Tuesday, September 30, 2008

Setting health priorities right - Indepth Network provides useful data

Friday, September 26, 2008 (Daily Graphic Pg 7)

By Rebecca Kwei
THE year was 1998 and the venue, White Sands Hotel, Dar-es Salaam, Tanzania. There, about 40 people, including scientists, researchers, funders and academicians met to constitute Indepth Network, an independent international organisation to provide health, social and demographic data and research to enable developing countries set health priorities and policies, based on scientific evidence.
Significantly, Indepth Network’s 8th annual general meeting (AGM) takes place at Dar-es Salaam, Tanzania, from September 22 -26, 2008, at the White Sands Hotel. It is on the theme: “INDEPTH @ 10: From knowledge generation to improved health policy and practice.”
Currently, the network is working together with 37 partner community-based health and demographic surveillance system (HDSS) sites in 19 countries in Africa, Asia, Central America and Oceania.
“Through this platform, the network has been playing a major role in co-ordinating the activities of these research institutions in the evaluation and monitoring of health outcomes and the burden of diseases in several countries. It has also been involved in the training and capacity development of scientists in Africa and Asia where the sites are located,” said Prof. Fred Binka, Dean of Public Health, University of Ghana, and who was the first Executive Director of Indepth Network.
Ten years in the life of any institution is no mean achievement and for Indepth Network, 10 years of working hard to bring reliable health information to bear on policy and planning in developing countries has been worthwhile.
“Indepth feels it is time to reflect on the work done in the past 10 years, achievements made, lessons learnt and general paradigm shifts, if any. There is need to review our approaches, capacities and networking,” says Dr Osman Sankoh, the new Executive Director of Indepth Network.
Over the years, the network has researched and collected data in many countries to provide a better, empirical understanding of health, nutrition, food security and social issues, and to apply this understanding to alleviate the most severe development and social challenges.
With a secretariat in Accra, Indepth Network has since 2000 been making systematic efforts to harness and make widely available data from various HDSS sites to fill the existing void in vital health information needed for planning.
In Ghana, the sites are located at Dodowa, Kintampo and Navrongo. The collection of data in these well-defined areas are done on a continuous basis and this helps to provide timely information for planning and service provision to communities.
According to Dr Sankoh, research generated from some of the INDEPTH sites in Ghana has resulted in the formulation of some national health policies.
An example is the Community-based Health and Planning Services (CHIPS), which is now the government's policy for delivering health services to the people of Ghana. CHIPS approach had its origins in ground-breaking research carried out at the Navrongo Health Research Centre in Northern Ghana.
Another example is the use of insecticide-treated bednets, whose pioneering research was also done at Navrongo. Also, the Dodowa District is being used to evaluate the National Health Insurance Scheme (NHIS).
Among the scientific and policy findings that have been developed, tested and demonstrated by HDSS sites are the effectiveness of Insecticide Treated Nets (ITNs) in reducing the incidence of malaria mortality; the impact of expanding the health care workers on health outcomes in a community and the first real model life tables for sub-Saharan Africa, which had previously relied on estimates based on non-African populations.
The impact of expanding the health care workers on health outcomes in a community; the first real model life tables for sub-Saharan Africa, which had previously relied on estimates over a hundred years, and family planning strategies tested at Matlab have been adopted nationwide and have led to Bangladesh’s recognition at the 1994 United Nations Conference on Population and Development in Cairo, a family planning success story, are all some of the success stories of Indepth.
One major boost of INDEPTH Network's projects for which Ghana is at the forefront is the establishment of the Malaria Clinical Trials Alliance (MCTA) in 2006 with a $17 million grant from the Bill and Melinda Gates Foundation to the INDEPTH Network.
The main goal of MCTA is to facilitate site preparation for the effective conduct of clinical trials for life-saving malaria interventions such as vaccines and drugs. MCTA is also supporting sites to develop tools to assess the disease profiles of countries, while encouraging the wise use of resources in resource-constrained countries in Africa.
Currently, there are 16 trial sites in 10 African countries (Burkina Faso, Gabon, Ghana, Kenya, Nigeria, Malawi, Mozambique, Senegal, Tanzania and The Gambia) on the MCTA platform. An international Management Board, headed by former Prime Minister of Mozambique, Dr Pascaol Mocumbi, was constituted.
Dr Sankoh sees a bright future for Indepth — “with many funders willing to give more support. The intention is to make Indepth a one-stop shop for all data and information related to population and health baseline research in the developing world,” he said.
Also, research protocols/principles and lessons generated will be shared through appropriate platforms as well as increase the capacities of scientists to deliver.

