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This paper provides insights from experiences in data gathering and recruitment from two research projects on disability/mental health in Ghana. The focus of the study explores stigma amongst individuals diagnosed with mental illness and their caregivers. The study investigates the positioning of the researcher in a superior light by participants which often wrests power from those who should be considered the true experts of their own circumstances. Inequality in the interview process thus carried the risk of impacting the quality of the data, as some participants did not consider themselves as 'experts' of their condition. The paper explores strategies for addressing these challenges of hierarchy and inequality in the research process in the Global South. Based on the study, we report on our experiences as follows: (1) ensuring that participants are empowered to engage with researchers; and (2) training local researchers to engage in culturally sensitive research processes. [ABSTRACT FROM AUTHOR]

Many children continue to be sexually abused worldwide. In Ghana, relatively high figures of child sexual abuse (CSA) are reported by the police daily. Although there are laws that seek to protect children from sexual abuse, in reality, there is a wide gulf between legislation and practice. This paper explores why this is so by examining the measures adopted in sanctioning perpetrators of CSA in the Ga community in Ghana. The study uses a qualitative approach to collect data from parents and guardians through in‐depth interviews. The study revealed that, generally, traditional rather than legal sanctions are adopted in handling CSA cases. This paper thus interrogates the consequences of the obvious contraventions of the law as traditional interventions are resorted to. We posit that CSA can be minimised only when child protection laws are enforced by the police and victims are reoriented to appreciate the benefits of seeking legal redress. Key Practitioner Messages: Conscious efforts must be made to destigmatise child sexual abuse.Sensitisation programmes should be organised periodically by stakeholders to educate community members on child sexual abuse.The police in partnership with the media must also lead the campaign to educate the populace that choosing traditional options of redress and non‐disclosure of incestuous acts against children is a clear violation of the law and the rights of the child. [ABSTRACT FROM AUTHOR]

Background: A gender gap exists in knowledge regarding persons living with HIV/AIDS in Ghana. Women living with HIV/AIDS (WLHIV) greatly outnumber males living with HIV/AIDS (MLHIV) in Ghana and Sub-Saharan Africa generally. This necessitates more gender-nuanced evidence-based information on HIV/AIDS to guide individuals, healthcare workers, and other stakeholders in Ghana particularly. This paper undertook a gender-focused analysis of the experiences of WLHIV and MLHIV in a municipal area in Ghana which has been most impacted by HIV/AIDS.Methods: In-depth interviews of 38 HIV-positive persons recruited using combined purposive and random sampling for one month, were tape recorded and analyzed using thematic content analysis. Participants were out-patients who were receiving routine care for co-morbidities at two specially equipped HIV/AIDS Voluntary Counseling and Testing Centers in the Lower Manya Krobo Municipality (LMKM), Eastern Region, Ghana.Results: Our data yielded three major themes: characteristics of participants, health status and health seeking behavior, and challenges encountered living with HIV/AIDS. Except for feeling of sadness due to their HIV/AIDS-positive status, there were significant differences in the experiences of MLHIV, compared to WLHIV. WLHIV were more likely to be housing insecure, unemployed due mostly to stigmatization/self-stigmatization, less likely to have revealed their HIV-positive status to multiple family members, and had more profound challenges regarding their healthcare. Most MLHIV expected, demanded, and had support from their wives; WLHIV were mostly single-never married, divorced or widowed (mostly due to HIV/AIDS). The vast majority of WLHIV complained of near-abject poverty, including for most of them, lack of food for taking their anti-retroviral medicines and/or taking it on time.Conclusions: The experiences of the MLHIV and WLHIV with living and coping with the virus mostly differed. These experiences were unequivocally shaped by differential socio-cultural tenets and gendered nuances; WLHIV had more negative experiences. Public education on the extra burden of HIV/AIDS on WLHIV, more social support, and affirmative action in policy decisions in favor of WLHIV in the study district are needed to seek public sympathy and improve health outcomes and livelihoods of WLHIV particularly. Further studies using multiple sites to explore these differences are warranted. [ABSTRACT FROM AUTHOR]

As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted. [ABSTRACT FROM AUTHOR]

Purpose: With the increasing number of assistance programs that target trafficking survivors around the globe, there is a need for documentation of evidence that can inform such programs. This paper examined and documented the post-intervention experiences of trafficked and vulnerable women who had received services at Lifeline, a residential care facility in Ghana, West Africa. Method: The study employed a secondary qualitative analysis of in-depth, face-to face interviews with n = 37 participants. Data analyzes were conducted using thematic analysis and themes and sub-themes were then extracted. Findings: Three major themes emerged from the study: major achievements after leaving Lifeline; challenges after leaving Lifeline; and family dynamics and relations after leaving Lifeline. Conclusion: Despite experiencing various social, psychological, and economic challenges after the intervention, participants reported that this particular agency had positively impacted their lives. [ABSTRACT FROM AUTHOR]

