A Descriptive Exploratory Study of the Causes and Effects of Hypertension Among Ghanaian Soldiers and Their Families.

Introduction: The quality of life of any soldier can be affected by a simple diagnosis of Hypertension. Hypertension has not been directly linked to a single cause; however, knowing the associated risks and early diagnosis can help with its management. This study aimed to explore and describe the causes of hypertension among soldiers and its effects on their families. Objectives: To explore and describe the causes of hypertension and its effects on soldiers and their families. Methods: A qualitative technique and an exploratory descriptive design were used in this study. At saturation, a total of 10 soldiers were face-to-face interviewed and gathered data simultaneously transcribed and subjected to a content analytic method of analysis. Participants approved being audio recorded on tape with an audio recording device. Results: Effects of hypertension on personal lives of soldiers, effects of hypertension on family life, and effects of hypertension on social life were identified as the causes and risk factors of hypertension among the soldiers. These themes are further expanded by their subthemes in the areas of decreased physical activity including sex life, decrease interaction with family, and isolation from friends. Conclusion: This study revealed that hypertension does have effects on one's personal life, family life, and social life. Hence, it is recommended that frequent health education on hypertension and its effects should be organized in the various Garrisons by the public health department for all soldiers and their families. Screening programs should be organized for early hypertension detection. Soldiers should be educated on appropriate eating habits, weight and financial management, and reduction in tobacco and alcohol.

Pregnant adolescents' lived experiences and coping strategies in peri-urban district in Southern Ghana.

BACKGROUND: Adolescence, a transition period from childhood to adulthood forms the foundation of health in later life. The adolescence period which should have been characterised by good health is often marred with life-threatening and irreparable consequences of public health concern. Teen pregnancy is problematic because it could jeopardise adolescents' safe transition to adulthood which does not only affect adolescents, but also their families, babies and society. There is ample evidence about the determinants and effects of teen pregnancy, but it is fragmented and incomplete, especially in Sub-Sahara Africa. This study presents pregnant adolescents' voices to explain significant gaps in understanding their lived experiences and coping strategies. METHODS: This narrative inquiry, involved in-depth interviews with 16 pregnant adolescents, who were recruited from a peri-urban district in Southern Ghana using purposive and snowball techniques in health facilities and communities respectively. The audio recorded interviews were transcribed verbatim and analysed manually using content analysis. RESULTS: Many pregnant adolescents are silent victims of a hash socio-economic environment, in which they experience significant financial deprivation, parental neglect and sexual abuse. Also, negative experiences of some adolescent girls such as scolding, flogging by parents, stigmatisation and rejection by peers and neighbors result in grieve, stress and contemplation of abortion and or suicide. However, adolescents did not consider abortion as the best option with regard to their pregnancy. Rather, family members provided adolescents with critical support as they devise strategies such as avoiding people, depending on God and praying to cope with their pregnancy. CONCLUSION: Adolescent pregnancy occurred through consensual sex, transactional sex and sexual abuse. While parents provide support, pregnant adolescents self-isolate, depend on God and pray to cope with pregnancy and drop out of school. We recommend that the Ministries of Education and Health, and law enforcement agencies should engage community leaders and members, religious groups, non-governmental organisations and other key stakeholders to develop interventions aimed at supporting girls to complete at least Senior High School. While doing this, it is also important to provide support to victims of sexual abuse and punish perpetrators accordingly.

Socioeconomic inequalities in access and use of skilled birth attendants during childbirth in Ghana: a decomposition analysis.

BACKGROUND: Equitable access to skilled birth attendance during delivery is vital for reducing global maternal deaths to 70 deaths per 100, 000 to achieve the Sustainable Development Goals (SDGs) by 2030. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequalities in access to skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assesses the socioeconomic inequalities in access and use of skilled birth attendants during delivery in Ghana. METHODS: Research was conducted through literature reviews and document reviews, and a secondary data analysis of the 2014 Ghana Demographic and Health Survey (GDHS), a nationally representative survey. A total of 1305 women aged 15-49 years, who had a live birth the year before to the survey in the presence of a skilled birth attendant were analysed using concentration indices and curves. The indices were further decomposed to identify the major socioeconomic factors contributing most to the inequalities. RESULTS: The results found that access to skilled birth attendants was more among women from rich households showing a pro-rich utilization. The decomposition analysis revealed that household wealth index, educational level of both mother and husband/partner, area of residence and mother's health insurance coverage were the major contributing factors to socioeconomic inequalities in accessing skilled birth attendants during child delivery among Ghanaian women. CONCLUSION: This study confirms that a mother's socioeconomic status is vital to reducing maternal deaths. Therefore, it is worthy to focus attention on policy interventions to reduce the observed inequalities as revealed in the study.

Practices of Adults in a Periurban Community of the Ho Municipality on Prevention of Hypertension.

