Knowledge, Attitudes, and Demographic Factors Influencing Cervical Cancer Screening Behavior of Zimbabwean Women

Aims: The aims of this study were (1) to estimate what proportion of rural females had received cervical screening, (2) to assess knowledge, beliefs, attitudes, and demographics that influence cervical screening, and (3) to predict cervical screening accessibility based on demographic factors, knowledge, beliefs, and attitudes that influence cervical screening. Methods: The study sample consisted of randomly selected, sexually active, rural females between 12 and 84 years of age. Five hundred fourteen females responded to an individually administered questionnaire. Results: Of the 514 participants, 91% had never had cervical screening and 81% had no previous knowledge of cervical screening tests; 80% of the group expressed positive beliefs about cervical screening tests after an educational intervention. Females who were financially independent were 6.61% more likely to access cervical screening compared with those who were dependent on their husbands. Females in mining villages were 4.47% more likely to access cervical screening than those in traditional rural reserve villages. Females in resettlement villages were 20% less likely to access cervical screening than those in traditional rural reserve villages. Conclusions: Accessibility of screening services could be improved through planning and implementation of screening programs involving community leaders and culturally appropriate messages. The government should incorporate the human papillomavirus (HPV) vaccine in its immunization program for adolescents, and health education should be intensified to encourage women and their partners to comply with diagnostic and treatment regimens.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90451/1/jwh-2E2010-2E2062.pd

Neonatal Sepsis in Rural Ghana: A Case Control Study of Risk Factors in a Birth Cohort

Neonatal sepsis poses a major challenge to achieving the MDG-4 due to lack of facilities to implement proposed management guidelines. Identifying risk factors of neonatal sepsis will help put strategies in place to prevent sepsis. This prospective case control study investigated risk factors of neonatal sepsis in the Asutifi District a typical rural setting of the Brong Ahafo Region of Ghana. A semi-structured check list was used to collect clinical and demographic data from 196 neonates (96 with sepsis as case and 100 without sepsis as control) and respective mothers. Maternal factors that were significantly associated with neonatal sepsis were foul smelling liquor (p=0.001), meconium stained amniotic fluid (p= 0.000), parity (p=0.000), history of UTI/STI (p=0.002) and maternal age (0.017). Neonatal factors that were significantly associated with sepsis include male sex (p=0.040), preterm (p=0.000), not crying immediately after birth (p=0.001), low birth weight \u3c2500g \u3e(p=0.000), APGAR score less than 7 (p=0.000) and resuscitation at birth (p=0.004). Priority attention must be given to neonates and mothers with the aforementioned characteristics during antenatal and postnatal care to prevent sepsis

Knowledge, practice, and barriers toward cervical cancer screening in Elmina, Southern Ghana

Aims: The aims of this study were: 1) to assess the level of knowledge of women about Pap smear tests, 2) to determine the practices of women regarding Pap smear tests, and 3) to determine the barriers to Pap smear tests in Elmina, Ghana. Methods: A cross-sectional study was conducted with 392 randomly selected sexually active females aged 10–74 years using structured interview questions. The Institutional Review Board of the University of Cape Coast gave ethical approval for the study and informed consent was obtained from participants. Data were analyzed with SPSS software (v19.0) using frequencies, chi-square test, and exploratory factor analysis. Results: The results revealed that 68.4% had never heard about cervical cancer, 93.6% had no knowledge on the risk factors, nine (2.3%) reported multiple sexual partners and being sexually active as risk factors, and 92% did not know about the prevention and treatment of cervical cancer. The majority (97.7%) had never heard of the Pap smear test. Only three (0.8%) women out of 392 had had a Pap smear test. Reasons for seeking a Pap smear test included referral, fear of cervical cancer, and radio campaigns. A significant association was found between institutional and personal barriers and having a Pap smear test. Conclusion: Comprehensive education on cervical cancer screening and removal of access barriers are critical in reducing risk associated with the disease and promoting women\u27s health

HIV diagnosis disclosure to infected children and adolescents; challenges of family caregivers in the Central Region of Ghana

