Adolescents’ exposure to mass media campaign messages on HIV/AIDS in Ghana

Abstract Using rich data collected from adolescents in Ghana by the Guttmacher Institute in collaboration with partners including the University of Cape Coast, this paper attempts to examine how exposure to specific messages designed for a media campaign dubbed “Stop AIDS-Love Life’ affected adolescents’ behaviour towards HIV/AIDS. Two logistic regression models are used to examine the effects of exposure to messages on HIV/AIDS on adolescents’ behavior towards HIV/AIDS. The study observed a direct and significant relationship between exposure to some of the messages and HIV/AIDS behavioural outcomes. It was established that adolescents who were exposed to the message titled “Think before you play” were about 1.3 times more likely to consider themselves at risk of HIV infection in both models. At

Trends in Health Insurance Subscription at Cape Coast, Ghana: A Retrospective Study from 2005 – 2014

Even though a major objective of the Ghana National Health Insurance Scheme at its promulgation in 2003 was a universal subscription by 2008, the scheme covered 38.3 per cent of the Ghanaian population by 2014. We examined trends in health insurance subscription at Cape Coast from 2005 to 2014. The study was conducted with data from the National Health Insurance Scheme from 2005 to 2014. A record review approach was adopted in extracting records of insurance subscription within the period under review. Data collected were presented using percentages and chi-square statistics. Subscription to the scheme declined from 43.9 per cent in 2005 to 40.6 per cent in 2014. There were more female than male subscribers in all the years under review. Subscription increased for persons under 18 years and those in the informal sector over the ten-year period, but declined for Social Security and National Insurance Trust contributors and pensioners, the aged, indigents, and pregnant women. The study underscores the need for the National Health Insurance Authority to increase subscription to the scheme through innovative ways such as sharing the scheme’s achievements through improved advertisement and contracting private entities through public-private partnerships to augment its efforts at recruiting more subscribers.

Trend and determinants of complete vaccination coverage among children aged 12-23 months in Ghana: analysis of data from the 1998 to 2014 Ghana Demographic and Health Surveys

Background Vaccination is proven to be one of the most cost-effective measures adopted to improve the health of children globally. Adhering to vaccines for children has the propensity to prevent about 1.5 million annual child deaths globally. This study sought to assess the trend and determinants of complete vaccination coverage among children aged 12–23 months in Ghana. Materials and methods The study was based on data from four rounds of the Ghana Demographic and Health Survey (GDHS 1998, 2003, 2008, and 2014). Information on 5,119 children aged 12–23 months were extracted from the children’s files. Both bivariate and multivariate analyses were conducted to assess the factors associated with complete vaccination and statistical significance was pegged at p<0.05. Results We found that complete vaccination coverage increased from 85.1% in 1998 to 95.2% in 2014. Children whose mothers were in rural areas [aOR = 0.45; CI = 0.33–0.60] had lower odds of getting complete vaccination, compared to those whose mothers were in urban areas. Also, children whose mothers had a secondary level of education [aOR = 1.87; CI = 1.39–2.50] had higher odds of receiving complete vaccination, compared to those whose mothers had no formal education. Children whose mothers were either Traditionalists [aOR = 0.60; CI = 0.42–0.84] or had no religion [aOR = 0.58, CI = 0.43–0.79] had lower odds of receiving complete vaccination, compared to children whose mothers were Christians. Conclusion The study revealed that there has been an increase in the coverage of complete vaccination from 1998 to 2014 in Ghana. Mother’s place of residence, education, and religious affiliation were significantly associated with full childhood vaccination. Although there was an increase in complete childhood vaccination, it is imperative to improve health education and expand maternal and child health services to rural areas and among women with no formal education to further increase complete vaccination coverage in Ghana

Knowledge and determinants of women’s knowledge on vertical transmission of HIV and AIDS in South Africa

