129 research outputs found
Unmet reproductive health needs among women in some West African countries: a systematic review of outcome measures and determinants
Context-specific Factors and Contraceptive Use: A Mixed Method Study among Women, Men and Health Providers in a Rural Ghanaian District
Suitable options for improving women‘s access to effective, safe and context-specific contraceptive methods must be explored to curtail rising unmet needs for contraceptive use in rural Ghana. The study aimed to outline context-specific factors associated with contraceptive use, access on demand and future use intentions among women in one district of Ghana. Using mixed method approach, quantitative data (n=720) was collected among women aged 18-28. Focus group discussions and in-depth interviews were also conducted among women (n=30) aged 18-49 and men (n=10) respectively. IDIs were conducted among 3 midwives. Women who received focused counseling on contraceptive use were twice likely to have ever used (OR=2 95% CI 1.163-3.467) or be current users (OR=2, 95% CI 1.146-4.010) of contraceptives. Male partner support can drive cultural sensitivities towards accepting use of contraception (OR=34.5, CI% 19.01-64.22). Covert use is still preferred by most in the study. Services delivered on good provider-relational grounds and convenient clinic hours encourage contraceptive use among women. Male targeting for improving contraceptive service use must first identify context-specific preferences of the woman, since covert use is highly valued. Ascertaining the prevalence of covert use and how community systems can address this for improved contraceptive uptake is further recommended. Keywords: context-specific factors, contraceptive use, access on demand, future contraceptive use, rural Ghana Des options appropriées pour améliorer l'accès des femmes à des méthodes contraceptives efficaces, sûres et spécifiques au contexte doivent être explorées pour réduire les besoins non satisfaits de l‘utilisation des contraceptifs au Ghana rural. L'étude visait à décrire les facteurs contextuels associés à l'utilisation de contraceptifs, l'accès sur demande et les intentions d'utilisation future chez les femmes d'un district du Ghana. En utilisant une approche par méthode mixte, des données quantitatives (n = 720) ont été recueillies parmi les femmes âgées de 18 à 28 ans. Des discussions à groupes ciblés et des entretiens approfondis ont également été réalisés auprès des femmes (n = 30) âgées de 18 à 49 ans et les hommes (n = 10) respectivement. Les IDI ont été menées auprès de 3 sages-femmes. Les femmes qui ont reçu des conseils ciblés sur l'utilisation des contraceptifs ont été deux fois plus susceptibles d'avoir déjà utilisé (OR = 2 95% IC 1.163-3.467) ou être des utilisateurs actuels (OR = 2, 95% IC 1.146-4.010) des contraceptifs. Le soutien des partenaires masculins peut stimuler les sensibilités culturelles à l'acceptation de l'utilisation de la contraception (OR = 34,5, IC% 19.01-64.22). L'usage secret est encore préféré par la plupart dans l'étude. Les services fournis sur de bons motifs relationnels avec les fournisseurs et les heures de clinique appropriées encouragent l'utilisation de contraceptifs chez les femmes. Le ciblage masculin pour améliorer l'utilisation des services de contraception doit d'abord identifier les préférences spécifiques au contexte de la femme, car l'utilisation secrète est très appréciée. On recommande en outre de déterminer la prévalence de l'utilisation secrète et comment les systèmes communautaires peuvent répondre à cette question pour une meilleure prise en charge des contraceptifs.Mots-clés: facteurs contextuels, utilisation des contraceptifs, accès sur demande, utilisation des contraceptifs future, Ghana rura
Context-specific Factors and Contraceptive Use: A Mixed Method Study among Women, Men and Health Providers in a Rural Ghanaian District
Predictors of Health Care Service Quality among Women Insured Under Ghana’s National Health Insurance Scheme
Background: Insured women in Ghana are more likely to use maternity care services than their uninsured counterparts. To improve service quality among insured women in Ghana, better understanding of the factors that predict quality standards of primary health care services is essential. Objective: To examine predictors of health care service quality among insured women under the National Health Insurance Scheme (NHIS) in Ghana. Methods: Data from the 2014 Ghana Demographic Health Survey was analysed. Cluster analysis was applied to construct a dependent variable; service care quality. Socio-demographic/background characteristics were used as independent variables. Descriptive and inferential analyses were performed followed by multiple regression to predict service quality among the insured population of women aged 15–49 years. SPSS version 21 was used during the clustering while STATA version 14 was used to perform the inferential and regression analyses. Findings: Overall, geographical region of respondents was significant to expressions of insured service quality (χ2=495.4, p ≤ 0.001). Literacy levels were significant at χ2=69.232 and p ≤ 0.001 for service quality. On place of residence, the estimation show urban residency was more positively correlated with indicating quality ratings of health services compared to rural residency (χ2=70.29, p ≤ 0.001). Highest educational level had the highest predictive influence with a coefficient of 0.15. Conclusions:A more supportive health insurance system approach that shifts towards introducing valued-based care models for patients, insurers and health care providers could be supportive in improving quality standards among insured population groups in Ghana
Reproductive-Age Women’s Knowledge and Care Seeking for Malaria Prevention and Control in Ghana:Analysis of the 2016 Malaria Indicator Survey
Introduction. Malaria is a major cause of morbidity and mortality worldwide, requiring individual and environmental level controls to prevent its adverse morbidity effects. This study examined reproductive-aged women’s knowledge and care-seeking practices for malaria prevention and control in Ghana. Methods. The 2016 Ghana Malaria Indicator Survey data for reproductive-age women was analysed (n=5,150). Multilevel mixed-effects logistic regression model was used to determine factors associated with reproductive-aged women’s knowledge and care-seeking practices for malaria. Results. 62.3%, 81.3%, and 64.6% knowledge levels on causes, signs/symptoms, and prevention of malaria were found, respectively, among respondents. Age, wealth and educational status, religion, region, and place of residence (rural) were found to significantly influence respondents’ knowledge of causes, signs/symptoms, and care-seeking practices for malaria. A 15% differential among Insecticide Treated Nets (ITNs) awareness and use was found. Increasing age (≥35 years) was associated with increasing knowledge of malaria. Regional variations were observed to significantly influence knowledge of malaria treatment. Conclusion. Though ownership of ITNs and knowledge of malaria prevention were high, it did not necessarily translate into use of ITNs. Thus, there is a need to intensify education on the importance and the role of ITNs use in the prevention of malaria
Reproductive-Age Women's Knowledge and Care Seeking for Malaria Prevention and Control in Ghana: Analysis of the 2016 Malaria Indicator Survey.
INTRODUCTION: Malaria is a major cause of morbidity and mortality worldwide, requiring individual and environmental level controls to prevent its adverse morbidity effects. This study examined reproductive-aged women's knowledge and care-seeking practices for malaria prevention and control in Ghana. METHODS: The 2016 Ghana Malaria Indicator Survey data for reproductive-age women was analysed (n=5,150). Multilevel mixed-effects logistic regression model was used to determine factors associated with reproductive-aged women's knowledge and care-seeking practices for malaria. RESULTS: 62.3%, 81.3%, and 64.6% knowledge levels on causes, signs/symptoms, and prevention of malaria were found, respectively, among respondents. Age, wealth and educational status, religion, region, and place of residence (rural) were found to significantly influence respondents' knowledge of causes, signs/symptoms, and care-seeking practices for malaria. A 15% differential among Insecticide Treated Nets (ITNs) awareness and use was found. Increasing age (≥35 years) was associated with increasing knowledge of malaria. Regional variations were observed to significantly influence knowledge of malaria treatment. CONCLUSION: Though ownership of ITNs and knowledge of malaria prevention were high, it did not necessarily translate into use of ITNs. Thus, there is a need to intensify education on the importance and the role of ITNs use in the prevention of malaria
Impact of a bottom-up community engagement intervention on maternal and child health services utilization in Ghana:a cluster randomised trial
