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  1. Article ; Online: Retraction Note: Prevalence and predictors of timely initiation of breastfeeding in Ghana: an analysis of 2017-2018 multiple indicator cluster survey.

    Apanga, Paschal Awingura / Kumbeni, Maxwell Tii

    International breastfeeding journal

    2021  Volume 16, Issue 1, Page(s) 16

    Language English
    Publishing date 2021-02-04
    Publishing country England
    Document type Retraction of Publication
    ZDB-ID 2227239-2
    ISSN 1746-4358 ; 1746-4358
    ISSN (online) 1746-4358
    ISSN 1746-4358
    DOI 10.1186/s13006-021-00362-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: An assessment of out of pocket payments in public sector health facilities under the free maternal healthcare policy in Ghana.

    Kumbeni, Maxwell Tii / Afaya, Agani / Apanga, Paschal Awingura

    Health economics review

    2023  Volume 13, Issue 1, Page(s) 8

    Abstract: Background: The free maternal healthcare policy was introduced in Ghana in 2008 under the national health insurance scheme as a social intervention to improve access to maternal health services. This study investigated the prevalence of out of pocket ( ... ...

    Abstract Background: The free maternal healthcare policy was introduced in Ghana in 2008 under the national health insurance scheme as a social intervention to improve access to maternal health services. This study investigated the prevalence of out of pocket (OOP) payment among pregnant women with valid national health insurance who sought skilled delivery services at public sector health facilities in Ghana. The study also assessed the health system factors associated with OOP payment.
    Methods: We used data from the Ghana Maternal Health Survey (GMHS), which was conducted in 2017. The study comprised 7681 women who delivered at a public sector health facility and had valid national health insurance at the time of delivery. We used multivariable logistic regression analysis to assess factors associated with OOP payment, whiles accounting for clustering, stratification, and sampling weights.
    Results: The prevalence of OOP payment for skilled delivery services was 19.0%. After adjustment at multivariable level, hospital delivery services (adjusted Odds Ratio [aOR] = 1.23, 95% Confidence Interval [CI] = 1.00, 1.52), caesarean section (aOR = 1.73, 95% CI = 1.36, 2.20), and receiving intravenous infusion during delivery (aOR = 1.31, 95% CI = 1.08, 1.60) were associated with higher odds of OOP payment. Women who were discharged home 2 to 7 days after delivery had 19% lower odds of OOP payment compared to those who were discharged within 24 hours after delivery.
    Conclusion: This study provides evidence of high prevalence of OOP payment among women who had skilled delivery services in public sector health facilities although such women had valid national health insurance. Government may need to institute measures to reduce OOP payment in public sector facilities especially at the hospitals and for women undergoing caesarean sections.
    Language English
    Publishing date 2023-01-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2634483-X
    ISSN 2191-1991
    ISSN 2191-1991
    DOI 10.1186/s13561-023-00423-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: An assessment of out of pocket payments in public sector health facilities under the free maternal healthcare policy in Ghana

    Maxwell Tii Kumbeni / Agani Afaya / Paschal Awingura Apanga

    Health Economics Review, Vol 13, Iss 1, Pp 1-

    2023  Volume 7

    Abstract: Abstract Background The free maternal healthcare policy was introduced in Ghana in 2008 under the national health insurance scheme as a social intervention to improve access to maternal health services. This study investigated the prevalence of out of ... ...

    Abstract Abstract Background The free maternal healthcare policy was introduced in Ghana in 2008 under the national health insurance scheme as a social intervention to improve access to maternal health services. This study investigated the prevalence of out of pocket (OOP) payment among pregnant women with valid national health insurance who sought skilled delivery services at public sector health facilities in Ghana. The study also assessed the health system factors associated with OOP payment. Methods We used data from the Ghana Maternal Health Survey (GMHS), which was conducted in 2017. The study comprised 7681 women who delivered at a public sector health facility and had valid national health insurance at the time of delivery. We used multivariable logistic regression analysis to assess factors associated with OOP payment, whiles accounting for clustering, stratification, and sampling weights. Results The prevalence of OOP payment for skilled delivery services was 19.0%. After adjustment at multivariable level, hospital delivery services (adjusted Odds Ratio [aOR] = 1.23, 95% Confidence Interval [CI] = 1.00, 1.52), caesarean section (aOR = 1.73, 95% CI = 1.36, 2.20), and receiving intravenous infusion during delivery (aOR = 1.31, 95% CI = 1.08, 1.60) were associated with higher odds of OOP payment. Women who were discharged home 2 to 7 days after delivery had 19% lower odds of OOP payment compared to those who were discharged within 24 hours after delivery. Conclusion This study provides evidence of high prevalence of OOP payment among women who had skilled delivery services in public sector health facilities although such women had valid national health insurance. Government may need to institute measures to reduce OOP payment in public sector facilities especially at the hospitals and for women undergoing caesarean sections.
    Keywords Free maternal healthcare policy ; National health insurance scheme ; Out of pocket payment ; Skilled delivery services ; Public sector health facilities ; Health system factors ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The practice of polygyny on the utilisation of reproductive health services among married women in Ghana.

