Health workers are prone to burnout, which can have an adverse effect on their person and the patients to whom care is offered. The goal of this paper was to assess the levels of burnout experienced by healthcare workers in Accra, Ghana. The study was conducted using the cross-sectional study design. Questionnaires were used to obtain data from 365 respondents who worked in 12 major healthcare facilities. Data obtained were analyzed with SPSS version 23. Majority of the respondents were females (56.7%) as against males (43.3%). The total score for all burnout variables among health worker groups ranged from good (71.50%), alarming (12.60%), acute crisis (6.02%), and burnout (9.90%). Among the health worker groups, nurses had the highest percentage score values for all burnout variables. There was an association between burnout and these sociodemographic characteristics: age (p<0.001), gender (p=0.003), educational qualification (p<0.001), occupation (p<0.001), years of work experience (p<0.001), marital status (p<0.001), and parenthood (having children) (p<0.001). It is recommended that measures should be put in place in Ghanaian hospitals to assess stress and burnout levels to ensure people who are going through such situations are properly cared and supported.

Ghana's healthcare expenditure has increased over the past two decades. Increased healthcare expenditures are required to enhance the acquisition of better hospital resources that may improve healthcare. This study presents an overview of healthcare expenditures and health outcomes (i.e. infant mortality, under-5 mortality and life expectancy) from 1995 to 2014 in Ghana. Infant and under-5 mortalities have declined by 50 and 25%, respectively, as of 2014, while life expectancy has increased from 60.7 to 64.8 years. Private spending on health, especially out-of-pocket payments, declined but is higher than the World Health Organization's recommended financial threshold. Non-communicable diseases (NCDs) are rising with healthcare costs leading to catastrophically high healthcare expenditures in the future. While government's investments on healthcare have yielded positive results, the improvement in the health outcomes cannot be attributed to increased health expenditure alone. Therefore, this paper outlines policies on maternal health, national health insurance and healthcare reforms that have influenced health outcomes. In parallel, the paper highlights challenges of the Ghana health system of which the major ones are (1) inadequate financial investments in health and (2) limited health workforce and facilities. These challenges can be ameliorated by (1) establishing new health institutions and expanding existed ones; (2) providing incentives to discourage the exodus of health workers; (3) introduction of the concept of predictive, preventive and personalized medicine (PPPM) for treating NCDs; and (4) alternative insurance schemes for vulnerable groups. This, coupled with the will of the government to curb misappropriation of funds, will be important to achieving better health outcomes.

Background Type II diabetes mellitus (T2DM) is complicated by multiple cardio-metabolic risk factors. Controlling these factors requires lifestyle modifications alongside utilisation of anti-diabetic medications. Different glucose lowering [(biguanides (BIGs), sulfonylureas (SUAs), thiazolidinediones (TNZ)], lipid lowering (statins), and anti-hypertensive medicines [angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs) and central acting drugs (CADs)] have been approved for controlling hyperglycaemia, dyslipidaemia and hypertension respectively. Here, we examined factors that characterise T2DM and explored the response to medication therapy among T2DM patients. Methods This prospective cohort study recruited 241 T2DM patients reporting at a clinic in Ghana, from January through to August, 2016. Each patient’s demographic, medications and anthropometric data was obtained while information on medication adherence was captured using Morisky adherence scale-8 (MMAS-8). Fasting blood samples were collected for biochemical analysis. Results The mean age of participants was 57.82 years for baseline and six-month follow-up. Physical activity differed at baseline and follow up (p < 0.05) but not body mass index (BMI). BIG alone, or in combination with SUA and TNZ did not improve glycaemic status at follow up (p > 0.05). Many participants using either ACEI or ARB were able to control their blood pressures. Among dyslipidaemia patients under statin treatment, there was an improved lipid profile at follow-up. Conclusions Statin medications are effective for reducing dyslipidaemia in T2DM patients. However, control of modifiable risk factors, particularly blood glucose and to a lesser degree blood pressure is suboptimal. Addressing these will require concomitant interventions including education on medication adherence and correct dietary plans, lifestyle modifications and physical activity. Electronic supplementary material The online version of this article (doi:10.1186/s40169-017-0162-5) contains supplementary material, which is available to authorized users.

