Mr Eric Badu

Purpose: Assess factors associated with the quality of mental health services. Design and Methods: Cross-sectional design, quantitative data, and 510 consumers from three psychiatric facilities. Results: The average age of consumers was 34 years¿and 51.57% males. Consumers reported mixed satisfaction with the quality of mental health services (mean = 3.2; SD = 0.56) but were dissatisfied with the range of interventions (mean = 1.57; SD = 0.77). Predisposing (age, education, and primary occupation), enabling (insurance status), and need factors (mental health status) were significantly associated with quality indicators (range of interventions, efficacy, and overall satisfaction). These factors were significantly associated with consumers¿ functionality (cognition, mobility, self-care, getting along, life activities, and participation). Practice Implications: Policymakers and clinicians are encouraged to incorporate the predisposing, enabling, and need factors into mental health planning, monitoring, and advocacy to improve service outcomes.

Purpose: The mass media have been described as an important institution in educating society about persons with disabilities and in facilitating their acceptance. However, calls to project a positive public image of persons with disabilities and to develop an inclusive society have coincided with the neo-liberal approach to policymaking, whereby government plays a minimised role in the provision of basic services to citizens. Although the extant literature from advanced countries has found stereotypical and disempowering portrayals of persons with disabilities in the mass media, this area remains unresearched in developing countries. The purpose of this study was to explore how the managers of media organisations conceptualise disability, their perception of the role and contribution of the media towards promoting effective public awareness campaigns about persons with disabilities. Methods: This descriptive, qualitative study draws on a purposive sample of 20 participants consisting of general managers, news editors and programme managers from ten media organisations in a region in Ghana. A semi-structured interview guide was developed from the literature, which included tenets of neo-liberalism, to collect the data. Results: The study found that the majority of respondents cited medical model explanations of disability. Also, they were unprepared to prioritise disability issues due to lack of public interest in disability programmes and lack of funds and sponsorship for disability programmes. Conclusion: Governments must offer tax rebates to media organisations to enable them to prioritise disability issues. Other recommendations for developing media interest in disability issues are also discussed.Implications for rehabilitation This study shows limited understanding of disability among decision-makers or key players in media organisations in Ghana. In an environment of meritocracy, persons with disabilities who struggle to access education in Ghana, may be unable to secure jobs at media organisation. This study shows that media organisations seem unprepared to support or project image of persons with disabilities because such ventures come with no reward. We conclude that if the government is committed towards achieving an inclusive society in Ghana, it could offer tax rebate to media organisations to enable them cover disability programmes.

The study aims to explore the perceived satisfaction of insured clients in financing health services through National Health Insurance in Ghana. A quantitative method was used to recruit 380 respondents, selected by multistage cluster sampling. Data were collected through the administration of questionnaires. More than half, 57.9%, of respondents were males, and the average age was 34¿years. Most respondents, 74.3%, were insured. Overall, 53.12% of insured clients were dissatisfied with the services of providers. Factors, such as benefit package of insurance, willingness to pay higher premium, and perceived discrimination were significantly associated with poor satisfaction with health services. The current advocacy for and awareness about the use of health insurance as a prepayment plan should be prioritised in policy initiatives. The benefit package for the insurance should be increased in order to cover all disease conditions that afflict the Ghanaian population.

This review synthesises theoretical approaches and methodological considerations in mental health service quality assessment from consumers-perspective. We searched published articles from databases: EMBASE, MEDLINE, CIHNAL, Scopus, Web of Science, and PsycINFO. Of the 30 included papers, 16 contained instruments used to mental health quality assessment and 14 focused on theoretical constructs. The review finds that mental health quality assessment is explained and measured using constructs that focus on structure, process and outcome. The methodological issues that need critical consideration are the context and cultural norms of services, outcome perspectives, evaluator, sources of information as well as the selection of consumers and instruments. The review recommends that researchers and clinicians should consider the theoretical constructs and methodological issues in mental health quality assessment.

Purpose: To explore factors influencing treatment pathways to mental health services among consumers in Ghana. Design and Methods: Cross-sectional design using quantitative method. Findings: Treatment pathways for mental illness were general hospitals/clinics, psychiatric hospitals, and faith-based practices. The predisposing (age, household size, primary occupation, ethnicity, marital status, religion, and geographic location, as well as attitudes and beliefs), enabling (affordability), and need factors (severity of mental illness) were significant predictors of treatment pathways. Practice Implications: Current advocacy and awareness for mental health services in Ghana should consider the predisposing, enabling, and need factors of consumers. Policy initiatives on mental health services should ensure adequate financing mechanisms and further establish collaboration between biomedical and faith-based services.

