25 research outputs found

    Self-medication practices of pregnant women attending antenatal clinic in northern Ghana: An analytical cross-sectional study

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    In Ghana, despite the dangers that self-medication poses to maternal and fetal health, there has been limited examination of self-medication among pregnant women. This study examines the practice of self-medication among pregnant women in Wa Municipality, Ghana. An analytical cross-sectional survey of 367 pregnant women was conducted in three health facilities. The prevalence of self-medication practice was 74.1%. The majority (68.4%) of pregnant women obtained unprescribed medicines from chemical shops; others utilized leftover drugs from previous hospital visits (15.8%) or herbal medications (9.9%), while others took unprescribed drugs from relatives or friends (5.9%). Analgesics (76.1%), antibiotics (24.6%), and antimalarials (16.2%) were the most frequently self-medicated drugs. The most common illnesses or symptoms for which pregnant women self-medicated were headaches (34.2%), back pain (33.1%), waist pain (32.7%), lower abdominal pain (20.6%), and malaria (16.2%). After adjusting for potential confounders, easy access to medication without prescription (AOR= 8.4), illness perceived as minor (AOR=4.1), availability of health facilities (AOR=4.2), and frequent lack of medicines at health facilities (AOR=1.7) were significantly associated with self-medication. Enforcing legislation to prevent the stocking and sale of certain analgesics and antibiotics, increasing service points, and improving service quality at antenatal clinics, outpatient departments and pharmacies could reduce self-medication.   Au Ghana, malgrĂ© les dangers que l'automĂ©dication fait peser sur la santĂ© maternelle et foetale, l'examen de l'automĂ©dication chez les femmes enceintes a Ă©tĂ© limitĂ©. Cette Ă©tude examine la pratique de l'automĂ©dication chez les femmes enceintes de la municipalitĂ© de Wa, au Ghana. Une enquĂȘte transversale analytique auprĂšs de 367 femmes enceintes a Ă©tĂ© menĂ©e dans trois formations sanitaires. La prĂ©valence de la pratique de l'automĂ©dication Ă©tait de 74,1 %. La majoritĂ© (68,4 %) des femmes enceintes ont obtenu des mĂ©dicaments sans ordonnance dans les magasins de produits chimiques ; d'autres utilisaient des restes de mĂ©dicaments provenant de visites antĂ©rieures Ă  l'hĂŽpital (15,8 %) ou des mĂ©dicaments Ă  base de plantes (9,9 %), tandis que d'autres prenaient des mĂ©dicaments non prescrits de parents ou d'amis (5,9 %). Les antalgiques (76,1 %), les antibiotiques (24,6 %) et les antipaludiques (16,2 %) Ă©taient les mĂ©dicaments les plus frĂ©quemment auto-mĂ©diquĂ©s. Les maladies ou symptĂŽmes les plus courants pour lesquels les femmes enceintes s'automĂ©dicament Ă©taient les maux de tĂȘte (34,2 %), les maux de dos (33,1 %), les douleurs Ă  la taille (32,7 %), les douleurs abdominales basses (20,6 %) et le paludisme (16,2 %). AprĂšs ajustement pour les facteurs de confusion potentiels, accĂšs facile aux mĂ©dicaments sans ordonnance (AOR = 8,4), maladie perçue comme mineure (AOR = 4,1), disponibilitĂ© des Ă©tablissements de santĂ© (AOR = 4,2) et manque frĂ©quent de mĂ©dicaments dans les Ă©tablissements de santĂ© (AOR = 1,7) Ă©taient significativement associĂ©s Ă  l'automĂ©dication. L'application de la lĂ©gislation pour empĂȘcher le stockage et la vente de certains analgĂ©siques et antibiotiques, l'augmentation des points de service et l'amĂ©lioration de la qualitĂ© des services dans les cliniques prĂ©natales, les services de consultation externe et les pharmacies pourraient rĂ©duire l'automĂ©dicatio

    Knowledge and Perception of Pupils on Health and Environmental Risk of Open Defaecation: A case Study in the First Cycle Schools in Eastern and Volta Regions of Ghana