BACKGROUND: Hypertension remains a rising health threat among developing countries and it is due to poor knowledge and lifestyles. Integrated knowledge and practices are central towards the control of hypertension, especially in the developing world. OBJECTIVES: This study assessed the practices of adults in a periurban community in the Ho Municipality of the Volta region on the prevention of hypertension. Methodology. A cross-sectional descriptive research design was carried out in a periurban community in the Volta region. Adults were recruited using a systematic sampling technique in the Ahoe community. Pretested questionnaires were used to collect information on sociodemographic, knowledge, and lifestyle practices regarding hypertension prevention. The data were entered into Microsoft excel 2013 spreadsheet, cleaned, and transported to the Statistical Package for Social Sciences (SPSS) version 22 software for analyses. The data were analysed using simple descriptive statistics. RESULTS: In this study, 49.3% explained that hypertension means the increased force of blood through the blood vessels as 90.8% indicated that taking antihypertensive medications can control hypertension. In describing the associated effects of hypertension, adults in the Ahoe community described the effects of hypertension as stroke (89.8%), heart attack (84.0%), diabetes (56.5%), and heart failure (82.3%). Also, 54.1% described hypertension as a lifelong disease while 55.8% indicated hypertension can be cured. Also, 92.2% identified exercising as an important factor in controlling hypertension as 32.7% use herbal preparations to control hypertension. Only 3.7% of adults in the Ahoe community were smokers and 54.5% smoked less than a year. The majority (61.6%) of the respondents did not drink alcohol as 69.7% engage in active exercises. CONCLUSION: Education on hypertension should be intensified, and emphasis should be laid on regular exercised and strict dietary restrictions that ensure reduction in hypertension risk. Healthcare authorities should engage hypertensive clients to desist from the intake of herbal medications whose actual composition has not been scientifically determined.

Women's experiences of midwifery care immediately before and after caesarean section deliveries at a public Hospital in the Western Region of Ghana.

BACKGROUND: Childbirth remains a uniquely multifaceted, mental-cognitive and a major life experience to women. It is composed of a variety of psycho social and emotional aspects and creates memories, sometimes bad experiences and unmet expectations which leaves the mother with lasting scars. Therefore, this study aimed at exploring post-caesarean section delivered mothers experiences of midwifery care in a public hospital in Ghana. METHODS: This descriptive exploratory qualitative research used an interpretative approach to explore mothers' experiences of midwifery care immediately before and after caesarean section (CS). The study employed a purposive sampling technique in recruiting 22 participants who had knowledge of the phenomenon under study. Data collection was guided by an interview guide, which involved face to face individual interviews and focus group discussion at the postnatal ward and clinic. All interviews were audio-recorded and lasted 30-40 min. Audio recordings were transcribed verbatim and inductive thematic data analysis employed. RESULTS: Four major themes emerged from the analysis of participants' transcripts: Support by Midwives (physical and psychological, and attitude towards patients' pain management); Protection of mothers (provision of privacy, confidentiality and physical environment); Provision of information/communication (before caesarean section, and before a minor task) and midwives' attitude (attitude towards delivery care). CONCLUSION: Mothers delivered by caesarean section had varied experiences of midwifery care which were both positive and negative ones. Provision of psychological support and adequate pain management were positive experiences. The challenges experienced were related to provision of information, privacy, and physical support. Participants, who underwent emergency CS in particular, were dissatisfied with the provision of information concerning the surgical procedure. Provision of privacy and physical support were also issues of great concern. We therefore, recommend supportive and sensitive midwifery care particularly for mothers undergoing emergency CS. Documenting women's diverse experiences of midwifery care before and after CS delivery is important to healthcare providers, hospital managers and policy makers as the feedback garnered can be used to improve maternity services and inform decisions on midwifery care.

Reasons for Women's Choice of Elective Caesarian Section in Duayaw Nkwanta Hospital.

BACKGROUND: Caesarean section is one of the most commonly performed major surgeries in obstetric practice intended to save the mother and child and in turn reduce maternal and perinatal mortality. The steadily increasing global rate of caesarean section has become one of the most debated topics in maternity care. This study identified the factors that influence women's choice of elective cesarean sections in the Duayaw Nkwanta Hospital. METHODOLOGY: This study used descriptive cross-sectional survey method to collect data from 78 post-caesarean section women above age 18 years. A whole population sampling method was used to trace respondents to their homes to administer a pretested questionnaire. Data was double-entered into Microsoft Excel spreadsheet, compared, cleaned, and transported to Statistical Package for Social Sciences (SPSS) version 21. Data was analyzed using descriptive statistics with a Pearson correlation test. RESULTS: Post-caesarean section women (37.2%) indicated CS is a pain-free method of birth while 57.1% reported CS is safe for both mother and baby. Others (28.2%) chose CS based on a friend's advice and 19.2% on religious advice. The relationship between age of respondents and the number of times of having CS showed a weak positive correlation (r= .170, N= 78, p≤0.136, two-tailed test). There was a significant positive correlation between average monthly income of respondents and the number of times of having a CS birth (r= .320, N= 78, p≤ 0.004). CONCLUSION: It is imperative that there is heightened interest in educating mothers on associated benefit and risk of elective caesarean sections as a method of birthing by nurses and midwives in the antenatal clinics.

