In Ghana, Expanded Programme on Immunization administrative coverages are usually high while childhood immunization status remains low. Majority of children do not receive all the recommended 7 vaccines in 15 doses before 1 year of age. Surveys to validate administrative coverages and identify predictors of immunization status are not given the desired attention. Thus, the objective of this study was to evaluate the immunization coverage and its associated factors among children aged 12–23 months in Techiman Municipality, Ghana. A cross-sectional cluster survey was conducted among 600 children. Data was collected using semi-structured questionnaire through face-to-face interviews. The tools were pre-tested in three communities with similar characteristics. The mothers/caregivers were interviewed and additional information extracted from child immunization cards. We observed the presence of Bacillus Calmette-Guerin scar on each child. Data was entered, cleaned and analyzed using Statistical Package for Social Sciences (SPSS) version 17.0. Descriptive statistics such as percentages, frequencies and cross tabulations performed using SPSS while bivariate and multivariate logistic regression analysis conducted using Stata 12.1 version to estimate the Odds Ratio of not being fully immunized. In total, 89.5% (537/600) of the children were fully immunized, 9.5% partially immunized and 1.0% received no vaccine. In the multivariate analysis, the following determinants were significantly associated with the likelihood of being not fully vaccinated (Odds Ratio (AOR) larger than 1) : age of the mother/caregiver 40–49 years (AOR = 0.15, 95%CI = 0.05–0.87) compared to less than 20 years; marital status (compared to never married/single: being married AOR = 0.29, 95%CI = 0.13–0.68), ethnicity (compared to the main ethnic group Akan: Frafra (AOR = 4.71, 95%CI = 146–15.18) and Kusaasi (AOR = 0.09, 95%CI = 0.02–0.51), religion (compared to Islam: Christianity AOR = 0.17, 95%CI = 0.06–0.50), sex of child (compared to male: female AOR = 0.39, 95%CI = 0.19–0.80) and possession of immunization card (compared to those having the card: those without the card AOR = 84.43, 95%CI = 17.04–418.33). Mothers/caregivers aged 40–49 years, being married, Kusaasi ethnic groups, Christian and female child have a higher likelihood of being fully immunized, while Frafra ethnic group and no immunization card have a higher likelihood of not being fully immunized. We found no association between immunization status and child’s relationship to respondent; parity; education; occupation and child’s age. Immunization status (89.5%) and coverages ranged 92 to 99% of the vaccine doses is high compared to national and regional. Problems of not fully immunized persists and needs urgent attention. Education on immunization should be intensified by health providers. Moreover, disadvantaged populations should be reached with immunization services using out-reach activities.

Immunization against diseases is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, a proportion of children particularly in Africa are not fully immunized with the recommended vaccines. Thus, many children are still susceptible to the Expanded Program on Immunization (EPI) targeted diseases. The objective of this study was to determine the immunization dropout rate and data quality among children aged 12–23 months in Techiman Municipality, Ghana. A cross-sectional cluster survey was conducted among 600 children. Data was collected using semi-structured questionnaire through face-to-face interviews. Before the main data collection, the tools were pre-tested in three different communities in the Municipality. The mothers/caregivers were interviewed, extracted information from the child immunization cards and observation employed to confirm the presence of Bacillus Calmette-Guerin (BCG) scar on each child. Routine immunization data was also extracted from immunization registers and annual reports in the Municipality. Immunization coverage for each of the fifteen vaccines doses is above 90.0% while full childhood immunized status is 89.5%. Immunization dropout rate was 5.6% (using BCG and Measles as proxy vaccines). This is lower than the 10.0% cutoff point by World Health Organization. However, routine administrative data was characterized by some discrepancies (e.g. > 100.0% immunization coverage for each of the vaccines) and high dropout rate (BCG - Measles = 31.5%). Binary regression was performed to determine predictors of dropout rate. The following were statistically significant: married (OR = 0.31; 95% = CI 0.15–0.62; and p = 0.001), Christianity (OR = 0.27; 95% CI = 0.13–0.91; and p < 0.001), female child (OR = 0.50; 95% CI = 0.26–0.91; and p = 0.024) and possession of immunization card (OR = 50.3; 95% CI = 14.40–175.92; and p < 0.001) were found to be associated with immunization dropout. Childhood full immunized status (89.5%) and immunization coverages (>90%) are high while dropout rate is lower than the recommended cutoff point by WHO. However, immunization data quality remains inadequate. Thus, health education and orientation of service providers is urgently needed. In addition, immunization registers and data quality are issues that require attention.

