Blind Trust in the Care-Giver: Is Paternalism Essential to the Health-Seeking Behavior of Patients in Sub-Saharan Africa?

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In the past, patients put their lives in the care of doctors in blind trust that the doctors would care for them. This kind of trust is no longer common particularly in the western industrialized nations but the same cannot be said about patients in Ghana and Sub-Sahara Africa. The first concern was whether paternalism was essential in medical practice in Ghana. The second was whether paternalism as an ethical standard should be considered from the ethical lens of the western industrialized nations, rather than from the African cultural context. This entailed a review and examination of the literature on paternalism. We searched databases such as PubMed, Medline and others for reports, editorials and published papers in the English Language. A search on Goggle Scholar on “paternalism in medical practice in Africa” yielded over 380,000 entries and “paternalism in medical practice in Ghana” yielded 2.1 million but more than 99% were not relevant in each instant. Hand searching of selected printed journals and grey literature such as technical reports, conference proceedings and workshops were also assessed. The studies that met the inclusion criteria were given additional review but those with poor methodology were excluded but discussed in this review. I assigned an overall score and identified the position taken in the publication or report in relation to the objectives and rated them objectively. The papers that received scores above 2.5 out of 4 in the evaluation were further analyzed. I summarized the findings into their respective units, and interpreted them based upon my skills, knowledge and specialization in medico-legal ethics, public health and law. The result shows that not enough research has been done on whether or not paternalism should be encouraged as a regular feature of medical practice in Ghana due to the lack of education. It also shows that paternalism enhances the health seeking behavior of patients despite developments on patient autonomy and capacity. Where the average patient is illiterate in general and in medical matters, the paternalism of the physician may be inevitable. Ethical standards such as Informed Consent, Autonomy, Due Process, Benevolence and No malfeasance should be defined and operationalized in clinical practice within the cultural context of Sub-Sahara Africa. A systematic indigenization of medico-legal ethical concerns in medical practice is needed in Ghana.

Cite this paper

Norman, I. (2015) Blind Trust in the Care-Giver: Is Paternalism Essential to the Health-Seeking Behavior of Patients in Sub-Saharan Africa?. Advances in Applied Sociology, 5, 94-104. doi: 10.4236/aasoci.2015.52008.

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Family Planning Awareness, Perceptions and Practice among Community Members in the Kintampo Districts of Ghana

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ABSTRACT

Family planning is known to prevent maternal deaths, but some social norms, limited supplies and inconsistent use makes this difficult to achieve in most low- and middle-income countries. In spite of the high fertility levels in most sub-Saharan African countries and the potential economic benefits of family planning, its patronage remains very low in the sub-region. This study was with the objective of identifying the levels of awareness, utilization, access to and perceptions about family planning and contraception. A cross-sectional study design was used for the study, with data collected from multiple sources using both quantitative and qualitative approaches. Relevant findings included a marked disconnect between family planning/contraceptive knowledge and use. The pills and injectables were the most frequently used, but females in the study population poorly patronised emergency contraception. Supplies of most family planning methods were found to be health facility based, requiring clients to have to necessarily go there for services. Some respondents harboured perceptions that family planning was the responsibility of females alone and that it fuelled promiscuity among female users. Recommendations made include ensuring that health facilities had adequate staff and expertise to provide facility-based family planning services and also to disabuse the minds of community members of the negative perceptions towards family planning.

Cite this paper

Nettey, O. , Enuameh, Y. , Mahama, E. , Sulemana, A. , Adjei, G. , Gyaase, S. , Afari-Asiedu, S. , Adda, R. , Yawson, A. , Nuamah, G. , Anane, E. , Abokyi, L. , Zandoh, C. , Abdulai, M. , Boamah, E. , Adjei, K. , Amenga-Etego, S. , Dzabeng, F. , Tawiah-Agyeman, C. , Baiden, F. , Asante, K. and Owusu-Agyei, S. (2015) Family Planning Awareness, Perceptions and Practice among Community Members in the Kintampo Districts of Ghana. Advances in Reproductive Sciences, 3, 1-12. doi: 10.4236/arsci.2015.31001.

