Increasing access to intrauterine contraceptive device uptake in Ghana: stakeholders views on task sharing service delivery with community health nurses

Introduction: Evidence supporting successful task sharing to increase Intrauterine Contraceptive Device (IUD) uptake exist in some developing countries that have challenges with availability of trained health professionals. Although Community Health Nurses (CHNs) in Ghana are trained to provide primary health care including emergency deliveries in rural communities, they are not professionally mandated to provide IUD services.Objectives: To explore stakeholders’ views on task sharing IUD services with CHNs in Ghana.Methods: This qualitative case study was conducted in Accra, Ghana between June and September 2018. Focus group discussions and in-depth interviews were used to collect data from purposively selected participants. Included in the study were policy makers, policy implementing institutions, service regulators, Non-Governmental Organisations, field providers and service end users. Interviews were recorded and transcribed verbatim. We manually performed thematic analysis of data and findings were appropriately described by paraphrasing and/or quoting relevant responses verbatim.Results: There is a general mixed feeling towards task sharing IUD services with community health nurses in Ghana. Policy makers, programmers, gynaecologists and IUD users interviewed believed that CHNs are capable of providing safe IUD services when well trained, adequately resourced and supervised. Based on some field experiences of complications associated with IUD insertions, participants who were midwives clearly indicated the need for effective training and careful implementation strategies.Conclusions: Despite concerns about user safety, respondents endorsed task-sharing IUD services with trained CHNs in Ghana. Implementation study focusing on competency-based IUD training for selected CHNs is recommended to provide empirical evidence to back policy decisions.Keywords: Task-sharing, IUD, Community Health Nurses, Policy, GhanaFunding: Marie Stopes Ghana funded the field work

STORYTELLING SONGS OF THE ÈWÈ-DÒMÈ OF GHANA

For the Central Èwè or Èwè-Dòmè people of Ghana’s Volta Region, storytelling is a vital practice used to transmit key lessons. For centuries the Èwè-Dòmè employed storytelling performances in initiation rites, war celebrations, wake-keeping, and praise singing to enrich the gathering by relaying important information, building group identity, and binding the community together with story, song, and dance. Storytellers and community participants point to the role that songs play within storytelling as cultural markers for the Èwè-Dòmè communities in the area around Ho, the Volta Region’s capital. Within the framework of extended family or town-wide storytelling performances, audience members habitually interrupt the story with song and dance that enlivens sleepy listeners and augments the story with an interpretive angle on the theme. Singing reverses the artist-audience roles. Other community events similarly provide an opportunity for artist-audience interaction and the reversal of roles. This paper documents the social role of songs in the context of storytelling as well as the performance practices, texts, melodies, rhythms, and harmonies of this important traditional musical genre in the face of numerous threats to its ongoing existence

De L’excision Au Nord Et À L’ouest De La Côte d’Ivoire

This exploratory study aims at understanding, through the theory of conventions, the social and psychosocial springs underlying the perpetuation of FGM in Côte d'Ivoire. It takes place in the northern and western regions, traditionally favorable to this practice. The approach consisted of interviewing 1008 subjects (women, children, circumcisers, administrative authorities and NGOs) by means of a questionnaire. It concludes with suggestions for strengthening policies in this field

Role-players in abortion decision-making in the Accra Metropolis, Ghana

BACKGROUND: Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana. METHODS: A retrospective cross-sectional mixed method study was conducted between January and December 2011. A total of 401 women with records in abortion logbooks were selected for an interviewer-administered questionnaire and an in-depth interview. Descriptive and multinomial logistic regression analyses were used to assess the quantitative data, and a thematic analysis was applied to the qualitative data. RESULTS: The findings of the study reveal that pregnant individuals, mothers of abortion-seekers, male partners, and “Others” (for example, friends, employers) were instrumental in making a decision to terminate unplanned/unwanted pregnancies. Several key factors influenced the decision-making processes, including aversion from the men responsible for the pregnancy, concerns about abnormalities/deformities in future births due to unprofessionally conducted abortions, and economic considerations. CONCLUSION: A number of individuals, such as friends, mothers, and male partners, influence the decision-making process regarding abortion among the participants of the study. Various targeted messages are needed for the various participants in the decision

