'Nothing about us, without us' : voices of leaders of disabled people's organisation in management of disability fund

In 2005, the Ghanaian government established cash grants for persons with disabilities (PWDs). However, PWDs are still living under deplorable conditions, which have raised questions about the involvement of fellow PWDs in the disbursement of cash grants. Using a human rights-based approach, nine participants with disabilities (hearing, visual and physical) who were leaders of the Disabled People’s Organisation in four districts were interviewed to explore their perspectives, which was thematically analysed. The results showed that leaders were not consulted or involved in the allocation of grants to PWDs. This paper discusses the need for bureaucrats to respect and involve PWDs in matters concerning their livelihoods

The self-efficacy of private school teachers toward the implementation of inclusive education in Ghana : a mixed-methods study

Background: Although efforts toward practicing inclusive education have stalled in countries such as Ghana, the available data have mainly centred on enacting inclusive education in public schools. With private schools being notable alternative service providers to public schools, understanding private school teachers’ perceived self-efficacy toward teaching students with disabilities in the classroom is essential. Method: To develop insights into inclusive practices, a two-phase mixed-methods design was adopted for this study. In the first phase, 82 teachers from six private schools responded to the self-reported Teacher Efficacy for Inclusive Practice (TEIP) scale. In the second phase, there were 10 participants, including principals (n = 3), heads of department (n = 4) and teachers (n = 3). While the quantitative data were subjected to confirmatory factor analysis, t-tests, analysis of variance and linear regression, the qualitative data were analysed thematically using the components of the TEIP scale as a priori themes. Result: The study confirmed the structural validity of the TEIP scale in measuring teachers’ self-efficacy and the correlations and covariances between efficacy in managing behaviour and performing instruction and collaboration. There was divergence between the quantitative and qualitative data and background variables, such as educational qualifications, pre-service training in inclusive education and participation in professional development, which provided additional insights into the teachers’ self-efficacy. Conclusion: The findings show that some private school teachers teach students with disabilities despite having no confidence in their capabilities. The study findings underscore the need to create more training opportunities for private school teachers to enhance their confidence in practicing inclusive education in schools

Barriers to utilization of sexual and reproductive health services among young deaf persons in Ghana

Despite significant progress made to improve access to sexual and reproductive health (SRH) services to the general populace in Ghana, information on the accessibility of such services to deaf persons is limited. This study investigated access to and utilization of SRH services among young female deaf persons in Ghana. Sixty deaf persons were interviewed from six metropolis/municipalities/districts in three regions of Ghana. The data were collected using focus group discussion and one-on-one interviews. The data were subjected to content analysis, leading to the identification of two broad themes. The study identified barriers at two levels: point of service delivery and barriers at the individual level. For instance, at the point of service delivery, they were claims that deaf women were victims of negative attitudes from health workers. The study concludes on the need forhealth policymakers to consider collaborating with the Ghana National Association of the Deaf in an effort towards designinginclusive SRH programmes. (Afr J Reprod Health 2022; 26[12]: 58-66). Malgré des progrès significatifs réalisés pour améliorer l'accès aux services de santé sexuelle et reproductive (SSR) pour la population générale au Ghana, les informations sur l'accessibilité de ces services aux personnes sourdes sont limitées. Cette étude a examiné l'accès et l'utilisation des services de SSR chez les jeunes femmes sourdes au Ghana. Soixante personnes sourdes ont été interrogées dans six métropoles/municipalités/districts dans trois régions du Ghana. Les données ont été recueillies à l'aide de discussions de groupe et d'entretiens individuels. Les données ont fait l'objet d'une analyse de contenu qui a conduit à l'identification de deux grands thèmes. L'étude a identifié des obstacles à deux niveaux : le point de prestation de services et les obstacles au niveau individuel. Par exemple, au point de prestation de services, il y avait des allégations selon lesquelles les femmes sourdes étaient victimes d'attitudes négatives de la part des agents de santé. L'étude conclut sur la nécessité pour les décideurs de la santé d'envisager e collaborer avec l'Association nationale des sourds du Ghana dans le but de concevoir des programmes de SSR inclusifs. (Afr J Reprod Health 2022; 26[12]: 58-66)

Level of satisfaction and sexual and reproductive health needs of deaf persons in Ghana : a sequential explanatory mixed method study

