Breastfeeding in Primary Healthcare Setting: Evaluation of Nurses and Midwives Competencies, Training, Barriers and Satisfaction of Breastfeeding Educational Experiences in Northern Ghana.

BACKGROUND: Breastfeeding education is critical in improving healthcare professionals' competencies in providing breastfeeding care to mothers. We evaluated breastfeeding competencies, training, barriers and satisfaction of breastfeeding educational experiences among nurses and midwives in the Sagnarigu Municipality, Ghana. METHODS: This cross-sectional study included nurses and midwives providing maternal and child health services at various primary healthcare facilities in Sagnarigu Municipality. RESULTS: Nurses and midwives had higher pre-service breastfeeding training than in-service training with a mean training score of 10.0 and 5.2, respectively. Nurses and midwives who had both pre-service and in-service training had better satisfaction score (P = .003), positive attitudes (P = .016) and higher confidence level about breastfeeding (P = .007). Approximately, 80% of the nurses and midwives reported that they need further training/updating on breastfeeding while 40% reported clinical/professional practice as the significant contributor to their breastfeeding counselling competencies. Mean satisfaction score correlated positively with confidence levels about breastfeeding counselling (r = .224, P = .022) and pre-service training (r = .342, P < .001); confidence levels about breastfeeding counselling also correlated positively with attitudes towards breastfeeding counselling (r = .348, P < .001). Commonly reported barriers to breastfeeding counselling were mother's poor compliance with breastfeeding recommendations, too much workload, inadequate time and materials for breastfeeding counselling. CONCLUSION: Nurses and midwives in this study felt confident about breastfeeding counselling, had positive attitudes towards breastfeeding counselling and generally, satisfied with their breastfeeding educational experiences. Despite nurses and midwives agreeing that breastfeeding counselling is integral in their professional practice, their role in providing breastfeeding counselling is hindered by individual and health systems barriers.

Assessing the knowledge of expectant mothers on mother-to-child transmission of viral hepatitis B in Upper West region of Ghana.

BACKGROUND: Viral Hepatitis B is of a major public health concern globally, especially in developing countries. Expectant mothers' knowledge of Mother-To-Child Transmission (MTCT) of the disease is significant in preventing the spread from an infected mother to her child. This study sought to assess the expectant mothers' knowledge of Mother-To-Child Transmission of viral hepatitis B in the Wa Municipality and Lawra District of Upper West Region, Ghana. METHODS: A descriptive cross-sectional study with a multi-stage sampling technique was employed to select a total of 450 study respondents (expectant mothers), and a semi-structured questionnaire was used for the data collection. Respondents were interviewed using face-to-face interview technique. RESULTS: Majority (54.0%) of the respondents were aged between 25 and 35 years and the results were similar in both districts. Overall, 62.4% (281/450) of the respondents had at least Junior High level education, and 76.2% (343/450) were multigravida. Educational levels among respondents in the two areas were above 50.0% and considered relatively high. Respondents' general knowledge of hepatitis B infection and disease was 46.0% (208/450). However, there was a slight difference between the two districts (40.1% in Lawra District and 51.6% in Wa Municipality). The overall knowledge level on MTCT of viral hepatitis B among the respondents was 34.7% (156/450): the Wa Municipality recorded higher knowledge (43.3%) compared to 24.8% in Lawra District. CONCLUSION: The knowledge level of the expectant mothers on MTCT of viral hepatitis B is relatively low in Upper West Region, Ghana. Majority of the respondents had some form of formal education. The age, marital status, education, occupation, gravity and family setup were found to be associated with knowledge of Hepatitis B infection and MTCT. Thus, there is urgent need to intensify efforts of health staff to educate expectant mothers. In addition, home education and outreach activities should be intensified on HBV infection as well as MTCT. Consequently, planning, implementation and execution of preventive activities, especially in the antenatal clinics should critically consider the social and demographic variations of mothers.

Treatment Outcome of Severe Acute Malnutrition Cases at the Tamale Teaching Hospital.

Objective. This study investigated the treatment outcomes and determinant factors likely to be associated with recovery rate. Methods. A retrospective chart review (RCR) was performed on 348 patients who were enrolled in the outpatient care (OPC) during the study period. Results. Of the 348 cases, 33.6% recovered (having MUAC ≥125 mm), 49.1% defaulted, and 11.5% transferred to other OPC units to continue with treatment. There were 187 (53.7%) males and 161 (46.3%) females with severe malnutrition. The average weight gain rate was 28 g/kg/day. Controlling for other factors, patients who completed the treatment plan had 3.2 times higher probability of recovery from severe acute malnutrition (SAM) as compared to patients who defaulted (adjusted odds ratio (AOR) = 3.2, 95% CI = 1.9, 5.3, and p < 0.001). The children aged 24-59 months had 5.8 times higher probability of recovery from SAM as compared to children aged 6-11 months (AOR = 5.8, 95% CI = 2.5, 10.6, and p < 0.001). Conclusions. Cure rate was low and the default rate was quite high. Children who were diagnosed as having marasmus on admission stayed longer before recovery than their kwashiorkor counterparts. Younger children were of greater risk of nonrecovery.