Fertility preferences are revised in the light of changing life and reproductive
circumstances. Over time, an individual's fertility preferences may fluctuate along a
continuum. In this study, we describe typical patterns of change (or stability) in individual
fertility preferences over a period of five years using a prospective panel study of women of
reproductive age in six communities in southern Ghana. We investigate whether patterns of change are
consistent with women's reproductive life circumstances by first comparing responses between
successive interviews and then over multiple interviews using latent class analysis. We find that
approximately 20 percent of the sample changed their fertility preference from one interview to the
next. Women who had attained or exceeded their ideal family size show considerable stability in
their desire to stop childbearing over multiple interviews. This desire does not waver even when
they experience unwanted pregnancies. The attainment of ideal family size appears to be an important
correlate of preference stability.
BackgroundGlaucoma is the leading cause of irreversible blindness globally, and treatment involves considerable cost to stakeholders in healthcare. However, there is infrequent availability of cost information and patterns of management, especially in developing countries. This study determined the cost of the medical management of POAG, adherence, and pattern of medication prescription in Ghana.MethodsA retrospective cross-sectional study involving 891 Primary Open Angle Glaucoma (POAG) cases seen in the year 2012 at three referral facilities. Demographics, ocular history, resource consumption, medication, test, surgery and other related cost were extracted from 84 patients who had fully complied with their treatment to calculate total cost (TC) based on 2012 estimates. Glaucoma drugs prescribed to patients who had adhered to all their review visits within the period evident from case folders were recorded and analysed for the prescription pattern.ResultsOut of 891 POAG cases seen in 2012, 351(39.4 %) attended all the required review visits, but only 84 (9.4) had fully and continually adhered to all their treatment regimes. They comprised 41(48.8 %) males and 43(51.2 %) females with a mean age of 65 ± 14.8. Majority of the respondents were elderly above 60 year of age (65.5 %). The total estimated cost for the 84 cases in the year was GH¢ 81,237 ($40,619), comprising GH¢ 72,193 ($36,097) direct medication cost and GH¢9,045 ($4,523) direct non-medication cost (surgery and test cost), and an average of GH¢ 967 ($484) for a mean visit of 5.6 ± 1.1 in the year. A total of 673 glaucoma medications had been prescribed for 351 patients for the year, with timolol being the most prescribed (64.19 %) and monotherapy as the most adopted form of therapy (61.06 %). Age and income showed concurrent increase with cost (P ≤ 0.05).ConclusionsCost of managing glaucoma constitutes a substantial financial burden and influenced the pattern of medication prescription.
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