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    Open defaecation remains major public and environmental health concerns and has attracted global attention in recent time. This study explores the knowledge and perception of pupils on health and environmental risk of open defaecation. Self-reported data were collected from 400 school pupils using questionnaires, focus group discussions and in-depth interview. Results of the study shows high knowledge level (89.8%) among the pupils. Pupils’ knowledge of environmental risks was fairly high (52%). Knowledge of health risks was, however, low among greater number (53%) of the pupils. Open defaecation shows statistical significant association with health risk (ᔥ2 =65.062, p=0.002), environmental risk (ᔥ2 = 44.961, p=0.006) and pupils level of perception of environmental risk (ᔥ2 = 36.887, p=0.045). The Ministry of Education must introduce courses into the school curriculum to help pupils acquire adequate knowledge on health and environmental consequences of open defaecation.  Keywords: Knowledge, perception, health & environmental risks, open defaecation, first cycle school pupils, Eastern, Volta, Ghana

    Clean delivery practices in rural northern Ghana: a qualitative study of community and provider knowledge, attitudes, and beliefs

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    Abstract Background Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1) Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2) Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3) Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of facility-based delivery, the disconnect between healthcare providers and the community, and the critical role grandmothers play in ensuring clean delivery practices. Future interventions to address clean delivery and prevention of neonatal infections include educating healthcare providers about harmful traditional practices so they are specifically addressed, strengthening facilities, and incorporating influential community members such as grandmothers to ensure success.http://deepblue.lib.umich.edu/bitstream/2027.42/112409/1/12884_2011_Article_543.pd

    A qualitative analysis of the effect of a community-based primary health care programme on reproductive preferences and contraceptive use among the Kassena-Nankana of northern Ghana

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    Background In 2000, Ghana launched the Community-based Health Planning and Services (CHPS) initiative to improve access to health and family planning services. This initiative was based in part on research, known as the Navrongo Project, conducted in the Kassena-Nankana district (KND) between 1994 to 2003 which demonstrated significant impact on fertility and child mortality. This paper examines current contraceptive perceptions in communities that were exposed to the Project’s service models over the 1994 to 2003 period, and the post-experimental policies of the CHPS era. Methods Qualitative study was conducted in the KND of Ghana from June to September, 2012, by convening 8 male and 8 female FGD panels as well as 8 in-depth interviews of community leaders. Data collection was stratified by original experimental cell of the Navrongo Project to permit appraisal of social effects of contrasting experimental conditions. Inductive content analysis was performed with QSR Nvivo 10 to identify predominant themes. Results While findings show that exposure to community-based services was associated with enhanced approval of birth spacing and limitation, this view is grounded in perceptions that childhood survival has improved. Nonetheless, concerns were expressed about contraceptive side effects, prominently permanent sterility. Strategies for male outreach and community engagement originally introduced during the Navrongo Project have not been sustained with CHPS scale-up. The apparent atrophy of attention to the needs of men may explain the resistance of some males to the notion of female reproductive autonomy and the practice of some women to adopt contraception in secret. Despite this apparent programmatic dearth of male engagement, there is evidence to suggest that social impact of the original male engagement strategy persists in communities where male mobilization was combined with doorstep provision of family planning care during the Navrongo Project. Conclusion Community-based services fostered attitudinal change towards family planning in a traditional sub-Saharan African setting. Sustained exposure to primary health care that have improved the survival of children has made the use of contraception more acceptable. Efforts should be embedded in primary health care programmes that address concerns about child survival while also consigning sustained priority to the information needs of men

    Clean delivery practices in rural northern Ghana: A qualitative study of community and provider knowledge, attitudes, and beliefs systems

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    Abstract: Background: Knowledge, attitudes and practices of community members and healthcare providers in rural northern Ghana regarding clean delivery are not well understood. This study explores hand washing/use of gloves during delivery, delivering on a clean surface, sterile cord cutting, appropriate cord tying, proper cord care following delivery, and infant bathing and cleanliness. Methods: In-depth interviews and focus group discussions were audiotaped, transcribed, and analyzed using NVivo 9.0. Results: 253 respondents participated, including women with newborn infants, grandmothers, household and compound heads, community leaders, traditional birth attendants, and formally trained health care providers. There is widespread understanding of the need for clean delivery to reduce the risk of infection to both mothers and their babies during and shortly after delivery. Despite this understanding, the use of gloves during delivery and hand washing during and after delivery were mentioned infrequently. The need for a clean delivery surface was raised repeatedly, including explicit discussion of avoiding delivering in the dirt. Many activities to do with cord care involved non-sterile materials and practices: 1) Cord cutting was done with a variety of tools, and the most commonly used were razor blades or scissors; 2) Cord tying utilized a variety of materials, including string, rope, thread, twigs, and clamps; and 3) Cord care often involved applying traditional salves to the cord - including shea butter, ground shea nuts, local herbs, local oil, or “red earth sand.” Keeping babies and their surroundings clean was mentioned repeatedly as an important way to keep babies from falling ill. Conclusions: This study suggests a widespread understanding in rural northern Ghana of the need for clean delivery. Nonetheless, many recommended clean delivery practices are ignored. Overarching themes emerging from this study included the increasing use of facility-based delivery, the disconnect between healthcare providers and the community, and the critical role grandmothers play in ensuring clean delivery practices. Future interventions to address clean delivery and prevention of neonatal infections include educating healthcare providers about harmful traditional practices so they are specifically addressed, strengthening facilities, and incorporating influential community members such as grandmothers to ensure success

