Background. Sleep habits and problems play a vital role in determining sleep quality. We describe sleep habits and problems among medical students and assess their possible effect on self-reported academic performance. Methods. We conducted a cross-sectional study among medical students at the University of Ghana during the 2014/2015 academic year. Data was collected using the Pittsburgh Sleep Quality Index (PSQI), a self-report questionnaire that assesses sleep quality over a 1-month time interval. Results. 153 medical students were recruited comprising 83 (54.2%) females and 70 (45.8%) males with a mean age of 23.1 ± 2.4 years. The mean duration of night sleep was 5.7 ± 1.2 hours; 88 (57.5%) students had sleep latency of 10-30 minutes while 18 (11.8%) woke up nightly. 23 (15%) students experienced nightmares, 13 (8.5%) snored at night, and only one student reported coffee intake of 2-3 times daily. Sleep quality was poor in 86 (56.2%) and was significantly associated with sleep latency, morning tiredness, daytime sleepiness during lectures, academic performance, living conditions, leisure time, frequency of nocturnal awakenings, waking up due to noise, sleep walking, and nocturnal awakening to use washroom. There was also a significant positive relation between sleep quality and academic performance (X2 = 10.004 p = 0.019). Conclusion. Poor sleep quality and daytime dysfunction are widespread among medical students in Ghana. There was a significant positive relation between sleep quality and self-reported academic performance.

This study shows that preoperative vessel mapping provides useful information regarding the choice of AVF. Access surveillance duplex scanning at 6-8 weeks post-operatively is viable and has a high sensitivity and specificity for final outcome of fistula. Identifying AVF with potential problems early means that further intervention or surgery can be planned earlier, which will have a positive impact on patients.

Background: There is an urgent need to scale up global action on rural workforce development. This World Health Organization-sponsored research aimed to develop a Rural Pathways Checklist. Its purpose was to guide the practical implementation of rural workforce training, development, and support strategies in low and middle-income countries (LMICs). It was intended for any LMICs, stakeholder, health worker, context, or health problem.Method: Multi-methods involved: (1) focus group concept testing; (2) a policy analysis; (3) a scoping review of LMIC literature; (4) consultation with a global Expert Reference Group and; (5) field-testing over an 18-month period.Results: The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; working conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.Conclusion: The Rural Pathways Checklist provides an agreed global conceptual framework for the practical implementation of “grow your own” strategies in LMICs. It can be applied to scale-up activity for rural workforce training and development in LMICs, where health workers are most limited and health needs are greatest.

The COVID-19 pandemic has affected nearly every country worldwide and all African countries. The issue of healthcare workers (HCWs) contracting the disease is a growing concern in Ghana, because of the risk of spreading infections amongst themselves and to vulnerable patients in their care. This article illustrates how 14 staff at the Korle Bu Polyclinic/Family Medicine Department were incidentally found to be Covid-19 positive with most of them being asymptomatic. This observation led to a modification of the personal protective equipment (PPE) used by clinical staff when attending to patients. Furthermore, this finding suggests that a different criteria or guideline may be needed for testing of HCWs during a pandemic where a significant proportion of infected people are asymptomatic. We conclude that in the primary care setting HCWs must be ready to see all the following cases safely: routine patients, asymptomatic COVID-19 patients and suspected COVID-19 patients.