Adjustment and coping in spousal caregivers of cervical cancer patients in Ghana: A qualitative phenomenological study.

Cervical cancer is a common and significant health issue for women worldwide. To address the dearth of research on male partners' experiences when their significant others are diagnosed with cervical cancer, we aim to explore the unique challenges and perspectives encountered by men in these circumstances. The study adopted interpretive phenomenological analysis to qualitatively assess the experiences of males with partners diagnosed of cervical cancer. A phenomenological research design with purposive sampling technique was used to recruit and collect data from 38 participants until saturation occurred. Face to face interviews were conducted using a developed semi-structured interview guide. The data collected was analyzed using content analysis after verbatim transcription was done. The study resulted in the identification of 2 main themes, and 10 subthemes. These themes focused on the multifaceted impact of cervical cancer on spousal caregivers' lives and the coping and support mechanisms utilized by spouses of cervical cancer patients. The findings indicated that men faced several challenging experiences as a result of their spouses' condition and revealed the strategies they employed to cope with the stress of caring for their wives. Almost every man adopted a strategy to cope with the condition of their wives. This study would assist other men to understand the psychological, social, emotional, and spiritual experiences the men went through to appreciate and adopt their coping strategies whenever they go through such challenges.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: A scoping review.

BACKGROUND: Over the past three decades, research studies on nurses' engagement in evidence-based practice (EBP) have been widely reported, particularly in high-income countries, with studies from these countries dominating literature reviews. As low- and middle-income countries (LMICs) continue to join the EBP movement, primary research has emerged over the past decade about nurses' engagement with EBP. AIMS: The aim of this scoping review was to identify the types and extent of published research regarding nurses' knowledge, skills, attitudes, beliefs, and implementation of EBP in LMICs. METHODS: The JBI scoping review methodology was used. Eight databases were searched up to November 2023. The review included primary studies (quantitative, qualitative, and mixed methods) that reported the knowledge, skills, attitudes, beliefs, or implementation of EBP among nurses in LMICs. Included studies focused on registered nurses in all healthcare settings within LMICs. Studies published in English were included with no limit on publication date. Two independent reviewers screened titles, abstracts, and full-text articles of published studies. Data were analyzed quantitatively using frequencies and counts. Textual data from qualitative studies were analyzed using descriptive content analysis. RESULTS: Fifty-three publications were included, involving 20 LMICs. Studies were published between 2007 and 2023, with over 60% published in the past 7 years. Studies that evaluated familiarity/awareness of EBP showed that in general, nurses had low familiarity with or awareness of EBP. Most studies (60%) described nurses' attitudes toward EBP as positive, favorable, or high, and 31% as moderate. However, over 60% of studies described nurses' EBP knowledge/skills as moderate, low, or insufficient. Approximately 84% of studies described EBP implementation in healthcare settings as moderate, low, poor, or suboptimal. LINKING EVIDENCE TO ACTION: Studies on nursing EBP have been increasing in LMICs for the past two decades, with findings highlighting opportunities for advancing EBP in nursing within LMICs. Health systems and healthcare organization leaders in LMICs should equip nurses with EBP knowledge and skills while providing the needed resources and support to ensure consistent implementation of EBP to improve health outcomes.

Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana.

Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviors for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.

Nutritional Challenges among African Refugee and Internally Displaced Children: A Comprehensive Scoping Review.

BACKGROUND: Children's nutrition in Africa, especially among those displaced by conflicts, is a critical global health concern. Adequate nutrition is pivotal for children's well-being and development, yet those affected by displacement confront distinctive challenges. This scoping review seeks to enhance our current knowledge, filling gaps in understanding nutritional and associated health risks within this vulnerable population. OBJECTIVE: We conducted a scoping review of the literature on the nutritional status and associated health outcomes of this vulnerable population with the goal of informing targeted interventions, policy development, and future research efforts to enhance the well-being of African refugee and internally displaced children. METHODS: This scoping review adopted Arksey and O'Malley (2005)'s methodology and considered studies published between 2000 and 2021. RESULTS: Twenty-three published articles met the inclusion criteria. These articles highlighted a wide variation in the levels of malnutrition among African refugee/internally displaced (IDP) children, with the prevalence of chronic malnutrition (stunting) and acute malnutrition (wasting) ranging from 18.8 to 52.1% and 0.04 to 29.3%, respectively. Chronic malnutrition was of 'high' or 'very high' severity (according to recent WHO classifications) in 80% of studies, while acute malnutrition was of 'high' or 'very high' severity in 50% of studies. In addition, anemia prevalence was higher than the 40% level considered to indicate a severe public health problem in 80% of the studies reviewed. CONCLUSION: In many settings, acute, chronic, and micronutrient malnutrition are at levels of great concern. Many countries hosting large, displaced populations are not represented in the literature, and research among older children is also lacking. Qualitative and intervention-focused research are urgently needed.