    Kumbeni, Maxwell Tii / Alem, John Ndebugri / Ziba, Florence Assibi / Afaya, Agani / Apanga, Paschal Awingura

    Journal of biosocial science

    2024  , Page(s) 1–12

    Abstract: While the practice of polygyny is common in Ghana, little is known about its impact on the use of reproductive health services. The aim of this study was to assess the relationship between polygynous marriage and the utilisation of skilled antenatal care ...

    Abstract While the practice of polygyny is common in Ghana, little is known about its impact on the use of reproductive health services. The aim of this study was to assess the relationship between polygynous marriage and the utilisation of skilled antenatal care (ANC), assisted skilled birth, and modern contraceptive services among married women in Ghana. Secondary data from the 2017 Ghana Maternal Health Survey were used for this study. The study included a weighted sample of 9,098 married women aged 15-49 years. We used multivariable logistic regression models to assess the association between polygyny and each outcome variables. Sensitivity analysis was conducted to assess the dose-response relationship between polygyny and each outcome variable. The prevalence of eight or more ANC contacts, assisted skilled births, and use of modern contraception were 47.0%, 81.4%, and 25.4%, respectively. The prevalence of women in polygynous marriages was 15.3%. Compared to monogynous marriage, polygynous marriage was associated with 19% lower odds of having eight plus ANC contacts (adjusted odds ratio [aOR] 0.81, 95% CI: 0.69, 0.96), 25% lower odds of having assisted skilled birth (aOR 0.75, 95% CI: 0.63, 0.89), and 19% lower odds of modern contraceptive utilisation (aOR 0.81, 95% CI: 0.66, 0.99). Interventions on reproductive health may need to prioritise women in polygynous marriages in order to improve the utilisation of skilled ANC, assisted skilled birth, and modern contraceptive services.
    Language English
    Publishing date 2024-01-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 390961-x
    ISSN 1469-7599 ; 0021-9320
    ISSN (online) 1469-7599
    ISSN 0021-9320
    DOI 10.1017/S0021932023000299
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Prevalence and predictors of timely initiation of breastfeeding in Ghana: an analysis of 2017-2018 multiple indicator cluster survey.

    Apanga, Paschal Awingura / Kumbeni, Maxwell Tii

    International breastfeeding journal

    2021  Volume 16, Issue 1, Page(s) 35

    Abstract: Background: Timely initiation of breastfeeding is putting the newborn baby to the breast within 1 h of birth. Its practice can prevent neonatal and under-5 mortality. This study aims to assess the prevalence and factors associated with timely initiation ...

