Birth weight, birth type and pre-weaning survivability of West African Dwarf goats raised in the Dangme West District of the Greater Accra Region of Ghana.

A study was conducted on 441 West African Dwarf goat (WADG) kids born from September 1999 to August 2002 at three locations in the Dangme West District of the Greater Accra Region in Ghana to determine the effect of environmental factors on birth weight, birth type and pre-weaning survivability. The overall mean birth weight was 1.32 +/- 0.01 kg. Birth weights were similar (p > 0.05) between single births (1.43 +/- 0.04 kg) and twins (1.34 +/- 0.03 kg), but singles were significantly heavier (p < 0.05) than triplets (1.24 +/- 0.05 kg). Kids born in the major wet season recorded the best mean birth weight (1.37 +/- 0.04 kg). Sex, parity of does, and year of birth of kids had no significant (p > 0.05) effect on birth weight. Mean litter size was 1.93 +/- 0.03. Does that kidded in the dry season had a significantly (p < 0.05) higher litter size (2.05 +/- 0.06) than those that kidded in the minor wet season (1.80 +/- 0.10). Litter size of first-parity kids was significantly smaller (p < 0.05) than in subsequent parities. Litter size dropped significantly (p < 0.05) from year 2 (2.03 +/- 0.07) to year 3 (1.83 +/- 0.07). Pre-weaning survivability was 79.1% and season of kidding had a significant (p < 0.05) effect on survivability. Survivability of quadruplets (61.8%) was significantly (p < 0.05) lower than in the other birth types.

Unmet need for essential obstetric services in a rural district in northern Ghana: complications of unsafe abortions remain a major cause of mortality.

AIM: The aim of this study was to review 4 years of hospital data on antenatal services, deliveries and maternal deaths as the baseline evaluation for a programme to improve care. METHODS: Descriptive analyses were made of data extracted from the monthly returns charts and clinical notes on all maternal deaths from January 2001 to December 2003 at the district hospital in the Kassena-Nankana district of rural northern Ghana. RESULTS: The majority (56.6%) of women first attended an antenatal clinic during the second trimester, and about 70% had haemoglobin levels of <10 g/dl. A total of 3160 deliveries were recorded. The prevalence of female genital cutting was 21.4%. Hospital and population rates of Caesarean section were 9.1 and 1.8%, respectively. Only one-third of women in need of a Caesarean section were able to access this intervention. Twenty-four maternal deaths were recorded, giving a hospital maternal mortality ratio of 759 per 100,000 live births. Complications of unsafe abortion (29.1%) and haemorrhage (20.8%) were the leading causes of death. Seventy-one percent of deaths occurred in women living within 15 km of the district hospital, and 50% occurred within 24 h of arrival. CONCLUSION: Late recourse to the health facility and complications of unsafe abortion are major contributory factors to maternal mortality in this district. A high level of unmet need for essential obstetric services, including access to contraceptive services, exists in this district. Decentralizing the availability of essential obstetric services through health centres to community level is necessary to reduce maternal mortality in developing countries.

Voluntary counseling and HIV testing for pregnant women in the Kassena-Nankana district of northern Ghana: is couple counseling the way forward?

This study reports the results of a cross-sectional questionnaire survey undertaken in the Kassena-Nankana district of Ghana to assess the perception and attitude of 270 antenatal clinic attendants towards voluntary counseling and HIV testing. It was found that although 92.6% (95% CI 88.8-95.4) of respondents indicated a willingness to get tested, only 51% (95% CI 45.0-57.2) considered HIV testing for pregnant women to be useful. Most (93.6%) indicated they would like their husbands (partners) to know the result of the test and 52.2% indicated that their husbands would be willing to accompany them to antenatal clinic (ANC) at least once during the pregnancy. The perception of the usefulness of HIV testing (OR = 8.5, 95% CI 1.8-40.0), the willingness to disclose test result to the husband (OR = 13.3, 95% CI 4.0-44.5) and perceived willingness of husband to accompany wife to antenatal clinic (OR = 5.2, 95% CI 1.4-19.8) were found to be independent predictors of a woman's willingness to get tested. The willingness to disclose test result to husband (OR 3.2, 95% CI 1.1-10.5) and knowledge of at least one mode of MTCT HIV transmission (OR = 2.1, 95% CI 1.2-3.6) were found to be independent predictors of a woman's perception that getting tested was useful. The results suggest that for pregnant women in this district, the willingness to get tested for HIV does not equate with the perception of the test's usefulness, and that spouses are likely to exert strong influence on the attitude of pregnant women towards VCT. Couple counseling facilitated through couple-friendly ANC services should be explored as strategy for the intended VCT program in this district.