Unveiling contextual influences of maternal satisfaction with labour care services in Nigeria: A qualitative inquiry.

BACKGROUND: In light of the rising global effort to lower maternal mortality rates, it is crucial for low- and middle-income countries with poor maternal indices to investigate the problem of maternal satisfaction and the key elements that affect it. To this effect, this study explored the experiences of postnatal women in relation to labour services and investigated the factors that contribute to their overall satisfaction. AIM: The study set out to explore factors influencing maternal satisfaction with labour care services in Ogbomoso, Oyo State, Nigeria. This study ultimately seeks to advance our understanding of this phenomenon to impact labour care and policy. SETTING: The study was conducted among multiparous women who had their antenatal care and delivery in Ogbomoso, Oyo State, Nigeria. METHODS: A qualitative study was performed using in-depth interviews among postnatal women. RESULTS: The results revealed a number of variables that could affect the women's satisfaction with labour care, including the choice of health facility, healthcare providers, environment of the facility, assurance of privacy, treating patients with dignity, provision of needed amenities and having a well-planned postnatal care assessment. CONCLUSION: The study revealed that the costs of care, the skill of the caregiver, the provision of confidential and dignified care, and the availability of supplies all have an impact on maternal satisfaction. Hospital administration should address these issues to enhance the experience of women and labour care services.Contribution: The study's findings provide insights that will inform strategies to improve the quality of care being provided to parturients in Nigeria.

Experiences of persons with lower limb amputation after prosthetic rehabilitation in Ghana: A qualitative inquiry.

BACKGROUND: Lower limb amputations (LLAs) have long been associated with physical, social, and psychological consequences. Individuals with LLAs have challenges with mobility and often become isolated from their social networks. Disability rehabilitation technologies such as prosthetic devices are used to improve the mobility capabilities of lower limb amputees. To improve clinical outcomes, feedback from the prosthetic users is a key element to consider. OBJECTIVES: The study sort to explore the experiences of lower-limb prosthetic users after prosthetic rehabilitation in a prosthetic and orthotic rehabilitation center in the Eastern Region of Ghana. STUDY DESIGN: This study adopted an exploratory descriptive qualitative study design. METHODS: A purposive sampling technique and semistructured interview guide was used to interview 17 participants by the first author. The social model of disability underpinned the study. Lower-limb prosthetic users (≥18 years) with unilateral LLA attending outpatient follow-up at a prosthetic and orthotic rehabilitation center were recruited. The interviews were audio recoded, transcribed verbatim, and analyzed using the procedure for thematic content analysis by Braun and Clarke (2013). RESULTS: Participants reported injuries and tingling in their residual limb. Internal stigma resulting from negative comments and labeling from the public were reported. Prosthetic users experienced empathy and being treated as weaklings by their family/peers. Participants avoided relationships because of recurrent rejection, embarrassment, fear of sexual abuse, and exploitation. As a coping method, some participants chose to isolate themselves to avoid humiliation and public disgrace. Other coping mechanisms included watching television, listening to music, conversing with others, ignoring criticism, and having faith in God. CONCLUSION: Participants' narrative in this study gave insight into the varied lived experiences on the individual level, family/peer level, and the coping mechanisms used. Challenges relating to discomfort from the prosthesis, internal stigma, relationship avoidance, and altered sexual life should be given much attention and used in implementing initiatives to improve clinical outcomes.

"The Health Caregivers Did Not Care about Me after the Loss": Maternal Experiences of Perinatal Loss in the Kumasi Metropolitan Area, Ghana.