Background: The cost burden of occupational injuries has significant effects on the social well-being of workers. Although there seems to be growing evidence on the cost burden on other public health issues, little is known about occupational injuries, especially in low- to middle-income countries including Ghana. Objective: This study, therefore, sought to estimate the cost burden of managing occupational injuries among frontline construction workers. Methods: A prevalence-based cost of illness approach was used to estimate the cost burden of construction injuries. A structured questionnaire was used to collect cost-related data from 640 frontline construction workers. Descriptive statistics were used to estimate direct and indirect cost of injuries using Microsoft Excel and STATA version 14. Results: Overall, a worker spends an average of GHC 104.84 ($24.52) and GHC 180.89 ($42.31) as direct and indirect costs, respectively. Compared with other injuries, fracture had the highest average cost, GHS 343.33 ($80.30), and concussion and internal injury recorded the lowest cost. Also, compared with other trade specialties, carpenters had the highest average cost burden and laborers had the lowest burden. Conclusion: There is high direct and indirect cost for managing occupational injury among construction workers. Advocacy and awareness about workplace insurance and regulatory policies should adequately be strengthened and prioritized through periodic monitoring and evaluations.

Purpose: The nutritional status of a woman before and during pregnancy is important for a healthy pregnancy outcome. The increasing prevalence of maternal overweight and obesity worldwide has become a problem of concern among public health professionals. The purpose of this paper is to review the evidence regarding the impact of maternal weight on pregnancy outcomes to facilitate the provision of evidence-based information to pregnant women during antenatal clinics in Ghana. Design/methodology/approach: A search was conducted in PubMed, PLOS ONE, Cochrane, Embase and bibliographies for all studies on maternal weight and pregnancy outcomes published from January 2000 to May 2013. The key words used for the search were: ¿pre-pregnancy BMI¿, ¿gestational weight gain¿, ¿maternal weight¿, ¿pregnancy outcomes¿ and ¿birth outcomes¿. Findings: The search yielded 113 papers; out of these, 35 studies were included in the review after exclusion of duplicates and irrelevant papers. Excluded papers included animal studies and human studies that did not meet inclusion criteria. Research limitations/implications: The review only considered papers published from 2000 to 2013 and might have left out other important papers published before 2000 and after 2013. Practical implications: The origins of the studies included in the review suggest paucity of studies on maternal weight and pregnancy outcomes in developing countries where there is a double burden of malnutrition. There is the need for more studies to be initiated in this area. Social implications: Results of this review have revealed that the extremes of maternal weight prior to and during pregnancy increase the risk of maternal and fetal complications. Originality/value: This paper provides evidential information on the impact of maternal weight on pregnancy outcomes for counseling during antenatal clinics.

Purpose: Women with disabilities are particularly vulnerable to violence and often at risk of being violated sexually. The study aimed to document the causes and consequences of sexual violence against women with disabilities in Mampong Municipality of Ashanti region in Ghana. Methods: This exploratory study recruited 41 participants, made up of women living with intellectual, visual and hearing disabilities, who were interviewed using convenience and snowball sampling techniques. Results: It was found that many participants had suffered sexual violence and factors such as poverty, rejection by families, isolation and unemployment were given as the cause. It was also found that these women suffered consequences such as unwanted pregnancies, divorce, outright rejection and psychological trauma. Conclusion: The current situation of women with disabilities make it impossible for them to escape sexual violence. Therefore, it is essential that national awareness campaigns be fashioned to encourage people to provide support to their family members with disabilities.

Purpose: Inclusive education, widely acknowledged as an alternative method of making education accessible to children with special needs, has been piloted for 10 years in selected districts of Ghana. This article aims to discuss the feasibility of implementing it throughout the country, by assessing the inclusive education programme piloted in Ghana¿s Ashanti and BrongAhafo regions. Method: One round of in-depth interviews was conducted with 31 participants, to collect data on the issue under study. Participants were officials of Special Education at the national Head Office, District Special Education Coordinators, Resource Teachers, Headmasters and Classroom Teachers of inclusive education. Results: The study findings indicated that the pilot programme did not live up to expectations when faced with challenges such as inaccessible environments, lack of resources, lack of funds, lack of qualified teachers, poor teaching methods and negative attitudes of teachers towards children with disabilities. Conclusion: It is very unrealistic to commence inclusive education programmes unless practical measures are put in place, such as adequate funding from the government and provision of sufficient resources for inclusive schools.

