Search

This paper presents findings of a study that explored the challenges and coping strategies of parents of children with mental disorders. In-depth interviews were conducted with 35 parents of children with mental disorders at the Psychiatric Unit of the Komfo Anokye Teaching Hospital in Kumasi. Data were analyzed using thematic content analysis. Findings indicated that financial constraints, inability to secure permanent employment, and stigma were the challenges of the parents. Having faith in God and accepting their children's condition were the coping strategies adopted by the parents. However, lack of effective support system makes coping difficult for the parents. [ABSTRACT FROM AUTHOR]

Integrating consumers' experiences into quality mental health service assessment is relevant to improve service outcomes. Despite this, limited studies have attempted to explore consumers' experiences, particularly in developing countries, such as Ghana. This paper aims to explore consumers' subjective experiences of the quality of mental health services. A qualitative method involving in-depth interviews was used to collect data from 21 consumers of mental health services. Thematic analysis was used to analyse the data, which is discussed using a realistic evaluation approach. The study identifies four themes, 33 inductive codes and 594 references. The themes used to interpret the verbatim narratives are the available mental health services, therapeutic interaction with the professionals, competency and skills of the professionals, and the changes experienced in the consumers' lives. The study indicates that the mental health services aim to provide a range of treatments and medications as well as recovery-oriented services, using mechanisms such as ensuring an effective therapeutic relationship and improving technical competency and skills. The contextual factors and the mechanisms have helped to achieve some changes in the lives of consumers (increased satisfaction, reduced symptoms, improved functionality, feeling normal, improved living skills and self-care, work and capabilities, and social inclusion). The study concludes that policymakers and clinicians should integrate evidence-based recovery services, principles and values into the existing mental health services. The mechanisms used to promote quality of mental health services should be strengthened, through periodic monitoring and evaluation, using approaches such as sensor data capturing, to ensure good coordination and continuity. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) is a key component of efforts to improve sexual and reproductive outcomes for young people. While many governments have established policies and curricula for CSE, there are no quantitative measures of the quality of their implementation in schools. We describe the construction of a school-level index to measure CSE implementation quality using data from Peru, Guatemala, Kenya and Ghana for validation. The composite index represents seven key components of a successful programme: range of topics, values imparted, teaching methods, teacher training, resources available, monitoring and evaluation, and the school environment. These components are combined into two sub-indices (curriculum content and implementation context), which together provide a summary index of implementation quality. We present scores for the seven components, the two sub-indices and the summary index for each country. Ghana scored highest on the summary index, while Guatemala scored lowest, but country rankings varied within the different components. The paper discusses the implications of the findings for improving school-based CSE in these countries. An assessment of the validity and reliability of the index indicates it can be used in other settings and could be a useful tool for educationalists, researchers and programme implementers to measure CSE implementation quality. [ABSTRACT FROM AUTHOR]

The successful implementation of comprehensive sexuality education (CSE) programmes in schools depends on the development and implementation of strong policy in support of CSE. This paper offers a comparative analysis of the policy environment governing school-based CSE in four low- and middle-income countries at different stages of programme implementation: Ghana, Peru, Kenya and Guatemala. Based on an analysis of current policy and legal frameworks, key informant interviews and recent regional reviews, the analysis focuses on seven policy-related levers that contribute to successful school-based sexuality education programmes. The levers cover policy development trends; current policy and legal frameworks for sexuality education; international commitments affecting CSE policies; the various actors involved in shaping CSE; and the partnerships and coalitions of actors that influence CSE policy. Our analysis shows that all four countries benefit from a policy environment that, if properly leveraged, could lead to a stronger implementation of CSE in schools. However, each faces several key challenges that must be addressed to ensure the health and wellbeing of their young people. Latin American and African countries show notable differences in the development and evolution of their CSE policy environments, providing valuable insights for programme development and implementation. [ABSTRACT FROM AUTHOR]

This paper aimed at providing evidence on the variations in HIV prevalence in mining communities in Ghana. Purposive sampling was used for collection of data. Five years records (2011–2015) were reviewed and data on age, sex, date of HIV screening, results and location were extracted from hospital registers and entered electronically for analysis. Findings emerging from this study suggest high HIV prevalence in mining communities in Ghana. This study also identified a decline in routine HIV testing. The study suggests means to tailor public health efforts to improve HIV testing in mining communities. Transactional sexual activities among women and the younger generations may account for the high HIV prevalence according to findings from this study. [ABSTRACT FROM AUTHOR]