One of the common undesirable outcomes of pregnancy is perinatal loss. Healthcare systems strive to reduce the incidence of perinatal loss but typically little attention is on the experiences of bereaved mothers following perinatal loss, particularly in low and middle-income countries where such deaths are common. This research explored the lived experiences of mothers with perinatal loss in the Kumasi metropolis, Ghana. A qualitative design was used to explore the experiences of nine (9) bereaved mothers from the Komfo Anokye Teaching Hospital's postnatal ward and the Mother and Baby Unit. Data were collected through face-to-face interviews using a semi-structured interview guide, audio-recorded, and thematically analyzed. One major finding was that mothers restricted mourning their dead babies based on fear of recurrent perinatal loss and traditional beliefs on delayed return to fertility. Mothers blamed healthcare providers for their loss due to their concerns about care received. Gaps in communication flow from healthcare professionals to bereaved mothers were commonly identified as mothers struggled to make meaning of their loss and coped with cultural restrictions and beliefs. Healthcare professionals must explore mothers' concerns and "gut-feelings," and pay attention to their communication needs following perinatal loss.

Female students' perspectives on cervical cancer screening inclusion in pre-admission university requirements in Ghana.

Cervical cancer is a huge contributor to cancer-related deaths and the commonest gynecological cancerous growth among women globally. Nevertheless, evidence suggests that cervical cancer incidence and mortality could be reduced through early diagnosis. Regardless of the accessibility of cervical cancer screening in Ghana, low reports of cervical screening had been recorded among female students and women in Ghana. The study objectives were to explore.Female students' opinions on the inclusion of cervical cancer screening in the pre-university admission screening requirement in Ghana. The facilitators and barriers to cervical cancer screening among female University students.Qualitative exploratory-descriptive design was employed for the purpose of this study. The target population was female students in a public university in Ghana who were purposively selected. Content analysis was employed for the data analysis. In all, 30 female students were selected to engage in face-face interviews using a semi-structured interview guide. Two categories and seven sub-categories were generated from the study analysis. It was interesting to know that majority 20 (66.66%) of the students supported adding CCS to the preadmission screening requirement with few refuting it. Others also recommended compulsory screening as a means of enhancing screening practices. The reasons for refusing this proposal by a few 10 (33.3%) of the participants were it being burdensome, time-consuming, and capital intensive. Other reasons for refusing it were sexual inactiveness following the screening, fear of discomfort, and the screening results. In conclusion, the study found that students were willing to undergo CCS if made mandatory for admission and suggested it be included in pre-admission screening requirements to encourage more Ghanaian women to participate. As CCS is effective in reducing cervical cancer incidence and burden, the proposal of including it in pre-university screening should be considered to increase uptake.

Hot fomentation of newborn fontanelles as an indigenous practice in Ghana: implications for policy and integrated community-based health care in Covid-19 pandemic and beyond.

OBJECTIVE: African newborns undergo numerous traditional and religious practices ranging from fontanelle fomentation to total head shaving, scalp molding, skin scarification and ano-genital irrigation which can negatively impact the health of neonates. Hot fomentation of fontanelles has been a predominant indigenous home-based postnatal practice in Ghana and among Africans in the diaspora. Mobility restrictions during the Covid-19 pandemic has impacted direct access to facility-based care as well as home care. The flourishing of newborn traditional practices among African populations during this Covid-19 pandemic offers opportunities to rethink the provision of family healthcare support for newborns during the ongoing pandemic and beyond. Hence, the aim of this critical review was to examine and describe a common indigenous practice-hot fontanelle fomentation to inform home birth support, discharge planning, and the delivery of optimal home-based care support. STUDY DESIGN: This study is a review of literature on hot fomentation of newborn fontanelles. METHODS: Literature search in CINAHL, PubMed, African Index Medicus and Scopus, was conducted and evidence synthesised from articles ranging from 1983-2022. Sixty articles were reviewed; however, 10 manuscripts were excluded prior to screening. The other 19 were exempted because they were either below 1983 or were not the best fit for the study purpose. In all, 31 studies were included in the study. The study was guided by Madeleine Leininger's Culture Care Diversity and Universality care theory. RESULTS: The current study identifies hot fomentation of newborn fontanelles practices in Ghana, the description of hot fomentation practices and the dangers associated with it. The findings and suggested ways to help overcome this challenge. CONCLUSION: There are several neonatal indigenous practices including fontanelle fomentation which pose threat to the health of the neonate as discussed in this study. Future research needs to investigate innovative ways of fontanelle fomentation where necessary instead of the use of hot water by mothers, especially in this Covid-19 pandemic where health and mobility restrictions impact physical access to timely health care. This research will help educate mothers about the dangers of fontanel fomentation and reduce the practice, especially in rural areas of developing countries. This could help reduce neonatal mortality and unnecessary healthcare costs.