Design, Development and Testing of a Neem Seed Steam Roaster

A neem seed roaster which makes use of steam as source of heat energy was designed and fabricated to be used in heating neem seeds prior to expelling oil from them. It helps to check the disadvantage of using seed scorchers which produces burnt or unevenly heated seeds which results in black oil formation. The equipment consists of an insulated heating unit, roaster, seed inlet unit, seed discharge outlet, power transmission unit and the frame work. A gear motor of 0.25kW was selected to supply power to the shaft whose end was welded to the stirrer. The roasting unit consists of three compartments: roasting chamber, steam chamber and insulator chamber. The insulated heating unit has two pipes: water inlet pipe and steam delivery pipe. Also, two electric heating elements of 2.75kW each were installed in the heating unit to help boil the water for steam to form; this steam will then be transported by the steam delivery pipe to the steam chamber which in turn heats up the outer surface of the roasting chamber and thus the seeds inside are roasted through the heat being supplied. The machine was fabricated with about 90% local materials. Test results of the seed roaster using neem seeds indicate successful heating/roasting, the seeds were not scorched or burnt, rather they were looking dry but fresh, this indicates that the design of the machine suits its purpose for heating neem seeds prior to oil expelling . The machine being a simple one will be easy to maintain by the local artisans. Keywords: Heating, steam, neem seed, roaster, desig

Motivations for food prohibitions during pregnancy and their enforcement mechanisms in a rural Ghanaian district

© 2015 Arzoaquoi et al. Background: Food taboos are known from virtually all human societies and pregnant women have often been targeted. We qualitatively assessed food taboos during pregnancy, its motivating factors, and enforcement mechanisms in the Upper Manya Krobo district of Ghana. Methods: This was an exploratory cross sectional study using qualitative focus group discussions (FGDs). Sixteen FGDs were conducted. Participants were purposively selected using the maximum variation sampling technique. Tape recorded FGDs were transcribed verbatim and analyzed using Malterudian systematic text condensation technique. Results: All the participants were aware of the existence of food prohibitions and beliefs targeting pregnant women in Upper Manya Krobo. The study identified snails, rats, hot foods, and animal lungs as tabooed during pregnancy. Adherence motivators included expectation of safe and timely delivery, avoidance of "monkey babies" (deformed babies); respect for ancestors, parents, and community elders. Enforcement mechanisms identified included constant reminders by parents, family members and significant others. Stigmatization and community sanctions are deployed sparingly. Conclusions: Food taboos and traditional beliefs targeting pregnant women exist in Upper Manya Krobo. Pregnant women are forbidden from eating snails, rats, snakes, hot foods and animal lungs. To a large extent, socio-cultural, and to a lesser, health concerns motivate the practice

Correlates of HIV, HBV, HCV and syphilis infections among prison inmates and officers in Ghana: A national multicenter study

<p>Abstract</p> <p>Background</p> <p>Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana.</p> <p>Methods</p> <p>A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and <it>Treponema pallidum</it>; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques.</p> <p>Results</p> <p>Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16–84) and 38.1 years (range 25–59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17–46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25–46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases.</p> <p>Conclusion</p> <p>The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of infection control practices and risk reduction programs targeted at prison inmates and officers in Ghana is urgently required to address this substantial exposure risk.</p

Seroprevalence of HHV-8, CMV, and EBV among the general population in Ghana, West Africa