Scaling up of integrated tuberculosis (TB)-human immunodeficiency virus (HIV) services remains sub-optimal in many resource-limited countries, including Ghana, where the two conditions take a heavy toll on the financial resources of health systems as well as infected persons. Previous studies have documented several implementation challenges towards TB-HIV service integration, but views of patients on integrated service delivery have not received commensurate research attention. This paper explored the experiences of 40 TB-HIV co-infected patients at different stages of treatment in Ghana. Using Normalisation Process Theory as a framework, data were coded using inter-rater coding technique and analysed inductively and deductively with the help of QSR NVivo 10. For several participants, either of the diseases was diagnosed ‘accidentally’, leading to inconsistencies in co-therapy administration, constraints regarding separate clinic appointment dates for TB and HIV and prolonged TB treatment due to treatment failure. Put differently, there were widespread negative experiences among TB-HIV co-infected patients with regard to treatment and care, especially among patients who were accessing care in separate facilities or separate units in the same facility. Co-infected patients unanimously support full-service integration. However, they felt powerless to request for reforms on a mode of service delivery. [ABSTRACT FROM AUTHOR]

There have been few assessments of sexual and reproductive health (SRH) education programmes in sub-Saharan Africa from the students' and educators' perspective. This study examined students' opinions on an SRH programme in northern Ghana and explored the facilitators and barriers for educators regarding the implementation of the programme. The sample comprised 147 students and 3 educators. Questionnaires were used to collect data from students, and semi-structured interviews were conducted with educators. According to the students, the SRH programme was both important and interesting. Their expectations were moderately well met. They agreed that the main objectives of the programme and most of the objectives regarding the ‘family planning’ sessions had been achieved. Significant differences were found for school type, age and religion, but not for gender. For the educators, important facilitators were a clear manual, the presence of foreign volunteers working as educators, the increased influence of new media, students' eagerness to learn, and the feeling that the SRH programme really benefited students' lives. Important barriers were traditional and cultural influences, lack of funding and poor scheduling of the programme within the schools. The paper concludes by offering recommendations regarding the implementation of future SRH programmes in Ghana. [ABSTRACT FROM PUBLISHER]

The use of mobile phone and factors influencing usage have least been explored in spite of its relevance in mHealth adoption. We conducted a descriptive exploratory study to evaluate the use of mobile phone alarm application, text messaging and voice call among HIV positive clients. We randomly selected 362 respondents who were 18–65 years and receive care from two health facilities in Accra, Ghana. Questionnaires were administered and data analysed to describe and predict mobile phone use. SPSS version 20 was used to process data for analysis. Findings revealed respondent (n = 338, 93%) did not share their mobile phones. Voice call was predominantly used (n = 227, 63%) while text messaging and mobile alarm functions were sparingly used. Majority (n = 285, 78.9%) did not use the mobile phone application to support adherence. Age and employment predicted the use of mobile phone alarm (OR ± 1.56, p < 0.05), test messaging (OR ± 1.48, p < 0.05) and voice calls (OR ± 1.25, p < 0.05). We observed that younger age and employment influence the use of mobile phones. Voice calls are more acceptable because it is simple and easy to use. Knowledge and persuasion are fundamental to mobile phone literacy skills development and should be integrated in mHealth interventions. [ABSTRACT FROM AUTHOR]

Sexual behavior among youths has been a focus of health programmes worldwide. Risky sexual behaviors among youth in sub-Saharan Africa (SSA) predispose them to HIV infection. The current study determined the predictors of risky sexual behavior among students aged 15–24 years in the Suhum Municipality, Ghana guided by the Health Belief Model (HBM). The study employed a cross-sectional design, collecting data using a structured pretested questionnaire and analyzing them using SPSS version 20 software program at the level 0.05. The overall prevalence of risky sexual behavior was 59.1% among the participants. None of the constructs of the HBM was statistically associated with risky sexual behavior. However, participants who perceived that they were at risk of contracting HIV and who perceived HIV/AIDS to have severe consequences were more likely to practice safe sexual behavior. Health promotion programmes should aim at increasing youths' perception of the threat posed by HIV/AIDS. [ABSTRACT FROM AUTHOR]

