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Objectives: Ghana's quest to reduce neonatal mortality, in hospital facilities and communities, continues to be a nightmare. The pursuit of achieving healthy lives and well-being for neonates as enshrined in Sustainable Development Goal three lingered in challenging hospital facilities and communities. Notwithstanding that, there have been increasing efforts in that direction. This study examines the contributing factors that hinder the fight against neonatal mortality in all hospital facilities in the Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana. Methods: The study utilized neonatal mortality data consisting of neonatal deaths, structural facility related variables, medical human resources, types of hospital facilities and natal care. The data was collected longitudinally from 2014 to 2019. These variables were analysed using the negative binomial hurdle regression (NBH) model to determine factors that contribute to this menace at the facility level. Cause-specific deaths were obtained to determine the leading causes of neonatal deaths within health facilities in the two municipal assemblies. Results: The study established that the leading causes of neonatal mortality in these districts are birth asphyxia (46%), premature birth (33%), neonatal sepsis (11%) and neonatal jaundice (7%). The NBH showed that neonatal mortality in hospital facilities depend on the number of incubators, monitoring equipment, hand washing facilities, CPAPb machines, radiant warmers, physiotherapy machines, midwives, paediatric doctors and paediatric nurses in the hospital facility. Conclusions: Early management of neonatal sepsis, birth asphyxia, premature birth and neonatal infections is required to reduce neonatal deaths. The government and all stakeholders in the health sector should provide all hospital facilities with the essential equipment and the medical human resources necessary to eradicate the menace. This will make the realization of Sustainable Development Goal three, which calls for healthy lives and well-being for all, a reality.
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In this paper we proposed three estimators namely linear shrinkage, preliminary test and shrinkage preliminary test for the rate parameter of univariate gamma. The salient feature of the proposed estimators is the admissibility property that is defined on belief of the uncertain prior information. Expressions for bias and relative efficiency under method of moment have been derived using asymptotic theory. A Monte Carlo simulation study shows that the proposed estimators are more efficient and minimally biased when prior information is close to the neighbourhood of the rate parameter.
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BACKGROUND: Child mortality is a global health problem. The United Nations' 2018 report on levels and trends on child mortality indicated that under-five mortality is one of the major public health problems in Ghana with a rate of 60 deaths per 1000 live births. To further mitigate this problem, it is important to identify the drivers of under-five mortality in order to achieve the United Nations SDG Goal 3 target 2. METHODS: In this study, we investigated the effects of some selected risk factors on child mortality using data from the 2014 Ghana Demographic Health Survey. We modelled the relationship between child mortality and the risk factors using a logistic regression model under the frequentist and Bayesian frameworks. We used the Metropolis-Hastings Algorithm to simulate parameter estimates from the posterior distributions, and statistical analyses were carried out using STATA version 14.1. RESULTS: Results from the frequentist framework are in line with those from the Bayesian framework. The results showed an increased risk of death among children who were delivered through caesarean and reduced relative odds of death among children whose sizes are average or large at birth and whose mothers have formal education. CONCLUSIONS: There is a need for improved health facilities for better health-care for mothers and children. Education should, among other things, emphasise on the need for mothers to go for regular check-ups during antinatal and postnatal periods for improved mother and child health.
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Mortalidad del Niño , Teorema de Bayes , Peso al Nacer , Distribución de Chi-Cuadrado , Preescolar , Escolaridad , Femenino , Ghana/epidemiología , Encuestas Epidemiológicas , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Modelos Logísticos , Masculino , Madres , Oportunidad Relativa , Embarazo , Factores de Riesgo , Factores SocioeconómicosRESUMEN
BACKGROUND: One of the major aims of marriage is to procreate or give birth to a child. Childbirth is so crucial in marriage that it often determines the happiness of the couple. Too much delay in childbirth after marriage or the likelihood that one cannot give birth after marriage can lead to divorce. However, causes of delay in childbirth are often difficult to detect by both the Gynaecologist and the couple involved. This makes proposing solutions to issues related to childbirth usually unsuccessful. METHODS: It is against this background that we conducted this study to identify factors that determine childbirth within 10 months or after 10 months of marriage (birth length) among women in Ghana. This was achieved by using a logistic regression model for the dichotomous birth length variable, adjusting for risk factors/predictors of birth length. The data used for the study were obtained from the 2014 Ghana Demographic and Health Survey, consisting 6,525 complete cases with 18 predictor variables. Statistical analyses were carried out using STATA version 14.1. RESULTS: The results show that respondents who have ever terminated pregnancy are more likely (OR = 0.178, 95%CI = 0.044, 0.312) to deliver after 10 months, wives whose husbands have higher education are less likely (OR = -0.162, 95%CI = -0.236, -0.088) to give birth after 10 months of marriage, wives who reported that beating is justified if she goes out without her husband's notice are more likely (OR = 0.466, 95%CI = 0.305, 0.628) to give birth after 10 months, wives who reported that beating is justified if she neglects the child are more likely (OR = -0.305, 95%CI = -0.461, -0.149) to give birth within 10 months, and wives who reported that beating is justified when she argues with her husband are less likely (OR = -0.301, 95%CI = -0.451, -0.152) to give birth after 10 months of marriage. Every unit increase in the age of the respondent at marriage increases the likelihood of giving birth after 10 months of marriage, and a unit increase in the age of the respondent at first sex decreases the likelihood of giving birth after 10 months in marriage. CONCLUSIONS: For conception within 1 month of marriage, wives and husbands should/are encouraged to have frequent sex, any negative social behaviour or policies must be discouraged, experts' advice on contraceptive use must be sought, and women are encouraged to desist from termination of pregnancy at any time of their life. Husbands should openly express their desire and love for their children since this increases the likelihood of wives' desire to give birth. This leads to frequent sex, which then reduces conception time, and hence childbirth within the shortest possible time.