Barriers to nurses' therapeutic communication practices in a district hospital in Ghana.

BACKGROUND: Patients accessing health care enter the hospital environment with extreme anxiety, fear and distress which impacts their interactions with nurses and other health care professionals who are expected to help allay these anxieties in order to enhance patients care satisfaction. However, evidence suggests that there is a lack of effective therapeutic nurse-patient interaction in hospitals and the clinical environment globally, especially in sub-Saharan Africa. METHODS: A qualitative research approach with an exploratory design was used to purposively select 30 participants who were engaged in face-face interactions. A semi-structured interview guide was used to conduct five audio-recorded FGDs with the 30 participants (6 in each group-2 males and 4 females) after which the discussions were transcribed verbatim, and content analyzed. FINDINGS: Two (2) main themes and 10 sub-themes emerged from the analysis of the data. The two themes were: Therapeutic communication practices and Barriers to therapeutic communication. Some of the factors identified by patients to impede therapeutic nurse-patient interaction include family interference, negative attitude from patients, patient condition, a discriminatory attitude of nurses, increased workload, and stress. CONCLUSION: Communication practices identified in this study include nurses' manner of communication, use of touch, positive reassurance, and nurses' demeanor. Several obstacles affect communication practices, hence the need to implement measures to improve nurse-patient interaction.

Challenges and ways of coping of parturient women with chronic hepatitis B in Ghana during COVID-19 pandemic: a qualitative inquiry.

OBJECTIVE: To explore the psychosocial concerns and ways of coping of pregnant women with chronic hepatitis B infection in Ghana. SETTING: Participants were selected from public health facilities in the Tema Metropolis. DESIGN: Exploratory descriptive qualitative design was employed. PARTICIPANTS: Fourteen pregnant women were purposively selected to participate in face-to-face interviews. The data were analysed using the content analysis procedure. RESULTS: The participants' psychosocial concerns and coping strategies were diverse. A significant number of the participants were concerned about the impact their hepatitis B seropositivity would have on their relationships, finances, and general well-being. Specifically, they feared that their social network, especially their spouses, would perceive them as having led a promiscuous lifestyle in the past to acquire hepatitis B infection. Also, fear of transmitting the infection to their infants and the effects of the infection on their infants later in life were identified as major concerns by nearly all participants. The participants further reported feelings of distress and diminished self-esteem. These psychosocial afflictions reported were attributed to lack of pre-test counselling during the antenatal care period. However, the participants coped using different strategies, including avoidance/denial, spirituality, and alternative treatment use. CONCLUSION: To achieve optimal psychological and social well-being of pregnant women with chronic hepatitis B, it is important that their unique challenges are considered in their care and treatment cascade. Explicitly, protocols for supportive care addressing the specific needs of pregnant women with chronic hepatitis B should be implemented in the study setting.

Ghanaian women's perception on cervical cancer threat, severity, and the screening benefits: A qualitative study at Shai Osudoku District, Ghana.

Objective: Cervical is one of the topmost causes of fatalities worldwide with mortality and incidence rates highest in sub-Saharan Africa including Ghana. The knowledge about cervical cancer threat and severity has not been extensively studied in most developing and developed countries of which Ghana is not exempted. The study, therefore, aimed to explore the views of women about cervical cancer threat, severity, and the benefits of cervical cancer screening in rural communities in the Greater Accra Region of Ghana. Study design: Qualitative exploratory descriptive design was used to purposively sample 17 participants. Methods: The data collection tool was pretested among 4 women from women to ensure its trustworthiness. Participants were interviewed face to face using a semi-structured interview guide. The interviews were recorded with audio recorders, transcribed verbatim and content analyzed. Ethics approval was obtained from Noguchi Memorial Institute for Medical Research Institutional Review Board (NMIMR-IRB). Results: Findings of this study discovered that participants perceived Cervical cancer (CC) as serious on the basis that it is causing death of most women and lead to depression, isolation and thoughts of suicide, and poor sexual performance. Almost all the women in this study were aware that cervical cancer screening (CCS) is beneficial in the early detection of cervical cancer and protecting women against cervical cancer in order to reduce the mortalities associated with cervical cancer. In conclusion, there is high perceived severity to CC and benefits of CCS and hence other studies could be done to assess the uptake of the screening and willingness to participate in the screening among these participants. It is expected that this high perceived severity and benefits will translate into their practices of CCS and hence other researchers could explore this phenomenon.

Knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to identify and map the evidence reporting the knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses in low- and middle-income countries. INTRODUCTION: Evidence-based practice aims to improve health care quality, safety, and health system efficiency. Numerous research studies have explored nurses' engagement in evidence-based practice in high-income countries. Developing nations have recently joined the evidence-based practice movement, and primary research about nurses' engagement with it are emerging. INCLUSION CRITERIA: The scoping review will include primary studies (quantitative, qualitative, and mixed methods) and gray literature addressing knowledge, skills, attitudes, beliefs, and implementation of evidence-based practice among nurses. Participants will include registered nurses working in low- and middle-income countries. Studies conducted in all health care settings, including acute and community settings, in low- and middle-income countries will be included. METHODS: We will search MEDLINE, Embase, CINAHL, Scopus, ERIC, JBI Evidence-based Practice Database, Cochrane Library, LILACS, and AIM. Gray literature will be sourced from ProQuest Dissertations and Theses Global and Google Scholar for primary studies. Studies published in the English language will be included, with no limit on publication date. Titles, abstracts, and full-text articles will be assessed against the inclusion criteria by 2 independent reviewers. The extracted data will be analyzed quantitatively using frequencies and counts. Textual data from qualitative studies will be analyzed using descriptive content analysis. Results of the data analysis will be presented using graphs, tables, and a narrative format. SCOPING REVIEW REGISTRATION: Open Science Framework ( https://osf.io/hau5y ).

Validating a Sclera-Based Smartphone Application for Screening Jaundiced Newborns in Ghana.

OBJECTIVES: Reducing the burden of bilirubin-induced neurologic complications in low-resource countries requires reliable and accessible screening tools. We sought to optimize and validate a sclera-based smartphone application, Neonatal Scleral-Conjunctival Bilirubin (neoSCB), for screening neonatal jaundice. METHODS: Using a cross-sectional design, consecutive eligible infants (aged 0-28 days, in the hospital, not critically ill) were enrolled in Ghana from March 2019 to April 2020. Jaundice screening was performed with neoSCB (Samsung Galaxy S8) to quantify SCB and JM-105 (Dräger) for transcutaneous bilirubin (TcB). Screening values were compared with total serum bilirubin (TSB) measured at the point of care. RESULTS: Overall, 724 infants participated in the optimization and validation phases of the study. The analysis for validation included 336 infants with no previous treatment of jaundice. Single neoSCB image captures identified infants with TSB >14.62 mg/dL (250 µmol/L) with reasonably high sensitivity, specificity, and receiver operating characteristic area under the curve at 0.94 (95% confidence interval [CI], 0.91 to 0.97), 0.73 (95% CI, 0.68 to 0.78), and 0.90, respectively. These findings were comparable to the sensitivity and specificity of JM-105 (0.96 [95% CI, 0.90 to 0.99] and 0.81 [95% CI, 0.76 to 0.86], respectively). The TcB/TSB had a larger correlation coefficient (r = 0.93; P < .01) than SCB/TSB (r = 0.78; P < .01). Performance of both devices was lower in infants with previous phototherapy (n = 231). CONCLUSIONS: The diagnostic performance of neoSCB was comparable to JM-105 and is a potential, affordable, contact-free screening tool for neonatal jaundice.

InspirE5: a participatory, internationally informed framework for health humanities curricula in health professions education.

