst farmers. Our findings demonstrate the disconnection between claims that Green Revolution technologies increase food security and income, and lived experiences of farmers.

Evaluation of neonatal mortality data completeness and accuracy in Ghana

Background Cause-specific mortality data are required to set interventions to reduce neonatal mortality. However, in many developing countries, these data are either lacking or of low quality. We assessed the completeness and accuracy of cause of death (COD) data for neonates in Ghana to assess their usability for monitoring the effectiveness of health system interventions aimed at improving neonatal survival. Methods A lot quality assurance sampling survey was conducted in 20 hospitals in the public sector across four regions of Ghana. Institutional neonatal deaths (IND) occurring from 2014 through 2017 were divided into lots, defined as neonatal deaths occurring in a selected facility in a calendar year. A total of 52 eligible lots were selected: 10 from Ashanti region, and 14 each from Brong Ahafo, Eastern and Volta region. Nine lots were from 2014, 11 from 2015 and 16 each were from 2016 and 2017. The cause of death (COD) of 20 IND per lot were abstracted from admission and discharge (A&D) registers and validated against the COD recorded in death certificates, clinician’s notes or neonatal death audit reports for consistency. With the error threshold set at 5%, ≥ 17 correctly matched diagnoses in a sample of 20 deaths would make the lot accurate for COD diagnosis. Completeness of COD data was measured by calculating the proportion of IND that had death certificates completed. Results Nineteen out of 52 eligible (36.5%) lots had accurate COD diagnoses recorded in their A&D registers. The regional distribution of lots with accurate COD data is as follows: Ashanti (4, 21.2%), Brong Ahafo (7, 36.8%), Eastern (4, 21.1%) and Volta (4, 21.1%). Majority (9, 47.4%) of lots with accurate data were from 2016, followed by 2015 and 2017 with four (21.1%) lots. Two (10.5%) lots had accurate COD data in 2014. Only 22% (239/1040) of sampled IND had completed death certificates. Conclusion Death certificates were not reliably completed for IND in a sample of health facilities in Ghana from 2014 through 2017. The accuracy of cause-specific mortality data recorded in A&D registers was also below the desired target. Thus, recorded IND data in public sector health facilities in Ghana are not valid enough for decision-making or planning. Periodic data quality assessments can determine the magnitude of the data quality concerns and guide site-specific improvements in mortality data management.