<p>Abstract</p> <p>Background</p> <p>Human herpesvirus 8 (HHV-8), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are prevalent in Africa, but less common elsewhere and the modes of transmission are still subject to debate. Generally, they rarely cause disease in the immunocompetent host but are highly oncogenic when associated with immunosuppression. Although the high prevalence of HHV-8, CMV and EBV has been well documented in Africa, such data are sparse from Ghana.</p> <p>Methods</p> <p>Serum samples from 3275 HIV-seronegative healthy blood donors and 250 HIV-AIDS patients were tested for antibodies specific for HHV-8, CMV and EBV by IgG ELISA assays. Differences in seropositivity rates by gender and age were evaluated using the Chi-square test with Yates correction.</p> <p>Results</p> <p>Of the 3275 HIV-seronegative healthy blood donors tested, 2573 (78.6%) were males and 702 (21.4%) were females, with ages ranging from 18 to 65 years (median 32.6; mean 31.2; mode 30). Of the 250 HIV-AIDS patients tested, 140 (56%) were males and 110 (44%) were females, with ages ranging from 17 to 64 years (median 30.8; mean 30.3; mode 28). Among the HIV-seronegative healthy blood donors, overall seroprevalence of HHV-8, CMV and EBV was 23.7%, 77.6% and 20.0%, respectively. Among the HIV-AIDS patients, overall seroprevalence of HHV-8, CMV and EBV was 65.6%, 59.2% and 87.2%, respectively. The seroprevalence of HHV-8 (p < 0.005) and EBV (p < 0.001) was statistically significantly higher in HIV-AIDS patients compared to HIV-seronegative healthy blood donors. There was no statistically significant difference (p = 0.24) between CMV seroprevalence in HIV-AIDS patients and HIV-seronegative healthy blood donors. Age and gender were not independent determinants (p > 0.05) for all three infections among HIV-seronegative healthy blood donors and HIV-AIDS patients in Ghana.</p> <p>Conclusion</p> <p>The results presented herein indicate that HHV-8, CMV and EBV infections are hyperendemic in both HIV-seronegative and HIV-seropositive Ghanaians, and suggest primarily a horizontal route of transmission of these three viral infections in Ghana.</p

Toward contraception education in basic schools: Teachers’ knowledge, perceptions, and attitudes regarding contraceptive use by basic school pupils in a Ghanaian Municipality

Objectives: We examined teachers’ knowledge, perceptions, and attitudes regarding contraception by basic school pupils in a Ghanaian Municipality. Methods: This was an explorative, analytical cross-sectional study using the mixed-method approach. Participants comprised 183 public and private basic school teachers and 20 school health coordinators in the study area. The statistical tests carried out were in two folds. Quantitative data were analyzed with a statistical package for social sciences version 20 to generate tables. A logistic regression model was used to examine associations between the predictor and the binary response variables. Adjusted odds ratio accounted for other predictor variables in the model. For the qualitative data, recorded interviews were transcribed and content analysis was done to identify themes, subthemes, and results presented as participants’ direct quotations/paraphrased statements. Knowledge, perceptions, and attitudes were assessed using 3-Likert scale type questions developed by the author. Results: Participants’ sociodemographic characteristics were associated with perceptions and attitudes toward contraception in basic schools. At 95% confidence intervals, the p -values were not significant for any of the variables tested. However, the adjusted odds ratio (aOR) showed positive perceptions among participants aged 35–39 (aOR = 7.24; p  = 0.35), women (aOR = 4.22; p  = 0.25), higher educated (aOR = 4.32; p  = 0.56), work experience between 16 and 20 years (aOR = 6.65; p  = 0.96), four or more children (aOR = 6.35; p  = 0.96); divorcee (aOR = 10.12; p  = 2.92); intrauterine contraceptive device (IUD) (aOR = 5.02; p  = 2.43); or condoms users (aOR = 7.09; p  = 0.32). Negative perceptions were noted among affiliates of other religions compared to Christians (aOR = 0.19; p  = 0.01) and subject teachers (aOR = 0.39; p  = 0.01). Participants’ perceptions were directly influenced by attitudes toward contraception and knowledge ( p  = 0.081). The qualitative findings showed mixed feelings about contraceptive education in basic schools. Conclusions: Basic school teachers have challenges with contraceptive education which have implications for comprehensive sex education in Ghanaian basic schools. We recommend a similar study among parents of the pupils and a nationwide study to examine this concept further

Problématique du phénomène prostitutionnel en Afrique de l’ouest

Le présent article porte sur l’impact du contexte familial sur la prostitution. Notre hypothèse est que les prostituées sont des personnes issues de foyers familiaux déstructurés. L’étude porte sur un échantillon de 20 prostituées professionnelles. Quatre thèmes ont été retenus : les causes de la prostitution, l’enfance des prostituées, la façon dont ces dernières envisagent leur avenir, et leurs relations aux ascendants. Les résultats obtenus montrent qu’en plus de la misère économique, le phénomène de la prostitution tire sa source de l’incapacité de certaines familles à avoir su jouer leur rôle éducatif, sécuritaire et d’épanouissement affectif