Is abortion justified to save the life or health of a woman? Evidence of public opinion from Accra, Ghana

ObjectiveIn this study, we sought to determine to what extent the abortion law in Ghana is reflective of public opinion.MethodsIn a cross‐sectional, community‐based survey, individuals in two fishing communities in Accra were interviewed about their beliefs on abortion between May and July 2016, and sociodemographic, attitudinal, and experience data were collected. Factors associated with the outcome variable (abortion is justified to save the life/health of the woman: Yes/No) were entered into a multivariate logistic regression.ResultsA total of 508 participants completed the survey. Thirty‐nine percent (n=198) of the sample agreed that abortion was justified to save the life/health of the woman, with no significant differences in this finding when controlling for understanding of the law, gender, marital status, or personal experience of abortion in multivariate analysis. Higher education (odds ratio [OR] 1.64 [P<0.001]) and older age (OR 1.28 [P<0.001]) are positively associated with abortion being justified to save life/health, while those who have had an experience of unwanted sex are less likely to believe that (OR 0.60 [P=0.029]).ConclusionThe participants held conservative views about the justification of abortion to save a woman’s life and/or health. Improving access to safe abortion services will require acknowledgment of the broader social and cultural context that may make accessing such services difficult.In a cross‐sectional survey, residents of urban Accra, Ghana, held relatively conservative views toward the justification of abortion.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151335/1/ijgo12927.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151335/2/ijgo12927_am.pd

Trends and determinants of contraceptive use among female adolescents in Ghana: Analysis of 2003-2014 Demographic and Health Surveys.

Introduction:Thirty percent (30%) of all deliveries in 2014 were recorded among adolescents in Ghana, whom contraceptive use has been found to be low. Our study, therefore, aimed to retrospectively look at the trends and determinants of contraceptive use (modern and traditional) among female adolescents in Ghana. Materials and methods:We used data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys. The sample for this study comprised sexually active female adolescents aged 15-19 for each of the rounds thereby resulting in a sample of 426 in 2003, 389 in 2008 and 726 in 2014. We calculated the proportion of adolescents using contraceptives (either traditional or modern) for each of the three surveys. We computed the use of contraceptives among adolescents and the type of contraceptives used with respect to their socio-demographic characteristics. Multinomial Logistic Regression was used to assess the determinants of contraceptive use at 95% confidence interval and Odds Ratios (OR) and p-values were reported. Results:Contraceptive use declined from 22.1% in 2003 to 20.4% in 2014. Adolescents who were married had lower odds [OR = 0.09, 95% CI = 0.03-0.96] of using traditional methods of contraception compared to those who were not married. Those who read newspapers at least once a week were more likely to utilize modern contraceptives [OR=1.84, CI = 1.05-4.78] compared to adolescents who did not read newspapers at all. Similarly, those who watched television at least once a week were more likely to use modern contraceptives than those who did not watch television at all [OR = 2.25, CI = 1.06-4.78]. Conclusion:These findings imply that intensifying educational messages on contraceptive use among adolescents using various newspapers and television stations to convey the messages and emphasizing the importance of using modern contraceptive is worthwhile

Abortion in Ghana: Legal or Illegal? An Observation at the Abura Dunkwa District Hospital

