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Antiretroviral therapy (ART) regimens in African countries, including Ghana, are often faced with the challenge of treatment default. To maximize ART utilization and efficiency among people living with HIV (PLHIV), it is pertinent to ensure that ART-related challenges that clients encounter are identified and addressed holistically. A phenomenological qualitative study of thirty participants recruited through the purposive sampling technique was conducted using in-depth interviews from June to July 2021. Independent coding was done using Atlas ti. Sub-themes were developed from the codes, using the most expressive phrases, and grouped under two broad themes, challenges, and opportunities to maximise ART uptake. Ten different challenges, grouped into the health system and individual constraints were reported. Health system constraints included stigmatisation and discrimination by healthcare workers, queuing outside while waiting to be served, long waiting periods, non-communication of laboratory test results to clients, lack of proper education on side effects associated with ART, and language barrier. Individual constraints included financial constraints, perceived non-improvement in health outcomes, food insecurity, and forgetfulness. Opportunities identified for improved ART uptake were assuring ART clients of improved health outcomes, leveraging the good rapport between ART clients and healthcare providers, leveraging the better counselling services offered to PLHIV at the ART clinic, provision of varied ART treatment regimens to clients, routine communication of laboratory test results to clients, and leveraging clients' satisfaction with ART services at ART clinic. We recommend health system reforms targeting healthcare service delivery to PLHIV to encourage linkage, continuity, and retention in care and augmenting ART regimes with financial and nutritional support while encouraging status disclosure to a trusted family member.
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BACKGROUND: Globally, there is a significant unmet need for the rapidly growing burden of Non-Communicable Diseases (NCDs). Ghana has adopted and implemented Wellness Clinics (WC) nationwide to respond to the rising burden of NCDs. Regrettably, very little is known about WCs, including their structure and the services they offer. This study explores the concept of WC, their structure, position within the hospital environment, and services from the perspectives of healthcare providers and clients. METHODS: An exploratory qualitative study was conducted with health professionals (n = 12) and clients (n = 26) of Wellness Clinics in two district hospitals and one regional hospital in a deprived region of Ghana where NCDs are rising. Using the WHO-PEN approach, an interview guide was purposely designed for this study. The data were analysed thematically using Atlas.ti. RESULTS: All three Wellness Clinics were sub-units under the outpatient department. The WC was created by the facilities to respond to the increase in NCDs and to meet annual performance review requirements. The Wellness Clinics provided NCD diagnosis, counselling, and treatment services to approximately 300 clients per week at the facility level. Only one of the WCs provided NCD prevention services at the community level. Integrated NCD care was also provided at the WC, despite the health system and individual-level challenges reported by the health workers and clients. CONCLUSION: The implementation of the Wellness Clinic demonstrates the government's commitment to addressing the increasing burden of NCDs in Ghana through the primary health system. To maximise the impact of the wellness clinics, we recommend developing best practices, providing logistics, and addressing health insurance challenges.
Subject(s)
Noncommunicable Diseases , Primary Health Care , Qualitative Research , Humans , Ghana , Noncommunicable Diseases/therapy , Noncommunicable Diseases/prevention & control , Primary Health Care/organization & administration , Female , Male , Middle Aged , Adult , Ambulatory Care Facilities/organization & administration , Interviews as TopicABSTRACT
BACKGROUND: Little is known about the nexus between online gambling and psychological distress among youth, especially in Ghana. This study aimed to investigate the effects of online sports betting on psychological distress, focusing on depression, anxiety, and stress among young individuals in the Volta region of Ghana. METHODS: A cross-sectional study was carried out at various betting centers in the Volta region of Ghana. Four hundred and three (403) participants were selected using a multi-stage sampling method. The study used a standardized questionnaire to assess psychological distress with the Depression, Anxiety, and Stress Scale (DASS 21) and problematic gambling with the Problem Gambling Severity Index (PGSI). The analysis included both descriptive and inferential methods. These include the implementation of the bootstrap technique within multiple regression models using the current versions of Jeffreys's Amazing Statistics Program (JASP) [0.18.2], Statistical Package for the Social Sciences (SPSS) [29.0.2], and Microsoft Excel (2019). RESULTS: The study found a prevalence of 40% for problematic gambling and 44% for moderate gambling problems among participants, resulting in an overall gambling prevalence of 84%. Regarding psychological distress, the estimated prevalence of depression among participants was 43.6%, with stress reported at 31.1% and anxiety at 68.8%. The overall prevalence of psychological distress was 48%. When analyzing the link between gambling and psychological distress, the study noted that males were more prone to gambling-related psychological distress than females (ß = 2.036, p = 0.025). Furthermore, individuals with problem gambling showed the highest probability of experiencing more significant psychological distress compared to other groups (ß = 9.228, p = 0.002), followed by those with moderate gambling levels (ß = 3.283, p = 0.002). CONCLUSION: We recommend that the mental health unit of the Ghana Health Service, in collaboration with the Gaming Commission of Ghana, should develop youth-friendly interventions to address the prevalence and onset of problematic gambling among the youth, especially males. This could, in turn, reduce the prevalence of psychological distress among youth engaged in online gambling in Ghana.