Access to basic health care improves

Saturday, September 27, 2008 (The Mirror Pg 34)

From Rebecca Kwei, Dar es Salaam, Tanzania
Research using Demographic Surveillance System (DSS) sites has improved access to basic health care in Ghana, Dr Cornelius Debpuur, a Research Fellow at the Navrongo Health Research Centre has said.
According to him, results of successful trials carried out at these sites have been translated into policies of health reforms in the country.
Dr Debpuur said this when he made a presentation on  "Contribution of DSS to Promoting Health for All in Ghana” at the 8th Annual General and Scientific Meeting of the Indepth Network in Dar es Salaam, Tanzania. It is on the theme ‘Indepth @ 10: From Knowledge Generation to Improved Health Policy and Practice’. More than 200 participants comprising scientists, researchers, young scientists and funders are taking part in the conference.
Citing an example of how DSS had contributed to improved healthcare delivery in Ghana, he said results of a trial known as Community-based Health Planning and Services (CHPS) which was launched in 1993 to identify ways to improve access to health care in rural communities in the Kassena-Nankana District by the Navrongo Health Research Centre were so impressive that the Navrongo system was seen as a national model for community-based health care.
The results of the trial showed an increase in service coverage, reduction in fertility by one birth and reduction in child mortality by 40 per cent in the district.
In 1999, the Ministry of Health adopted the Navrongo model and launched the CHPS initiative as a national  policy.
Additionally, he said, the Vitamin A Supplementation Trial in the Kassena-Nankana District showed that the vitamin supplementation reduced child mortality by 20 per cent while the Insecticide Treated Bednet (ITN) trial also indicated a reduction in child mortality by 17 per cent in the same district.
Dr  Debpuur said the DSS sites, apart from guiding policy makers, also helped in generating evidence of what worked in promoting health care and building local capacity for research and health delivery.
He noted that there was also direct investment in health and development of catchment populations and facilitating development of evidence-based health programmes and policies.
 Indepth Network is an independent organisation that works to provide health, social and demographic data and research. Currently, the network has 37 community-based Health and Demographic Surveillance System (HDSS) sites in 19 countries in Africa, Asia, Oceania and Central America.  In Ghana the sites are located at Dodowa, Kintampo and Navrongo.
 

New diarrhoea vaccine being tested

Saturday, September 27, 2008 (Daily Graphic Pg 6)

Story: Rebecca Kwei, Dar es Salaam, Tanzania

A new vaccine to prevent the incidence of rotavirus diarrhoea in children is being tested in three African countries namely Ghana, Kenya and Mali.
Rotavirus is a major cause of diarrhoea in children and accounts for 25 per cent mortality in children worldwide. It also accounts for about 50 per cent hospitalisation of severe diarrhoea and vomiting in children globally but majority of these incidences are recorded in developing countries.
Speaking at the 8th Annual General and Scientific Meeting of the Indepth Network in Dar es Salaam, Tanzania, Prof George Armah of the Noguchi Memorial Institute for Health Research said treatment of diarrhoea was through rehydration if it is caused by a virus and antibiotics if it is bacterial.
However, he noted that there was the need for a rotavirus vaccine to complement existing and improved interventions to control diarrhoea diseases in children since it could be fatal especially in developing countries.
He said studies have shown that hygiene and sanitation measures do not impact rotavirus incidence hence prevention through vaccination was the best method for reducing rotavirus mortality.
He noted that diarrhoea was the the second leading cause of death in children under five globally and 85 per cent of children would have rotavirus before the third birthday.
He said in Ghana, the infection rate is 40 per cent and it is common between October to April during the cool-dry periods.
Already two rotavirus vaccines, Rotarix and Rotateq have been developed and tested in Europe and America and have been found to be efficacious. However, there was the need to test the vaccines in Africa as well to see its efficacy .
On the rotavirus vaccine introduction in the three African countries, he said about 5000 children are involved in the study with 2200 of the children being followed up in Navrongo.
Five thousand children from the three African countries out of which 2,200 are from Ghana are being used in the vaccine trial to see the protection rate. The study which started in March last year will end in March 2009.
Prof Armah who is leading one of the teams introducing the rotavirus vaccine in Africa said the World Health Organisation (WHO) recommends the inclusion of rotavirus vaccination in the national immunisation programmes of developing countries and it was important for more awareness on the burden of disease, the vaccine potential and efficacy so that it could be introduced early into the Expanded Programme on Immunisation with support from the Gates Alliance for Vaccine Initiative (GAVI).