Background: Elective abortion with its medico-legal controversies is a major worldwide debatable topic. The question whether to legalize abortion or not continues to be a contentious affair.  The public interest nature of this debate has led to the emergence of two advocacy groups: Pro-Life and Pro-Choice. The former argues that the unborn fetus is human with life. The latter strongly postulates that women should have choices of what happens to their body. Whilst this debate lingers on, we decided to do a four month clinical observation of the reality on the ground in Ghana’s Abura Dunkwa Ditrict Hospital.  Methods: This was a clinical observational study. It covered a four month clinical management of abortion related patients at the Abura Dunkwa district hospital of Ghana.  History of presenting complaints and social/ family histories were particularly noted in details. We then compared our observation against abortion laws around the world and Ghana in particular. Findings: we observed that the lack of publicity and agreed interpretation of Ghana’s abortion laws have resulted in criminal abortions leading to complications such as incomplete abortion, hemorrhage, sepsis, etc. We also discovered that many criminal abortions   in fact met Ghana’s abortion Acts’ ‘exceptions for termination of pregnancy’Conclusion: Ghana’s abortion Acts  though do not make abortion legal, the laws have permitted enough grounds for justifiable  terminations of pregnancies,   yet ignorance of the law has led to women’s continued engagement in criminal and unsafe abortions leading to severe morbidities and  mortalities Keywords: Abortifacients, hemorrhage, sepsis, morbidity, mental health, adjustment disorder DOI: 10.7176/JHMN/61-02 Publication date: April 30th 201

Evidence Advisory System Briefing Notes: Ghana

There has been a growing global concern for improving the use of evidence to inform health policy in recent years. Increasingly there is recognition that individual projects or programmes building evidence synthesis skills, may be limited in their effect without a broader consideration of the systems in place which ‘embed’ or ‘institutionalise’ evidence informed policy making practices (Alliance for Health Policy and Systems Research and WHO 2007). The GRIP-Health programme is a five-year project supported by the European Research Council which studies the political nature of health policy to understand how to best improve the use of evidence. This explicitly political lens enables us to focus on the contested nature of health issues as well as the institutions that shape the use of evidence in health policy making. We understand institutions as including both formal structures and rules, as well as informal norms and practices (Lowndes and Roberts 2013). The GRIP-Health programme follows the World Health Organization’s view that Ministries of Health remain the ultimate stewards of a nation’s health, and further play a key role in providing information to guide health decisions (World Health Organization 2000, Alvarez-Rosette, Hawkins et al. 2013). As such, GRIP-Health is particularly concerned with the structures and rules created by government to gather, synthesise, or otherwise provide evidence to inform policy making. This working paper is one of a series of six briefs covering a set of countries in which the GRIP-Health programme is undertaking research. This brief presents an overview of what is termed the ‘Evidence Advisory System’ (EAS) for health policy making within the country of interest, which is taken to encompass the key entry points through which research evidence can make its way into relevant health policy decisions. This can include both formal (government mandated) and informal structures, rules, and norms in place. Individual reports in this series can be useful for those considering how to improve evidence use in specific country settings, while taken together the reports identify the differences that can be seen across contexts, permitting reflection or comparison across countries about how evidence advisory systems are structured – including which responsibilities are given to different types of bodies, and how well evidence advice aligns with decision making authority structures

A review of food and nutrition communication and promotion in Ghana

Dietary perception, behavior, and nutritional status can all be influenced by exposure to information. Behavior change communication that is appropriately designed and implemented is critical for motivating optimal dietary behavior. On the other hand, inadvertent or deliberate misinformation can drive unhealthy dietary behaviors. As part of the process to develop food-based dietary guidelines (FBDGs) for Ghana, this rapidevidence review examined the nature, extent, sources, and medium of food and nutrition information dissemination and promotion in Ghana.&nbsp; PubMed, Cochrane, Google Scholar, and Open Access Theses Dissertations (OATD) databases were searched systematically using keywords to&nbsp; identify relevant peer-reviewed and grey literature. The review included 31 documents, after excluding 1,302 documents for ineligibility (based on&nbsp; irrelevant title, abstract, and duplicates). Limited reporting of undernutrition was found in print and electronic media. Unhealthy foods, including sugar-sweetened beverages, snacks, yogurt, instant noodles, candy/chocolate, and ice cream were frequently advertised through various&nbsp; communication media. Children are highly exposed to food advertisements, which target them. Promotional characters, animation, billboards, and&nbsp; front-of-store displays; product-branded books, and toys are common strategies for food marketing and advertisement in Ghana. The most frequently reported sources of health and nutrition information were television, radio, social media, health professionals, families, and friends.&nbsp; Children and adults experienced changes in food preferences and choices as a result of exposure to food advertised on television. The commonly&nbsp; used traditional media were radio and television; printed newspaper use has declined tremendously in the past decade. Social media use&nbsp; (particularly WhatsApp, Facebook, and YouTube) is highest in urban areas, and is growing rapidly; young adults are the most active users of social&nbsp; media platforms. Experts recommend regulation as a mitigation for nutrition miscommunication and inaccurate promotion. The current review&nbsp; highlights the need for regulation of food marketing, and advertisement to safeguard a healthy food environment in Ghana.&nbsp;&nbsp