Purpose: According to the World Health Organisation, 10% to 15% of the population of every developing country lives with disability. This amounts to about 2.4 - 3.6 million Ghanaians with disability. Since their contribution is important for the development of the country, this study aimed to assess the financial access to healthcare among persons with disabilities in the Kumasi Metropolis of Ghana. Methods: A cross-sectional study, involving administration of a semistructured questionnaire, was conducted among persons with all kinds of disabilities (physically challenged, hearing and visually impaired) in the Kumasi Metropolis. Multi-stage sampling was used to randomly select 255 persons with disabilities from 5 clusters of communities-Oforikrom, Subin, Asewase, Tafo and Asokwa. Data analysis involved descriptive and analytical statistics at 95% CI using SPSS software version 20. Results: There were more male than female participants, nearly one-third of them had no formal education and 28.6% were unemployed. The average monthly expenditure on healthcare was GHC 21.46 (USD 6.0) which constituted 9.8% of the respondents¿ income. Factors such as age, gender, disability type, education, employment, and whether or not they stayed with family members had significant bearing on the average monthly expenses on healthcare (p<0.05). Transportation cost, the travel distance to facilities, and the regular sources of payment for healthcare, had significant relationship with access to healthcare (p<0.05). Although about 63.5% of the respondents used the National Health Insurance Scheme as the regular source of payment for healthcare, 94.1% reported that sources of payment did not cover all their expenses and equipment. Conclusion: Financial access to healthcare remains a major challenge for persons with disabilities. Measures to finance all healthcare expenses of persons with disabilities are urgently needed to improve their acc ess to healthcare.

Purpose: Disability cuts across every society and all spheres of life. For an inclusive society, it is important to understand people¿s perceptions about persons with disabilities. However, there seems to be limited information, particularly about the perceptions of students who are the generation of future policy-makers. This study examines the perceptions of students in the University of Yaoundé II about persons with disabilities in Cameroon. Methods: A cross sectional study design using quantitative methods was employed with a sample of students at the University of Yaoundé II. A questionnaire was used to gather information from 500 students selected by simple random sampling. The data analysis involved descriptive and inferential statistics at 95% CI. Results: Among the participants, 51.8% were males, 89.2% were single and the average age was 24.9 years. Findings showed that 69.8% did not know about the actual population of persons with disabilities in Cameroon, though 14.6% had relatives with disabilities. None of the students perceived disability as a contagious condition, and 79.8% agreed that education had influenced their perceptions about persons with disabilities. Gender and education level had significant relationship with changes in perception (OR=1.8; p=0.01 and OR=1.91; p=0.04). However, 13.5% were unwilling to work with a person with disability in the future. Conclusion: The findings suggest that issues of disability have not been taken into consideration in Cameroon. Therefore, there is the need for education and sensitisation of the general population towards disability. Additionally, policy-makers should factor persons with disabilities into national strategic plans, in order to ensure an inclusive society.

Purpose: Tourism contributes a great deal to the world¿s economy. However, persons with disabilities are underrepresented in the industry, particularly in Ghana, due to inaccessible tourism structures and facilities. Accessibility and participation in tourism will enhance social inclusion of persons with disabilities. This study sought to document the nature of access as well as the participation of persons with disabilities in tourism, from the perspective of tourism workers in the Ashanti region of Ghana. Methods: An exploratory study using qualitative methods was conducted among workers at tourist centres in the Ashanti region of Ghana. A total of 21 participants were involved in the study. A voice-recorded interview was used to collect data from respondents. Results were generated through thematic content analysis to develop themes. Results: Findings revealed that the participation of persons with disabilities in tourism is limited due to factors such as the inaccessible tourism environment, the nature of transport services and the language barrier. Suggested provisions were canopy walks, accessible banquets, vehicles, and sign language interpreters at various tourism destinations. Conclusion: Tourism destinations should be made disability friendly through regulations, monitoring and supervision with regard to accessibility, structures and environment.