Background The use of institutional delivery services is essential for improving maternal and child health. However, studies in Liberia reveal over 20% of women still deliver at home. We assessed the prevalence and associated factors of home delivery among women of reproductive age in Margibi County, Liberia. Methods We conducted a cross-sectional study among 438 women of reproductive age in Margibi County. Data were obtained using a semi-structured questionnaire. A simple random sampling approach was used to select the participants for the study. We performed binary logistic regression to identify factors influencing home delivery. Findings were summarized into tables displaying the frequencies, percentages, crude, and adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results Prevalence of home delivery in the County was 90.6% (95% CI = 87.5 – 93.0). Women who were ≥ 31 years (aOR = 6.74, 95%CI = 2.86—15.90), women who had two or more children (aOR = 9.68, 95%CI = 4.07—22.99) and those who had rapid onset of labor (aOR = 6.35, 95%CI = 1.59 – 25.27) were associated with increased odds of home delivery. Good attitude of health workers (aOR = 0.01, 95%CI = 0.001 – 0.08) and the availability of transport to the nearest health facility (aOR = 0.01, 95%CI = 0.003 – 0.03) were factors associated with a decreased odds of home delivery among the study participants. Conclusion The high prevalence of home delivery in the county is a call for urgent interventions by the government of Liberia and various non-governmental organizations. The government may need to supply the county with ambulances and ensure in-service training of health workers on good attitudes.

Introduction in the absence of a vaccine and definitive treatment, non-pharmacological measures of physical distancing, regular hand hygiene and wearing of face covering remain the mainstays of mitigating coronavirus disease 2019 (COVID-19). In Ghana, these measures are mandatory in public places and underpin COVID-19 infection prevention and control (IPC). We assessed adherence and appropriate performance of these measures among patrons of community convenience shops in selected hotspots. Methods we conducted a non-intrusive observation of patrons of convenience shops in COVID-19 burden hotspots. We observed patrons as they entered and exited the shops and collected data on their gender, adherence and appropriate use of face covering and hand hygiene facilities. Data were analyzed descriptively and inferentially to determine factors associated with adherence to IPC guidelines. Results of 800 patrons observed from eight community shops, 481 (60.1%) were males. Of these, 653 (81.6%) wore face covering and 98 (12.3%) performed hand hygiene; with 92 (11.5%) adhering to both measures. Patrons who wore face mask appropriately were 578; comprising 299 (92.3%) of patrons who wore face mask before entering the shops. Of 89 patrons who washed their hands, appropriate handwashing was recorded among nine (10.1%). Compared to inappropriate handwashing, appropriate handwashing was negatively associated with adherence to IPC guidelines [aOR=0.1 (95% CI=0.01-0.59)]. Conclusion adherence to and appropriate performance of IPC measures of handwashing and use of face covering in the selected shops was low. There is the need to complement availability of IPC measures with intensification of risk communication messaging targeted at ensuring their appropriate use.

Introduction: Malaria is endemic in Ghana, accounting for about 40% of all OPD diagnosis. Data on malaria is routinely collected as part of the IDSR monthly reporting forms. Sunyani municipality recorded 56,540 malaria cases in 2016 with about 35% of the cases occurring in children under five years of age. We analyzed malaria surveillance data to identify the distribution of malaria cases by person, place and time and determine the timeliness and completeness of malaria report submission in the municipality.Methods: We analyzed malaria surveillance data in Sunyani municipality reported between 2015 and 2019 from the District Health Management Information System II. We calculated morbidity and mortality rates of cases by person and estimated proportion of cases by sub-districts. We performed trend analysis and calculated disease threshold levels. We presented the findings using tables and figures.Results: Of 639,361 malaria cases suspected, 93.5% (597,512/639,361) were tested, of which 49.4% (295,458/597,512) was positive. Females accounted for 55.7% (164,436/295,458) of the morbidity. Children <5 years recorded the highest proportion, 29.9% (88,135/295,458) of cases in the municipality. The case fatality rate was 3.7% (18/484) and 1.4% (7/484) for persons under age five and over age five, respectively. Abesim (6,276.03 per 10,000) recorded the highest number of cases, and the least cases were in New Dormaa (1,890.97 per 10,000). The majority of malaria cases were in May and October of each year. Antwi-krom recorded the highest rates of completeness and timeliness of 41.9% and 40.0% respectively. Conclusion: More females were diagnosed with malaria and children <5 years recorded the highest proportion of cases in the municipality. Abesim recorded the highest proportion of malaria cases during the period. High patterns of malaria transmissions occurred during months of high rainfalls. None of the sub-districts met the WHO target for timeliness and completeness of report submission. The NMCP should consider interventions such as SMC among children under five, in the Sunyani municipality.

