Exploring Experiences of Pregnant Adolescents and Their Utilization of Reproductive Health Services in Ho West District, Ghana: A Salutogenic Approach

Adolescent pregnancy (AP) is a significant public health problem across Africa. In the Volta Region of Ghana, 32% of adolescents were exposed to unintended pregnancies in 2011 due to lack of knowledge and use of available methods of contraceptives. In addition to the health consequences, adolescent pregnancy also contributes to the perpetuation of poverty cycle among populations. Although several studies have investigated problems associated with adolescent pregnancy, its risk factors and prevention, few have examined the experiences that pregnant adolescents and adolescent mothers go through in their communities. From a salutogenic theoretical perspective, this study explored adolescent lived experiences with a focus on stressors and resources inherent. Issues surrounding their utilization of reproductive health services were also explored. Objectives: The objectives of the study were to identify, through exploration, stress and resource experiences of pregnant adolescents and adolescent mothers. Methods: Qualitative methodology with phenomenological design was used and the salutogenic model formed the theoretical framework. Data collection techniques included in-depth interviews and focus group discussions. Interviews were conducted with 6 key informants (two Queen Mothers, two Health personnel, two teachers, and an NGO official) and 11 adolescent girls (6 pregnant and 5 mothers). Data were transcribed, coded and analysed using Attride- Stirling's thematic network analysis. Findings: Five stressors emerged: a) severe economic/financial constraints before/after pregnancy, b) educational/schooling difficulties, c) Psychological, social and emotional stresses d) Cultural and Religious constraint e) Misinformation about and stigmatization of ARHS. Resources that emerged included a) support from parents, educated family, benevolent persons, female teachers, and churches b) Personal strength and courage (Hardiness) c) Availability of reproductive health services (RHS) d) The community midwife e) Traditional Birth Attendants (TBAs) f) Existence of government policies (NHIS, GES directives, NGOs). Conclusions: Pregnant adolescents and adolescent mothers experience multiple stressful life events with few resources to deal with such stressors. These stressors limit their access to and utilization of adolescent reproductive health services. Stakeholder action to provide more support to adolescents and education for their families and communities are recommended. However, the pregnant adolescents and adolescent mothers in the Ho west district in the Volta Region of Ghana are able to thrive amidst all these stressors due to the strong sense of coherence hardiness on the part of the girls and the availability of a community midwife.Master of Philosophy in Health PromotionHEPRO350MPHEPR

Food Hygiene Practices at the Ghana School Feeding Programme in Wa and Cape Coast Cities

Objective. The integrity and the wholesomeness of the food served to school pupils cannot be overlooked, especially when one considers the magnitude of health and sanitation issues that are plaguing the West African nations. This study aimed to investigate some of the personal hygiene practices by the pupils and the hygienic conditions in which food is cooked and served to these school-going children under the Ghana School Feeding Programme (GSFP). Design. A cross-sectional and descriptive survey research designs were used in the study. Purposive and simple random sampling techniques were employed in selecting participants. Participants. There were 720 respondents for the study, comprising 600 pupils, 60 teachers, and 60 kitchen staff members from 20 schools. Information was obtained using questionnaire, observation, and unstructured interview instruments. Results. Findings from the study revealed that the majority of pupils (92% in Wa and 65% in Cape Coast) did not wash their hands with soap under running water. No hand washing centers for pupils were also seen in most of the schools studied. Majority of the cooks did not have health certificate, and neither had attended any in-service training in two years. In both Wa and Cape Coast municipal schools, none of the kitchen staff admitted that pupils and teachers ever complained about the meals they served to the pupils. Conclusion. The GSFP in basic schools forms part of the integral diet of the school children; hence, provision of good quality food can affect the health, learning, and physical activities of these children. Observational checklist revealed that most of the kitchen staff do not strictly adhere to basic food hygiene practices, and this affects the wholesomeness of the food served to the children. There is, therefore, a need for kitchen staff training on hygiene and food preparation practices