Fertility Preferences of Women Living with HIV in the Kumasi Metropolis, Ghana

This study sought to determine fertility preferences and their predictors among women living with HIV. A survey of 295 women aged 18 to 49 years living with HIV, and attending two HIV/AIDS clinics in the Kumasi metropolis, was conducted between July and August 2012. We administered questionnaires, and retrieved records of clinical status for review. We conducted multiple logistic regressions with fertility preference as the dependent variable. Fifty-eight percent of the respondents desired to have a child. The desire to have children was associated with age > 40years (AOR 0.25; 95% CI: 0.06-1.00), parity >3 (AOR 0.07; 95% CI: 0.01-0.78), those that responded that their HIV status did not affect fertility preference were more likely to desire a child (AOR 4.37; 95% CI: 1.28-14.95) and those whose partner’s did not desire to have children were less likely to desire to have children (AOR 0.06; 95% CI: 0.02-0.18). Most of the respondents do not discuss their fertility preferences with healthcare providers. Policy makers should protect the health of women living with HIV by putting in place counselling and support services with regular antiretroviral medications. If implemented, this has the potential to reduce mother-to-child transmission of HIV. Keywords: Desire to have a child, HIV- positive women, KumasiRésuméCette étude visait à déterminer les préférences de fécondité et leurs indices chez les femmes vivant avec le VIH. Une enquête de 295 femmes âgées de 18 à 49 ans vivant avec le VIH, et qui fréquentent deux cliniques du VIH / SIDA dans la métropole de Kumasi, a été menée entre juillet et août 2012. Nous avons administré des questionnaires, et avons récupéré les dossiers de l'état clinique pour les étudier. Nous avons effectué une régression logistique multiple avec la préférence de fécondité comme un variable dépendant. Cinquante-huit pour cent des interrogées ont souhaité avoir un enfant. Le désir d'avoir des enfants a été associée à l'âge> 40 années (AOR 0,25; IC à 95%: 0,06 à 1,00), la parité> 3 (AOR 0,07; IC à 95%: 0,01 à 0,78), celles qui ont répondu que leur état du VIH n'a pas affecté la préférence de la fécondité étaient plus susceptibles de désirer un enfant (AOR 4,37; IC à 95%: 1,28 à 14,95) et celles dont la partenaire n'a pas le désir d'avoir des enfants étaient moins susceptibles de vouloir avoir des enfants (AOR 0,06; IC à 95%: 0,02 à 0,18 ). La plupart des interrogées ne discutent pas leurs préférences de fécondité avec les fournisseurs de soins de santé. Les décideurs politiques devraient protéger la santé des femmes vivant avec le VIH en mettant en oeuvres des services d’orientation et de soutien avec les médicaments antirétroviraux réguliers. Si ceci est réalisées, il a le potentiel de réduire la transmission du VIH de la mère à l'enfantMots-clés: désir d'avoir un enfant, femmes séropositives, Kumas

Rural Origin and Exposure Drives Ghanaian Midwives Reported Future Practice

A primary cause of Ghana’s higher than global average maternal mortality rate is limited access to maternal care in rural areas. To date, few studies have examined how rural background/training of midwives impacts their future willingness to work in remote areas. The purpose of this paper is to describe the relationship between Ghanaian student midwife place of origin and rural training on their willingness to choose a future rural practice location. A cross-sectional computer-based survey was completed by 238 final year Ghanaian midwifery students from two public midwifery training schools located in urban Ghana between October and December 2009. The relationship between rural exposure and willingness to work in rural Ghana was analyzed using independent t-test, chi-square, and bivariate logistic regression. Participants who experienced a rural rotation (OR: 1.51, 95% CI: 0.71, 3.22) and those born in a rural area (OR: 2.24, 95% CI: 0.74, 6.75) resulted in greater odds ratio to choose rural practice following graduation. This study indicates an association between midwifery students’ place of origin and training and their willingness to practice in a rural area after graduation. (Afr J Reprod Health 2014; 18[3]: 95-100)Keywords: Midwifery, Ghana, human resources for health, maldistribution, rural practice, rural incentive

Prevalence of refractive errors among junior high school students in the Ejisu Juaben municipality of Ghana

Among school children, uncorrected refractive errors have a considerable impact on their participation and learning in class. The aim of this study was to assess the prevalence of refractive error among students in the Ejisu-Juabeng Municipality of Ghana. A survey with multi-stage sampling was undertaken. We interviewed 504 students aged 12-17 years and examined them for refractive errors. The prevalence of refractive errors among those with and without refractive error was compared by means of the chi-square test. Logistic regression analysis using refractive error as the dependent variable and adjusting for risk factors were performed. The overall prevalence rate of refractive errors was 7.5%. Out of the number of children with refractive errors, 39.5% had astigmatism, 31.6% had hyperopia and 28.9% had myopia. The prevalence rate was significantly higher among urban compared with rural students. Astigmatic refractive errors consists of with–the–rule (WTR) astigmatism 66.7%, against–the–rule (ATR) astigmatism 26.7% and oblique astigmatism (OBL) 6.6%. WTR and ATR astigmatism were more common in females than males. Multivariate logistic regression models showed no substantial confounding effects between near work, sex, and residence, suggesting that each covariate has an independent association with refractive error. In conclusion, near work, sex and high parental education level are factors contributing to refractive errors. Children in urban areas are at higher risk compared with their rural counterparts. We suggest that an efficient pre-school vision examination must be made part of the admission policy of all schools in Ghana.Keywords: Prevalence, refractive error, students, visual impairment, Ejisu-Juaben Municipalit