Background: The intersection between deafness and culture in sub-Saharan African contexts such as Ghana has culminated in restricted access to sexual and reproductive health (SRH) services. While some attention has been given to the barriers faced by deaf persons in accessing SRH services, discussion of their needs and satisfaction with SRH services is at an embryonic stage. This lends support to the use of sequential mixed-method study design to assess the level of satisfaction and SRH needs of deaf persons. Methods: This study was guided by explanatory sequential mixed-method study design. Thus, a two-phase data collection approach was adopted. In Phase I, a 32-item questionnaire with 16 items each for satisfaction regarding SRH services and SRH needs, was used for data collection from 288 deaf persons recruited from 3 of the 16 regions in Ghana. The data were subjected to the following computations: means, t-tests, analysis of variance, correlations, and multiple regression. In Phase II, a semi-structured interview guide was used to collect data from 60 participants who were drawn from the earlier pool. The interviews were subjected to thematic analysis. Results: The results showed of correlation and multiple analyses showed a small relationship and significant contribution of needs in the variance of satisfaction. Also, there was a convergence between both the qualitative and quantitative data as participants confirmed the lack of consideration given to the needs of deaf persons regarding SRH service provisions. Conclusion: Deaf persons who took part in this study were unsatisfied with SRH services due to barriers such as sign language interpreters and inaccessible information. Consequently, they expressed the need for preferred mode of communication and expedition of awareness creation on SRH. The study findings warrant the need for policymakers to inculcate the needs of deaf person in SRH services to improve access and thus, enhance satisfaction. For instance, recommendations such as the training of health professionals in the use of sign language could be considered in future SRH policy and other implications, are discussed

The interaction between typically developing students and peers with autism spectrum disorder in regular schools in Ghana : an exploration using the theory of planned behaviour

The purpose of this study is to assess the intention of typically developing peers towards learning in the classroom with students with Autism Spectrum Disorder (ASD). In developing countries, such as Ghana, the body of literature on the relationship between students with disabilities and typically developing peers has been sparsely studied. Using Ajzen’s theory of planned behaviour as a theoretical framework for this study, 516 typically developing students completed four scales representing belief constructs, attitudes, subjective norms, and perceived behavioural controls (self-efficacy), hypothesised to predict behavioural intention. The data were subjected to a t-test, analysis of variance, and structural equation modelling. The modelling confirmed the combining ability of attitude, subjective norms, and perceived behavioural controls to predict intention. We conclude by revealing the need for policymakers to consider designing programmes aimed towards promoting social relationships between students with ASD and typically developing peers

Preservice training amid a pandemic in Ghana : predictors of online learning success among teachers

The coronavirus disease 2019 outbreak has brought the world to a standstill, especially the education sector. Globally, it has claimed over two million lives, with over 100 million people infected, forcing schools to close down. This has reignited the importance of online teaching and learning for preservice teachers who comprise the next frontiers in providing online education to their future students. However, studies on online learning [OL] success among preservice teachers in developing countries, such as Ghana, remain scarce. Accordingly, this study mainly aimed to assess the predictors of OL success among preservice teachers in Ghana. Bandura’s social cognitive theory guided the study; in total, 526 preservice teachers were recruited from four colleges of education. Although the teachers were ambivalent regarding the success of OL, significant differences were found between the following demographics: gender, specialization, marital status, the preferred mode of learning, and the place of residence. Moreover, the study discussed the need for intensive information and communications technology education among preservice teachers, particularly women, developing their confidence in computer skills, and other recommendations

Experiences of primary caregivers of children with cerebral palsy across the trajectory of diagnoses in Ghana

Background: Cerebral palsy (CP) is a non-progressive disorder of posture or movement caused by a lesion to the developing brain that results in functional limitations. The diagnosis of CP can vary from one child to another, causing family stress because of vague and unknown outcomes of the disorder. Although there are negative attitudes in Ghanaian societies towards primary caregivers and children with disabilities, fewer attempts have been made to understand their experiences. Objectives: The main aim of this study was to explore the experiences of primary caregivers across the trajectory of the diagnosis (before, during and after) of CP in the setting of a tertiary hospital. Method: Using Social Capital Theory as framework, 40 primary caregivers of children with CP, who were receiving treatment at a major referral hospital in Ghana, were interviewed about their experiences before, during and after diagnosis. Results: The results that emerged from the thematic analysis were discussed as follows: experiences before diagnosis, experiences during the diagnosis and experiences after the diagnosis. Particularly, participants discussed their inability to access essential services such as education for their children with CP. Conclusion: In light of systemic challenges faced by participants and their children with CP, the need for health policymakers to prioritise the public education about CP, promoting the well-being of caregivers and other implications of the study have been discussed

