IntroductionEmergency care is an essential component of health systems, particularly in low- and middle-income countries. We sought to assess the availability of resources to provide emergency care at a second-level hospital in Ghana. By doing so, deficits that could guide development of targeted intervention strategies to improve emergency care could be identified.MethodsA qualitative and quantitative assessment of capacity for care of emergency patients was performed at the Emergency Centre of the Police Hospital, a second-level hospital in Accra, Ghana. Direct inspection and job-specific survey of clinical, orderly, administrative and ambulance staff was performed. Responses to quantitative questions were described. Qualitative responses were examined by content analysis.ResultsAssessment revealed marked deficiencies in many essential items and services. However, several successes were identified, such as laboratory capacity. Among the unavailable essential items, some were of low-cost, such as basic airway supplies, chest tubes and several emergency medications. Themes from staff responses when asked how to improve emergency care included: provide periodic training, increase bed numbers in the emergency unit, ensure availability of essential items and make personal protective equipment available for all staff caring for patients.ConclusionThis study identified opportunities to improve the care of patients with emergency conditions at the Police Hospital in Ghana. Low-cost improvements in training, organization and planning could improve item and service availability, such as: developing a continuing education curriculum for staff in all areas of the emergency centre; holding in-service training on existing protocols for triage and emergency care; adding checklists to guide appropriate triage and safe transfer of patients; and perform a root cause analysis of item non-availability to develop targeted interventions.
Objectives: The knowledge and attitudes of commercial drivers in Ghana as regards alcohol impaired driving were investigated. This was done in order to provide information that could subsequently be used to develop antidrunk driving social marketing messages built upon the intrinsic values and motivation of these drivers. Methods: Focus group discussions were held with 43 bus and minibus drivers in the capital city, Accra. A structured discussion guide was used to capture information related to values, risk perceptions, leisure time activities, and attitudes on alcohol impaired driving. Results: The majority of drivers expressed an understanding that drunk driving was a significant risk factor for crashes. There was a significant under-appreciation of the extent of the problem, however. Most believed that it was only rare, extremely intoxicated drivers who were the problem. The drivers also had a minimal understanding of the concept of blood alcohol concentration and related legal limits. Despite these factors, there was widespread support for increased enforcement of existing antidrunk driving laws. Conclusions: In Ghana, commercial drivers understand the basic danger of drunk driving and are motivated to assist in antidrunk driving measures. There are misconceptions and deficits in knowledge that need to be addressed in subsequent educational campaigns.I njuries are one of the leading causes of death in both developed and less developed countries (LDCs). However, whereas rates of injury related death are decreasing in most developed countries, they are on the increase in most LDCs. [1][2][3][4] One of the main causes of injury fatalities is road traffic related. Recent data from the World Health Organization show that in the developing world as a whole, road traffic crashes alone are the third leading cause of death in 5-14 year olds and the second leading cause in 15-44 year olds. 5Despite this problem, limited attention has been focused on issues related to road safety in LDCs. Matters crying out for attention involve the entire spectrum of road safety activities, including safer road infrastructure, vehicle design and maintenance, and driver behavior. As regards driver behavior, a major risk factor in developed countries has been alcohol impaired driving. 1 6 7 Accordingly, one of the cornerstones of road safety efforts in these countries has been antidrunk driving measures.From the evidence, it appears that the situation is similar in many other LDCs. In a recent review of the literature, Odero et al summarized a total of 26 articles on alcohol involvement in motor vehicle related injuries in LDCs.8 Almost all studies reported high rates of alcohol use by drivers involved in crashes producing both fatal and non-fatal injuries. Rates of alcohol impaired driving (blood alcohol concentration (BAC) >80 mg/dl) among these drivers ranged from 30% to 53%, [9][10][11][12][13][14] similar to the values reported from the USA in the past few decades. 6 15Likewise, a recent roadside breathalyzer survey in Ghana 16 sho...
The goal was to evaluate the effectiveness of recent televised advertisements conducted by the National Road Safety Commission in Ghana. These concerned speeding and alcohol-impaired driving and were targeted towards commercial drivers. Focus group discussions were conducted with 50 commercial drivers in four cities. Discussions addressed coverage, clarity and appropriateness of messages, including suggestions for improvements. Most discussants indicated that the messages were clear and appropriate. Television reached all participants in this urban group. However, they felt that other modes of communication, such as flyers and radio, should also be used to reach drivers who did not own televisions. A particular problem was language. The advertisements had been in English and Akan (the most common vernacular language). Participants wanted the messages diversified into more of the major Ghanaian languages. Some participants were unclear on the behaviour that the advertisements were telling viewers to take. Participants advocated greater involvement by police in road safety and called for laws banning the sale of alcohol at bus stations. The advertisements reached and were understood by most of the target audience. Opportunities for strengthening the messages included using other media; increasing the number of languages; and stressing the change in behaviour being recommended. Overall road safety activities would be strengthened by increasing accompanying law enforcement activities related to speed and alcohol-impaired driving. To the authors' knowledge this is the first formal evaluation of a road safety social marketing programme in a low-income sub-Saharan African country. This evaluation will hopefully assist Ghana and other similar countries in strengthening road safety work.
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