Browsing by Author "Amankwaa, John"

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    Accessibility and Utilization of Family Planning Services in Selected Districts in Central Region of Ghana
    (KNUST, 2015-08) Amankwaa, John
    ABSTRACT Family planning has been considered to contribute immensely to child survival and reduction in maternal mortality, hence targeted as one of the main reproductive health services in achieving the fifth millennium development goal (MDG 5). The 2011 Multiple Indicator Cluster Survey report indicates that use of modern contraceptives in Central region has improved from 17.0 percent in 2008 to 29 .1 percent in 2011 and subsequently decline of unmet need for contraceptives from 49.7 percent to 22.6 percent for the same years respectively. In spite of this improvement, there is huge variations in utilization of family planning methods especially between districts in the region, particularly in Upper Denkyira East and Mfantsiman, and the causes of this variations are not clearly known. Hence, the main aim of the study is to assess the level of accessibility and utilization of family planning services in the selected districts and factors influencing them. The study design adopted was descriptive cross –sectional, using both quantitative and qualitative approach for data collection. The sample size was 373 women of reproductive age 15 – 49 years. Again, 66 husbands/male partners were also interviewed to solicit for their views about the subject matter. Eight health institutions as well as 22 religious establishments were also interviewed. The study revealed high knowledge level of modern contraceptives among women of reproductive age (93 percent) and men (88 percent) in general. There is little (0.3 percent) difference in contraceptives use between the Upper Denkyira East (25.9 percent) and Mfantsiman (25.6 percent) district. Poor data management in facilities in Upper Denkyira East was accounting for the huge variations. Factors such as proximity to facility or clinic (12.5 percent), privacy and confidentiality at clinic (19.5 percent), wanting to delay pregnancy (49.2 percent) among others motivate use of contraceptives whiles factors such as desire for many children (14.8 percent) , health concerns (9.7 percent) and fear of side effects (7.6 percent) accounted for non-use. Again, social issues such as stigma of use (3.5 percent), husbands/partners opposition (4 percent) and religious prohibition (1.6 percent) among others hinder the use of contraceptives among women. There is good physical accessibility with respect to location of clinic providing family planning services in all study districts. Again financial accessibility to family planning services is good despite unapproved charges for family planning services by health facilities in the study districts. Social accessibility regarding service providers’ attitude, privacy and confidentiality is also good in FP facilities, however social factors such as stigmatization, husband/partner opposition, religious opposition among others hinder access and utilization of contraceptives. To improve on family planning services in the study districts, there is the need for family planning (FP) data collection tools’ training for all FP service providers in the facilities in order to improve on FP data quality. Also, family planning awareness or education should be intensified particularly with respect to health concerns, side effects as well as prices of contraceptives or FP services.
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    Sustaining the NHIS- the case of non- renewal of membership with Berekum district health insurance scheme
    (2011-07-12) Amankwaa, John
    Background: It has been estimated that millions of people are faced with problem of financing health care globally. Further the cash and carry system was also an obstacle for many people to access healthcare in most developing countries like Ghana. As a result of this, health insurance has been adopted as an alternative way of financing health care in order to increase access to health care by most developing countries. In 2004, Berekum District NHIS registered 69,000 people in the district representing 70% of the total population. Since then the scheme has not been able to maintain its membership as some members drop out of the scheme every year. Therefore, the research sort to find out why people are not renewing their membership with the scheme. Hence the topic for this study is ‘Sustaining the NHIS- The case of non-renewal of membership with the scheme. Methods: A cross sectional study design was used and the study subjects were adults aged 18 years and above in the district, who were members of the Berekum District Health Insurance Scheme in 2007 and did not renew their membership in 2008. The study subjects were electronically selected randomly and records about them, retrieved from the insurance enrolment database were used, to trace the study subjects to their residence where the interview guides were administered onto them. A descriptive analysis was done. Results: Majority of respondents mentioned scheme management related reasons such as high premium, large family size, unfavourable timing for premium collection, no immediate benefit for non-renewal. In addition lack of community involvement in fixing premium was mentioned. Further issues relating to quality of healthcare receive from service providers were also mentioned as reasons for non-renewal of membership such as delay of insured clients at health facility, fewer and non-availability of insured drugs at facility. Most respondents were also identified to have poor understanding of health insurance concept. Conclusion: With reference to the above findings there is need for strong collaborative effort between the stakeholders of the District health insurance scheme to put in place strategic interventions along side with the recommendations of this report to ensure that, the citizens of the district if not all would enroll onto the scheme. Hence, the success of the scheme.