Identification of national research agendas for mental health and disability can be supported by well-designed research priority-setting studies. Few low- and middle-income countries (LMICs) have undertaken such studies. To identify mental health and disability research priorities in Ghana. A mixed methods study comprising a rapid review, research priority ranking survey, and research capacity needs assessment survey was employed. Participants in the surveys included five expert pools identified from online search and existing database on mental health civil society organisations/non-governmental organisations. The research priority ranking was completed in two stages, using the Child and Nutrition Research Initiative (CHNRI) method to identify priority questions for immediate and short term (0 to 5 years) and medium to long term (>5 years) in stage two. Both surveys were deployed online using google forms. Analysis for the ranking survey involved computing total scores from the CHNRI criteria and generating ranks for the research questions. A total of 68 experts (97% response rate), generated 94 and 92 questions for the short and long term, respectively. Forty experts (58% response rate) completed the ranking stage. The top 10 ranked research questions included: 4 questions addressing health systems; 2 questions on epidemiology; and 4 questions on interventions. All research questions were considered urgent and should be conducted in the immediate to short term (0–5 years). The methodological capacity of researchers to conduct disability and mental health research is weak. Our approach has generated an agenda for mental health and disability research priorities for Ghana and demonstrated that it is feasible to employ a systematic methodology for research priority setting that includes key parameters of context and research capacity. [ABSTRACT FROM AUTHOR]

Introduction: There is growing evidence that group-based mental health intervention programmes can encourage the development of peer support, psychosocial skills, and collaborative therapeutic relationships with longer lasting effects. This study explored participants' experiences of, perceived benefits of, and recommendations to improve a 10-session group-based multicomponent positive psychology intervention (mPPI)—the Inspired Life Programme (ILP)—designed to promote positive mental health and reduce symptoms of depression and negative affect in a sample of rural Ghanaian adults. Method: Face-to-face semi-structured individual interviews were conducted with 18 randomly selected programme participants three months after their participation in the ILP. Data were analysed thematically with an inductive approach. Results: Participants described their experience of the ILP as a forum for growth that granted them the opportunity to introspect, practicalise and situate everyday life challenges, connect with others, and to develop a sense of mutual accountability. Results indicate that the ILP led participants to develop a stronger sense of positivity and well-being, fructify their ideas, and to cultivate stronger social networks and relationships that led to increased vocational productiveness. Participants recommended that researchers include facets of physical health promotion in the programme and invite close relations of participants to participate in the programme. Conclusion: This study provides the first insight into participants' experiences of a group-based mPPI in Ghana. These findings may provide useful information to inform the design of context-appropriate community-based mental health interventions to fit participants' specific needs, capacities, and circumstances. [ABSTRACT FROM AUTHOR]

The objectives of this study were to assess the nutritional status and the most commonly reported nutrition-related factors contributing to nutritional risk in people living with HIV/AIDS (PLWHA) in Ghana and the specificity and sensitivity of the Rapid Nutrition Screening for HIV disease tool (RNS-H) in this population. A cross-sectional design was utilised. Patients were screened for nutritional status during a one-week period by clinic nurses using the RNS-H. Results were compared with a comprehensive nutritional assessment by a dietitian. The research was conducted in a public health clinic at the University of Ghana Hospital, Legon. Patients receiving care at the clinic were asked to participate. The nutritional screening and nutritional assessment both resulted in participants being assigned to one of three nutritional statuses: 'low risk', 'at risk' and 'high risk'. The association between the nutritional screening and nutritional assessment was measured. The results of the nutritional status assigned by the RNS-H and nutritional assessment were compared. A total of 51 patients participated. A high prevalence of nutritional risk based on the RNS-S (54.9%) was found with 33.3% of the sample being malnourished. The most common nutrition-related complications were food insecurity, poor appetite, weight loss and diarrhoea. The RNS-H was found to have a strong specificity and sensitivity in a sample of Ghanaian PLWHA. Because of the nutritional risk and complexity of HIV in Ghana, nutritional screening using the RNS-H and nutrition care by a dietitian should be a standard of care. [ABSTRACT FROM AUTHOR]