    Abstract Background: Timely initiation of breastfeeding is putting the newborn baby to the breast within 1 h of birth. Its practice can prevent neonatal and under-5 mortality. This study aims to assess the prevalence and factors associated with timely initiation of breastfeeding among mothers in Ghana.
    Methods: We used data from the 2017-2018 Ghana multiple indicator cluster survey and our analysis was restricted to 3466 mothers who had a live birth within 2 years. Multivariable logistic regression was used to estimate the factors associated with timely initiation of breastfeeding whilst adjusting for potential confounders, and accounted for clustering, stratification, and sample weights.
    Results: The prevalence of timely initiation of breastfeeding was 52.3% (95% CI 49.7%, 54.9%). Mothers who were assisted by a skilled attendant at birth had 65% higher odds of timely initiation of breastfeeding compared to mothers who were not assisted by a skilled attendant (adjusted prevalence odds ratio [aPOR] 1.65; 95% CI 1.28, 2.13). Mothers who delivered by Caesarean section had 74% lower odds of timely initiation of breastfeeding compared to mothers who had vaginal delivery (aPOR 0.26; 95% CI 0.18, 0.36). Mothers who had planned their pregnancy had 31% higher odds of timely initiation of breastfeeding compared to mothers who had an unplanned pregnancy (aPOR 1.31; 95% CI 1.05, 1.63). There were also 74% and 51% higher odds of timely initiation of breastfeeding among mothers who perceived their baby was large (aPOR 1.74; 95% CI 1.34, 2.26), and of average size (aPOR 1.51, 95% CI 1.16, 1.97) at birth respectively, compared to mothers who perceived their baby was small.
    Conclusions: Interventions to increase timely initiation of breastfeeding should provide breastfeeding support to mothers who have had a Caesarean section, small sized babies and unplanned pregnancies, and to promote birthing by skilled birth attendants.
    MeSH term(s) Breast Feeding ; Cesarean Section ; Female ; Ghana/epidemiology ; Humans ; Infant ; Infant, Newborn ; Mothers ; Pregnancy ; Prevalence
    Language English
    Publishing date 2021-04-17
    Publishing country England
    Document type Journal Article
    ISSN 1746-4358
    ISSN (online) 1746-4358
    DOI 10.1186/s13006-021-00383-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Association between early antenatal care and antenatal care contacts across low-and middle-income countries: effect modification by place of residence.

    Apanga, Paschal Awingura / Kumbeni, Maxwell Tii

    Epidemiology and health

    2021  Volume 43, Page(s) e2021092

    Abstract: Objectives: The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ... ...

    Abstract Objectives: The relationship between receiving early antenatal care (ANC) and 8 or more antenatal contacts (ANC8+) has not been well characterised across low-and middle-income countries (LMICs). It is also unclear whether the association between early ANC and ANC8+ is modified by a woman's place of residence. Our primary aim was to assess the relationship between early ANC and ANC8+ and to investigate whether this relationship was modified by place of residence. We also estimated the coverage of ANC8+ across LMICs.
    Methods: We analysed data on 207,388 mothers with a recent live birth using multiple indicator cluster surveys conducted between 2017 and 2020 in 30 LMICS. Modified Poisson regression with robust variance was used to evaluate the relationship between early ANC and ANC8+, whilst adjusting for country, clustering, stratification, and sampling weights. Effect modification by place of residence was assessed on additive and multiplicative scales. A meta-analysis was conducted to pool prevalence estimates of ANC8+ across all countries.
    Results: The overall prevalence of ANC8+ was 35.6%, ranging from 1.7% in Madagascar to 99.4% in Belarus. Early ANC was positively associated with ANC8+ (adjusted prevalence ratio [aPR], 2.61; 95% confidence interval [CI], 1.82 to 3.74). There was evidence of positive effect modification on additive (relative excess risk due to interaction, 0.39; 95% CI, 0.35 to 0.44) and multiplicative (aPR, 1.78; 95% CI, 1.08 to 2.95) scales.
    Conclusions: Many LMICs may not have adopted the 2016 World Health Organization guidelines on ANC8+. Receiving early ANC was associated with a higher likelihood of ANC8+, particularly for women in rural areas.
    MeSH term(s) Developing Countries ; Female ; Humans ; Mothers ; Poverty ; Pregnancy ; Prenatal Care ; Surveys and Questionnaires
    Language English
    Publishing date 2021-11-02
    Publishing country Korea (South)
    Document type Journal Article ; Meta-Analysis
    ZDB-ID 2590698-7
    ISSN 2092-7193 ; 2092-7193
    ISSN (online) 2092-7193
    ISSN 2092-7193
    DOI 10.4178/epih.e2021092
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Adherence to COVID-19 preventive measures and associated factors among pregnant women in Ghana.

    Apanga, Paschal Awingura / Kumbeni, Maxwell Tii

    Tropical medicine & international health : TM & IH

    2021  Volume 26, Issue 6, Page(s) 656–663

    Abstract: Objective: To assess adherence to COVID-19 preventive measures and its associated factors among pregnant women in Ghana.: Methods: This was a cross-sectional study conducted in the Nabdam district, Ghana. Data were collected from 527 pregnant women ... ...

