This paper examines some of the problems and dilemmas that African women scholars face in U.S. academic institutions: how such experiences inform the nature of their relationships with colleagues and students, and the pedagogical and resistance strategies that they practice. By reflecting on our own professional journeys as scholars of women’s studies and sociology in various academic institutions in the United States, we are particularly interested in narrating our experiences as well as some of the ways in which we challenge and navigate situations that we encounter in our classrooms.

African Feminist Scholars in Women's Studies: Negotiating Spaces of Dislocation and Transformation in the Study of Women

Hannah Kudjoe was Ghana’s leading woman nationalist in the struggle for independence from British colonial rule in the 1940s and 1950s. As Ghana celebrated a half century of independence in 2007 and the heroes of that struggle were publicly honored by street naming ceremonies, the unveiling of statues, and historical reenactments, Hannah Kudjoe’s name was nowhere to be found. Who was Hannah Kudjoe and how could such a high-profile, formidable, and well-connected nationalist leader be forgotten so quickly? Employing an agnotological approach to women’s history that interrogates the construction of ignorance and sanctioned forgetting, this article traces the processes by which Hannah Kudjoe “got disappeared,” and the ways in which feminist and nationalist histories have conspired in her disappearing.

The Disappearing of Hannah Kudjoe: Nationalism, Feminism, and the Tyrannies of History

abstract:As Africans sought to build nations during the independence era, their efforts were informed by international currents. In addition to political parties, nonstate actors such as civil society groups played a role in this process. Women activists in an emergent Ghana—most notably, the National Federation of Gold Coast Women and one of its leaders, Evelyn Amarteifio—created a new form of internationalism that merged the nation-building strategies of Kwame Nkrumah and the Convention People's Party with women's efforts elsewhere in Africa and the wider Diaspora. Thus, she and her organization did not fit neatly into the conventional Ghanaian nationalist political and economic narrative and at times came into conflict with national political leaders. Examining Amarteifio's actions and those of the Federation demonstrates the diverse and conscious ways in which African women sought to achieve their own objectives through engagements with the Ghanaian state and international groups.résumé:Alors que les Africains cherchaient à construire leurs nations durant l'indépendance, leurs efforts ont été influencés par des courants internationaux. Outre les partis politiques, des acteurs non-étatiques comme des groupes de la société civile ont joué un rôle dans ce processus. Des femmes activistes dans un Ghana naissant—en particulier la Fédération Nationale des Femmes de la Côte-de-l'Or et une de ses dirigeantes, Evelyn Amarteifio—ont créé une nouvelle forme d'internationalisme fusionnant les stratégies de construction nationale de Kwame Nkrumah et la Convention Nationale du Peuple, avec les efforts des femmes africaines et de la diaspora au sens large. Ainsi, elle et son organisation ne cadraient pas bien avec le discours politico-économique nationaliste ghanéen et entraient parfois en conflit avec les dirigeants politiques nationaux. L'examen des actions d'Amarteifio et de celles de la Fédération montre les différents moyens délibérément utilisés par les Africaines pour atteindre leurs propres objectifs à travers leur engagement avec l'état ghanéen et les groupes internationaux.

Women's International Alliances in an Emergent Ghana

Healthcare-associated infections (HAIs) result in millions of avoidable deaths or prolonged lengths of stay in hospitals and cause huge economic loss to health systems and communities. Primarily, HAIs spread through the hands of healthcare workers, so improving hand hygiene can reduce their spread. We evaluated hand hygiene practices and promotion across 13 public health hospitals (six secondary and seven tertiary hospitals) in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021. The mean score for all hospitals was 273 ± 46, indicating an intermediate level of hand hygiene. Nine hospitals achieved an intermediate level and four a basic level. More secondary hospitals 5 (83%) were at the intermediate level, compared to tertiary hospitals 4 (57%). Tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education. Lack of budgets to support hand hygiene implementation is a priority gap underlying this poor performance. These gaps hinder hand hygiene practice and promotion, contributing to the continued spread of HAIs. Enhancing the distribution of hand hygiene resources and encouraging an embedded culture of hand hygiene practice in hospitals will reduce HAIs.

