Community health care and hospital attendance: A case study in rural Ghana

Zwart, Sjoerd; Voorhoeve, H. W. A.

doi:10.1016/0277-9536(90)90165-o

Cited by 6 publications

(1 citation statement)

References 9 publications

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“…In Ghana, physicians are more common in hospitals than in lower-level facilities, and skewing data collection towards hospitals may lead to findings mirroring practices at this level of care. Primary health centres/clinics in Ghana serve as first points of contact with formal health services ( Zwart and Voorhoeve 1990 ; Bour 2003 ). Since the referral systems in Ghana encourage treatment of acute infections at lower-level facilities and referral of complications and chronic conditions such as cardiovascular diseases to hospitals ( Ministry of Health 2010b ), primary health-care facilities are more likely to have clients with acute infectious diseases.…”

Section: Discussionmentioning

confidence: 99%

A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

Ahiabu

Tersbøl

Biritwum

et al. 2015

Health Policy Plan.

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Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and ‘no malaria drug’ on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support of rational drug use.

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Section: Discussionmentioning

confidence: 99%