    Abstract Objective: To assess adherence to COVID-19 preventive measures and its associated factors among pregnant women in Ghana.
    Methods: This was a cross-sectional study conducted in the Nabdam district, Ghana. Data were collected from 527 pregnant women randomly selected from antenatal care clinics from 16 healthcare facilities. Descriptive statistics were used to assess the prevalence of adherence to COVID-19 preventive measures. Multivariable logistic regression was used to estimate the factors associated with COVID-19 preventive measures, whilst adjusting for potential confounders.
    Results: The prevalence of wearing a face mask 18.0% (95% CI: 14.73%, 21.32%); of handwashing/hand sanitising 31.7% (95% CI: 27.70%, 35.67%), and of social distancing, 22.0% (95% CI: 18.46%, 25.56%). Multivariable logistic regression analysis revealed that knowledge of COVID-19 symptoms [Adjusted odds ratios (aOR): 2.86, 95% CI: 1.03, 7.89] and knowledge of COVID-19 transmission via contaminated surfaces/objects (aOR: 4.60, 95% CI: 1.23, 17.18) were associated with wearing a face mask. Pregnant women who knew that avoiding the touching of eyes, nose and mouth can prevent COVID-19 (aOR: 2.71, 95% CI: 1.01, 7.28), and knowledge of the virus being transmitted via contaminated objects/surfaces (aOR: 4.08, 95% CI: 1.42, 11.76), were associated with handwashing/hand sanitising. Knowledge of COVID-19 transmission via contaminated surfaces/objects (aOR: 15.27, 95% CI: 1.87, 124.43) was also associated with social distancing.
    Conclusion: The findings of our study suggest that knowledge of COVID-19 symptoms, transmission and preventive measures may play an important role in the practice of preventive measures against COVID-19 among pregnant women.
    MeSH term(s) Adult ; COVID-19/prevention & control ; Cross-Sectional Studies ; Female ; Ghana ; Hand Disinfection ; Humans ; Infection Control/methods ; Infection Control/statistics & numerical data ; Logistic Models ; Masks ; Multivariate Analysis ; Physical Distancing ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control ; Prenatal Care/methods ; SARS-CoV-2 ; Surveys and Questionnaires ; Young Adult
    Language English
    Publishing date 2021-03-15
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ZDB-ID 1314080-2
    ISSN 1365-3156 ; 1360-2276
    ISSN (online) 1365-3156
    ISSN 1360-2276
    DOI 10.1111/tmi.13566
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Factors associated with diarrhoea and acute respiratory infection in children under-5 years old in Ghana: an analysis of a national cross-sectional survey.

    Apanga, Paschal Awingura / Kumbeni, Maxwell Tii

    BMC pediatrics

    2021  Volume 21, Issue 1, Page(s) 78

    Abstract: Background: Diarrhoea and acute respiratory infection (ARI) are major causes of morbidity and mortality in children under-5 years old in Ghana. The aim of the study was to assess factors associated with diarrhoea and ARI in children under-5 years old.!## ...

    Abstract Background: Diarrhoea and acute respiratory infection (ARI) are major causes of morbidity and mortality in children under-5 years old in Ghana. The aim of the study was to assess factors associated with diarrhoea and ARI in children under-5 years old.
    Methods: We analysed nationally representative data from the 2017-2018 Ghana Multiple Indicator Cluster Survey (MICS) on 8879 children under-5 years old. Multivariable logistic regression was used to assess the factors associated with diarrhoea and ARI. We applied sample weights, stratification and clustering to account for the sampling design of the MICS.
    Results: The prevalence of diarrhoea was 17.0% (95% CI: 15.70, 18.24%). Children aged 6-11 months [Adjusted prevalence odds ratio (aPOR): 2.06, 95% CI: 1.45, 2.92], and 12-23 months (aPOR: 2.37, 95% CI: 1.67, 3.35), had higher prevalence of diarrhoea compared to children aged 0-5 months. Children whose mothers had a college or higher education (aPOR: 0.41, 95% CI: 0.22, 0.78), and a secondary education (aPOR: 0.66, 95% CI: 0.51, 0.86), had 59% and 34% lower odds of diarrhoea respectively, compared to children whose mothers had no formal education. Children from the richest households (aPOR: 0.58, 95% CI: 0.39, 0.86), had 42% lower odds of diarrhoea compared to children from the poorest households. Children resident in rural areas had 22% lower odds of diarrhoea compared to their peers in urban areas (aPOR: 0.78, 95% CI: 0.63, 0.98). The prevalence of ARI was 33.3% (95% CI: 31.72, 34.82%). Children aged 6-11 months (aPOR: 1.43, 95% CI: 1.06, 1.93), and 12-23 months (aPOR: 1.41, 95% CI: 1.10, 1.82), had higher prevalence of ARI compared to children aged 0-5 months.
    Conclusions: This study suggests that the prevalence of diarrhoea and ARI among children aged 6-11 and 12-23 months was higher compared to children aged 0-5 months. Children under-5 years old whose mothers had a secondary or higher education had a lower prevalence of diarrhoea compared to children whose mothers had no formal education.
    MeSH term(s) Child ; Cross-Sectional Studies ; Diarrhea/epidemiology ; Family Characteristics ; Female ; Ghana/epidemiology ; Humans ; Infant ; Infant, Newborn ; Prevalence ; Respiratory Tract Infections/epidemiology ; Risk Factors
    Language English
    Publishing date 2021-02-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-021-02546-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The Association Between Early Antenatal Care and Intermittent Preventive Treatment of Malaria in Pregnancy in Sub-Saharan Africa: Effect Modification by Planned Pregnancy Status.