Background: HIV/AIDS is still one of the major public health concerns globally. It is one of the major contributory causes of deaths among women in the reproductive age (15–49 years) and has resulted in about 14 million orphaned children globally. Knowledge of Mother-to Child transmission is one of the strategies to fight against HIV. This study, therefore, sought to assess the knowledge and determinants of women’s knowledge on vertical transmission of HIV and AIDS in their reproductive age in South Africa. Methods: Data were obtained from the South Africa Demographic and Health Survey (SADHS) 2016. Both descriptive (frequencies and percentages) and inferential analysis (multilevel mixed-effects complementary log–log regression model) were conducted and the statistical significance was set at p < 0.05. Results: The prevalence of knowledge of mother to child transmission of HIV and AIDS during pregnancy, delivery, breastfeeding and at least knowledge of one source are 87.0%, 81.1%, 80.3% and 91.4% respectively. At the individual level, those with secondary [AOR = 1.28, CI = 1.04,1.57] and higher [AOR = 1.55, CI = 1.21,1.99], those who read newspaper less than once a week [AOR = 1.16, CI = [1.05,1.28], at least once a week [AOR = 1.14, CI = 1.04,1.25], and those who listen to the radio less than once a week [AOR = 1.22, CI = 1.03,1.43] had higher odds of knowledge on MTCT of HIV and AIDS. However, those with parity 0 [AOR = 0.73, CI = [0.63,0.85] had lower odds of knowledge of MTCT of HIV and AIDS compared with those with parity 4 or more. At the contextual level, those in the poorest wealth quintile [AOR = 0.82,CI = 0.69,0.97] had lower odds of having knowledge of MTCT of HIV and AIDS. Those in the urban areas [AOR = 1.17, CI = [1.04,1.31], those in Limpopo [AOR = 1.35, CI = [1.12,1.64], Gauteng [AOR = 1.35, CI = [1.12,1.62] and North west[AOR = 1.49, CI = [1.22,1.81] had higher odds of knowledge of mother to child transmission of HIV and AIDS. Conclusion: The study has demonstrated that there is relatively high knowledge of mother to child transmission of HIV and AIDS in South Africa. The factors associated with the knowledge are educational level, exposure to mass media, parity, wealth status, place of residence and the region of residence. To further increase the knowledge, it is imperative to adopt various messages and target respondents in different part of SSA through the mass media channels. This should be done taking cognizant of the rural–urban variations and socio-economic status

Skilled antenatal care services utilisation in sub-Saharan Africa: a pooled analysis of demographic and health surveys from 32 countries

Background: Each day, an estimated 800 women die from preventable pregnancy and childbirth related complications, where 99% of these avoidable deaths happen in low-and middle-income countries. Skilled attendance during antenatal care (ANC) plays a role in reducing maternal and child mortality. However, the factors that predict the utilisation of skilled ANC services in sub-Saharan Africa (SSA) remains sparsely investigated. Therefore, we examined women’s utilisation of skilled ANC services in SSA. Methods: The research used pooled data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA between January 1, 2010, and December 31, 2019. Binary logistic regression was used to examine the predictors of skilled ANC services utilisation. The results are presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI). Results: The prevalence of skilled ANC services utilisation in SSA was 76.0%, with the highest and lowest prevalence in Gambia (99.2%) and Burundi (8.4%), respectively. Lower odds of ANC from skilled providers was found among women aged 45–49 compared to those aged 20–24 (aOR = 0.86, CI = 0.79–0.94); widowed women compared to married women (aOR = 0.84, CI = 0.72–0.99); women who consider getting permission to visit the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.74, CI = 0.71–0.77); women who consider getting money needed for treatment as not a big problem compared to those who consider that as a big problem (aOR = 0.84, CI = 0.72–0.99); and women who consider distance to the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.75, CI = 0.72–0.77). Conclusion: SSA has relatively high prevalence of skilled ANC services utilisation, however, there are substantial country-level disparities that need to be prioritised. Increasing maternal reproductive age being widowed and far distance to health facility were factors that predicted lower likelihood of skilled ANC services utilisation. There is, therefore, the need to intensify female formal education, invest in community-based healthcare facilities in rural areas and leverage on the media in advocating for skilled ANC services utilisation