Subject(s)
Gambling , Psychological Distress , Stress, Psychological , Humans , Male , Ghana/epidemiology , Cross-Sectional Studies , Female , Adolescent , Gambling/psychology , Gambling/epidemiology , Young Adult , Stress, Psychological/epidemiology , Depression/epidemiology , Depression/psychology , Surveys and Questionnaires , Prevalence , Severity of Illness Index , Adult , Anxiety/epidemiologyABSTRACT
Introduction: self-quarantine was one of the key public health interventions in halting the spread of the coronavirus disease (COVID-19) in Ghana. Despite its success, self-quarantine was bridled with challenges across the country, including in the Eastern Region. Consequently, it was pertinent to ascertain these challenges to inform future self-quarantine interventions in the region and the country. The study aimed to ascertain challenges faced by COVID-19 self-quarantined persons in the Eastern Region of Ghana to inform future policies on self-quarantine in the region and the country in general. Methods: thirty-five (35) participants were interviewed in both Twi and English. Following the thematic content analysis approach, Atlas. ti software was used to analyse the data. Relevant quotes were extracted from the transcripts to back the various sub-themes in presenting the results. Results: three global themes emerged from the analyses: socio-economic challenges of self-quarantine (lack of access to essential goods and services, loss of income, and poor housing conditions), health-related challenges (sedentary lifestyle, non-supply of essential personal protective equipment such as face masks, development of oedema and weight gain), and psychological challenges (loneliness, boredom, and anxiety). Conclusion: COVID-19-related challenges self-quarantined persons faced in the Eastern Region of Ghana were multifaceted, ranging from socio-economic, and health to psychological ones. Consequently, emergency preparedness for future pandemic control using self-quarantine as a tool should bring on board various stakeholders to ensure challenges identified in this study are holistically addressed and do not recur.
Subject(s)
COVID-19 , Quarantine , Humans , Quarantine/psychology , COVID-19/prevention & control , Ghana , SARS-CoV-2 , Public HealthABSTRACT
BACKGROUND: Systems of across the world have developed and implemented patient rights policies to protect and improve the provider-patient relationship. The Patient Charter of Ghana was developed in 2002 to improve service quality and protect patients' rights. However, it is not yet known whether those at the frontline of healthcare delivery can read and understand the contents of the charter. While studies have explored the socioeconomic and institutional level factors related to awareness and knowledge of the Patient Rights Charter, there is a lack of literature on its readability and comprehensibility among nurses. This study assesses nurses' knowledge of the Patient Rights Charter and associated literacy-related factors. METHOD: An exploratory cross-sectional design and quantitative methods were used to collect data on knowledge, comprehension, and readability of the Patient Rights Charter. 205 nurses from four district hospitals in the Central Region were recruited using proportional and total enumeration sampling. Data were collected using structured questionnaires and were processed using SPSS (version 26) and an online text readability consensus calculator (version 2.0). Descriptive and inferential statistical analyses were performed, and data were presented using simple frequencies, readability statistics, and regression output. RESULTS: The results show the charter is written at a higher reading grade level; Flesch-Kincaid Grade Level (13.36), Simple Measure of Gobbledygook (11.57), and Coleman-Liau Readability Index (14.2). The average reading grade level score was 14. The Gunning Fox Index (15.40) and the Flesch Reading Ease Score (34%) show the patient charter is difficult to read and will require at least 14 years of education to be able to read. 87.3% of nurses were able to read and comprehend the charter. Very few (8.3%) read at frustration level. Nurses' actual comprehension of the charter was the only significant predictor of knowledge of the charter. CONCLUSION: Comprehension of the patient charter is an important predictor of its knowledge. The results emphasize the need to enhance the readability and comprehensibility of the charter for providers. Hospitals can stimulate nurses' knowledge of the charter by simplifying the charter's language and deliberately educating nurses on its content.