Background Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about the child’s HIV status should be shared with him/her and how to go about it. The aim of the study was to identify family caregiver factors associated with non-disclosure of HIV status to infected children and adolescents accessing Antiretroviral Therapy (ART) at the three main ART sites within the Central Region of Ghana. Methods A quantitative analytical survey was conducted among 103 family caregivers of HIV infected children (aged 6–17 years) assessing ART services in the Central Region of Ghana. Data were analyzed using SSPS version 21. Results The age range of caregivers was 20–69 years. The study found a low disclosure rate (23.3%) among caregivers. Majority of the caregivers (80.6%) lacked knowledge on the process of disclosure (how and what to tell child), and majority (64%) also had never received guidance about the disclosure process from their healthcare providers. The main barriers to disclosure were caregiver lack of knowledge regarding the disclosure process and when to disclose, the fear of child’s reaction, and fear of stigmatization and associated negative social consequences. Conclusion These findings suggest a lesser involvement of health care providers in preparing caregivers for the disclosure process. This therefore highlight the need for the National HIV/AIDS/STI Control Program to strengthen the involvement and training of healthcare providers in HIV diagnosis disclosure to infected children, based on context-specific policy guidelines informed by the WHO recommendations

Effects of Chronic Hepatitis B Infection on Pregnancy and Birth Outcomes in Ghana

Ghana is a known endemic area for hepatitis B virus (HBV) infections, yet the consequences of HBV infection on pregnancy outcomes are unknown. This prospective cohort study was thus conducted among 512 pregnant women attending antenatal clinic in the Cape Coast Teaching Hospital, Ghana, between January, 2011 and December, 2013 to determine the effects of hepatitis B during pregnancy on birth outcomes in Ghana. The HBsAg status of all pregnant women was determined by the latex agglutination test while a researcher administered semi-structured checklist was used to collect demographic/obstetric/medical data of respondents. We obtained 262 HBsAg positive and 250 HBsAg negative women most of whom were aged 20-29 (40%), classified themselves as low income earners (50%), and had attained primary education (42%). Logistic regression analysis showed that pregnant women who had chronic hepatitis B were more likely to develop PROM (p=0.008) and foul smelling liquor (p=0.024) at delivery. Moreover, neonatal consequences for chronic hepatitis B were; preterm babies (p=0.002), underweight (p\u3c0.001), Apgar score lower than 7 (p\u3c0.001), asphyxia at birth (p=0.006) and still birth (p=0.04). We conclude that babies born to mothers with positive HBsAg status have a higher risk for vertical transmission as well as adverse neonatal consequences

Cervical cancer screening: Perceptions of women in sub Saharan cultures. An example of Zimbabwe.

In Zimbabwe cervical cancer now accounts for about 25% of women's cancer mortality. Even women aged as young as fifteen years are dying from this disease. The purpose of this study was to examine critically the factors that might contribute towards Zimbabwean women's Pap smear seeking behavior. The Fishbein, Bandura, Triandis, Kanfer, Becker and Middlesstadt's (1991) behavior and behavior change model provided the framework for identification of relevant study concepts. The study sample consisted of randomly selected sexually active rural women aged between 12 years and 84 years who live in Shamva district and have not had a hysterectomy. Five hundred and fourteen women responded to the questionnaires. Ninety percent of the women had never had a Pap smear and 84% had no knowledge of a Pap smear. Despite never having a Pap smear and lacking prior knowledge of the purpose of Pap smear eighty percent of the women expressed positive beliefs about Pap smear after they had been taught. There was a marginal difference in the responses to the beliefs, occupation, age and type of village between women who had prior knowledge of Pap smear (Plan A) and those who lacked prior knowledge (Plan B) but significant predictors emerged only when the total sample was analyzed. The major constraints for obtaining a Pap smear were that it was not offered routinely at the health institutions and was expensive. Moreover, women had no money or health insurance. Further, health care providers often did not advise women to have a Pap smear. While seventy seven percent of women had skills to access health care services, more than half of the women in the overall sample felt that health providers did not care about their feelings and neither offered explanations nor respected their right to make decisions about their health. Education level, financial situation, occupation, respondent's village, positive beliefs and age were predicting factors that influenced the likelihood of having a Pap smear. Women who perceived fewer barriers were more likely to utilize the Pap smear in future. Based on these findings health care providers need to offer information about Pap smear and respect clients' rights to make decisions regarding their health. It is recommended that the government of Zimbabwe institute a cervical cancer screening policy that minimizes barriers to women's access to Pap smear, targets the risk age groups and allocates resources for the treatment of cervical cancer.Ph.D.Health and Environmental SciencesNursingPublic healthUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/125001/2/3016822.pd