Search

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]

This paper examines Ghanaian young people's perceptions of the determinants of HIV- and AIDS-related stigma and discrimination, and how these perceptions may influence the de-stigmatisation process. Drawing on findings from an in-depth, multi-method qualitative study involving 104 school and street young people aged between 14 and 19 years, the paper presents young people's accounts of HIV and AIDS. The paper provokes discussion on how language and images associated with existing educational programmes on HIV and AIDS place young people in a dilemma. It also argues that fear and secrecy associated with the disease not only consolidate stigmatisation and discrimination, but also create the desire for retribution. It concludes by challenging health educators to pay particular attention to the language and images used in future educational programmes. [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]

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]

Prior studies show an association between caregiver depression and child health outcomes. There has been little examination of depression among caregivers of HIV-infected children in sub-Saharan countries where pediatric HIV is concentrated. Using baseline data collected in the pediatric HIV disclosure intervention trial, Sankofa, we examined the prevalence and factors associated with depression among caregivers (N = 446) of children infected with HIV in Ghana. Data were analyzed with descriptive and regression analyses. The mean age of the caregivers was 42.2 ± 10.4 years. Eighty percent of the caregivers were female and 59% were HIV-infected. Twenty-eight percent (n = 126) of the caregivers were found to have mild to severe depression. In the adjusted model, factors significantly associated with caregiver depression included: HIV-positive caregiver status (P = 0.04), low income (P = 0.02), lower social support, (P = 0.01), lower HIV knowledge, (P = 0.01), worse HIV illness perceptions (P≤0.001), and greater perceived HIV stigma (P≤0.001). Although we found a high prevalence of depression among our study participants, several of the risks factors identified are modifiable and amenable to interventions that are locally available and affordable. [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]

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]

Objective. To describe the lay meanings of sickle cell disease (SCD) in the Ashanti region of Ghana. Design. Depth interviews with 31 fathers of people with SCD; a focus group with health professionals associated with the newborn sickle cell screening programme, and a focus group with mothers of children with SCD. Results. Whilst there are discourses that associate sickle cell with early or recurrent death, with supernatural undermining of family well-being, and with economic challenges in purchasing medical care, other discourses that value children and other family practices that resist stigma are also in evidence. Conclusion. Lay perspectives on SCD are constructed in the contexts of enduring culture (the high value placed on children); changing culture (medicine and research as available alternative discourses to supernatural ones); altered material circumstances (newborn screening producing cohorts of children with SCD); changing political situations (insurance-based treatment); enhanced family resources (the experience of a cohort of young people with SCD). Above all the praxis of successfully caring for a child with SCD, and the political experience of sharing that praxis, stands in opposition to discourses of death and helps parents resist stigma and despair. [ABSTRACT FROM AUTHOR]

This article compares Ghanaian and Zambian church mobilisation on HIV and AIDS. It analyses why long-term interest in HIV and AIDS has declined in Ghana but increased in Zambia, and why church involvement in promoting access to HIV/AIDS treatment has been less apparent in Ghana than in Zambia. The article uses three levels of analysis - society, state, and international - to explicate these different patterns. The analysis finds that continued HIV/AIDS stigma hampered Ghanaian church activities, while a decline in stigma opened up space for church-related HIV/AIDS responses in Zambia. The elite and professional nature of Ghana's churches promoted early HIV/ AIDS activities, but may have prevented these activities from responding to the needs of people with HIV or AIDS. Overlapping personal networks between civil society and state elites in Ghana urged early HIV/AIDS church-related actions, while state co-optation and civil-society divisions in Zambia limited early HIV/AIDS activities. As Zambian churches built ties to external actors, however, they gained autonomy in their HIV/AIDS responses. In contrast, the fact that Ghana was less incorporated into global HIV/AIDS responses (particularly, the global treatment movement) weakened the long-term interest in HIV and AIDS among the country's churches. The article is based on more than 50 semi-structured interviews with a range of participants affiliated with HIV/AIDS organisations (e.g. church, secular, government, donor) in Zambia and Ghana. [ABSTRACT FROM AUTHOR]