Factors associated with treatment-seeking for malaria in urban poor communities in Accra, Ghana

BACKGROUND: In Ghana, about 3.5 million cases of malaria are recorded each year. Urban poor residents particularly have a higher risk of malaria mainly due to poor housing, low socio-economic status and poor sanitation. Alternative treatment for malaria (mainly African traditional/herbal and/or self-medication) is further compounding efforts to control the incidence of malaria in urban poor communities. This study assesses factors associated with seeking alternative treatment as the first response to malaria, relative to orthodox treatment in three urban poor communities in Accra, Ghana. METHODS: This cross-sectional study was conducted in three urban poor localities in Accra, Ghana among individuals in their reproductive ages (15-59 years for men and 15-49 years for women). The analytic sample for the study was 707. A multinomial regression model was used to assess individual, interpersonal and structural level factors associated with treatment-seeking for malaria. RESULTS: Overall, 31% of the respondents sought orthodox treatment, 8% sought traditional/herbal treatment and 61% self-medicated as the first response to malaria. At the bivariate level, more males than females used traditional/herbal treatment and self-medicated for malaria. The results of the regression analysis showed that current health insurance status, perceived relative economic standing, level of social support, and locality of residence were associated with seeking alternative treatment for malaria relative to orthodox treatment. CONCLUSIONS: The findings show that many urban poor residents in Accra self-medicate as the first response to malaria. Additionally, individuals who were not enrolled in a health insurance scheme, those who perceived they had a low economic standing, those with a high level of social support, and locality of residence were significantly associated with the use of alternative treatment for malaria. Multi-level strategies should be employed to address the use of alternative forms of treatment for malaria within the context of urban poverty

Exploring Contraceptive Knowledge and Use among Women Experiencing Induced Abortion in the Greater Accra Region, Ghana

Using a qualitative research methodology, twenty-four semi-structured interviews were conducted with women with induced abortion experiences at Korle Bu and Tema Hospitals in the Greater Accra Region, Ghana. Results suggest that these women tended not to have knowledge of contraceptive methods prior to the abortion, while others were informed but failed to use for a variety of reasons ranging from rumours of side effects to personal negative experiences with modern contraceptive methods. A few womenalso stated contraceptive failure as a reason for their unintended pregnancies that were later aborted. Peer and reproductive health education must be reinforced in communities in the Greater Accra Region to curb adolescents engaging in early sex and should challenge the existing rumours associated with contraception in Ghana. In addition, family planning services in terms of appropriate methods with no side effects must be made available to women in the reproductive ages (Afr J Reprod Health 2011; 15[1]: 37-46)