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BACKGROUND: Globally, one of the measures of high performing healthcare facilities is the compliance of patient safety culture, which encompasses the ability of health institutions to avoid or drastically reduce patient harm or risks. These risks or harm is linked with numerous adverse patient outcomes such as medication error, infections, unsafe surgery and diagnosis error. OBJECTIVES: The general objective of this study was to investigate into the impact of patient safety culture practices experienced on patient satisfaction among patients who attend the Kwesimintsim Government Hospital in the Takoradi municipality. METHODS: This study was a descriptive cross-sectional study and a consecutive sampling technique was used to select 336 respondents for the study. Data was collected using a structured questionnaire and processed using Statistical Package for Social Sciences, V.21. Both descriptive and inferential statistics were carried out and result were presented using figures and tables. RESULTS: The study found that the overall patient safety compliance level observed by the respondents was poor (29.2%). The prevalence of adverse events experienced among the respondents was high (58%). The leading adverse events mentioned were medication errors, followed by wrong prescriptions and infections. The consequences of these adverse events encountered by the respondents were mentioned as increased healthcare costs (52%), followed by hospitalisation (43%), worsening of health conditions (41%) and contraction of chronic health conditions (22%). Patient safety cultural practices such as teamwork (ß=0.17, p=0.03), response to error (ß=0.16, p=0.005), communication openness (ß=0.17, p=0.003) and handoffs and information exchange (ß=0.17, p=0.002) were found to positively influence patient satisfaction. CONCLUSION: The poor general compliance of the patient safety culture in the facility is unfortunate, and this can affect healthcare outcomes significantly. The study therefore entreats facility managers and various stakeholders to see patient safety care as an imperative approach to delivering quality essential healthcare and to act accordingly to create an environment that supports it.
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Attitude of Health Personnel , Patient Safety , Humans , Cross-Sectional Studies , Ghana , Patient Satisfaction , Safety Management , Personal SatisfactionABSTRACT
Introduction: the stress associated with hypertension treatment makes using coping strategies inevitable. However, most patients with hypertension apply inefficient coping strategies, leading to uncontrolled blood pressure (BP). The study analyzed coping strategies associated with hypertension treatment and determined how these coping strategies predicted the current BP of patients with hypertension. Methods: the study was a prospective observational cohort conducted between January and December, 2020. Consecutive sampling technique was used to enumerate 508 patients who consistently sought treatment at the healthcare facilities. A sphygmomanometer was used to measure BP to determine controlled and uncontrolled BP based on Ghana Health Service standards. A questionnaire was adapted from Coping Inventory for Stressful Situations-2 to measure patients' coping strategies. Descriptive statistics, cut off percentage and multiple linear regression were applied in analyzing the data at a 0.05 level of significance. Results: females were two-thirds (74%) of the study population and the mean age was 58.40 ± 11.72. All patients with hypertension used the three coping strategies: emotion-oriented coping (EOC), task-oriented coping (TOC) and avoidance coping (AC). However, EOC was highly used (61.2%), followed by TOC (58.5%) and AC (46.2%). Also, the study found coping with treatment regimens to be relatively poor since it was only physical exercise (79.5%) that they effectively observed. The multiple linear regression results revealed that the three coping strategies were significant predictors of current BP levels [F (3, 117) = 12.390 at p < 0.001]. Thus, AC, TOC, and EOC explained 37.4% of the variability of current BP status (R2 adj=0.374). Specifically, patients who use TOC (66.3%) were more likely to have a controlled BP than those using EOC (53.7%) and AC (35.8%). Conclusion: patients' coping strategies were inadequate for hypertension treatment since treatment regimens were poorly observed. Meanwhile, EOC is most likely to negatively affect a patient's treatment, leading to uncontrolled BP. Our study recommends the need to encourage patients to combine their EOC with TOC to enable them control their BP better.