/pdf/how-well-are-hand-hygiene-practices-and-promotion-293lda6v.pdf

How Well Are Hand Hygiene Practices and Promotion Implemented in Sierra Leone? A Cross-Sectional Study in 13 Public Hospitals

Abstract Objective: Despite the impact of inappropriate prescribing on antibiotic resistance, data on surgical antibiotic prophylaxis in sub-Saharan Africa are limited. In this study, we evaluated antibiotic use and consumption in surgical prophylaxis in 4 hospitals located in 2 geographic regions of Sierra Leone. Methods: We used a prospective cohort design to collect data from surgical patients aged 18 years or older between February and October 2021. Data were analyzed using Stata version 16 software. Results: Of the 753 surgical patients, 439 (58.3%) were females, and 723 (96%) had received at least 1 dose of antibiotics. Only 410 (54.4%) patients had indications for surgical antibiotic prophylaxis consistent with local guidelines. Factors associated with preoperative antibiotic prophylaxis were the type of surgery, wound class, and consistency of surgical antibiotic prophylaxis with local guidelines. Postoperatively, type of surgery, wound class, and consistency of antibiotic use with local guidelines were important factors associated with antibiotic use. Of the 2,482 doses administered, 1,410 (56.8%) were given postoperatively. Preoperative and intraoperative antibiotic use was reported in 645 (26%) and 427 (17.2%) cases, respectively. The most commonly used antibiotic was ceftriaxone 949 (38.2%) with a consumption of 41.6 defined daily doses (DDD) per 100 bed days. Overall, antibiotic consumption was 117.9 DDD per 100 bed days. The Access antibiotics had 72.7 DDD per 100 bed days (61.7%). Conclusions: We report a high rate of antibiotic consumption for surgical prophylaxis, most of which was not based on local guidelines. To address this growing threat, urgent action is needed to reduce irrational antibiotic prescribing for surgical prophylaxis.

/pdf/high-levels-of-surgical-antibiotic-prophylaxis-implications-1p1u57vm.pdf

High levels of surgical antibiotic prophylaxis: Implications for hospital-based antibiotic stewardship in Sierra Leone

There is limited information on surgical site infections (SSI) and the related antibiotic resistance needed to guide their management and prevention in Sierra Leone. In this study, we aimed to establish the incidence and risk factors of SSI and the related antibiotic resistance among adults attending a tertiary hospital, and a secondary health facility in Freetown, Sierra Leone.This is a prospective cohort study designed to collect data from adult (18 years or older) patients who attended elective and emergency surgeries at two hospitals in Freetown between February and July, 2021. Data analysis was done using STATA version 16.Of 338 patients, 245 (72.5%) and 93 (27.5%) had their surgeries at the tertiary and secondary hospitals, respectively. Many were males 192 (56.8%), less than 35 years 164 (48.5%), and 39 (11.5%) developed an SSI. Of the 39 patients who acquired an SSI, 7 (17.9%) and 32 (82.1%) had their surgeries at the secondary and tertiary hospitals, respectively. The incidence of SSI is higher in contaminated 17 (43.6%) than in clean-contaminated 12 (30.8%) and clean 10 (25.6%) wounds. Wound swabs were collected in 29 (74.4%) patients, of which 18 (62.1%) had bacterial growth. In total, 49 isolates of 14 different bacteria including gram-negative 41 (83.7%) and gram-positive 8 (16.3%) isolates were identified. Of these, 32 (65.3%) were Enterobacteriaceae, 9 (18.4%) were Non-fermenting gram-negative bacilli and 10 (12.2%) were Enterococci. The most common isolates were Escherichia coli (12, 24.5%), Klebsiella pneumoniae (10, 20.4%), Acinetobacter baumannii (5, 10.2%), Klebsiella oxytoca (4, 8.2%) and Enterococcus faecalis (4, 8.2%). The Enterobacteriaceae were either resistance to carbapenems (4, 8.2%) or were extended-spectrum beta-lactamase (ESBL) producing organisms (29, 59.2%). Male sex [p = 0.031], an ASA score ≥ 2 [p = 0.020), administration of general anaesthesia [p = 0.018] and elevated fasting glucose [p = 0.033] were predictive of SSI.The incidence of SSI in this study is comparable to other low- and middle-income countries, but a substantial proportion of these postoperative wounds have an ESBL-producing Enterobacteriaceae. Therefore, routine surveillance of SSI and related antibiotic resistance is required in resource-limited settings. 

/pdf/incidence-and-risk-factors-of-surgical-site-infections-and-1gnhmw08.pdf

Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study

/pdf/incidence-and-risk-factors-of-surgical-site-infections-and-3tnzjlw0.pdf

Constance A. Cummings-John

Papers

Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study

Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study

Constance Agatha Cummings-John: Memoirs of a Krio Leader