Factors influencing condom use among women in Ghana: an HIV/AIDS perspective

Although in Ghana information on HIV infection and prevention, both in terms of quality and quantity, has increased considerably within the past few years, available literature indicates that behaviour change is yet to correspond with the amount of information and education provided. The objective of this study is to examine factors that influence condom use among women in Ghana in the context of HIV/AIDS prevalence. Data for this study are from the 2003 Ghana Demographic and Health Surveys (GDHS) and the study population (N=5 691) was analysed using logistic regression with the Health Belief Model (HBM) as an explanatory tool. The outcome variable for this study is condom use during last sexual intercourse. The HBM identifies perception of HIV/AIDS risks, awareness of its seriousness, knowledge about prevention, and confidence in condom use as predictors of safe sexual activity. Results show that the proportion of women reporting use of condoms remains tremendously low, in both the rural and urban areas. In the urban areas, only 15% of women reported having sex with condom during their last intercourse, whereas in the rural areas the proportion is even lower (10%). However, multivariate analyses based on the HBM components show that speaking with a partner about how to avoid AIDS (Odds Ratio = 1.63) and perceived benefits of using condoms (Odds Ratio = 1.54) are notable factors that predict condom use. Overall, the study points out that with the exception of perceived severity, the HBM can be applied to understand condom use among the study population. It will be important to emphasise all components of the HBM and empower women with condom negotiation skills.Keywords: Health Belief Model (HBM), HIV/AIDS, condom use, Ghana.Au Ghana, bien que l´information sur la prévention et l´infection VIH est considérablement augmentée au cours des dernières années, aussi bien en qualité qu’en quantité, les publications récentes indiquent que les changements de comportement ne sont pas encore liés à la quantité d’information et à l’éducation dispensée. L’objectif de cette étude est d’examiner les facteurs qui influencent l’utilisation du préservatif chez les femmes au Ghana, dans le cadre de la prévalence du VIH/SIDA. Les données de cette étude provenant de l’enquête sur la démographie et la santé de 2003 et du recensement de la population (N=5 691) ont été analysées en utilisant la méthode de régression logistiques avec le ‘Health Belief’ Modèle (HBM) comme outil d’explication. La finalité de cette étude est de connaître le niveau d’utilisation du préservatif durant les derniers rapports sexuels. La méthode HBM détermine le niveau de perception du risque VIH/SIDA et la conscience de sa gravité, connaissance des mesures de prévention et confiance envers le préservatif comme outil de protection de l’activité sexuelle. Les résultats montrent que la proportion de femmes qui dit utiliser le préservatif demeure extrêmement faible, aussi bien au niveau rural qu’urbain. Dans les zones urbaines, seulement 15% des femmes disent avoir utilisé le préservatif durant le dernier rapport. Aussi, en milieu rural cette proportion est encore plus faible (10%). Quoi qu’il en soit, les multiples analyses basées sur la méthode HBM montrent que parler avec son partenaire sur comment éviter le SIDA (Odds Ratio = 1.63) et des avantages perçus de l’utilisation du préservatif (Odds Ratio = 1.54) sont les facteurs clés qui poussent à l’utilisation du préservatif. En général, l’étude révèle qu’en dehors de sa perception de sévérité, le HBM peut être utilisé pour comprendre l’utilisation du préservatif au sein d’une population. Il est important de souligner tous les aspects de la méthode HBM et en particulier le pouvoir des femmes dans la négociation pour l’utilisation du préservatif

Covert contraceptive use among women attending a reproductive health clinic in a municipality in Ghana.

BACKGROUND: Covert contraceptive use (CCU) in sub-Saharan Africa is an indication of women's inability to exercise autonomy in their reproductive choices. The aim of this study was to assess the prevalence and determinants of CCU among a sample of FP clients in a municipality of Ghana. METHODS: We conducted a mixed method study among women attending a public reproductive health clinic in Sunyani, a city of over 250,000 inhabitants in Ghana. An initial survey inquired into sociodemographic characteristics, use of family planning (FP) methods and partner awareness of contraceptive use. The predictors of CCU were explored using logistic regressions. We used the findings to develop a guide which we applied in-depth interviews and focus group discussions with attendants at the same facility. Qualitative data analysis was conducted using a framework approach. RESULTS: We interviewed 300 women, 48 % of whom were aged between 26-33 years. The injectable was the most widely used method (56 %). The prevalence of CCU was 34 %. In multivariate analysis, single women were more likely to practice CCU than married or co-habiting women (Adjusted OR = 12.12, 95 % C.I. 4.73-31.1). Muslim and traditionalist women were similarly more likely to practice CCU than non-Muslim, non-traditionalist (Adjusted OR = 4.56, 2.29-9.06). Women who preferred to have their first or next child in 4 or more years from the time of the interview were more likely to be in CCU than women who intended to have children within 4 years of the interview (2.57; 1.37-4.83). Single women saw in covert use a statement of their social autonomy. To succeed in CCU, women wished that clinic attendance cards would not be given to them to keep at home. Though many participants saw in CCU a source of anxiety, they expected health workers to consider it and uphold confidentiality in the provision of services. CONCLUSIONS: Covert contraceptive use was high in this municipality and being single was the strongest predictor of the practice. Providers of FP services should reflect on how to adequately address the challenges faced by women who practice CCU