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Hypertension , Female , Humans , Middle Aged , Aged , Ghana , Prospective Studies , Hypertension/drug therapy , Adaptation, Psychological , Blood Pressure , Hospitals , Antihypertensive Agents/therapeutic useABSTRACT
BACKGROUND: The variations in health between rural and urban population have become an increasingly significant public health concern in developing countries including Ghana where urbanization is occurring. Whereas urbanization results in improved access to healthcare services, the concomitant negative consequences of urbanization coupled with unfavorable compositional and contextual attributes can affect the health of populations. The study sought to examine the effect of rural-urban residence and selected socio-demographic factors on perceived health state among aging population by employing a nationally representative data collected by the WHO from 2014 to 2015. METHODS: The data were derived from the WHO Study on Aging wave 2 released in 2019. A total of 4511 individuals, made up of 1018 adults between 18 and 49 years and 3493 respondents within the ages of 50 years and above, were involved in this study. The study examined the Spearman's rho correlations between perceived health, rural-urban residence, age, sex, marital status, ever schooled, current work state, religion, and regional location. Subsequently, the study employed a multivariable ordinal logistic regression model to test the effect of the selected biosocial and contextual variables on perceived health state. RESULTS: The selected socio-demographic variables significantly correlated with health state, except for rural-urban residence. However, the predictive ability of rural-urban residence and the socio-demographic variables on perceived health state were strongly ascertained. It was observed that age, sex, rural-urban residence, and current state of work among aging populations were significant predictors of perceived health state as demonstrated by odds ratios and significant p values. The contextual factor of regional location was the most significant variable that increases the perceived health state of respondents in the study. CONCLUSIONS: Continues engagement in work-related activities, an individual's age within the aging continuum and regional location coupled with its environmental and ecological attributes, may significantly influence the development of positive perception toward health state, which forms a vital constituent of an individual health seeking behavior.
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Aging , Health Status , Adult , Humans , Aged , Ghana , Urban Population , Marital StatusABSTRACT
BACKGROUND: In achieving the WHO's Universal Health Coverage and the Global Developmental Agenda: Sustainable Development Goal 3 and 9, the Ministry of Health launched a nationwide deployment of the lightwave health information management system (LHIMS) in the Central Region to facilitate health service delivery. This paper assessed the efficient use of the LHIMS among health professionals in the Central Region. METHODS: A non-interventional descriptive cross-sectional study design was employed for this research. The study used stratified and simple random sampling for selecting 1126 study respondents from 10 health facilities that use the LHIMS. The respondents included prescribers, nurses, midwives and auxiliary staff. Descriptive statistics (weighted mean) was computed to determine the average weighted score for all the indicators under efficiency. Also, bivariate (χ2) and multivariate (ordinal logistic regression) analyses were conducted to test the study's hypotheses. RESULTS: Findings revealed that the LHIMS enhanced efficient health service delivery. From the bivariate analysis, external factors; sex, educational qualification, work experience, profession type and computer literacy were associated with the efficient use of the LHIMS. However, training offered prior to the use of the LHIMS, and the duration of training had no association. At the multivariate level, only work experience and computer literacy significantly influenced the efficient use of the LHIMS. CONCLUSION: The implementation of LHIMS has the potential to significantly improve health service delivery. General computing skills should be offered to system users by the Ministry of Health to improve literacy in the use of computers. Active participation in the use of LHIMS by all relevant healthcare professionals should be encouraged.
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Health Information Management , Health Services , Humans , Ghana , Cross-Sectional Studies , Health PersonnelABSTRACT
INTRODUCTION: Lesbian, gay, bisexual, transgender, and intersex (LGBTI) and related activities have been a topic of debate and discussion among policymakers and stakeholders, as well as common citizens in the African region, especially in Ghana. The current anti-LGBTI-related bill being put before Ghana's Parliament signifies the intensity of the issue. Even though some studies have looked at some aspects of the issue, no study presently has explored people's opinion on the passage of any future anti-LGBTI and related legislations in Ghana. AIM: This study examined the perspective of tertiary-level students on the passage of anti-LGBTI legislation, as well as the non-physical factors that influence support for the passage of anti-LGBTI and related legislation in Ghana. METHODS: The study employed a quantitative cross-sectional design using 1,001 tertiary-level students. The study used convenience sampling technique with an online closed-ended, structured survey questionnaire as the main data collection instrument. The data was then analysed using Statistical Package for the Social Sciences, version 29 at a 5% significance level. RESULTS: The results of the study indicated that majority of the respondents (81%) were in support of the passage of anti-LGBTI and related legislations. Their reasons included the health implications of LGBTI and related activities (63%), cultural and societal values (62%), religious reasons (54%), and western culture (25%). Also, almost half of the respondents (49%) held that health related perceptions about LGBTI have little or no empirical basis. The inferential analysis, further, revealed that even when age and sex assigned at birth are controlled, perceived health implications of LGBTI (ß = 0.247, p = < .001), religious beliefs (ß = 0.189, p = < .001), and cultural values (ß = 0.218, p = < .001) positively predict the support for passage of anti-LGBTI legislation. CONCLUSIONS: People's level of support for the passage of anti-LGBTI legislation is influenced by several factors including religious beliefs, cultural values, and the perceived health implications of LGBTI. There is, however, the need for policy makers and other stakeholders to create awareness and educate the public about the various perceptions about LGBTI and related activities that are not scientifically legitimate.