Cross-national study of communal attitudes toward individuals with intellectual disabilities in sub-Saharan Africa : Cameroon vs. Ghana

Background: An intellectual disability (ID) is characterized by a deficit in the functional, cognitive, and adaptive skills required for independent living. Due to the low cognitive capabilities of individuals with IDs, they have become victims of marginalization, exclusion, and denial of their fundamental rights to basic necessities in societies around the world. While efforts are being made to improve service provision to and acceptance of individuals with disabilities, the extent of communal acceptance and recognition of these individuals as equal members of society remains underexplored in sub-Saharan African countries such as Cameroon and Ghana. Objective: As attitudes toward individuals with IDs are pivotal in shaping national policies, this cross-national study examined communal attitudes toward persons with IDs in Cameroon and Ghana. Method: The Community Living Attitude Scale for Intellectual Disabilities (CLAS-ID) was used to collect data from a total of 741 university students in the two countries. The validity of the scale was assessed using confirmatory factor analysis and principal component analysis. The association between the background variables and attitudes was examined using t-tests, analysis of variance, linear regression, and two-way factor analysis. Results: The results showed the validity of the CLAS-ID as a valid tool for measuring communal attitudes toward individuals with IDs in sub-Saharan Africa. The participants appeared ambivalent about attitude towards individuals with ID and other findings showed no association between attitudes and variables such as gender, relation, and contact with individuals with IDs. Conclusion: We discuss the need for innovative approaches aimed at changing attitudes toward individuals with IDs in sub-Saharan Africa as well as other study implications

Global, regional, and national burden of meningitis and its aetiologies, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background Although meningitis is largely preventable, it still causes hundreds of thousands of deaths globally each year. WHO set ambitious goals to reduce meningitis cases by 2030, and assessing trends in the global meningitis burden can help track progress and identify gaps in achieving these goals. Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we aimed to assess incident cases and deaths due to acute infectious meningitis by aetiology and age from 1990 to 2019, for 204 countries and territories. Methods We modelled meningitis mortality using vital registration, verbal autopsy, sample-based vital registration, and mortality surveillance data. Meningitis morbidity was modelled with a Bayesian compartmental model, using data from the published literature identified by a systematic review, as well as surveillance data, inpatient hospital admissions, health insurance claims, and cause-specific meningitis mortality estimates. For aetiology estimation, data from multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature studies were analysed by use of a network analysis model to estimate the proportion of meningitis deaths and cases attributable to the following aetiologies: Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, group B Streptococcus, Escherichia coli, Klebsiella pneumoniae, Listeria monocytogenes, Staphylococcus aureus, viruses, and a residual other pathogen category. Findings In 2019, there were an estimated 236 000 deaths (95% uncertainty interval [UI] 204 000–277 000) and 2·51 million (2·11–2·99) incident cases due to meningitis globally. The burden was greatest in children younger than 5 years, with 112 000 deaths (87 400–145 000) and 1·28 million incident cases (0·947–1·71) in 2019. Age-standardised mortality rates decreased from 7·5 (6·6–8·4) per 100 000 population in 1990 to 3·3 (2·8–3·9) per 100 000 population in 2019. The highest proportion of total all-age meningitis deaths in 2019 was attributable to S pneumoniae (18·1% [17·1–19·2]), followed by N meningitidis (13·6% [12·7–14·4]) and K pneumoniae (12·2% [10·2–14·3]). Between 1990 and 2019, H influenzae showed the largest reduction in the number of deaths among children younger than 5 years (76·5% [69·5–81·8]), followed by N meningitidis (72·3% [64·4–78·5]) and viruses (58·2% [47·1–67·3]). Interpretation Substantial progress has been made in reducing meningitis mortality over the past three decades. However, more meningitis-related deaths might be prevented by quickly scaling up immunisation and expanding access to health services. Further reduction in the global meningitis burden should be possible through low-cost multivalent vaccines, increased access to accurate and rapid diagnostic assays, enhanced surveillance, and early treatment.publishedVersio

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe