Adolescents and parents\u27 perceptions of best time for sex and sexual communications from two communities in the Eastern and Volta Regions of Ghana: Implications for HIV and AIDS education

Background Adolescents and parents’ differ in their perceptions regarding engaging in sexual activity and protecting themselves from pregnancy and sexually transmitted infections (STIs). The views of adolescents and parents from two south-eastern communities in Ghana regarding best time for sex and sexual communications were examined. Methods Focus Group interviews were conducted with parents and adolescents (both In-school and Out-of school) from two communities (Somanya and Adidome) in the Eastern and Volta regions of Ghana with epidemiological differentials in HIV infection. Results Findings showed parents and adolescents agree that the best timing for sexual activity amongst adolescents is determined by socioeconomic viability. In practice however, there were tensions between adolescents and parents crystallized by spoilt generation and physiological drive ideologies. Whilst one community relied on a more communal approach in controlling their children; the other relied on a confrontational approach. Sex-talk is examined as a measure to reduce these tensions, and children in both communities were ambivalent over sexual communication between their parents and themselves. Parents from the two communities however differed in their perceptions. Whilst parents in one community attributed reduced teenage pregnancies to sex education, those in the other community indicated a generalized adolescents’ sexual activeness manifested in the perceived widespread delinquency in the community. Conclusion Parents in both communities reported significant barriers to parents-adolescents sexual communication. Parents in both communities should be educated to discuss the broader issues on sexuality that affects adolescents and their reproductive health needs

Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo

Several years of war have created a humanitarian crisis in the Democratic Republic of Congo (DRC) with extensive disruption of civil society, the economy and provision of basic services including health care. Health policy and planning in the DRC are constrained by a lack of reliable and accessible population data. Thus there is currently a need for primary research to guide programme and policy development for reconstruction and to measure attainment of the Millennium Development Goals (MDGs). This study uses the 2001 Multiple Indicators Cluster Survey to disentangle children's health inequalities by mapping the impact of geographical distribution of childhood morbidity stemming from diarrhoea, acute respiratory infection, and fever. We observe a low prevalence of childhood diarrhoea, acute respiratory infection and fever in the western provinces (Kinshasa, Bas-Congo and Bandundu), and a relatively higher prevalence in the south-eastern provinces (Sud-Kivu and Katanga). However, each disease has a distinct geographical pattern of variation. Among covariate factors, child age had a significant association with disease prevalence. The risk of the three ailments increased in the first 8–10 months after birth, with a gradual improvement thereafter. The effects of socioeconomic factors vary according to the disease. Accounting for the effects of the geographical location, our analysis was able to explain a significant share of the pronounced residual geographical effects. Using large scale household survey data, we have produced for the first time spatial residual maps in the DRC and in so doing we have undertaken a comprehensive analysis of geographical variation at province level of childhood diarrhoea, acute respiratory infection, and fever prevalence. Understanding these complex relationships through disease prevalence maps can facilitate design of targeted intervention programs for reconstruction and achievement of the MDGs

Maternity care provider knowledge, attitudes, and practices regarding provision of postpartum intrauterine contraceptive devices at a tertiary center in Ghana

ObjectiveTo assess knowledge, attitudes, and practices of maternity care providers regarding the provision of postpartum intrauterine contraceptive devices (IUDs) in Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana.MethodsA descriptive, cross‐sectional study was conducted between June 28 and July 15, 2011. Specialists, residents, house officers, and nurse midwives who had been working in the Department of Obstetrics and Gynecology for at least 3 months were included. Self‐administered questionnaires assessed formal training, current proficiency in IUD insertion, and attitudes toward postpartum IUD provision.ResultsOf 91 providers surveyed, 70 (77%) reported previous training in contraceptive counseling. Fewer than one in three respondents had ever inserted an IUD: 17 (44%) of 39 physicians and 9 (17%) of 52 midwives reported ever having inserted an IUD. A total of 33 (36%) respondents reported that they would recommend an IUD in the immediate postpartum period.ConclusionAlthough most maternity care providers at KATH had received training in contraceptive counseling, few felt confident in their ability to insert an IUD. Further training in postpartum contraceptive management is needed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135552/1/ijgo137.pd

Improving the Ghanaian Safe Motherhood Programme

Prior to the Ghana Ministry of Health scaling up the country’s Safe Motherhood program, they requested support from the Population Council’s USAID-funded Frontiers in Reproductive Health program to undertake an operations research study to evaluate and compare the cost-effectiveness of two training approaches and other performance improvement interventions. The study measured and compared changes in provider knowledge and skills and the costs of implementing a three-week residential vs. self-paced learning (SPL) approach. The SPL approach costs more per trainer than the traditional residential approach, both in financial costs alone and when opportunity costs are added, however, a cost-effectiveness analysis showed that for improving provider knowledge, the SPL approach was clearly more cost-effective. At a dissemination meeting, stakeholders agreed that the SPL and residential approaches are not mutually exclusive—both approaches have their strengths and weaknesses. Training for safe motherhood should be developed based on the strengths of the two approaches

Household and market survey on availability of adequately iodized salt in the Volta region, Ghana