Background Although IPTp-SP is a lifesaving World Health Organization (WHO) recommended preventive intervention for pregnant women in malaria-endemic regions, IPTp-SP uptake in the Northern region of Ghana is much lower than the sub-optimal national coverage level. Assessing the extent of health workers’ compliance and its associated factors will generate valuable pointers to be targeted at the program level. The study examined the factors influencing health workers’ compliance with the WHO recommended guidelines for IPTp-SP in the Northern Region. Methods A cross-sectional study among 315 health workers in the Northern region was conducted. Semi-structured questionnaires were used to collect data on health workers’ sociodemographic characteristics, facility-based factors and knowledge level. Data were collected on health workers’ compliance with the recommended practices through covert observations using a checklist. Facility observations were carried out using a checklist. Crude and adjusted logistic regression were used to determine predictors of health workers’ compliance, at a 5% significance level adjusting for clustering. Results Of the 315 health workers studied, the median age was 29 years (26–34 years). Females constituted (80.5%; 252) of the 313 workers. The majority (47.4%;148) of the 312 health workers were midwives. Overall, 56.2% (CI 51.0 – 62.0) were adequately complying with the recommended guidelines. Lower levels of compliance were recorded in health centres 15.6% (5.0 – 33.0) and CHPS compounds 21.2% (11.0 – 35.0). The factors associated with compliance included health workers’ knowledge (aOR = 7.64, 95% CI 4.21 – 13.87, p < 0.001), job satisfaction (aOR 10.87, 95% CI 7.04 – 16.79, p < 0.001), in-service training (aOR 10.11, 95% CI 4.53 – 22.56, p < 0.001), supervision (aOR 4.01, 95% CI 2.09 – 7.68, p < 0.001), availability of job aids (aOR 3.61, 95% CI 2.44 – 5.35, p < 0.001), health workers experience (aOR = 10.64, 95% CI 5.99 – 18.91, p < 0.001) and facility type (aOR 0.03, 95% CI 0.01–0.07, p < 0.001). Conclusion Compliance with the recommended IPTp-SP guidelines is suboptimal in the region, with lower-level health facilities recording the least compliance levels. Health centres and CHPS facilities should be prioritized in distributing limited resources to improve health worker quality of care for antenatal care clients.

Background Although IPTp-SP is a lifesaving WHO recommended preventive intervention for pregnant women in malaria-endemic regions, IPTp-SP uptake in the Northern region of Ghana is much lower than the sub-optimal national coverage level. Assessing the extent of health workers’ compliance and its associated factors will generate valuable pointers to be targeted at the program level. The study examined the factors influencing health workers’ compliance with the WHO recommended guidelines for IPTp-SP in the Northern Region. Methods A cross-sectional study among 315 health workers in the Northern region was conducted. Semi-structured questionnaires were used to collect data on health workers’ sociodemographic characteristics, facility-based factors and knowledge level. Data were collected on health workers’ compliance with the recommended practices through covert observations using a checklist. Facility observations were carried out using a checklist. Crude and adjusted logistic regression were used to determine predictors of health workers’ compliance, at 5% significance level adjusting for clustering. Results Of the 315 health workers studied, the median age was 29 years (26 – 34 years). Females constituted 252 (80.5%) of the 313 workers. The majority 148 (47.44%) of the 312 health workers were midwives. Overall, 56.2% (CI 51.0 – 62.0) were adequately complying with the recommended guidelines. Lower levels of compliance were recorded in health centers 15.6% (5.0 - 33.0) and CHPS compounds 21.2% (11.0 - 35.0). The factors associated with compliance included health workers’ knowledge (aOR = 7.64, 95% CI 4.21 - 13.87, p<0.001), job satisfaction (aOR 10.87, 95%CI 7.04 - 16.79, p<0.001), in-service training (aOR 10.11, 95%CI 4.53 - 22.56, p<0.001), supervision (aOR 4.01, 95%CI 2.09 - 7.68, p<0.001), availability of job aids (aOR 3.61, 95%CI 2.44 - 5.35, p<0.001), health workers experience (aOR = 10.64, 95% CI 5.99 - 18.91, p<0.001) and facility type (aOR 0.03, 95%CI 0.01 - 0.07, p<0.001). Conclusion Compliance with the recommended IPTp-SP guidelines is suboptimal in the region, with lower-level health facilities recording the least compliance levels. Health centers and CHPS facilities should be prioritized in distributing limited resources to improve health worker quality of care for antenatal care clients.