Trends in the prevalence of female genital muti-lation and its effect on delivery outcomes in the kassena-nankana district of northern Ghana

Rational: Female genital mutilation (FGM) is prevalent in northern Ghana, as the practice is seen as a passage rite to women adulthood and thus undertaken just before marriage. Objectives: We determined the changes in trend of FGM in deliveries at the Navrongo War Memo-rial hospital, and compared the outcomes and FGM status.Design: Retrospective extraction and analysis of delivery data at the hospital from 1st January 1996 to 31st December 2003. Results: Of the 5071 deliveries, about 29% (1466/5071) were associated with FGM. The high-est prevalence (95% CI) of 61.5% (50.9, 71.2) was in women aged 40 years and above, and the lowest of 14.4% (11.7, 17.0) was in women below 20 years. The all-age prevalence of FGM showed a significant decline (p-value for linear trend < 0.01) from 35.2% in 1996 to 21.1% in 2003. About 6% (89/1466) of mothers with FGM had stillbirths compared with about 3% (123/3605) of mothers without FGM. Again FGM was associated with 8.2% (120/1466) caesarean section rate compared with 6.7% (241/3605) in mothers without FGM. Mean birth weight and frequency of low birth weights were not significantly associated with FGM status. Conclusion: Although there is a high rate of FGM among mothers in the district and is associated with a higher proportion of stillbirths and caesar-ean sections, practice has shown a significant de-cline in the district in recent years due to the pre-vailing campaigns and intervention studies. There is therefore the need to sustain the ongoing inter-vention efforts

Towards effective participation of the private health sector in Ghana’s COVID-19 response

The private health sector is a major service provider group within the health systems of most sub-Saharan African countries. Currently, 90% of COVID-19 cases in Ghana are in urban areas where private health facilities play a major role in service delivery. Yet, there is limited understanding of the issues mediating private health sector participation in public health emergency responses. Challenges related to its involvement in Ghana´s COVID-19 response include lack of clarity on its role, sub-optimal communication channels, inadequate personal protective equipment and fragmentation of the sector. Hence, operational and regulatory actions addressing these challenges will ensure the private sector is fully prepared to contribute to the COVID-19 response and future public health emergencies, thereby strengthening Ghana’s health system

Willingness to undergo HIV testing in the Kintampo districts of Ghana

Background: HIV testing is currently a major prevention intervention and remains an entry point to early treatment, care and support. Uptake is  however low and alternative approaches are currently being adopted.Objective: An HIV module was incorporated into the routine survey of the Kintampo Health and Demographic Surveillance System (KHDSS) to assess the willingness of adults living in the Kintampo North and South districts to undergo HIV testing.Design: The study was a descriptive cross-sectional household survey.  Univariate and multivariate analysis were used to identify predictors of the willingness to undergo HIV testing.Participants: Respondents were community members aged 15 to 49 years and selected from randomly generated household listings from the KHDSS.Results: A total of 11,604 respondents were interviewed, 10,982 (94.6%) of respondents had good general knowledge on HIV/AIDS. Among those with knowledge about HIV/AIDS, 10,819 (98.5%) indicated their willingness to get tested for HIV. Rural residents were more willing to undergo HIV testing than urban dwellers Odds ratio=1.42 (95% Confidence interval:1.03, 1.96; P-value=0.031). Respondents with primary education were more likely to go for testing relative to those without any education OR=2.02 (95% CI: 0.87, 4.70; P-value=0.046).Conclusion: Expressed willingness to test for HIV is high in this population. Exploring community and population-based interventions to HIV testing and counseling could increase uptake of HIV testing services and should be considered. The underlying motivations need to be explored in order to translate willingness into actual testing.Key words: HIV/AIDS, Routine survey, Willingness to test, Logistic regression, Ghan

Human vs robot baristas during the COVID-19 pandemic: effects of masks and vaccines on perceived safety and visit intention