Aim: To explore the perspectives of individuals living with type 2 diabetes mellitus on the influence of social factors on diabetes self‐management in Ghanaian context. Design: Hermeneutic phenomenological approach to qualitative research was used. Method: A semi‐structured interview guide was used to collect data from 27 participants who were newly diagnosed with type 2 diabetes. Analysis of data was carried out by using content analysis approach. One main theme with five subthemes emerged. Results: Participants experienced social stigma due to the changes in their physical appearance. Mandatory isolation was created by participants in order to manage the diabetes. The financial status of the participants was affected by the diabetes self‐management. Differing from the social issues, the overall participants' responses to experiences living with type 2 diabetes mellitus culminated with psychological or emotional hassles, and therefore, patients resorting to alcohol consumption to deal with diabetes related stress, fears, anxiety, apprehension and pain among others. [ABSTRACT FROM AUTHOR]

Although sub-Saharan Africa has the world's highest rates of early pregnancy, there is little awareness of pregnancy and parenting among young people in out-of-home care in this region. Therefore, this study looked into the experiences of pregnancy and parenting among young women who had been in residential care in Ghana and Uganda. We gathered data from ten parenting care leavers in both countries using semi-structured interviews and then analyzed the data from the interviews thematically. The study's findings revealed that the young mothers had minimal sexual and reproductive health education, as well as a lack of sufficient monitoring, which predisposed them to early pregnancy. The young mothers indicated that emotional stress, financial and employment obstacles, as well as stigma, were some challenges they had experienced. They used personal motivation and spirituality as coping mechanisms to deal with their challenges. Training caregivers to deliver sexual and reproductive health information, having practitioners who will offer supervision during the semi-independent phase of leaving care, and providing separate housing for young mothers are some implications for practice emerging from the study. Policy implications include the need for social inclusion programs to support the academic, vocational, and parenting skills of young mothers who leave care. [ABSTRACT FROM AUTHOR]

Despite advances in human rights and treatments, stigma toward individuals diagnosed with mental illness is common across the African continent. This article explores experiences of stigma and social exclusion among individuals diagnosed with mental illness and receiving treatment in a psychiatric facility in Ghana. The study, based on in-depth, semi-structured interviews generated the following themes: beliefs in spiritual causes of mental illness; spirituality as a coping mechanism; mistreatment and abuse. The findings highlight the significance of social exclusion and spirituality as the main roots of stigma; also the importance of awareness-raising as tools for anti-stigma work in the global South. [ABSTRACT FROM AUTHOR]

Adherence to antiretroviral therapy (ART) remains an important factor in HIV prevention and treatment efforts. We explored the individual and environmental factors influencing antiretroviral adherence among PLWH in Ghana. This study used 20 semi‐structured in‐depth interviews and three focus group discussions (FGD) involving 29 PLWH attending one of three antiretroviral clinics. Thematic analysis covered experiences of PLWH clinic visits, knowledge, attitudes, self‐efficacy related to ART adherence, psychological wellbeing and stigma. The findings suggest that both individual and environmental factors including treatment outcome, coping skills, disclosure, self‐regulation, healthcare‐provider interaction, family and partner support, organization of ART clinics, stigma, and transportation cost influenced treatment adherence. Interventions that empower PLWH and reduce HIV‐related stigma in the community will most likely support antiretroviral adherence. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

Due to stigma, discrimination and economic insecurity, persons living with HIV/AIDS (PLWHAs) are highly vulnerable to housing instability. For instance, PLWHAs are more likely to either remain stable in inadequate homes or change residence. Yet, few studies explore the contexts of housing stability and change among PLWHAs, especially in sub-Saharan Africa, where the majority reside. This study used qualitative in-depth interviews to explore the narratives of 38 PLWHAs on the contexts of housing stability and the circumstances leading to change in residence. On diagnosis with HIV, the majority of PLWHAs (58%) changed housing locations, mostly from bad to worse conditions. Reasons for change include: eviction due to stigma and discrimination, inability to afford rent, quest to hide HIV status and death of a cohabiting partner. Our findings suggest policy makers should pay attention to the deplorable and poor housing conditions of PLWHAs in Ghana. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the emotional experiences of children in selected orphanages. Design/methodology/approach: The study was executed in three orphanages in Accra, Tema and Aburi through the use of semi-structured interviews and observations. Findings: In total, 15 respondents reported some emotional experiences such as loneliness, entrapment, deprivation, rejection and helplessness. Originality/value: The number of children living in orphanages has increased in recent times. Previous studies have examined psychological risk and protective factors among children orphaned as a result of HIV/AIDS and also compared orphan children to non-orphans. Notwithstanding this, little is known about the emotional experiences of children living in orphanages in Ghana. [ABSTRACT FROM AUTHOR]