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Determinants of Stock-Out in Retail Shops in Ghana: Evidence from Kumasi Metropolis

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52489#.VJoaUcCAM4

ABSTRACT

This study investigates factors influencing stock-out occurrence in retail shops in Kumasi Metropolis in Ghana. The study sampled two hundred and forty four retail outlets located in the central business areas of Kumasi Metropolis. A well structured questionnaire was used to solicit information from the respondents. Both descriptive statistics and inferential statistics were used to analyse the data. The results of the study revealed that delay in supplier’s items, demand underestimation, and bad back-of-store practices were the main causes of stock-outs. Generally, the study reveals that most retailers are not equipped to use most of the sophisticated stock control techniques and only limit themselves to the use of stock books to control stock. Information and communication technology and collaboration with suppliers were considered by the retailers as the main stock control implementation barriers. The study concludes that, although retailers are aware of the occurrence and the causes of stock-outs, many of them had done little to put in place measures to control it; and even the few that have been able to put in place stock control measures were confronted with implementation challenges. It is therefore recommended that retailers should adopt effective and efficient stock control techniques to limit out-of-stock occurrence.

Cite this paper

Adusei, C. and Awunyo-Vitor, D. (2014) Determinants of Stock-Out in Retail Shops in Ghana: Evidence from Kumasi Metropolis. Modern Economy, 5, 1240-1252. doi: 10.4236/me.2014.513115.

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Profiles of HIV-Affected Households in Ghana

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=48948#.VJjffcCAM4

ABSTRACT

Background: To contribute to a fuller appreciation of Ghana’s HIV epidemic, this paper presents various profiles of the Ghanaian HIV-affected household. To comprehensively tackle the HIV epidemic in Ghana, the profiles would provide stakeholders with ready information for policy formulation. Methods: We used data from a nationally representative survey that measured livelihood activities, household asset wealth, household composition, health, and nutrition variables of 1745 HIV-affected households. From these emerged various profiles. Results: About 50% of the households are headed by females. Households headed by men have an average size of three members, compared to two for female-headed households. There are far more AIDS widows than widowers. The annual death rate among the surveyed households was about 1000 per 100,000-households. Relatively more deaths occurred in male-headed households. Two-thirds of the households were asset poor. Various coping strategies were instituted by the households in reaction to threat of food insecurity. The national prevalence of chronic energy deficiency is 16%. Conclusions: Our data show that age of household head, hosting of a chronically ill member, and average size of household differed by sex of household head. The annual death rate of 1000 per 100,000 households is very high.

Cite this paper

Laar, A. , Fiaveh, D. , Laar, M. , Boatemaa, S. , Abugri, J. , El-Adas, A. , Amenyah, R. , Atuahene, K. , Adjei, A. and Quakyi, I. (2014) Profiles of HIV-Affected Households in Ghana. Health, 6, 2004-2013. doi: 10.4236/health.2014.615235.

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http://dx.doi.org/10.1207/s15326888chc2501_3                                                                           eww141223lx

Deciding to Urban-Migrate and Agricultural Development: Evidence from the Millennium Challenge Account (MCC)-Millennium Development Authority (MiDA) Intervention Zones, Ghana

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=52204#.VIjxgMnQrzE

ABSTRACT

The decision to migrate involves both “push” and “pull” factors. Push factors forces migrants out of rural areas while pull factors attracts rural folks to the urban areas. The information set which displays the realities on the ground, if positive will motivate a potential migrant to move to an urban area and vice versa. Movement of labour for agriculture in the rural areas decreases resources needed to help promote the needed growth in the sector. With a sample size of 46,110 household members from two batches (about 3000 farmers/households for each batch) of selected farmers who enjoyed agricultural interventions (technology), a probit model is estimated to find the factors that influence the decision to urban-migrate. In particular we discuss the question of whether the MiDA intervention through the training of farmers on various techniques/technologies to be more productive, has had an impact on farmers’ as well as their household members’ decision to urban-migrate. Generally, household, Farmer Based Organization and individual characteristics were considered in the model. We find that, farmers and their household members in the Southern Horticultural belt were less likely to migrate while those in the Northern Agricultural Zone were more likely to migrate to the urban area. Education, households with returned migrants, and remittances were positive in influencing the decision to urban-migrate. On the other hand, being self-employed and being married reduces the probability that an individual will migrate. Generally, the differential economic opportunities through the relative increased knowledge in the urban areas remain a pull factor of labour resources of the undeveloped rural agricultural sector. Bridging the gap between the expected income differential of rural and urban areas resulting from differences in knowledge and opportunities will be the key to reducing this phenomenon as suggested by [4] and many other studies.