    Feasibility and acceptability of ACT for the community case management of malaria in urban settings in five African sites

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    <p>Abstract</p> <p>Background</p> <p>The community case management of malaria (CCMm) is now an established route for distribution of artemisinin-based combination therapy (ACT) in rural areas, but the feasibility and acceptability of the approach through community medicine distributors (CMD) in urban areas has not been explored. It is estimated that in 15 years time 50% of the African population will live in urban areas and transmission of the malaria parasite occurs in these densely populated areas.</p> <p>Methods</p> <p>Pre- and post-implementation studies were conducted in five African cities: Ghana, Burkina Faso, Ethiopia and Malawi. CMDs were trained to educate caregivers, diagnose and treat malaria cases in < 5-year olds with ACT. Household surveys, focus group discussions and in-depth interviews were used to evaluate impact.</p> <p>Results</p> <p>Qualitative findings: In all sites, interviews revealed that caregivers' knowledge of malaria signs and symptoms improved after the intervention. Preference for CMDs as preferred providers for malaria increased in all sites.</p> <p>Quantitative findings: 9001 children with an episode of fever were treated by 199 CMDs in the five study sites. Results from the CHWs registers show that of these, 6974 were treated with an ACT and 6933 (99%) were prescribed the correct dose for their age. Fifty-four percent of the 3,025 children for which information about the promptness of treatment was available were treated within 24 hours from the onset of symptoms.</p> <p>From the household survey 3700 children were identified who had an episode of fever during the preceding two weeks. 1480 (40%) of them sought treatment from a CMD and 1213 of them (82%) had received an ACT. Of these, 1123 (92.6%) were administered the ACT for the correct number of doses and days; 773 of the 1118 (69.1%) children for which information about the promptness of treatment was available were treated within 24 hours from onset of symptoms, and 768 (68.7%) were treated promptly and correctly.</p> <p>Conclusions</p> <p>The concept of CCMm in an urban environment was positive, and caregivers were generally satisfied with the services. Quality of services delivered by CMDs and adherence by caregivers are similar to those seen in rural CCMm settings. The proportion of cases seen by CMDs, however, tended to be lower than was generally seen in rural CCMm. Urban CCMm is feasible, but it struggles against other sources of established healthcare providers. Innovation is required by everyone to make it viable.</p

    Pilot implementation of community health advocacy teams to improve the effectiveness of long-lasting insecticide net distribution through both campaigns and continuous channels in Ghana: a qualitative study of opportunities and barriers to implementation

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    IntroductionIn Ghana, the National Malaria Elimination Programme (NMEP) distributes long-lasting insecticide net (LLIN) to households for free through the periodic point mass distribution (PMD) campaign and continuous distribution to populations most vulnerable to malaria. It is known that the existence of effective and functional community-based groups could influence positive behaviours regarding health interventions promoted through health campaigns. However, there is no evidence of functional community-based groups that aim to improve the effectiveness of LLIN distribution campaigns by transitioning into primary healthcare delivery. This study aimed to explore the opportunities and barriers to the pilot implementation of co-created community health advocacy teams (CHATs) to improve the effectiveness of LLIN distribution through both campaigns and continuous channels in Ghana.MethodsA qualitative research approach was used among 43 CHAT members across six communities in the Eastern and Volta regions of Ghana. The CHAT constitutes significant community actors whose roles are centred on key elements of community/social mobilisation and capacity building, all nested in social and behaviour change communication (SBCC) strategies. The CHATs were pilot implemented in all study communities for 4 months after which we identified opportunities and barriers during implementation. CHAT members participated in six focus group discussions which were audio recorded, transcribed verbatim, and analysed thematically using the NVivo 13.ResultsCHATs were instrumental in sensitising community members through SBCC strategies. Moreover, there were changes in the behaviour of community members who were receptive towards and participated in CHAT activities. Community members were accurately informed about malaria (e.g., causes and preventive measures). However, the CHAT experienced barriers during implementation, including a lack of financial support to aid in transportation, organisation of meetings, and outreach activities. Additionally, the level of participation by CHAT members in activities and the medium of communication among members were key areas of concern.ConclusionThe CHATs would be instrumental in promoting LLINs' use during and after PMD campaigns through community outreaches. It is therefore necessary to provide resources to support their operations and a good network to address communication barriers. Finally, continuous capacity strengthening of CHAT members by the NMCP is important