Purpose This study aims to compare the effect of barista type (human vs robot) on perceived safety and examine the role of two moderators (mask-wearing and coronavirus vaccination) on the effects of barista type on perceived safety and visit intention. Design/methodology/approach The research design consists of three studies. Three experiments were sequentially designed and conducted to address research questions. Findings Study 1 found that perceived safety mediates the effect of barista type on customers’ visit intention. Study 2 revealed that the mask-wearing of human and robot baristas differently influences perceived safety. Study 3 showed that customers, especially where robot baristas are used, perceive the effect of mask-wearing differently depending on their coronavirus vaccination status. Research limitations/implications Given that the levels of restrictions vary worldwide, together with the extent of countries’ vaccination rollouts, caution is required when generalising the research findings. Practical implications The findings have practical implications for the hospitality industry, where the roles of face masks and coronavirus vaccines in shaping consumer psychology and behaviour have been underexplored. Originality/value Coronavirus vaccination is considered one of the most important driving forces for the recovery of hospitality businesses. As a heuristic-systematic model postulated, this study identified that vaccination status (fully vaccinated vs not vaccinated) changes the level of involvement when customers assess the level of risk in service environments. By pinpointing the function of service robots in safeguarding customers from the potential spread of the disease, this study broadens the scope of human–robot interaction research in hospitality

Developing a Data Dashboard Framework for Population Health Surveillance: Widening Access to Clinical Trial Findings

Background: Population surveillance sites generate many datasets relevant to disease surveillance. However, there is a risk that these data are underutilized because of the volumes of data gathered and the lack of means to quickly disseminate analysis. Data visualization offers a means to quickly disseminate, understand, and interpret datasets, facilitating evidence-driven decision making through increased access to information. Objectives: This paper describes the development and evaluation of a framework for data dashboard design, to visualize datasets produced at a demographic health surveillance site. The aim of this research was to produce a comprehensive, reusable, and scalable dashboard design framework to fit the unique requirements of the context. Methods: The framework was developed and implemented at a demographic surveillance platform at the Africa Health Research Institute, in KwaZulu-Natal, South Africa. This context represents an exemplar implementation for the use of data dashboards within a population health-monitoring setting. Before the full launch, an evaluation study was undertaken to assess the effectiveness of the dashboard framework as a data communication and decision-making tool. The evaluation included a quantitative task evaluation to assess usability and a qualitative questionnaire exploring the attitudes to the use of dashboards. Results: The evaluation participants were drawn from a diverse group of users working at the site (n=20), comprising of community members, nurses, scientific and operational staff. Evaluation demonstrated high usability for the dashboard across user groups, with scientific and operational staff having minimal issues in completing tasks. There were notable differences in the efficiency of task completion among user groups, indicating varying familiarity with data visualization. The majority of users felt that the dashboards provided a clear understanding of the datasets presented and had a positive attitude to their increased use. Conclusions: Overall, this exploratory study indicates the viability of the data dashboard framework in communicating data trends within population surveillance setting. The usability differences among the user groups discovered during the evaluation demonstrate the need for the user-led design of dashboards in this context, addressing heterogeneous computer and visualization literacy present among the diverse potential users present in such settings. The questionnaire highlighted the enthusiasm for increased access to datasets from all stakeholders highlighting the potential of dashboards in this context

Prevalence and Determinants of Hearing Loss Among Primary School Children in Selected Schools in the Central Region of Ghana

Hearing loss in children often inhibits speech and language development, thus affecting academic performance, social and emotional well-being. Thus a comparative cross-sectional study was conducted in three primary schools in Ghana to assess hearing of the children attending those schools and also compare differences between these schools based on the pupils’ socioeconomic backgrounds. The data was used to determine prevalence of hearing loss in the schools. A comparison was then made between the results obtained among children attending the more affluent school and the less affluent schools. A total of 773 pupils were included in this study even though 839 pupils were screened as some pupils failed to adequately complete the questionnaires. The average age was 10 years with a standard deviation of 2.65. Significant hearing loss was identified in 4 children (0.5%). Abnormal tympanometry was identified in 86 (10.2%). Abnormal otologic findings identified included cerumen impaction in 73 children (36.5%), acute otitis externa in 7, acute otitis media in 6 and foreign bodies in 10. Schools with lower socioeconomic pupils had a higher prevalence of abnormal tympanometry but there was no difference in hearing loss prevalence. In conclusion, unidentified hearing loss in the three basic schools in Ghana was uncommon and prevalence was not impacted by the school’s socioeconomic background. However, a significant portion had abnormal middle ear function or external auditory canal occlusion from cerumen impaction and thus required further management

Exploring the biochemistry at the extracellular redox frontier of bacterial mineral Fe(III) respiration

Many species of the bacterial Shewanella genus are notable for their ability to respire in anoxic environments utilizing insoluble minerals of Fe(III) and Mn(IV) as extracellular electron acceptors. In Shewanella oneidensis, the process is dependent on the decahaem electron-transport proteins that lie at the extracellular face of the outer membrane where they can contact the insoluble mineral substrates. These extracellular proteins are charged with electrons provided by an inter-membrane electron-transfer pathway that links the extracellular face of the outer membrane with the inner cytoplasmic membrane and thereby intracellular electron sources. In the present paper, we consider the common structural features of two of these outer-membrane decahaem cytochromes, MtrC and MtrF, and bring this together with biochemical, spectroscopic and voltammetric data to identify common and distinct properties of these prototypical members of different clades of the outer-membrane decahaem cytochrome superfamily