BACKGROUND: Reporting on the effect of health humanities teaching in health professions education courses to facilitate sharing and mutual exchange internationally, and the generation of a more interconnected body of evidence surrounding health humanities curricula is needed. This study asked, what could an internationally informed curriculum and evaluation framework for the implementation of health humanities for health professions education look like? METHODS: The participatory action research approach applied was based on three iterative phases 1. Perspective sharing and collaboration building. 2. Evidence gathering 3. Development of an internationally relevant curriculum and evaluation framework for health humanities. Over 2 years, a series of online meetings, virtual workshops and follow up communications resulted in the production of the curriculum framework. RESULTS: Following the perspective sharing and evidence gathering, the InspirE5 model of curriculum design and evaluation framework for health humanities in health professions education was developed. Five principal foci shaped the design of the framework. ENVIRONMENT: Learning and political environment surrounding the program. Expectations: Graduate capabilities that are clearly articulated for all, integrated into core curricula and relevant to graduate destinations and associated professional standards. EXPERIENCE: Learning and teaching experience that supports learners' achievement of the stated graduate capabilities. EVIDENCE: Assessment of learning (formative and/or summative) with feedback for learners around the development of capabilities. Enhancement: Program evaluation of the students and teachers learning experiences and achievement. In all, 11 Graduate Capabilities for Health Humanities were suggested along with a summary of common core content and guiding principles for assessment of health humanities learning. DISCUSSION: Concern about objectifying, reductive biomedical approaches to health professions education has led to a growing expansion of health humanities teaching and learning around the world. The InspirE5 curriculum and evaluation framework provides a foundation for a standardised approach to describe or compare health humanities education in different contexts and across a range of health professions courses and may be adapted around the world to progress health humanities education.

Neonatal jaundice in Ghanaian children: Assessing maternal knowledge, attitude, and perceptions.

BACKGROUND: Neonatal jaundice (NNJ) is a major cause of preventable childhood mortality and long-term impairment especially in countries with significant prevalence of the inherited condition, glucose-6-phosphate dehydrogenase (G6PD) defect. In Ghana, routine screening of pregnant women for G6PD defect is standard care. Prevention of poor health outcomes from NNJ is contingent on population health literacy and early diagnosis. As part of a project to evaluate a screening tool for NNJ, we assessed the knowledge, attitude, and perceptions of Ghanaian mothers on NNJ at baseline. METHODS: Using a cross-sectional design, mothers attending antenatal and postnatal clinics at 3 selected health facilities in 2 geographical regions of Ghana were interviewed. Data on mothers' understanding, perceptions, beliefs, and actions towards NNJ were evaluated. Chi-square test was used to determine the association between selected maternal characteristics and knowledge, attitude, and perception to NNJ. RESULTS: Of the 504 mothers interviewed, 428(85.4%) had heard about NNJ, 346 (68.7%) said the earliest signs are seen in the eyes, 384(76.2%) knew NNJ may be harmful and 467(92.7%) recommended seeking healthcare for the jaundiced newborn. None of the women knew about G6PD or their G6PD status following antenatal screening. Most did not know the signs/symptoms of severe NNJ. Of the 15 mothers who had had a jaundiced neonate, cost was the most perceived (8 out of 15) barrier to accessing health care. There were significant associations (p-value ≤ 0.05) between maternal age, educational level, and knowledge of NNJ. CONCLUSION: Despite the high level of awareness of NNJ, gaps still exit in the knowledge, attitudes and perceptions of mothers concerning NNJ. Improving education of women about the causes, symptoms/signs, and the role of G6PD in severe NNJ is recommended. Addressing barriers to accessing healthcare for the jaundiced infant may enhance timely management of NNJ and reduce the associated complications and mortality.

Women's experiences of surviving severe obstetric complications: a qualitative inquiry in southern Ghana.

Women who survive severe obstetric complications (SOC) have health and well-being issues even up to 1 year postpartum and have challenges in their quality-of-life (QoL). However, little is known about their predicaments. This study aimed to describe the impact of severe obstetric complications on women's QoL and well-being after surviving severe obstetric complications. Using the WHO standards for near-miss, twelve (12) women who survived severe obstetric complications were recruited between January and March 2019. The study adopted a qualitative approach with an exploratory descriptive design to explore the experiences of women who survived SOC in Southern Ghana. The participants were purposively sampled and were interviewed face to face in their homes and healthcare facility after discharge from the Hospital. Recorded interviews were transcribed and analyzed. Two (2) major themes and nine (9) sub-themes emerged. The findings revealed that women who suffered SOC are unable to perform functional activities, have financial constraints, residual hypertension, signs and symptoms of anaemia, pain, and mostly have difficulty in sleeping due to fear of death when they fall asleep. Anxiety, sadness, and emotional trauma was a common phenomenon. The study findings offer insights and directions on measures to improve the care and QoL of women who have survived severe obstetric complications in Ghana.

High impact health service interventions for attainment of UHC in Africa: A systematic review.

African countries have prioritized the attainment of targets relating to Universal Health Coverage (UHC), Health Security (HSE) and Coverage of Health Determinants (CHD)to attain their health goals. Given resource constraints, it is important to prioritize implementation of health service interventions with the highest impact. This is important to be identified across age cohorts and public health functions of health promotion, disease prevention, diagnostics, curative, rehabilitative and palliative interventions. We therefore explored the published evidence on the effectiveness of existing health service interventions addressing the diseases and conditions of concern in the Africa Region, for each age cohort and the public health functions. Six public health and economic evaluation databases, reports and grey literature were searched. A total of 151 studies and 357 interventions were identified across different health program areas, public health functions and age cohorts. Of the studies, most were carried out in the African region (43.5%), on communicable diseases (50.6%), and non-communicable diseases (36.4%). Majority of interventions are domiciled in the health promotion, disease prevention and curative functions, covering all age cohorts though the elderly cohort was least represented. Neonatal and communicable conditions dominated disease burden in the early years of life and non-communicable conditions in the later years. A menu of health interventions that are most effective at averting disease and conditions of concern across life course in the African region is therefore consolidated. These represent a comprehensive evidence-based set of interventions for prioritization by decision makers to attain desired health goals. At a country level, we also identify principles for identifying priority interventions, being the targeting of higher implementation coverage of existing interventions, combining interventions across all the public health functions-not focusing on a few functions, provision of subsidies or free interventions and prioritizing early identification of high-risk populations and communities represent these principles.

Perspectives of nurses on preparedness for combating COVID-19 crisis in Ghana: A qualitative inquiry.

BACKGROUND: COVID-19 has impacted negatively on people physically, psychologically, spiritually, and socioeconomically worldwide. Nurses' ability to prepare towards case management is imperative because the potential of one coming across the virus at the hospital is inevitable. This study intended to explore and describe nurses' perspectives on preparation towards fighting COVID 19 in Ghana. METHODS: A qualitative exploratory descriptive design was adopted. Nine major health facilities designated for COVID-19 treatment centres in four regions in Ghana were involved in the study. A semi structured interview guide was used to interview twenty-nine nurses via telephone based on data saturation. Ethics approval was obtained from the Ethics Review Committee of the Nursing and Midwifery Council of Ghana. RESULT: data yielded two major themes and four subthemes. The two main themes were 1. Health facilities' preparation of nurses towards COVID-19, with its subthemes; targeted training, and selection of experienced staff. 2. Nurses' individual preparedness towards COVID-19 with the subthemes; information sourcing and sharing. Nurses in Ghana prepared for combating COVID-19 by going through training on infection prevention and control, and case management using demonstrations and simulations. Experienced nurses in Ghana volunteered to be at the frontline managing cases. Continuous updates on the virus and its management through information tracking sharing played a key role. CONCLUSION: Nurses in Ghana need to have more specialty training targeted at diseases of public health importance. Key words: Nurse; preparedness; covid-19.

Health Humanities curriculum and evaluation in health professions education: a scoping review.

BACKGROUND: The articulation of learning goals, processes and outcomes related to health humanities teaching currently lacks comparability of curricula and outcomes, and requires synthesis to provide a basis for developing a curriculum and evaluation framework for health humanities teaching and learning. This scoping review sought to answer how and why the health humanities are used in health professions education. It also sought to explore how health humanities curricula are evaluated and whether the programme evaluation aligns with the desired learning outcomes. METHODS: A focused scoping review of qualitative and mixed-methods studies that included the influence of integrated health humanities curricula in pre-registration health professions education with programme evaluate of outcomes was completed. Studies of students not enrolled in a pre-registration course, with only ad-hoc health humanities learning experiences that were not assessed or evaluated were excluded. Four databases were searched (CINAHL), (ERIC), PubMed, and Medline. RESULTS: The search over a 5 year period, identified 8621 publications. Title and abstract screening, followed by full-text screening, resulted in 24 articles selected for inclusion. Learning outcomes, learning activities and evaluation data were extracted from each included publication. DISCUSSION: Reported health humanities curricula focused on developing students' capacity for perspective, reflexivity, self- reflection and person-centred approaches to communication. However, the learning outcomes were not consistently described, identifying a limited capacity to compare health humanities curricula across programmes. A set of clearly stated generic capabilities or outcomes from learning in health humanities would be a helpful next step for benchmarking, clarification and comparison of evaluation strategy.