    Apanga, Paschal Awingura / Kumbeni, Maxwell Tii / Chanase, Mary-Ann Wepiamo

    Annals of global health

    2022  Volume 88, Issue 1, Page(s) 4

    Abstract: Background: Evidence of the association between early antenatal care (ANC) and receiving at least three doses of sulphadoxine-pyrimethamine (IPTp3+) during pregnancy is limited. It's also unclear whether the association between early ANC and IPTp3+ is ... ...

    Abstract Background: Evidence of the association between early antenatal care (ANC) and receiving at least three doses of sulphadoxine-pyrimethamine (IPTp3+) during pregnancy is limited. It's also unclear whether the association between early ANC and IPTp3+ is modified by planned pregnancy status.
    Objectives: Our primary aim was to assess the relationship between early ANC and IPTp3+ and to assess whether this relationship is modified by a woman's planned pregnancy status. We also estimated IPTp3+ coverage across Sub-Saharan African countries.
    Methods: Data on 77 183 mothers with a live birth in the past two years were analyzed using multiple indicator cluster surveys (MICSs) from 17 Sub-Saharan African countries conducted between 2013 and 2019. We used modified Poisson regression with a robust variance to assess the association between early ANC and IPTp3+, while adjusting for country, clustering, stratification and sample weights. Effect modification by planned pregnancy status was assessed on the additive and multiplicative scales. We used meta-analytic techniques to pool prevalent estimates of IPTp3+ across all countries.
    Findings: IPTp3+ overall coverage was 22.1% (95% CI: 17.0%, 27.1%), and ranged from 2.9% (95% CI: 1.3%, 4.4%) in São Tomé and Príncipe to 51.7% (95% CI: 49.2%, 54.1%) in Ghana. IPTp3+ coverage was 30% higher among mothers who had early ANC compared to those who did not have early ANC [adjusted prevalence ratio (aPR): 1.30, 95% CI: 1.23,1.36]. There was evidence of effect modification on the additive [relative excess risk due to interaction (RERI): 0.08, 95% CI: 0.0002, 0.15] and multiplicative (aPR: 1.10, 95% CI: 1.01, 1.20) scales.
    Conclusions: IPTp3+ coverage was low across many of the countries in Sub-Saharan Africa. Women who had early ANC were more likely to receive IPTp3+. Women whose pregnancies were unplanned were less likely to receive IPTp3+, but our effect modification analysis showed that early ANC among such women can increase IPTp3+ coverage.
    MeSH term(s) Antimalarials/therapeutic use ; Family Planning Services ; Female ; Ghana/epidemiology ; Humans ; Malaria/epidemiology ; Malaria/prevention & control ; Pregnancy ; Prenatal Care
    Chemical Substances Antimalarials
    Language English
    Publishing date 2022-01-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2821756-1
    ISSN 2214-9996 ; 2214-9996
    ISSN (online) 2214-9996
    ISSN 2214-9996
    DOI 10.5334/aogh.3550
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Retraction Note

    Paschal Awingura Apanga / Maxwell Tii Kumbeni

    International Breastfeeding Journal, Vol 16, Iss 1, Pp 1-

    Prevalence and predictors of timely initiation of breastfeeding in Ghana: an analysis of 2017–2018 multiple indicator cluster survey

    2021  Volume 1

    Abstract: This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13006-020-00335-3. ...

    Abstract This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13006-020-00335-3.
    Keywords Pediatrics ; RJ1-570 ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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