A review of food and nutrition communication and promotion in Ghana

Dietary perception, behavior, and nutritional status can all be influenced by exposure to information. Behavior change communication that is appropriately designed and implemented is critical for motivating optimal dietary behavior. On the other hand, inadvertent or deliberate misinformation can drive unhealthy dietary behaviors. As part of the process to develop food-based dietary guidelines (FBDGs) for Ghana, this rapid evidence review examined the nature, extent, sources, and medium of food and nutrition information dissemination and promotion in Ghana. PubMed, Cochrane, Google Scholar, and Open Access Theses Dissertations (OATD) databases were searched systematically using keywords to identify relevant peer-reviewed and grey literature. The review included 31 documents, after excluding 1,302 documents for ineligibility (based on irrelevant title, abstract, and duplicates). Limited reporting of undernutrition was found in print and electronic media. Unhealthy foods, including sugar-sweetened beverages, snacks, yogurt, instant noodles, candy/chocolate, and ice cream were frequently advertised through various communication media. Children are highly exposed to food advertisements, which target them. Promotional characters, animation, billboards, and front-of-store displays; product-branded books, and toys are common strategies for food marketing and advertisement in Ghana. The most frequently reported sources of health and nutrition information were television, radio, social media, health professionals, families, and friends. Children and adults experienced changes in food preferences and choices as a result of exposure to food advertised on television. The commonly used traditional media were radio and television; printed newspaper use has declined tremendously in the past decade. Social media use (particularly WhatsApp, Facebook, and YouTube) is highest in urban areas, and is growing rapidly; young adults are the most active users of social media platforms. Experts recommend regulation as a mitigation for nutrition miscommunication and inaccurate promotion. The current review highlights the need for regulation of food marketing, and advertisement to safeguard a healthy food environment in Ghana

Estimating the stochastic uncertainty in sample-based estimates of infant mortality in Ghana

The Infant Mortality Rate (IMR) is an important population health statistic often used as one of the indicators of the health status of a nation. In many countries lacking adequate vital registration systems, sample methods are used to estimate IMRs. However, evaluations of this approach are rare and the literature contains no assessments of the stochastic uncertainty underlying these estimated IMRs. Stochastic uncertainty reflects the fact that even where the underlying IMR is constant in a small population over time, there is a likelihood of yearly fluctuation in its empirical observations even if it is measured from a complete count of the events of interest. In this study a method is presented that can be used to assess this stochastic uncertainty. We use the country of Ghana as a case study for this purpose. The method, a beta-binomial model, is described, tested for validity, and illustrated using 2014 sample-based estimates of IMR for 13 sample regions in Ghana. As such, the approach we described regarding the revision of sample-based IMR estimates is aimed at taking into account of the stochastic uncertainty while preserving the information concerning the uncertainty due to sampling. In applying the method to Ghana, we find that the sample-based IMR estimates perform well in accounting for stochastic uncertainty and could be applied elsewhere