Cite this paper

Mochiah, E. , Osei, R. and Akoto, I. (2014) Deciding to Urban-Migrate and Agricultural Development: Evidence from the Millennium Challenge Account (MCC)-Millennium Development Authority (MiDA) Intervention Zones, Ghana. Modern Economy, 5, 1187-1207. doi: 10.4236/me.2014.513111.

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Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51593#.VG6Uy2fHRK0

ABSTRACT

In lower middle-income countries like Ghana, it is common to find low contraceptive use among adolescents with corresponding high pregnancy outcomes. Evidence points to the fact that the use of contraceptives prevents maternal, neonatal and infant deaths, but in most lower middle-income countries, socio-cultural practices inhibit adolescents’ use. Ensuring the uptake of family planning among adolescents is deemed a necessary means of reducing maternal, neonatal and infant mor-tality. This manuscript seeks to provide contextually relevant approaches to satisfying family planning needs of adolescents in a population lacking it. We employed a qualitative study design from an interpretive paradigm with phenomenology as the methodology to understand societal attitudes towards family planning delivery to adolescents, so as to arrive at contextually appro-priate ways of providing family planning to this needy group. Focused group discussions and in-depth interviews techniques were used in data collection among adolescents, relevant commu-nity opinion leaders and family planning & health services providers. Themes that emerged from data analysis with respect to “perspectives on family planning care delivery to adolescents” and “best ways in addressing adolescents’ family planning needs” are presented, followed by discussion of the issues emerging. A significant and encouraging finding of the study was that opinion leaders and healthcare providers viewed family planning as a means of protecting adolescents against pregnancies and their complications. A key recommendation is for policy makers and political leaders to enact legislations that enable adolescents to have friendly family planning service delivery in all places and at all times.

Cite this paper

Enuameh, Y. , Tawiah, C. , Afari-Asiedu, S. , Nettey, O. , Sulemana, A. , Mahama, E. , Adjei, G. , Boamah, E. , Manu, A. , Gyaase, S. , Zandoh, C. , Amanfo, N. , Asante, K. , Letsa, T. and Owusu-Agyei, S. (2014) Making Family Planning Services Relevant to Adolescents: Perspectives from Rural Communities in Central Ghana. Open Journal of Preventive Medicine, 4, 852-859. doi: 10.4236/ojpm.2014.411096.

References

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Road Traffic Accidents in Ghana: A Public Health Concern, and a Call for Action in Ghana, (and the Sub-Region)

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http://www.scirp.org/journal/PaperInformation.aspx?PaperID=51371#.VGVZImfHRK0

Author(s)

ABSTRACT

This paper highlights the increasing problem of road traffic accident (RTA) related morbidity and mortality in Ghana, and the public health measures needed to control the problem. Descriptive data in the public domain from statutory bodies and media houses reports on country RTA information, as well as academic papers on the problem, were used as source of information about the problem. The observed trend in Ghana indicates that RTA related fatalities and injuries continue to be increasing, as morbidity and mortality factors since the year 2000. Most of the remedial measures suggested in academic papers, and state agencies measures to curb the RTA trend in Ghana to date, have discussed the problem in terms of injury and safety issues/measures. This paper suggests that the increasing RTAs with associated morbidity and mortality in Ghana need to be looked at more as a public health problem and priority, that requires prompt tackling using a public health problem orientated approach and measures, than just as a safety problem due to RTAs’, as is currently done.

Cite this paper

Coleman, A. (2014) Road Traffic Accidents in Ghana: A Public Health Concern, and a Call for Action in Ghana, (and the Sub-Region). Open Journal of Preventive Medicine, 4, 822-828. doi: 10.4236/ojpm.2014.411092.

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