Factors Influencing Information and Communication Technology Knowledge and Use Among Nurse Managers in Selected Hospitals in the Volta Region of Ghana.

This study adopted a cross-sectional design to examine the factors that influence the use of information and communication technology among 108 nurse managers in selected hospitals in the Volta Region of Ghana. A self-administered questionnaire was used to gather data. A χ test of association identified sex (P < .0001), age (P < .0001), years of work experience (P < .0001), rank of the respondents (P < .0001), computer training (P < .0001), computer ownership (P < .0001), and previous use of computers before appointment as a unit manager (P < .0001) as the factors that significantly influenced the use of information and communication technology among nurse managers.

Perspective of Traditional Birth Attendants on Their Experiences and Roles in Maternal Health Care in Rural Areas of Northern Ghana.

BACKGROUND: Traditional birth attendants play significant roles in maternal health care in the rural communities in developing countries such as Ghana. Despite their important role in maternal health care, there is paucity of information from the perspective of traditional birth attendants regarding their role on maternal health care in rural areas in Ghana. OBJECTIVE: The aim of this study was to explore and describe the role of traditional birth attendants in maternal health care in the rural areas in Ghana. METHODS: A qualitative explorative approach was adopted to explore the role of traditional birth attendants in maternal health care in the rural areas of Ghana. Ten (10) out of a total of twenty-seven (27) practising traditional birth attendants in the study area were purposefully selected from five (5) rural communities in the Bongo District of Ghana for the study. Data were collected through in-depth, unstructured, individual interviews using a guide. Data collected from the interviews were transcribed verbatim and analysed to identify themes. RESULTS: Six main roles of traditional birth attendants on maternal health care in rural areas were identified in this study: traditional birth attendants conduct deliveries at home, they provide health education to women on nutrition during pregnancy and lactation, they arrange means of transport and accompany women in labour to health facilities, they provide psychological support and counselling to women during pregnancy and childbirth, and traditional birth attendants are not paid in cash for the services they render to women in the rural areas. CONCLUSION: Our study brought to light the critical role traditional birth attendants play in maternity in rural and remote areas in Ghana. There is a need for skilled birth attendants to collaborate with traditional birth attendants in rural and deprived communities to provide quality and culturally accepted care in the rural communities.

Effects of parents training on parents' knowledge and attitudes about adolescent sexuality in Accra Metropolis, Ghana.

BACKGROUND: Attitudes of parents about discussing sexuality issues with adolescents may or may not be influenced by their level of knowledge on such issues. This study seeks to examine parents' training and its effects on parent knowledge and attitudes about sexuality in Accra Metropolis, Ghana. METHODS: This was an intervention study consisting of 145 parents who were recruited through their wards from 12 public junior high schools in Accra Metropolis. Parents were randomized equally into intervention and control groups and the intervention group received a 4 weeks training on adolescent sexuality topics. At pre-intervention and 3 months after parent training, parents answered questions on knowledge and attitudes about adolescent sexuality. Changes in baseline and follow-up within and between groups were compared using the difference- in-difference model and logistic regression. RESULTS: The ages of the parents ranged from 26 to 63 years and 44.1% of them completed middle school. There were 69.9% and 59.7% mothers in the intervention and control groups respectively. At pre-intervention, 21.9% of parents in the intervention group had very good knowledge but this increased significantly to 60% three months after the training. Knowledge about sexuality increased to a lesser degree from 18.1% to 34.7% in the control group. Parents' positive attitudes towards adolescents' sexuality increased by 50% in the intervention group compared to 20% in the control group. There were significant differences in knowledge on adolescent sexuality as parents in the intervention group had a greater positive effect than parents in the control group (28.7%, p-value = <0.001). Regarding attitudes of parents towards allowing adolescents to use family planning services (FPS), there was a greater positive effect on parents in the intervention group compared to those in the control group (37.4%; p- value  = <0.001). Being part of the intervention group increased the odds of parent knowledge on adolescent sexuality by 16-fold (p-value = <0.001), whilst being in the intervention group increased the likelihood of parents' attitudes towards allowing adolescents to use FPS by four fold (p-value = 0.039). CONCLUSION: Training parents for a relatively short period of time can positively impact parents' knowledge and attitudes about adolescent sexuality. This may have beneficial effects on adolescent reproductive health.