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Health Promotion and Education on 27/10/2016, available online: http://www.tandfonline.com/doi/full/10.1080/14635240.2016.1250658Consumption of adequately iodized salt (AIS) ≥15ppm is one of the criteria for measuring progress towards universal salt iodization (USI) and sustainable elimination of iodine deficiency disorders. After series of health promotion activities, this survey was conducted to evaluate the extent to which USI was achieved. Cross-sectional survey was conducted in 1,961 households and 350 markets to estimate the iodine levels of salt consumed or sold. Three degrees of iodization were estimated from fine, coarse and granular texture salt using MBI rapid field test kits. Differences in iodization levels were determined using Bonferroni test in STATA. Determinants for household utilization of AIS were identified using regression analysis and reported as odds ratio (OR). Availability of AIS in households (24.5%) and markets (30.9%) was far below the 90% recommendation. No differences where observed in urban (26.8%) and rural (24.1%) households. Households that used fine-texture salt (OR: 40.13; CI: 30.1-53.4) or stored salt in original packs (OR: 8.02; CI: 6.01-10.70) were more likely to consume AIS. Across districts, highest household availability of AIS was 51.7% while the least was 7.5%. The district with the highest market availability of AIS was 85.7% while the least was 8.3%. Almost 32% of the traders were aware that selling non-iodized salt was unauthorized but out of this, only 12% sold AIS. Public education should emphasis appropriate handling and storage of salt throughout the supply chain. To ensure adequate salt fortification with iodine, improved surveillance of factories and mining sites is recommended

The Incidence of Self Induced Abortion in Ghana: What are the Facts?

In Ghana, despite the growing number of studies, induced abortion remains a relatively unknown aspect of the national demographics. Interest in abortion research is, however, reemerging, partly as a result of political changes and partly due to evidence of the contribution of induced abortion to the high level of maternal mortality. A recent prospective study in Southern Ghana indicates that abortion rates in Ghana could range between 22 and 28 abortions per 1,000 women of reproductive age. Most of the abortion patients studied were young, some married and others unmarried. Results of logistic regression models suggest that those who work outside their homes, the self-employed, urban dwellers, single persons, women who have had a previous abortion, women with levels of education beyond Middle/JSS and Christians rather than Muslims are the ones likely to have an abortion. Because official statistics on illegal abortion do not exist and the numbers of such procedures must be estimated, the data presented here are the best available estimate; but they are not definitive. (Inst. of African Studies Research Review: 2002 18 (1): 33-42

Determinants of Women\u27s Health Care Utilization, Child Survival and Child Immunization in Ghana: The Role of Empowerment

Over the last few decades, the field of research examining the social and cultural factors influencing the health outcomes of women and children has burgeoned significantly. Some of this research has focused on women\u27s empowerment: attempting to conceptualize notions of empowerment and to understand how factors of empowerment and its proxies, affect the health of women and their children. It is argued that establishing such connections will open up new avenues of possibilities to policy-makers. There is some inconsistency in the work in this field related to the measures of empowerment and differing definitions of the problem. Therefore, it was the objective of this dissertation to review the extent of the literature set in sub-Saharan Africa and to investigate the association between empowerment and health outcomes in Ghana specifically. Data for this dissertation came from a systematic review of the empowerment research between 1995 and 2017 and from the 2014 Ghana Demographic and Health Survey, a nationally representative survey of the Ghanaian population. The review of the literature suggested that empowerment research, set in sub-Saharan Africa, is a growing field of study with some 74 publications specifically examining the associations between various empowerment factors and health outcomes in the areas of family planning, health care utilization and disease knowledge and testing, among others. In Ghana, aspects of household decision-making, perceptions of spousal abuse and spousal age differences were associated with women\u27s utilization of health care. Similarly, maternal age, education, and domicile were associated with the child health outcomes of vaccination status and under-five mortality. Despite these findings, the majority of empowerment measures utilized in this analysis were not significantly associated with the health outcomes of Ghanaian women and their children. This dissertation also briefly discussed limitations of the analysis and future steps to be taken in this area of research

Reliability, Validity, and Associations With Sexual Behavior Among Ghanaian Teenagers of Scales Measuring Four Dimensions of Relationships With Parents and Other Adults

Little research has been done on the social contexts of adolescent sexual behaviors in sub-Saharan Africa. As part of a longitudinal cohort study (N=1275) of teenage girls and boys in two Ghanaian towns, interviewers administered a 26 item questionnaire module intended to assess four dimensions of youth-adult relationships: monitoring conflict, emotional support, and financial support. Confirmatory factor and traditional psychometric analyses showed the four scales to be reliable. Known-groups comparisons provided evidence of their validity. All four scales had strong bivariate associations with self-reported sexual behavior (odds ratios = 1.66, 0.74, 0.47, and 0.60 for conflict, support, monitoring, and financial support). The instrument is practical for use in sub-Saharan African settings and produces measures that are reliable, valid, and predictive of sexual behavior in youth

Peer Influences on Sexual Activity among Adolescents in Ghana.

Little is known about the influences of peers on the sexual activity of adolescents in sub-Saharan Africa. Better understanding of these issues could lead to more effective interventions promoting sexual and reproductive health. Using two waves survey data from adolescents (n=1275) in two towns in southeastern Ghana, we examined age, gender, and community differences in peer group characteristics. We also examine prospective associations between peer group characteristics and self-reported sexual initiation, multiple partnerships, and lack of consistent condom use with most recent partner over a 20-month follow-up period. Gender differences in peer context variables were small. Affiliation with antisocial peers and perceived peer norms favoring sex increased the odds of transition to first sex. Having more friends increased the odds of accruing multiple new sexual partners among younger respondents. Among males, perceived peer norms favoring sex increased the odds of accruing multiple partners. No peer context variables were significantly associated with condom use with most recent partner. We discuss the implications of these findings for adolescent sexual and reproductive health intervention strategies in sub-Saharan Africa