ABSTRACT
Historically, infectious diseases have generated fears among populations. Unhealthy handling of these fears result in the stigma and discrimination of infected patients. Globally, measures taken so far by governments to curb the spread of the novel coronavirus disease-2019 (COVID-19) pandemic, although helpful, have created fears in people. Consequently, there are reported Ghanaian media cases of stigmatisation against persons who were infected and recovered from COVID-19. However, these reports remain unsubstantiated. This study, therefore, sought to examine stigma and discriminatory tendencies towards COVID-19 survivors among the adult population in Ghana. This was a population-based cross-sectional study among 3,259 adults. A multi-stage sampling technique was used to recruit study participants. Descriptive and inferential statistics comprising frequency, percentage, chi-square, and multivariable logistic regression were employed in analysing the data. Knowledge on COVID-19 was poor among 33.6% of the participants. Forty-three per cent had a good attitude towards COVID-19. Nearly half (45.9%) exhibited stigma and discriminatory tendencies towards COVID-19 survivors. Participants who had poor COVID-19 related knowledge (aOR = 1.91, 95%CI = 1.59-2.29, p<0.001) and poor attitude towards COVID-19 (aOR = 5.83, 95% CI = 4.85-6.98, p<0.001) were more likely to exhibit stigma and discriminatory tendencies towards COVID-19 survivors. Our study found relatively high proportions of poor knowledge and negative attitudes towards COVID-19. Stigma and discriminatory tendencies were consequently high. Our findings call for increased public education on COVID-19 by the Ghana Health Service and the Information Services Department, to increase the level of knowledge on the pandemic while reducing stigma and discrimination associated with it.
ABSTRACT
BACKGROUND: Maternal, Child Health and Nutrition improvement Project is a World Bank-funded project implemented in all then ten regions of Ghana, which aims at improving access and utilization of community-based maternal, child health, and nutrition services in order to accelerate progress. This study is aimed at determining the implementation status of the project in the Eastern region by evaluating the processes involved and identifying implementation barriers from the perspective of implementors. METHODS: The study was a cross-sectional in design and employed a quantitative data collection approach in ten Community-based Health Planning and Services (CHPS) centres in five districts in the region. The project coordinators and Community Health Officers were interviewed using a structured questionnaire. The project implementation reports at the facility level were reviewed using a checklist. Tertile statistic was used to describe the status of the project implementation. RESULT: The finding from this study indicated "complete implementation status" for maternal, child health, and nutrition activities of the project. However, none of the facilities evaluated had satisfactorily implemented all the governance processes and were therefore rated as "partially complete." The main implementation barriers emerged from the study were related to restrictions placed on the use of project funds and delays in the fund disbursement to CHPS facilities. CONCLUSION: The evidence gathered from the study showed very good implementation status for community-led maternal and child health service delivery, indicative of a positive response to the guidelines by service providers at the periphery and can have positive impact on the project's objectives and goals. Governance component of the project, however, revealed inadequate alignment with guidelines which might have been influenced by the lack of knowledge as a result of lack of training for implementers. This therefore calls for in-service training and improved supportive supervision at both administrative and service delivery levels.