Objectives. Abnormal vaginal discharge (Sayalan al-Rahim) is a common public health problem that significantly disrupts the health-related quality of life (HRQoL). Syndromic management infers the concurrent treatment of two or more infections. Hence, a comparative, single-blind study was planned to determine the efficacy of Acacia (Acacia nilotica Linn.) pod’s sitz bath (Abzan) plus vaginal pessary (Farzaja) vs. placebo in abnormal vaginal discharge syndromic management, its associated symptoms, and women’s HRQoL. Methods. Diagnosed patients (n = 66) were randomly divided into Acacia (n = 33) and placebo (n = 33) group. Acacia group received Sitz bath with Acacia pod powder (30g) solution followed by vaginal cotton pessary (5 ml of the same solution) once daily for 10 days. The placebo group received palm sugar powder (30g) solution for Sitz bath plus vaginal cotton pessary same as the Acacia group. Primary outcomes included clinical cure assessed with VAS for symptoms and Modified McCormack Pain Scale (McPS) for pelvic tenderness. The secondary outcomes included were the EQ-5D-5 L questionnaire, TSQM questionnaire, sachet count, and microbiological cure. Overall, therapeutic cure included clinical and microbiological cure after treatment. Results. The overall therapeutic cure for bacterial vaginosis, cervicitis, and uncomplicated pelvic inflammatory disease was 100% (n = 7/7), 45.45% (n = 10/22), and 71.42% (n = 5/7), respectively, in the Acacia group, while in the placebo group none of the patients had responded. The VAS score for symptoms was significantly reduced in Acacia than in the placebo group. At each follow-up, the improvement in the EQ-5D-5 L level of HRQoL was significantly higher in the Acacia group than in the placebo group. Conclusion. Acacia would be an effective and safe alternative in syndromic management of abnormal vaginal discharge, associated symptoms, and improved women’s HRQoL. Trial registration. This trial was registered in the Clinical Trials Registry of Indian Trials Website and given the identification no. CTRI/2018/02/012175 (dated: 27/02/2018).
PurposeGovernments all over the world are increasingly entering into partnership agreement with the private sector through public–private partnership (PPP) models for the development and management of public projects and services. Thus, the purpose of this study is to first examine the factors that enter into government's attitude, value for money (VFM) and PPP-based waste management projects (WMPs) in Ghana. Further, this study examines the relationship between PPP-based waste management and VFM, along with the mediating role of government's attitude.Design/methodology/approachData were collected through a survey questionnaire from four metropolitan municipal assemblies of Ghana. This study’s sample consisted of 230 respondents, and structural equation modeling was employed to conduct an empirical analysis. The structured model had evaluated the critical success factors (CSFs). Subsequently, the measurement model helped in the path analysis of the proposed model.FindingsThe authors found a nonpositive relationship between PPP-based WMPs and VFM; however, government's attitude will influence the achievement of VFM. Reliance on quality targets is ranked as the highest CSF in PPP-based WMPs in Ghana. Also, incentives for private sector participation and effective private sector participation are ranked as the least CSFs.LimitationsMost of the questionnaire's items were self -rated by employees of municipal assemblies who were not policymakers. This must have increased the possibility of common method bias. In addition, the study was limited to Ghana (a developing economy); therefore, the generalization of the results should be done with much caution.Practical implicationsThis study suggests to develop a network of private sector consortiums considering international and national participants who are engaged in PPPs in order to ensure successful delivery and hence valuing for money.Originality/valueThis study offers a novel perspective to investigate the relationship of PPP-based WMPs and VFM and shows how the government's attitude mediates this relationship.
There is an increasing demand for infrastructure projects all over the world. One important model adopted in providing them is Public –private partnership. To this end, this study aims at identifying the most influential factors as well as new factors that will serve as barriers against the adoption of PPP as a model in procurement of social projects in Technical Universities in Ghana. Using a survey questionnaire, appropriate data were obtained from Ghanaian Technical Universities. In all, a total of 152 questionnaires were collected from the participants. The research found that `lack of governmental guidelines and procedures’ was perceived as the most important factor with a mean score of 4.12. The remaining four factors in descending order include; ‘high risk relying on the public sector, high charge to direct users, very few scheme reach the contract stage and high participation cost. These are depicted with the following mean scores (4.10, 4.02, 4.01 and 3.99 respectively. The factors considered as neither most important nor least important include; less employment positions, lack of experience and appropriate skills, a great deal of management time spent on contract transactions and lengthy delays in negotiations. Interesting enough, the factors that are considered as least important include; excessive restrictions on participations for PPP with a mean score average of 3.67. Also, high project cost and political instability were also perceived as least important. This shows that these two factors were not seen as the same most important hindrances. The results shows that practitioner’s (public institutions and private investors) should consider these key factors as barriers to be address for adoption and implementation of a successful achievement of PPP projects. Citation: Mumuni Ishawu, Chen Guangyu, Emelia Darko Adzimah, Aliu Mohammed Aminu. A Survey Analysis on Institutional Challenges in implementing Public Private Partnership (PPP) Projects: A perspective from a developing economy of Ghana, 2020; 5 (2): 24-35. Received: April 14, 2020 Accepted: June 30, 20
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