While the role of evidence-based public health in improving health outcomes is frequently touted, there remains a dearth of research examining the use of evidence in public health service particularly in low- and middle-income countries. Therefore, the aim of this research was to examine the use of evidence in local public health service in Ghana, a lower middle-income country. Semi-structured in-depth interviews were conducted with local health managers from 11 District Directorates of Health in Ashanti Region. Three organising themes emerged from the interview transcripts: understanding of evidence-based public health; the process of using evidence; and the value of evidence in public health practice. The study suggests that though evidence-based practice was not new to the local health managers, its application was very low. The process of using evidence commenced with making a decision about the direction of a programme which had been already prioritised and planned by other high-level actors and then various sources of information, including available research evidence, were used to justify the decision. The study has revealed that there is an urgent need for pre-service and in-service training programmes that build and maintain common skill sets and language among local public health practitioners in Ghana to accomplish evidence-based public health goals. Similarly, giving local health managers flexibility to prioritise and make decisions would result in increased uptake of evidence in local public health service. [ABSTRACT FROM PUBLISHER]

Women in their reproductive years make up about 50% of all HIV-positive persons globally. These women, just as their HIV-negative counterparts, wield the right to procreate. However, HIV infection and lack of appropriate information on reproductive options may negatively impact women's procreative decision-making. This study assessed fertility intentions of HIV-positive women receiving antiretroviral therapy (ART) in southern Ghana. Quantitative methods were used to collect data from HIV-positive women receiving ART at four treatment centers. HIV-positive aged 18–49 years, and receiving ART were selected using systematic random sampling technique. Three hundred eighteen women were interviewed after informed consent. We used univariate analysis to generate descriptive tabulations for key variables. Bivariate analysis and logistic regression modeling respectively produced unadjusted and adjusted associations between background attributes of respondents and their childbearing decision-making. All analyses were performed using IBM SPSS Statistics for Windows, Version 20.0. Irrespective of age, reproductive history, and duration of HIV diagnosis, 46% of the women were desirous of procreating. The bivariate level analysis shows that women in their late reproductive ages (30–39 years) had the strongest desire to procreate (p< 0.001). After controlling for a number of covariates, primiparous and secundiparious women were about twice as likely to desire children (aOR = 2.553; 95% CI 1.480–4.401), and so were women aged 30–39 years (aOR = 2.149; 95% CI 1.202–3.843). Of 54% women who do not wish to procreate, achievement of desired family size (64.3%) was more popular a reason than fear of vertical transmission of HIV (7.5%), poor health status (5%), and pregnancy-related complications (1.6%). [ABSTRACT FROM AUTHOR]

The objective of this research was to explore the context of abortion stigma in Ghana and Zambia through qualitative research, and develop a quantitative instrument to measure stigmatizing attitudes and beliefs about abortion. Ultimately, we aimed to develop a scale to measure abortion stigma at the individual and community level that can also be used in the evaluation of stigma reduction interventions. Focus group discussions were conducted in both countries to provide information around attitudes and beliefs about abortion. A 57-item instrument was created from these data, pre-tested, and then administered to 531 individuals (n = 250 in Ghana and n = 281 in Zambia). Exploratory factor analyses were conducted on 33 of the original 57 items to identify a statistically and conceptually relevant scale. Items with factor loadings >0.39 were retained. All analyses were completed using Stata IC/11.2. Exploratory factor analysis resulted in a three-factor solution that explained 53% of the variance in an 18-item instrument. The three identified subscales are: (i) negative stereotypes (eight items), (ii) discrimination and exclusion (seven items), and (iii) potential contagion (three items). Coefficient alphas of 0.85, 0.80, and 0.80 for the three subscales, and 0.90 for the full 18-item instrument provide evidence of internal consistency reliability. Our Stigmatizing Attitudes, Beliefs, and Actions scale captures three important dimensions of abortion stigma: negative stereotypes about men and women who are associated with abortion, discrimination/exclusion of women who have abortions, and fear of contagion as a result of coming in contact with a woman who has had an abortion. The development of this scale provides a validated tool for measuring stigmatizing attitudes and beliefs about abortion in Ghana and Zambia. Additionally, the scale has the potential to be applicable in other country settings. It represents an important contribution to the fields of reproductive health, abortion, and stigma. [ABSTRACT FROM AUTHOR]