Informed Consent under the Ghana Health Service Patients Charter: Practice and Awareness

Background: Every human being of adult years and sound mind has a right to determine what shall be done with his/her own body. Patient autonomy and the practice of informed patient consent are now pivotal in medical practice. Aim: To assess patient’s knowledge of Patients’ Rights Charter and whether patients receive adequate information to enable them make an informed consent to a particular treatment. Methodology: Patients who were undergoing elective surgery from selected surgical departments of Komfo Anokye teaching hospital in Kumasi were randomly selected and assisted to answer structured questionnaire without the knowledge of their doctors. The study period was in June to December (2014). Descriptive analysis was done using SPSS (II) of the results. Results: 84.7% (144) had no idea about the Patients’ Rights Charter of the Ghana Health Service. 75% (128) did not know or had not heard of informed patient consent. Of those who knew of the charter, 85% (37) had ever stayed in a developed country. 60% (102) did not know of their diagnosis. 79% (134) said the doctor only asked them to either sign or thumb print the consent document without giving them treatment options or possible complications. Conclusion: Most of respondents undergoing various surgical procedures at the Komfo Anokye Teaching Hospital were not aware of the existence of the Patients’ Rights Charter of the Ghana Health Service. Again, practitioners did not provide sufficient information to patients for them to make an informed decision about their health.

Immunisation Status of Children Born with Orofacial Clefts Who Visited the Komfo Anokye Teaching Hospital (KATH) Multidisciplinary Cleft Clinic

Background: The Ghana Expanded Programme on Immunisation recommends that children receive Bacillus Calmette-Guerin (BCG) and Oral Polio Vaccine (OPV) at birth;three doses of Penta vaccine and OPV at 6, 10 and 14 weeks of age;and measles vaccine at 9 months of age. Aim/Objective: To evaluate the immunisation status of children born with orofacial clefts who visited the KATH multidisciplinary Cleft clinic. Methodology/Statistics: The study was a descriptive study with a cross-sectional design. The methodology consisted of in-person interviews of mothers of children born with cleft lip and palate reporting at KATH Cleft clinic. Interview guides were used for mothers who could not read. Mothers who were literate and as such could answer the questions directly were given questionnaires to fill. Result: It was reported that of the 83 children included, 47 (57%) had been fully vaccinated and on time, 24 (29%) had been fully vaccinated but delayed and 12 (14%) had not been vaccinated at all. Children with isolated cleft palate and macrostomia were fully vaccinated on time (77.3% and 100%, respectively) as compared to those with combined cleft lip and palate (43.3%) and isolated cleft lip (50.0%). The majority (77%) of the mothers who either had not vaccinated their children or had delayed in vaccinating them attributed stigmatisation as the main cause. Most of the mothers (95%) had knowledge of immunisation. About two-thirds of the mothers (65%) agreed that establishing an immunisation centre at the cleft clinic is the best way to improve immunisation rate among children with orofacial clefts. Conclusion: The study showed that the percentage of children with orofacial cleft who visited the KATH Cleft Clinic and were vaccinated on time was above the national average. Cleft palates were more vaccinated and on time than cleft lips. According to the children’s mothers, lack of timely vaccination was mainly due to the stigma associated with clefts in their societies.

Motorcycle Related Oral and Maxillofacial Injuries Seen at Komfo Anokye Teaching Hospital, Kumasi-Ghana

Background: Motorcycle related injuries have become a major public health problem because the increased use of motorcycles has been accompanied with a corresponding increase of road traffic accidents. Objective: The purpose of this study was to evaluate the occurrence of oral and maxillofacial injuries associated with motorcycles as seen at the second largest Teaching Hospital in Ghana, the Komfo Anokye Teaching Hospital (KATH). Method and Materials: The compiled data that were reviewed for this retrospective study were obtained from the Accident and Emergency unit of KATH. These comprised 135 successive maxillofacial trauma patient records entered from August 2017 to August 2018. Results: Total number of road traffic related injuries seen at OMFS was 135 during the study period. Out of this number, 66 were related to motorcycle injuries. This represented 48.7% of the Road Traffic Accidents seen at oral and maxillofacial surgery department (OMFS). The age range was from 3 to 64 years. The average age was 26.7 years. 62 (93.9%) were males and 4 (6.1%) were females. 16 (24.2%) of the motorcycle injuries were caused by the “Okada”, 2 (3.0%) by “Pragia” and 48 (72.8%) by the “Aboboyaa”. 46 (69.7%) of the motorcycles victims were themselves the riders, 12 (18.2%) were pedestrians and 8 (12.1%) were passengers. There were 8 deaths. 6 (75.0%) of the deaths were caused by the “Aboboyaa”. “Okada” accounted for only 2 (15.0%) deaths. Concerning the riders and the passengers, only 8 (14.8%) of the victims were helmeted. The majority were unhelmeted (85.2%). Conclusion: Motorcycle transportation is the cause of many oral and maxillofacial injuries. Majority of the victims suffered multiple facial bone fractures. Males were more often affected than females and the majority were unhelmeted.

The Perspectives of Kwame Nkrumah University of Science and Technology Dental School Graduates

Background: The idea of establishing a Dental school at the Kwame Nkrumah University of Science and Technology (KNUST) was borne out of a need. There was a shortfall in the supply of dental surgeons, especially in the northern half of the country. Aim/Objective: To seek for feedback from KNUST Dental school graduates over the past six about their overall assessment of the BDS courses taught during their clinical training and challenges faced in the course of their training. Methodology: A cross-sectional retrospective study of all KNUST Dental school graduates from 2012 to 2017. A structured goggle form questionnaire was developed. The Google form link was emailed to the representatives who in turn forwarded the link to their year mates. The questionnaire was filled online and submitted as requested. Results: This represented 63.0% of the entire graduates from KNUST Dental School. The male to female ratio was 1.3:1.0. The age range of our graduate was from 24 yrs (3.8%) to 32 years (1.9%). The average age was 26.3 years. 48.10% of respondents said their training was very good. The major challenges were inadequate clinical space (25.2%) and lack of materials and dental chairs for students’ clinic (27.3%). Conclusion: On the whole, the quality of the training was rated as very good even though some of the courses taught during the clinical training were rated as poor. Inadequate dental chairs, laboratory and clinic materials, supervision of student’s clinic were some of the major challenges expressed by the graduates.