Viral Hepatitis B is of a major public health concern globally, especially in developing countries. Expectant mothers’ knowledge of Mother-To-Child Transmission (MTCT) of the disease is significant in preventing the spread from an infected mother to her child. This study sought to assess the expectant mothers’ knowledge of Mother-To-Child Transmission of viral hepatitis B in the Wa Municipality and Lawra District of Upper West Region, Ghana. A descriptive cross-sectional study with a multi-stage sampling technique was employed to select a total of 450 study respondents (expectant mothers), and a semi-structured questionnaire was used for the data collection. Respondents were interviewed using face-to-face interview technique. Majority (54.0%) of the respondents were aged between 25 and 35 years and the results were similar in both districts. Overall, 62.4% (281/450) of the respondents had at least Junior High level education, and 76.2% (343/450) were multigravida. Educational levels among respondents in the two areas were above 50.0% and considered relatively high. Respondents’ general knowledge of hepatitis B infection and disease was 46.0% (208/450). However, there was a slight difference between the two districts (40.1% in Lawra District and 51.6% in Wa Municipality). The overall knowledge level on MTCT of viral hepatitis B among the respondents was 34.7% (156/450): the Wa Municipality recorded higher knowledge (43.3%) compared to 24.8% in Lawra District. The knowledge level of the expectant mothers on MTCT of viral hepatitis B is relatively low in Upper West Region, Ghana. Majority of the respondents had some form of formal education. The age, marital status, education, occupation, gravity and family setup were found to be associated with knowledge of Hepatitis B infection and MTCT. Thus, there is urgent need to intensify efforts of health staff to educate expectant mothers. In addition, home education and outreach activities should be intensified on HBV infection as well as MTCT. Consequently, planning, implementation and execution of preventive activities, especially in the antenatal clinics should critically consider the social and demographic variations of mothers.

BackgroundThe recent Ebola virus disease (EVD) outbreak has been described as unprecedented in terms of morbidity, mortality, and geographical extension. It also revealed many weaknesses and inadequacies for disease surveillance and response systems in Africa due to underqualified staff, cultural beliefs, and lack of trust for the formal health care sector. In 2014, Ghana had high risk of importation of EVD cases.ObjectiveThe objective of this study was to assess the EVD surveillance and response system in northern Ghana.DesignThis was an observational study conducted among 47 health workers (district directors, medical, disease control, and laboratory officers) in all 13 districts of the Upper East Region representing public, mission, and private health services. A semi-structured questionnaire with focus on core and support functions (e.g. detection, confirmation) was administered to the informants. Their responses were recorded according to specific themes. In addition, 34 weekly Integrated Disease Sur...

Background: The Community-based Health Planning and Services (CHPS) is a national health reform programme that provides healthcare at the doorsteps of rural community members, particularly, women and children. It seeks to reduce health inequalities and promote equity of health outcomes. The study explored implementation and utilization challenges of the CHPS programme in the Northern Region of Ghana. Methods: This was an observational study that employed qualitative methods to interview key informants covering relevant stakeholders. The study was guided by the systems theory. In all, 30 in-depth interviews were conducted involving 8 community health officers, 8 community volunteers, and 14 women receiving postnatal care in four (4) CHPS zones in the Yendi Municipality. The data were thematically analysed using Atlas.ti.v.7 software and manual coding system. Results: The participants reported poor clinical attendance including delays in seeking health care, low antenatal and postnatal care visits. The barriers of the CHPS utilization include lack of transportation, poor road network, cultural beliefs (e.g. taboos of certain foods), proof of women’s faithfulness to their husbands and absence of health workers. Other challenges were poor communication networks during emergencies, and inaccessibility of ambulance service. In seeking health care, insured members of the national health insurance scheme (NHIS) still pay for services that are covered by the NHIS. We found that the CHPS compounds lack the capacity to sterilize some of their equipment, lack of incentives for Community Health Officers and Community Health Volunteers and inadequate infrastructures such as potable water and electricity. The study also observed poor coordination of interventions, inadequate equipment and poor community engagement as setbacks to the progress of the CHPS policy. Conclusions: Clinical attendance, timing and number of antenatal and postnatal care visits, remain major concerns for the CHPS programme in the study setting. The CHPS barriers include transportation, poor road network, cost of referrals, cultural beliefs, inadequate equipment, lack of incentives and poor community engagement. There is an urgent need to address these challenges to improve the utilization of CHPS compounds and to contribute to achieving the sustainable development goals.

Bacterial infections caused by multidrug resistant organisms are a major global threat. There is still a knowledge gap on this situation in the Northern Region of Ghana. This study determined the prevalence and resistance profile of bacterial infections. It also identified factors associated with multidrug resistance in the study area. This was a retrospective cross-sectional design and it analyzed data from the samples received at the Tamale Zonal Public Health Reference Laboratory from June 2018 to May 2022. The data were analyzed using the R software version 4.2.0. Univariate and multivariable binary logistic regression analyses were used to determine the factors associated with multidrug resistance. The samples included all specimen types possible. The specimens were collected for the purpose of clinical bacteriology diagnostics. Overall a total of 1222 isolates were obtained. The three (3) main bacteria responsible for infections were: Klebsiella spp. (27%), Moraxella spp. (22%), Escherichia spp. (16%). High resistance levels were found against the tested antibiotics and about 41.60% of the bacterial strains isolated were multidrug resistant. Hospitalization was associated with multidrug resistance in univariate (COR 1.96; 95% CI 1.43–2.71; P-value < 0.001) and multivariable analyses (AOR 1.78; 95% CI 1.28–2.49; P-value < 0.001). There is the need for further research on the molecular epidemiology of antibiotic resistance genes in the study area to effectively control the spread of multidrug resistant pathogens. In addition, efforts to build the capacity of health professionals on infection prevention and control as well as diagnostic and antimicrobial stewardship needs urgent attention.