Barriers to accessing healthcare among women in Ghana: a multilevel modelling

Background: Women’s health remains a global public health concern, as enshrined in the Sustainable Development Goals. This study, therefore, sought to assess the individual and contextual factors associated with barriers to accessing healthcare among women in Ghana. Methods: The study was conducted among 9370 women aged 15–49, using data from the 2014 Ghana Demographic and Health Survey. Barrier to healthcare, derived from four questions— whether a woman faced problems in getting money, distance, companionship, and permission to see a doctor—was the outcome variable. Descriptive and multilevel logistic regression analyses were carried out. The fixed effect results of the multilevel logistic regression analyses were reported using adjusted odds ratios at a 95% confidence interval. Results: More than half (51%) of the women reported to have at least one form of barrier to accessing healthcare. Women aged 45–49 (AOR = 0.65, CI: 0.49–0.86), married women (AOR = 0.71, CI:0.58–0.87), those with a higher level of education (AOR = 0.51, CI: 0.37–0.69), those engaged in clerical or sales occupation (AOR = 0.855, CI: 0.74–0.99), and those who were covered by health insurance (AOR = 0.59, CI: 0.53–0.66) had lower odds of facing barriers in accessing healthcare. Similarly, those who listened to radio at least once in a week (AOR =0.77, CI: 0.66–0.90), those who watched television at least once a week (AOR = 0.75, CI: 0.64–0.87), and women in the richest wealth quintile (AOR = 0.47, CI: 0.35–0.63) had lower odds of facing barriers in accessing healthcare. However, women who were widowed (AOR = 1.47, CI: 1.03–2.10), those in the Volta Region (AOR 2.20, CI: I.38–3.53), and those in the Upper West Region (AOR =2.22, CI: 1.32–3.74) had the highest odds of facing barriers to healthcare accessibility. Conclusion: This study shows that individual and contextual factors are significant in predicting barriers in healthcare access in Ghana. The factors identified include age, marital status, employment, health insurance coverage, frequency of listening to radio, frequency of watching television, wealth status, and region of residence. These findings highlight the need to pay critical attention to these factors in order to achieve the Sustainable Development Goals 3.1, 3.7, and 3.8. It is equally important to strengthen existing strategies to mitigate barriers to accessing healthcare among women in Ghana

Early sexual relationships and age mixing among older adolescents living in an urban slum in Ghana: Early sexual relationships and age mixing among older adolescents living in an urban slum in Ghana

Understanding Adolescents’ sexual and reproductive health behaviour is paramount if the attainment of improved health outcomes and ultimately, the realisation of Sustainable Development Goals are to be achieved. However, the extant literature appears to be disproportionately focused on adolescents in the rural context. Using both qualitative and quantitative data collected from adolescents aged 15-19 years living in Kwesimintsim zongo – an urban slum, this paper attempts to examine early sexual relationships and age mixing among older adolescents. The results point to the presence of risky sexual behaviour among the respondents. Specifically it was found that about a fifth of the respondents were engaged in both early sexual relationships and age mixing. These findings provide useful insight on urban adolescents and their sexual reproductive health in Ghana and it is recommended that preventive measures such as educational campaigns be deployed to dissuade adolescents from engaging in these risky behaviours whose resultant social, psychological and economic costs affect the wider society

Adolescents&apos; exposure to mass media campaign messages on HIV/AIDS in Ghana

Using rich data collected from adolescents in Ghana by the Guttmacher Institute in collaboration with partners including the University of Cape Coast, this paper attempts to examine how exposure to specific messages designed for a media campaign dubbed "Stop AIDS-Love Life&apos; affected adolescents&apos; behaviour towards HIV/AIDS. Two logistic regression models are used to examine the effects of exposure to messages on HIV/AIDS on adolescents&apos; behavior towards HIV/AIDS. The study observed a direct and significant relationship between exposure to some of the messages and HIV/AIDS behavioural outcomes. It was established that adolescents who were exposed to the message titled "Think before you play" were about 1.3 times more likely to consider themselves at risk of HIV infection in both models. At p<.05, adolescents who reported exposure to HIV/AIDS messages "No means no - think" were more than 1.2 times more likely to express willingness to care for an HIV infected persons. The study highlights the need to put in place measures which will ensure that adolescents are reached with appropriate messages through mass media channels which are accessible to them. Efforts should be made to use mass media messages to reach adolescents on issues concerning HIV/AIDS stigma and discrimination. It is recommended that adolescents should be provided with supportive environments which will help them to sustain positive behaviour that they adopt in order to avoid a "slip" or "relapse". Also, program designers and implementers should avoid the &apos;once-size-all approach&apos; and consider the heterogeneity that exists among adolescents in the design of campaign messages.En utilisant les données recueillies auprès des adolescents au Ghana par l&apos;Institut Guttmacher, en collaboration avec des partenaires dont l&apos;Université de Cape Coast, cet article tente d&apos;examiner comment l&apos;exposition à des messages spécifiques destinés à une campagne médiatique baptisée «Arrêtez les SIDA ! Aimez la vie ! » a affecté le comportement des adolescents à l&apos;égard du VIH / SIDA. Deux modèles de régression logistique sont utilisés pour examiner les effets de l&apos;exposition à des messages à propos du VIH / SIDA sur le comportement des adolescents face au VIH / SIDA. L&apos;étude a montré une relation directe et significative entre l&apos;exposition à certains des messages et les résultats comportementaux du VIH / SIDA. Il a été établi que les adolescents qui ont été exposés au message intitulé "Réfléchissez avant de jouer" ont été environ 1,3 fois plus susceptibles de se considérer à risque d&apos;infection du VIH dans les deux modèles. A p <.05, les adolescents qui ont déclaré être exposés aux messages du VIH / SIDA «Pas de moyens, Non ! Réfléchissez !» ont été plus de 1,2 fois plus susceptibles d&apos;exprimer leur volonté de prendre soin d&apos;une personne infectée par le VIH. L&apos;étude souligne la nécessité de mettre en place des mesures qui feront en sorte que les adolescents aient les messages appropriés par les médias de masse qui leur sont accessibles. Des efforts devraient être déployés pour utiliser les messages des médias de masse pour atteindre les adolescents sur les questions concernant la stigmatisation et la discrimination relatives au VIH / SIDA. Il est recommandé que les adolescents accèdent aux environnements de soutien qui les aideront à maintenir un comportement positif qu&apos;ils adoptent afin d&apos;éviter une «erreur» ou «rechute». En outre, les concepteurs et exécutants de programmes devraient éviter le "une fois à taille tous les approche» et tenir compte de l&apos;hétérogénéité qui existe chez les adolescents dans la conception des messages de campagne

