Background Improving maternal health and achieving universal health coverage (UHC) are important expectations in the global Sustainable Development Goals (SDGs) agenda. While health insurance has been shown as effective in the utilisation of maternal healthcare, there is a paucity of literature on this relationship in sub-Saharan Africa (SSA). We examined the relationship between health insurance coverage and maternal healthcare utilisation using demographic and health survey data. Methods This was a cross-sectional study of 195 651 women aged 15–49 y from 28 countries in SSA. We adopted bivariable and multivariable analyses comprising χ2 test and multilevel binary logistic regression in analysing the data. Results The prevalence of maternal healthcare utilisation was 58, 70.6 and 40.7% for antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC), respectively. The prevalence of health insurance coverage was 6.4%. Women covered by health insurance were more likely to utilise ANC (adjusted OR [aOR]=1.48, 95% CI 1.41 to 1.54), SBA (aOR=1.37, 95% CI 1.30 to 1.45) and PNC (aOR=1.42, 95% CI 1.37 to 1.48). Conclusion Health insurance coverage was an important predictor of maternal healthcare utilisation in our study. To accelerate progress towards the achievement of SDG 3 targets related to the reduction of maternal mortality and achievement of UHC, countries should adopt interventions to increase maternal insurance coverage, which may lead to higher maternal healthcare access and utilisation during pregnancy.

ObjectiveAlthough several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MDR-TB in the Ashanti Region, Ghana.DesignA retrospective, cross-sectional analysis.SettingThe study was conducted in the Ashanti Region, the second most populous region in Ghana. The regional MDR-TB register, which contains information on all patients with MDR-TB being treated at the various TB centres in the region, was analysed between February and May 2021.ParticipantsThe participants consisted of all registered patients with MDR-TB who were placed on treatment between 1 January 2015 and 31 December 2020. Patients were included in the analysis if their treatment outcome had been assigned. Patients with no record of treatment outcome were excluded from the study.Outcome measuresThe main outcome variable for the study was MDR-TB treatment outcome, standardised as ‘cured’, ‘treatment completed’, ‘treatment failure’, ‘died’ and ‘lost to follow-up’. A logistic regression model was fitted for factors associated with the outcome measure.ResultsOut of 159 patients included in the analysis, 86 (54.1%) were declared cured, 28 (17.6%) completed their treatment successfully, 6 (3.8%) were declared treatment failure, 12 (7.5%) were lost to follow-up and 27 (17.0%) died. The overall treatment success rate was 71.7%. Patients who were female (adjusted OR (AOR)=1.27, 95% CI: 1.18 to 1.39, p=0.023), younger (AOR=0.53, 95% CI: 0.19 to 2.11, p=0.012), had a higher level of education (AOR=1.12, 95% CI: 0.65 to 1.90, p=0.034), had a baseline body mass index of 18.5 kg/m2 or above (AOR=1.57, 95% CI: 1.23 to 2.47, p=0.011) and those who did not have a history of TB (AOR=0.47, 95% CI: 0.10 to 0.75, p=0.028) were more likely to have successful MDR-TB treatment outcomes.ConclusionsFavourable treatment outcomes for patients with MDR-TB can be achieved in a resource-limited country. Although the recommended WHO target of ≥75% was not met, the current result (71.7% treatment success rate) is still commendable considering all the challenges associated with TB treatment in Ghana.

Background Maternal mortality among adolescents remains high, meanwhile, it is an avoidable tragedy which can be prevented by increasing adolescent knowledge of obstetric emergencies and improving birth preparedness. The study aimed to assess pregnant adolescents’ knowledge of obstetric emergencies and their birth preparedness in Techiman Municipality, Ghana. Methods In the facility-based survey, the target population consisted of 3 months and above pregnant adolescents (16–19 years) who resided in the municipality and attended ANC at Holy Family Hospital in Techiman. A consecutive sampling technique was used to select 422 pregnant adolescents for the study with a questionnaire as the instrument for data collection. Data were analyzed using SPSS software version 20. Moreover, frequency, percentages, chi-square, and binary logistic regression were applied in the data analysis. Results The results show that the majority of the respondents 233 (55.2%) had heard about obstetric emergencies and most of them 344 (81.5%) were able to notice danger signs in pregnancy. Meanwhile, 68.2% of the respondents were poorly prepared for delivery. Moreover, chi-square, bivariate and multivariate analysis revealed that the age of respondents, educational status, ethnicity, religion, marital status, number of children, and monthly income were statistically significant on knowledge and obstetric emergency preparedness. However, employment status was not statistically significant. Conclusion The study concludes that if pregnant women, especially adolescents, are given in-depth information regarding obstetric emergencies; they will not only be able to notice them but also take actions to deal with them. Moreover, if the adolescents’ educational status, marital status, and monthly income are improved, it will go a long way to increase the knowledge and emergency preparedness among the pregnant adolescent.

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Objective Data quality is critical in ensuring sound healthcare decision making and service delivery. Data quality provided at all levels of health care enhances accurate and timely information for effective and efficient health service delivery decision making. The study sought to assess the Sunyani West Municipality’s Expanded Programme on Immunization (EPI) data quality on measles vaccinations. Method The study adopted a descriptive cross sectional design. It involved a structured observation of data from EPI tally books from five sub-municipal facilities to inform healthcare decision making. WHO Immunization Data Quality Self-Assessment Tool (DQS) was adopted to assess data quality. The DQS captured period was from January to December, 2018. Field data was entered into the DQS Toolbox to generate accuracy ratio (%) and discrepancy rate (%) figures. Results When capturing data into the tally books at the facility level, there were over ninety reported data, whereas data reported to the Municipal Health Information Management System (DHIMS2) was one hundred and fifty-one (151) under-reported data. Furthermore, data gathered from all the sub-municipal facilities showed that data accuracy ratio from the point of immunization to the facility was 97% and discrepancy rate of 3%. However, when reported to the Municipality, the accuracy ratio was found to be 105% with a discrepancy ratio of 5%. Conclusion Immunization data quality was generally good, however, there were insufficient and irregular on-site observation and weekly monitoring by facility heads. It is, therefore, important for Sunyani West Municipal Health Directorate to ensure regular monitoring and assessment of immunization data in sub-Municipalities so that errors encountered in capturing and reporting of data are rectified in order to harness the full potential of immunization data.