    Top 10 public health challenges to track in 2023: Shifting focus beyond a global pandemic

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    The year 2022 saw COVID-19 as the primary public health concern, with vaccine rollout and mandates at the forefront. Other viral infectious diseases, such as Monkeypox and Ebola, emerged as public health concerns. Climate change and political conflicts significantly impacted global health, increasing the demand for humanitarian assistance and protection. In 2023, it remains crucial to identify global and public health priority areas to coordinate and implement effective solutions. Through discussions with public health practitioners and researchers, we have identified key priority areas for 2023, namely, health systems, the mental health crisis, substance abuse, infectious diseases, malnutrition and food insecurity, sexual and reproductive health challenges, environmental pollution, the climate crisis, cancer, and diabetes. These priority areas highlight shared concerns that should be addressed to facilitate proactive and innovative health interventions and practices. To achieve universal healthcare targets for 2030, prioritization, financial investment, international cooperation, and collaboration in addressing these global health challenges are crucial. This requires coordination among public health decision-makers, the private health sector, and opinion leaders to implement country-specific healthcare financing and food security measures. Research, scientific knowledge, and technical capacities must be leveraged to produce sustainable interventions that effectively reduce health disparities and improve health system responsiveness to prevent these challenges from progressing to public health emergencies

    How local community knowledge about malaria affects insecticide-treated net use in northern Ghana.

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    Large-scale trials of insecticide-treated nets (ITNs) throughout Sub-Saharan Africa demonstrated that they reduce child mortality in malaria endemic communities. These encouraging results have generated interest in ITNs as a viable malaria control strategy in many malaria endemic countries. However, regular use of ITNs under routine or non-project conditions has been beset with several problems. This paper explores how local community knowledge about malaria acts as a barrier to the use of ITNs in three settings. We employed structured formal observation and a range of interviewing techniques which included informal interviews, focus group discussions, semi-structured in-depth interviews, and structured survey interviewing. People recognize the term 'malaria' but have limited biomedical knowledge of the disease, including its aetiology, the role of the vector, and host response. Convulsions and anaemia are rarely linked to malaria. The people acknowledged a role for ITNs in nuisance reduction, but not for malaria prevention

    Risk factors for self‐reported postpartum hemorrhage in Ga East, Ghana

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    ObjectiveTo document the prevalence of self-reported postpartum hemorrhage (PPH) in Ga East, Accra, Ghana, and examine the demographic, biological, and social risk factors for PPH.MethodsThe present study was a cross-sectional secondary analysis of data collected during 2010–2012 from the Ghana Essential Health Interventions Program, a quasi-experimental interventional study surveying households in the urban Ga East Municipal District. The analysis included data from randomly selected parous women of childbearing age (15–49 years), excluding those with a history of abortion (spontaneous or induced) or stillbirth. The χ2 test and logistic regression were used to identify significant risk factors for self-reported PPH.ResultsThe current analysis included 2136 women. Self-reported PPH was recorded for 95 (4.4%) participants. The maternal age at delivery, the duration of labor, and the number of skilled delivery providers were significantly associated with self-reported PPH. Prolonged labor (odds ratio 3.70, 95% confidence interval 2.27–5.94; P&lt;0.001) and maternal age (odds ratio 0.96, 95% confidence interval 0.94–0.99; P=0.020) were predictors of self-reported PPH.ConclusionProlonged labor and younger maternal age were related to a higher burden of reported PPH. These findings were congruent with global and regional data on the prevalence and risk factors for objectively measured PPH and could help focus intervention strategies to high-risk groups, particularly in resource-limited settings
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