Barriers and motivations for health insurance subscription in Cape Coast, Ghana: a qualitative study

Abstract Background One of the main objectives of the Ghana National Health Insurance Scheme, at its establishment in 2003, was to ease financial burden of the full cost recovery policy, particularly on the poor. However, currently, majority of the scheme’s subscribers are individuals in the upper wealth quintile, as the poor in society rather have not subscribed. We explored the motivational factors as well as the barriers to health insurance subscription in the Cape Coast Metropolis of Ghana. Methods This study collected qualitative data from 30 purposively selected subscribers and non-subscribers to the National Health Insurance Scheme using an in-depth interview guide. Results Major motivational factors identified were; affordable health insurance premium, access to free drugs, and social security against unforeseen health challenges. Encouragement by friends, family members, and colleagues, was also found to motivate subscription to the health insurance. The major barriers to health insurance subscription included; long queues and waiting time, perceived poor quality of drugs, and negative attitude of service providers both at the healthcare facilities and the health insurance office. The study underscores the need for the National Health Insurance Authority to conduct intensive education to change the negative perception people have regarding the quality of health insurance drugs. Efforts should also be made to reduce the waiting time in accessing healthcare with the National Health Insurance Scheme card. This would motivate more people to subscribe or renew their membership. Conclusions The implication of barriers found is that people may not subscribe to the scheme in subsequent years. This would, therefore, consequently defeat the objective of achieving universal healthcare coverage with the scheme

Women's reproductive health decision-making: A multi-country analysis of demographic and health surveys in sub-Saharan Africa

IntroductionWomen's ability to make decisions regarding their reproductive health has important implications for their health and well-being. We studied the socio-demographic factors affecting reproductive health decision-making among women in 27 sub-Sahara African countries.Materials and methodsThe study made use of pooled data from current Demographic and Health Survey (DHS) conducted from January 1, 2010 and December 31, 2016 in 27 countries in sub-Sahara African. Binary and multivariate logistic regression models were used to investigate the associations of women's socio-demographic factors with decision-making regarding sexual reproductive health.ResultsThe proportion of women who can ask their partners to use a condom during sexual intercourse ranged from lowest in Mali (16.6%) to highest in Namibia (93.4%). Furthermore, the proportion of women who can refuse sex ranged from 18.3% in Mali to 92.4% in Namibia. Overall, approximately every five out of ten women can ask their partners to use a condom, six out ten women could refuse their partners sex and seven out of ten women could make at least 1 decision. Women from rural areas (OR = 0.51, CI = 0.48-0.54), those with no education (OR = 0.11, CI = 0.10-0.12), Muslim women (OR = 0.29, CI = 0.27-0.31), women not working (OR = 0.53, CI = 0.51-0.56) and women whose partners had no education (OR = 0.17, CI = 0.16-0.19) were less likely to make a decision on their reproductive health.ConclusionResidence, age, level of education, religion, occupation and partner's education were found to be associated with women's decision-making about sexual intercourse, condom use and reproductive health decision-making index. This study contributes to the discourse on reproductive health decision-making in Africa. Policies and intervention targeted at improving women's autonomy and empowering them to take charge of their sexual and reproductive health issues should be focused on these factors