What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

Background In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana. Materials and methods Data for this study was obtained from the 2014 Ghana Demographic and Health Survey. We used data of 1,441 women who gave birth in the 5 years preceding the survey and were dwelling in urban areas. By the use of Stata version 14.2, we conducted both descriptive and multivariable logistic regression analyses. Results We found that 7.9% of women in urban areas in Ghana delivered at home. The study revealed that, compared to women who lived in the Northern region, women who lived in the Brong Ahafo region [AOR = 0.38, CI = 0.17–0.84] were less likely to deliver at home. The likelihood of home delivery was high among women in the poorest wealth quintile [AOR = 2.02, CI = 1.06–3.86], women who professed other religions [AOR = 3.45; CI = 1.53–7.81], and those who had no antenatal care visits [AOR = 7.17; 1.64–31.3]. Conversely, the likelihood of home delivery was lower among women who had attained secondary/higher education [AOR = 0.30; 0.17–0.53], compared to those with no formal education. Conclusion The study identified region of residence, wealth quintile, religion, antenatal care visits, and level of education as factors associated with home delivery among urban residents in Ghana. Therefore, health promotion programs targeted at home delivery need to focus on these factors. We also recommend that a qualitative study should be conducted to investigate the factors responsible for the differences in home delivery in terms of region, as the present study could not do so

Exploring the roles of men and masculinities in abortion and emergency contraception pathways, Ghana: a mobile phone-based mixed-methods study protocol

Introduction Global commitments have established goals of achieving universal sexual and reproductive health and rights (SRHR) access, but critical obstacles remain. Emergency contraception and induced abortion are overlooked in policy and research. Men’s roles in the SRHR of others are significant, particularly as obstacles to universal SRHR. Evidence on gender, masculinities and SRHR is essential to understand and reduce the barriers faced by individuals seeking to avoid the conception or continuation of a pregnancy. Methods and analysis This study aims to understand men’s masculinities and their relationships with emergency contraception and abortion. The protocol presents a multimethod study of men aged over 18 years in James Town, Accra, Ghana. In response to the COVID-19 pandemic, the research will use two mobilebased methods: a survey and in-depth interviews. Using respondent-driven sampling, an estimated 789 men will be recruited to participate in the survey, asking questions on their knowledge, attitude, behaviours and roles in emergency contraception and abortion. In-depth interviews focused on constructions of masculinity will be conducted with a purposive sample of men who participated in the survey. Data will be analysed concurrently using multiple regression analyses of quantitative data and abductive analysis of qualitative data. Ethics and dissemination Ethical approval has been granted by the London School of Economics and Political Science and the Ghana Health Service. The findings in this study will: engage with emerging research on masculinities and SRHR in Ghana and elsewhere; offer methodological insight for future research; and provide evidence to inform interventions to reduce obstacles for emergency contraception and abortion care seekers. Dissemination will occur at all levels—policy, academic, community—including multiple academic articles, policy briefs, workshops and presentations, conference papers, and theatre/radio-based performances of key messages

Upscaling Community-Arranged Preparedness for Preventing Maternal Mortality in Ghana: A Case Study of Keta and Akatsi Districts of Volta Region

The main objective of the study is to assess maternal health in Ghana using empirical evidence from Akatsi and Keta districts of the Volta Region. Interviews were conducted from a sample size of 6,250 respondents within the reproductive age group of 15-49 years drawn from both districts in 2007. The results show that most of the women had only basic education and were generally petty traders, farmers and fishmongers. Overwhelming majority of the women stated that there was no community-arranged preparedness to aid them in times of emergency obstetric care. A significant proportion of the women (about 30%) relied on relatives/friends/home or traditional birth attendants (TBAs) to deliver their babies, while the road network in both districts was poor. The Government of Ghana should therefore rehabilitate roads or construct new ones that could help the people transport emergency complications to the health facility on time to prevent deaths. These TBAs should be trained to recognize complications and not to manage complications professionally and they should be motivated to make referrals to mainstream health facilities. The Government of Ghana should aim at increasing girls’ participation at all levels of the education system in the country since education is the key to ending poverty