Poverty is both a cause and a consequence of poor health, and the scarcity of resources limits access to
essential health care services.
The development of the Country Cooperation Strategy (CCS) was based on a consultative and participatory process with strong commitment and support from the Ministry of Health of Ghana. The CCS draws on lessons from the implementation of the first, and second generation CCSs, the country focus strate...gy, and the United Nations Sustainable Development Cooperation Framework (2023–2025).
The strategic agenda of the CCS outlines three strategic priorities, which are:
1. improving universal access to essential health services through the primary health care approach.
2. health emergency preparedness and response: addressing gaps in IHR core capacities and strengthening national capacities to prevent, detect and respond appropriately to public health emergencies through a resilient health system.
3. addressing social, economic, and environmental determinants of health; promoting high-impact interventions to address public health risks using multisectoral approaches.
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The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct ...definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
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