Dimensions of risks and impacts of occupational heat stress due to climate change on workers' health and safety, productivity, and social well-being are significantly deleterious. Aside from empirical evidence, no systematic review exists for policy development and decision making in managing occupation heat stress impacts and adaptation strategies of workers. This study sought to synthesise evidence on the social impacts of occupational heat stress and adaptation strategies of workers. From a review of existing literature, eight categories were obtained from 25 studies and grouped into three syntheses: (1) awareness of occupational heat stress, (2) social impacts of occupational heat stress and (3) workers' adaptation to occupational heat stress due to changing climate. Awareness of occupational heat stress among workers varied and their social impacts were related to workers' health and safety, productivity and social well-being. Sustainable adaptation to occupation heat stress due to climate change hinges on financial resource availability. Adequate investment and research are required to develop and implement policies to combat the threat of rising temperature and climate change to enhance workers' adaptive capacity, boost resilience and foster sustainable development.

No abstract

Environmental health hazards faced by farmers, such as exposure to extreme heat stress, are a growing concern due to global climate change, particularly in tropical developing countries. In such environments, farmers are considered to be a population at risk of environmental heat exposure. The situation is exacerbated due to their farming methods that involve the use of primitive equipment and hard manual labour conducted in full sunshine under hot and humid conditions. However, there is inadequate information about the extent of heat exposure to such farmers, both at the household and farm levels. This paper presents results from a study assessing environmental heat exposure on rural smallholder farmers in Bawku East, Northern Ghana. From January to December 2013, Lascar USB temperature and humidity sensors and a calibrated Questemp heat stress monitor were deployed to farms and homes of rural farmers at Pusiga in Bawku East to capture farmers' exposure to heat stress in both their living and working environments as they executed regular farming routines. The Lascar sensors have the capability to frequently, accurately and securely measure temperature and humidity over long periods. The Questemp heat stress monitor was placed in the same vicinity and showed strong correlations to Lascar sensors in terms of derived values of wet-bulb globe temperature (WBGT). The WBGT in the working environment of farmers peaked at 33.0 to 38.1 °C during the middle of the day in the rainy season from March to October and dropped to 14.0-23.7 °C in the early morning during this season. A maximum hourly WBGT of 28.9-37.5 °C (March-October) was recorded in the living environment of farmers, demonstrating little relief from heat exposure during the day. With these levels of heat stress, exposed farmers conducting physically demanding outdoor work risk suffering serious health consequences. The sustainability of manual farming practices is also under threat by such high levels of heat exposure.

The importance of waste management cannot be overemphasized. Improper waste management and disposal has rippling effect on the environment and human health. The aim of this study is to assess solid waste management among household in a large Ghanaians district. Multi-stage sampling technique comprising a cluster, simple random sampling, and systematic sampling techniques were used to select 600 respondents for the study. Data was analyzed using (SPSS) version 23.0. Results indicates that communal waste collection bins were far from households as confirmed by the majority (57.3%) of the respondents. The majority (56.5%) of the households walked a distance of 11-15 min before reaching the refuse site. The study found that the number of waste collection point in the community were few (1-3 collection bins) as confirmed by majority (92.2%) of the respondents. The distance from the center of the community to the final waste disposal site covered 1-2 h journey. There was a significant relationship between the number of waste disposal sites in the community and the average distance (in kilometers one way) from the city center to a disposing site. In conclusion, the study found that communal waste collection bins were far from households; number of waste collection point in the community were few. This indicates that the distance from the center of the community to the final waste disposal site covered 1-2 h journey. Based on the major findings of the study, we recommend that district assembly should provide waste collection bins to every household to ensure that residents do not dispose their housrhold waste indiscriminately. District by-laws should be strengthened to ensure proper household waste disposal at all districts in Ghana.

Across the tropical developing countries, smallholder farmers are confronted with various climate related risks that hinge on agricultural activities. Climate change is predicted to impact smallholder farmers and their livelihood, especially within and beyond this century. Several studies have examined the impact of drought and rainfall on smallholder farmers as climate change impact assessment. However, there is limited information on impacts and coping strategies of poor farmers to heat exposure at household and farm level in tropical developing countries. As global temperature is predicted to increase with robust impacts on farmers in African region due to poverty and low adaptive capacity, this study evaluates how farmers in Bawku East of Northern Ghana experience the impacts of heat stress and how they cope with it both at the household level and on the field of cultivation. Using household survey and focus group discussion, the authors elicited impacts and responses of heat exposure from 308 resident farmers in three selected farming communities in Bawku East to gauge their vulnerability to heat exposure. Even though farmers have various impacts and coping strategies to heat exposure, these are ineffective to prevent them from heat related morbidity and mortality at both household and farm level. The study recommends the need for government led intervention to assist farmers in their effort to cope with heat stress as global temperatures will exacerbate heat stress impacts on small holder farmers especially in African region.