RESUMO
Background: The global health sector strategy on viral hepatitis aims to reduce new hepatitis B infections by 90% by 2030. Yet, hepatitis B birth dose (HepB-BD) vaccination, which is effective in preventing mother-to-child transmission of hepatitis B, remains low in sub-Saharan Africa. Given the essential role that midwives play in infants' birth dose immunisation, we explore their perspectives on the reasons for delays and non-administration of HepB-BD to eligible neonates in Ghana. Methods: We conducted interviews with 18 midwives, stratified by region (Greater Accra and Northern regions). Participants were selected purposively. The data were transcribed, coded, and analysed following the Braun and Clarke data analysis procedure. Results: The participants conveyed a broad range of barriers to HepB-BD vaccination in Ghana. These include the mother's denial of hepatitis B seropositivity; the mother's ignorance of the impact of hepatitis B on their newborn; partners' non-involvement in post-test counselling; and the high cost of hepatitis B immunoglobulin and hepatitis B monovalent vaccine. Other reasons included vaccine unavailability and midwives' oversight and documentation lapses. Conclusion: We recommend educating expectant mothers on the importance and effectiveness of HepB-BD vaccination during antenatal care (ANC) visits, as well as educating midwives on HepB-BD vaccination procedures. In addition, ensuring sufficient supplies and administering hepatitis B vaccines in the delivery ward should be done to guarantee that babies receive the vaccines on time. Importantly, Ghana needs policies that require HepB-BD vaccination as part of the Expanded Programme on Immunisation (EPI) to ensure the investments and funding it needs.
RESUMO
Hepatitis B remains a public health concern in Ghana, with an estimated prevalence of 8.4% in adults and 14.3% in adolescents. This study explored the cognitive and emotional illness representations of persons with chronic hepatitis B who sought care at a tertiary hospital's liver clinic in Ghana. A qualitative exploratory descriptive design was adopted, and 15 participants were purposefully chosen for in-person interviews. The data was analyzed using the content analysis procedure. The findings revealed that participants' cognitive representations of hepatitis B infection varied. Some believed they got the infection through unsafe sexual practices, while others thought it was from their mother or spiritual sources. Participants' predominant emotional representations included shock, confusion, and fear. Education about the causes and management of hepatitis B should be addressed as part of patient care.