Indepth Network meeting opens

Thursday, September 25, 2008 (Daily Graphic Pg 5

Story: Rebecca Kwei, Dar es Salaam, Tanzania

The Deputy Minister of Health and Social Welfare of Tanzania, Dr Aisha Omar Kigoda, has called on African governments to use available evidence from research and information systems in the hub of policy development and implementation.
She said evidence-based policy approach helps in making better informed decisions about policies, programmes and strategies.
Speaking at the opening ceremony of the 8th Indepth Network Annual General and Scientific Meeting in Dar es Salaam, Tanzania on the theme ‘Indepth @ 10: From Knowledge Generation to Improved Health Policy and Practice, Dr Kigoda noted that despite enormous advances in information technology, Africa with many emerging economies, remains starved of vital health and equity information.
“Trends in demographics, health status, burdens of disease, causes of death, and access to functional health systems, which could help scientists and strategists in health and development tools remain largely hidden from view,” she said.
The only way to get information that reflect the health status and needs of rural and urban communities, she said was to go to the communities and households adding that “that is what Indepth HDSS sites do so well”.
She observed that HDSS sites apart from providing a platform of demographic and health surveillance sites for monitoring impact of interventions can also aid in tracking new health threats such as climate change, dynamics in household food security, emerging and re-emerging infectious diseases, drug and insecticide resistance and can help alert the health community to prepare a response.
Dr Kigoda said the burden of disease was still unacceptably high especially among women and children and there was the need for more bodies such as Indepth to continue collecting data, generating information, and producing local evidence that will help guide the health and other social sectors addressing such dynamics.
She said so far Indepth was the only network in Africa facilitating a functioning system across 19 countries which provides the much needed sentinel information with regard to time, accurate, birth, death and migration trends.
The Assistant Director of General, Information, Evidence and Research Cluster, World Health Organisation, Tim Evans who was represented by Dr Clara AbouZahr, called on Indepth to consider linking to emerging global collaboration on health metrics and evaluation and also nurture early and ongoing engagement among key policy makers and all people.
The board chairman of Indepth, Dr Seth Owusu-Agyei, said the network has made significant strides in the past 10 years and the decisions that would be taken at the meeting will take it to the next level.
More than 200 participants comprising scientists, researchers, young scientists and donors are taking part in the conference.
Indepth Network is an independent organisation that works to provide health, social and demographic data and research. Currently, the network has 37 community-based Health and Demographic Surveillance Systems (HDSS) sites in 19 countries in Africa, Asia, Oceania and Central America. In Ghana the sites are located at Dodowa, Kintampo and Navrongo.