Global improvements in health care have resulted in improved longevity for the general population, including persons with autism spectrum disorders (ASD). Increasingly, many parents are living with and providing care for their young adults with ASD. Little, however, is known about the experiences of ageing parents of young adults with ASD, particularly in developing countries like Ghana. This study explored the unique experiences of nine ageing parents and their young adults with ASD using semi-structured interviews. Data were analysed using the thematic analysis approach. Findings from the analysis of their responses revealed five themes: psychological exhaustion, future uncertainties, planning for the future, isolation and stigmatization and social support. Findings of this study serve to extend the developmental perspective of caring for caregivers and adult persons with ASD, with implications for designing interventions for such population in developing regions. [ABSTRACT FROM AUTHOR]

Purpose: The study aims to explore the burden of caregiving among mental health nurses providing services to consumers with depression in Ghana. Design and Methods: Interpretative phenomenological design and qualitative data Findings: The study shows that several health system constraints and individual factors contribute to the burden of caregiving among mental health nurses. Health system challenges are the poor state of the psychiatric facility, while individual factors are stigmatizing attitudes, nonadherence to medication instructions, limited family support, and physical and verbal abuse. The coping strategies used by mental health nurses are self‐motivation, emotional boundaries, and the perceived clinical outcomes of treatment. Practice Implications: Clinical policies, procedures, and health facility practices should adequately address caregiving challenges, to facilitate effective mental health services. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore patient and healthcare provider (HCP) perspectives about patients' barriers to the performance of diabetic self‐care behaviours in Ghana. Background: Sub‐Saharan African urban populations are increasingly affected by type 2 diabetes due to nutrition transition, sedentary lifestyles and ageing. Diabetic self‐care is critical to improving clinical outcomes. However, little is known about barriers to diabetic self‐care (diet, exercise, medication taking, self‐monitoring of blood glucose and foot care) in sub‐Saharan Africa. Design: Qualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Methods: Semi‐structured interviews were conducted among 23 people living with type 2 diabetes and 14 HCPs recruited from the diabetes clinics of three hospitals in Tamale, Ghana. Interviews were audiotaped and transcribed verbatim. The constant comparative method of data analysis was used and identified themes classified according to constructs of the theory of planned behaviour (TPB): attitudes/behavioural beliefs, subjective norms and perceived behavioural control. Results: Barriers relating to attitudes included misconceptions that diabetes was caused by spiritual forces or curses, use of herbal medicines, intentional nonadherence, difficulty changing old habits, and feeling or lacking motivation to exercise. Barriers relating to subjective norms were inadequate family support, social stigma (usually by spouses and other members of the community) and cultural beliefs. Perceived behavioural control barriers were poor income levels, lack of glucometers, busy work schedules, long distance to the hospital and inadequate access to variety of foods due to erratic supply of foods or seasonality. Conclusions: Both patients and HCPs discussed similar barriers and those relating to attitude and behavioural control were commonly discussed. Relevance to Clinical Practice: Interventions to improve adherence to diabetic self‐care should focus on helping persons with diabetes develop favourable attitudes and how to overcome behavioural control barriers. Such interventions should have both individualised and community‐wide approaches. [ABSTRACT FROM AUTHOR]

This study investigated psychosocial experiences and coping strategies of caregivers of persons with mental illness in a psychiatric hospital in Ghana. The study adopted a qualitative design in which 20 participants (10 psychiatric nurses and 10 family caregivers) were sampled from the hospital and interviewed. Using thematic analysis, the results showed that stress was common with both psychiatric nurses and family caregivers, which impact on their physical health. Both groups of caregivers reported experiences of stigma, with psychiatric nurses being stigmatized mainly by other health workers whereas family caregivers reported stigma from the public, particularly neighbors. Coping strategies differed between family caregivers and psychiatric nurses, in that nurses mostly used avoidance strategies and humor in dealing with stress and stigma associated with their work whereas family caregivers used emotion-focused coping. The implications of these findings include the need for counseling services to help caregivers manage negative experiences and psychoeducation of caregivers on adaptive coping strategies as well as training strategies targeting the public and healthcare workers on measures to reduce the stigma associated with caring for persons with mental illnesses. [ABSTRACT FROM AUTHOR]

Drawing on Earnshaw and Chaudoir’s HIV stigma framework, this study explored the experiences of persons living with HIV and AIDS regarding stigmatization and discrimination in accessing health services. Using a qualitative research methodology, 42 participants were purposively recruited during support group meetings of persons living with HIV and AIDS (PLWHA) at Amasaman in Accra, Ghana. Four focus group discussions (n= 22) and 10 in-depth interviews were conducted. Discussions and interviews were audio-taped, transcribed, and categorized based on the objectives of the study. The findings indicated that PLWHAs had knowledge of stigma that was experienced through enacted, anticipated, and internalized stigma mechanisms. Evidence showed that PLWHA did not experience stigma and discrimination when they accessed services at the Korle-Bu Teaching Hospital, the largest hospital in Ghana. However, the situation was different when they accessed services at other public health facilities. Based on the findings, implications are discussed for policy, social work, and public health practices. [ABSTRACT FROM AUTHOR]