Subject(s)
Disorders of Sex Development , Sexual and Gender Minorities , Transgender Persons , Female , Infant, Newborn , Humans , Ghana , Cross-Sectional Studies , StudentsABSTRACT
BACKGROUND: Improving maternal health and achieving universal health coverage (UHC) are important expectations in the global Sustainable Development Goals (SDGs) agenda. While health insurance has been shown as effective in the utilisation of maternal healthcare, there is a paucity of literature on this relationship in sub-Saharan Africa (SSA). We examined the relationship between health insurance coverage and maternal healthcare utilisation using demographic and health survey data. METHODS: This was a cross-sectional study of 195 651 women aged 15-49 y from 28 countries in SSA. We adopted bivariable and multivariable analyses comprising χ2 test and multilevel binary logistic regression in analysing the data. RESULTS: The prevalence of maternal healthcare utilisation was 58, 70.6 and 40.7% for antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC), respectively. The prevalence of health insurance coverage was 6.4%. Women covered by health insurance were more likely to utilise ANC (adjusted OR [aOR]=1.48, 95% CI 1.41 to 1.54), SBA (aOR=1.37, 95% CI 1.30 to 1.45) and PNC (aOR=1.42, 95% CI 1.37 to 1.48). CONCLUSION: Health insurance coverage was an important predictor of maternal healthcare utilisation in our study. To accelerate progress towards the achievement of SDG 3 targets related to the reduction of maternal mortality and achievement of UHC, countries should adopt interventions to increase maternal insurance coverage, which may lead to higher maternal healthcare access and utilisation during pregnancy.
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Maternal Health Services , Sustainable Development , Female , Pregnancy , Humans , Multilevel Analysis , Cross-Sectional Studies , Prenatal Care , Patient Acceptance of Health Care , Health Services Accessibility , Africa South of the Sahara , Insurance Coverage , Maternal MortalityABSTRACT
OBJECTIVE: Although several studies have assessed treatment outcomes of drug-susceptible tuberculosis (TB) in Ghana, very little has been done in the area of multidrug-resistant TB (MDR-TB). The aim of this study was to determine treatment outcomes and associated factors among patients treated for MDR-TB in the Ashanti Region, Ghana. DESIGN: A retrospective, cross-sectional analysis. SETTING: The study was conducted in the Ashanti Region, the second most populous region in Ghana. The regional MDR-TB register, which contains information on all patients with MDR-TB being treated at the various TB centres in the region, was analysed between February and May 2021. PARTICIPANTS: The participants consisted of all registered patients with MDR-TB who were placed on treatment between 1 January 2015 and 31 December 2020. Patients were included in the analysis if their treatment outcome had been assigned. Patients with no record of treatment outcome were excluded from the study. OUTCOME MEASURES: The main outcome variable for the study was MDR-TB treatment outcome, standardised as 'cured', 'treatment completed', 'treatment failure', 'died' and 'lost to follow-up'. A logistic regression model was fitted for factors associated with the outcome measure. RESULTS: Out of 159 patients included in the analysis, 86 (54.1%) were declared cured, 28 (17.6%) completed their treatment successfully, 6 (3.8%) were declared treatment failure, 12 (7.5%) were lost to follow-up and 27 (17.0%) died. The overall treatment success rate was 71.7%. Patients who were female (adjusted OR (AOR)=1.27, 95% CI: 1.18 to 1.39, p=0.023), younger (AOR=0.53, 95% CI: 0.19 to 2.11, p=0.012), had a higher level of education (AOR=1.12, 95% CI: 0.65 to 1.90, p=0.034), had a baseline body mass index of 18.5 kg/m2 or above (AOR=1.57, 95% CI: 1.23 to 2.47, p=0.011) and those who did not have a history of TB (AOR=0.47, 95% CI: 0.10 to 0.75, p=0.028) were more likely to have successful MDR-TB treatment outcomes. CONCLUSIONS: Favourable treatment outcomes for patients with MDR-TB can be achieved in a resource-limited country. Although the recommended WHO target of ≥75% was not met, the current result (71.7% treatment success rate) is still commendable considering all the challenges associated with TB treatment in Ghana.