Monday, September 15, 2008

Insurance awards launched

Saturday, September 13, 2008 (The Mirror Pg 34)
By Rebecca Kwei
Players in the insurance industry will have their contributions in the country recognised with the introduction of the Ghana Insurance Awards.
The maiden edition of an insurance awards which was launched on Tuesday, is based on customer survey. The award ceremony which is expected to come off in October will coincide with the Insurance Week when deserving companies in the insurance sector would be given awards in various categories from the perspective of the consumer.
The Ghana Insurance Awards format, which is modelled alongside the Ghana Banking Awards format, is the initiative of Corporate Initiative Ghana (CIG) and supported by the Ghana Insurers Association, which is the umbrella organisation of all the insurance players in the country.
In all, 16 awards will be given and would involve interviews with corporate bodies and individuals about 3,000 entities on the whole.
Launching the awards, an economist, Dr Joe Abbey, said the insurance industry faced a lot of challenges but the growth prospects for them were promising.
He said insurers had to move up the value chain by providing innovative products, value-added services and holistic risk management.
Dr Abbey noted that the increase in wealth and life expectancy would lead individuals to demand a range of wealth protection and health insurance products, as well as property casualty coverage.
He added that the economic growth, coupled with the higher use of vehicles in the country would give rise to new risks requiring insurance coverage from factory owners to cover property and casualty and to car owners that needed automobile insurance.
According to Dr Abbey, Ghana’s growing wealth and increasing sophistication of economic activities would lead to a sharp growth in the volume and complexity of risks, adding that investors and individuals would be more conscious of managing these risks.
He said further that even as more complex insurance products were being introduced to the market, insurance intermediaries had a duty to ensure that consumers were only offered products they could understand and find suitable.
“Any undesirable sales practice such as churning and inappropriate switching will undermine the reputation of the insurance industry, with adverse consequence for its ability to attract good quality talent,” Dr Abbey said.
According to CIG, the organisers of the awards, the insurance awards ceremony was part of its vision to enhance financial service delivery in the country.
Mr Afotey Odarteifio, the Executive Secretary of CIG, said having organised successfully seven Ghana Banking Awards, CIG was set to deliver yet another prestigious awards scheme in the insurance industry.
He said the awards were unique because users of financial service and products would be the judges of which insurance company would merit awards.
The award would be based on 2007 financial results and performance.

Monday, September 8, 2008

Beauties storm Accra for 'Exquisite Face of the Universe'

Saturday, September 6, 2008 (The Mirror Pg 46)

By Rebeca Kwei
Next month promises to be an October to remember as more than 60 ‘exquisite’ ladies from across the globe descend on Accra to participate in the Exquisite Face of the Universe 2008 beauty, fashion and tourism festival.
The event, which was first held in 2006 was founded by the Ghanaian company, 1st Royal Events Company Limited and seeks to bring the rest of the world to Africa to see for themselves what the continent has to offer, especially in the area of fashion and tourism.
It is also to unveil “that universal face that has the features of a super model whose life will positively touch everybody in the world.”
As part of activities for the this year’s show scheduled to run from October 4 to 20, the delegates will pay a courtesy call on the President, J. A. Kufuor and also be the guests of the Okyehene, Osagyefo Amoatia Ofori Panin. The climax will be at the National Theatre Accra, on Saturday, October 18.
Twenty-two countries participated in the maiden event which was held in Accra on December 16, 2006. The delegate from Bosnia, Ajsela Kesmer was adjudged the Exquisite Face of the Universe 2006 while Tracy Awuni from Ghana was the first runner-up.
It was the first time such an international beauty and fashion event instituted by a Ghanaian company was held in Africa.
According to Evelyn Addy-Sackey, Director of 1st Royal Events, Africa’s image in the rest of the world is not as sunny as one would expect and hosting the representatives from different countries will reveal the real image of Africa to them — and not what is portrayed in the international media.
Additionally, she noted that the contest will further boost Africa’s (Ghana’s) tourism drive.
“Hosting delegates from the world over exposes our rich heritage as well as our tourism which is richly endowed with a lot of attractions, to the world,” she said.
The maiden event was a huge success and 1st Royal is optimistic that this year’s contest will be bigger and better. “Ghana will experience an event in a different light.”
1st Royal Events has been the power behind contests such as Model of the Universe, Miss Tourism Queen International and Miss Earth International.
The Director said a crack team of local and international production experts have been put together to achieve best results for this year’s show.
Exquisite Face of the Universe is sponsored by Royal Atlantic Resorts, Universal Motors, Cokelight, Maxmart, TV3, Somovision, Woodin, Grafitec and supported by Melcom, Lufthansa, Egyptair, Afriqiyah, Forwin Ghana, Darlingwigs, Rimartex Fashion, Everpack, Exotic Modelling Agency, Ministries of Tourism, Aviation, Chieftaincy and Culture and the Ghana Tourist Board.

Monday, September 1, 2008

Kidney diseases need urgent attention

Saturday, August 30, 2008 (The Mirror Pg 15)
By Rebecca Kwei
A Nephrologist, Dr Charlotte Osafo, of the Renal Dialysis Unit of the Korle Bu Teaching Hospital, has described the number of Ghanaians suffering from kidney diseases as a serious problem that need urgent attention.
She said although there were no statistics on the general population on kidney diseases, 9.5 per cent of admissions to the medical block of the hospital were due to renal or kidney diseases.
Additionally, Dr Osafo indicated that a research she conducted last year where she screened 770 hypertensive patients in the four polyclinics in Accra showed that 42.9 per cent of the patients had chronic kidney disease while 12.6 per cent had moderate to severe kidney disease.
Also, she said approximately she sew five to 10 new cases of chronic kidney disease at the hospital every week.
What was worrying, she said, was that the patients did not know they had the disease and it was evident that they would only report to the clinic when the situation had deteriorated or at its end stage.
The kidney performs very important functions in the body such as maintaining fluid and electrolyte balance (thus controlling blood pressure), acid base balance, filtering the blood, getting rid of metabolic waste and other toxic products. In addition, the kidney produces several chemical messengers, one of which is erythropoietin, which controls red blood cell production in the bone marrow. According to Dr Osafo, because of its important role, when there is renal failure or kidney failure, a situation where the kidneys fail to function adequately, there was a big problem and it could be fatal.
She said kidney failure could be acute, which was reversible, and chronic, which was irreversible.
Some of the causes of chronic kidney failure are uncontrolled hypertension, poorly controlled diabetes, infections and use of some drugs.
Dr Osafo said kidney disease presented no symptoms but in very advanced cases of kidney failure patients experienced chronic fatigue, weakness, vomiting, nausea, swelling around the eyes and feet and significant reduction in the amount of urine passed in a day.
She said chronic kidney disease was assessed using the Kidney Disease Outcome Quality Initiative (KDOQI) guideline, which has five stages. Stages one and two are mild, stages three and four are moderate and stage five is severe.
She explained that if a patient is within the range of stages one to four, the disease can be managed by aggressive blood pressure (in the case of hypertension) and sugar control (in the case of Diabetes), in order to prevent progression to end-stage kidney disease or kidney failure, which is stage five.
However, if the patient has advanced to stage five, then, the patient will have to be put on haemodialysis or peritoneal dialysis while the patient prepares for the ultimate treatment for the end-stage kidney disease, which is kidney transplantation.
She said dialysis did some of the work of kidney but not all. “Dialysis only performs the excretory function of the kidney as it only manages the waste accumulated in the blood.”
The patient with kidney failure therefore will have to buy the erythropoietin injection, which costs about GH¢100 a week in addition to the haemodialysis.
Dr Osafo noted that it was very expensive for patients to be on dialysis, since it cost 100 euros per session and a patient would have to undergo the treatment three times a week.
She, therefore, advocated that treatment of chronic kidney failure should be included in the National Health Insurance Scheme (NHIS), since patients could not afford it and would eventually lose their lives.
To buttress her point, she said “the total kidney cases that were admitted to medical block of the hospital from 2006 to date was 558 and only 38 out of that number were on dialysis. This shows how serious the problem is. This is only the tip of the iceberg because you can imagine the others that are not reported from the other parts of the hospital including the outpatients department, the Surgical Medical Emergency, the Cardiothoracic Centre and the many other departments in the hospital.”
Dr Osafo advised that people who were hypertensive decrease their salt intake, take their medication seriously and control their blood pressure while diabetics should try and control their sugar level.
Above all she encouraged healthy living, healthy eating and regular exercise and cautioned people to avoid drugs or herbs that they did not know their side effects.
She appealed to the public to support the National Kidney Foundation that had been established to create awareness about the disease and screen people for kidney disease.
In a related development, Ecobank Ghana last week presented $20,000 to Transplant Links, a UK charity that has the primary objective of saving lives through kidney transplants in the developing world.
Members of the charity, who will partner their counterparts in Korle Bu, will in November this year carry out kidney transplant for three Ghanaian patients, the first-ever in the country.