BackgroundGhana is among African countries not likely to achieve the Sustainable Development Goal (SDG) three (3) target of reducing maternal mortality to 70 per 100,000 live births by the year 2030 if maternal and child health services utilization are not improved. Community engagement in health is therefore advocated to help address this challenge. This study evaluated the impact of a community engagement intervention on maternal and child health services utilization in Ghana.MethodsThis study was a cluster randomised trial among primary healthcare facilities (n = 64) in the Greater Accra and Western regions in Ghana. Multivariate multiple regression analysis and paired-ttest were used to determine impact of the community engagement intervention on maternal and child health indicators at baseline and follow-up.ResultsIntervention health facilities recorded significant improvements over control facilities in terms of average spontaneous vaginal deliveries per month per health facility (baseline mean = 15, follow-up mean = 30, p = 0.0013); child immunizations (baseline mean = 270, follow-up mean = 455, p = 0.0642) and female condoms distribution (baseline mean = 0, follow-up mean = 2, p = 0.0628). Other improved indicators in intervention facilities were average number of Human Immunodeficiency Virus (HIV) tests for non-pregnant women (baseline mean = 55, follow-up 104, p = 0.0213); HIV tests for pregnant women (baseline mean = 40, follow-up mean = 119, p = 0.0067) and malaria tests (baseline mean = 43, follow-up mean = 380, p = 0.0174). Control facilities however performed better than intervention facilities in terms of general laboratory tests, voluntary counselling and testing, treatment of sexually transmitted infections, male child circumcisions and other minor surgical procedures.ConclusionCommunity engagement in health has the potential of improving utilization of maternal and child health services. There is the need for multi-stakeholder dialogues on complementing existing quality improvement interventions with community engagement strategies
Self-reported breast and cervical cancer screening practices among women in Ghana:predictive factors and reproductive health policy implications from the WHO study on global AGEing and adult health
BackgroundBreast and cervical cancers constitute the two leading causes of cancer deaths among women in Ghana. This study examined breast and cervical screening practices among adult and older women in Ghana.MethodsData from a population-based cross-sectional study with a sample of 2749 women were analyzed from the study on global AGEing and adult health conducted in Ghana between 2007 and 2008. Binary and multivariable ordinal logistic regression analyses were performed to assess the association between socio-demographic factors, breast and cervical screening practices.ResultsWe found that 12.0 and 3.4% of adult women had ever had pelvic screening and mammography respectively. Also, 12.0% of adult women had either one of the screenings while only 1.8% had both screening practices. Age, ever schooled, ethnicity, income quantile, father’s education, mother’s employment and chronic disease status were associated with the uptake of both screening practices.ConclusionNationwide cancer awareness campaigns and education should target women to improve health seeking behaviours regarding cancer screening, diagnosis and treatment. Incorporating cancer screening as a benefit package under the National Health Insurance Scheme can reduce financial barriers for breast and cervical screening
Self-reported breast and cervical cancer screening practices among women in Ghana:predictive factors and reproductive health policy implications from the WHO study on global AGEing and adult health
BackgroundBreast and cervical cancers constitute the two leading causes of cancer deaths among women in Ghana. This study examined breast and cervical screening practices among adult and older women in Ghana.MethodsData from a population-based cross-sectional study with a sample of 2749 women were analyzed from the study on global AGEing and adult health conducted in Ghana between 2007 and 2008. Binary and multivariable ordinal logistic regression analyses were performed to assess the association between socio-demographic factors, breast and cervical screening practices.ResultsWe found that 12.0 and 3.4% of adult women had ever had pelvic screening and mammography respectively. Also, 12.0% of adult women had either one of the screenings while only 1.8% had both screening practices. Age, ever schooled, ethnicity, income quantile, father’s education, mother’s employment and chronic disease status were associated with the uptake of both screening practices.ConclusionNationwide cancer awareness campaigns and education should target women to improve health seeking behaviours regarding cancer screening, diagnosis and treatment. Incorporating cancer screening as a benefit package under the National Health Insurance Scheme can reduce financial barriers for breast and cervical screening
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