Luginaah, Isaac

Wullo Anfaara, Florence

English

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Western University Scholarship@Western Community, Equity, Gender Western Heads East 11-15-2017 The Influence of Primary Health Care (PHC) on Hepatitis B Voluntary Testing in the Upper West Region of Ghana Florence Wullo Anfaara Isaac Luginaah Follow this and additional works at: https://ir.lib.uwo.ca/wheceg Introduction Hepatitis B virus (HBV) accounts for about 47% of all hepatitis related deaths, and it is the leading cause of liver cirrhosis and liver cancer (World Health Organization, 2016).   Most deaths occur in low and middle income countries due to poor access to critical health care services, high illiteracy rates and endemic poverty.   Ghana is among HBV endemic countries globally (10-15% prevalence rate). Overall contribution of HBV related deaths to national mortality rate has increased by 17.2% in the last two decades largely due to limited uptake of voluntary testing for early detection and treatment (The Global Burden of Disease Chart, 2016).  Relatedly, high endemic regions are associated with disproportionally low rate of testing and knowledge of hepatitis B status. It has been reported in different studies across developing countries that less than 5% of people infected with chronic HBV know their status (WHO, 2016; Painter, 2001; UNICEF, 2008).  Voluntary testing over the years has proven to be the best alternative to reducing the spread of infectious diseases. It is associated with changes in risky health behaviors and adoption of healthy lifestyles (MacPhail et al., 2013)  PHC facilities serve as a source of health information and promotion of testing in most rural areas in Ghana.  Research Question Does type of PHC facility impact HBV voluntary testing among residents in the UWR of Ghana?   Methodology Data Cross-sectional survey conducted on randomly sampled males and females above 18 years (n=1,374) in the UWR from June to August 2016.  The sampling technique followed the Ghana Statistical Service multi-staged sampling method, where four districts where randomly drawn from the eleven districts in the region in the first stage of sampling.  To further promote randomness in the selection of participants, the study interviewed the household member whose birthday was closer to the date of the data collection, regardless of the person‟s sex.  Measures Dependent variable: HB voluntary testing   Binary variables coded as “0”= required ad “1”= voluntary  Key independent variable: Place of primary health care  „Where do you go for healthcare‟ The Influence of Primary Health Care (PHC) on Hepatitis B Voluntary Testing in the  Upper West Region Of Ghana  Florence Wullo Anfaara and Isaac Luginaah (Ph.D.) Department of Geography         Western University, London, Canada Results Table 1: Distributions of selected variables  Variable % of respondents (n=380 ) HBV testing      Voluntary 18.42    Required 81.58 Source of health care      Hospital 51.05    Clinic 13.68    CHPS 35.26 Place of residence      Urban 39.74    Rural 60.26 District of residence      JWa West 37.11    Jirapa 18.95    Sissala East 14.21    Wa Municipal 29.74 Wealth Quintile      Richest 20.00    Rich 20.00    Middle 20.53    Poor 19.47   Poorest 20.00   Model1 Model2 Model3 OR (Std. Err) OR (Std. Err) OR (Std. Err) Source of health care (ref: Hospital)          Clinic 2.370(0.749)*** 2.518(0.849)*** 2.271(0.892)**    CHPS 1.625(0.488) 2.008(0.645)** 2.533(0.863)*** Place of residence (ref: Urban)*** p<0.01, ** p<0.05, * p<0.1; standard errors in parenthesis; all models are adjusted for clustering.          Rural 0.890(0.262) 1.066(0.337) 1.161(0.358) District of residence (ref: Wa West)        Jirapa 1.154(0.351) 1.372(0.468) 1.605(0.729)    Sissala East 0.082(0.084)** 0.098(0.100)** 0.141(0.180)    Wa Municipal 0.907(0.260) 0.880(0.265) 1.101(0.368) Wealth Quintile (ref: Richest)          Rich   1.192(0.437) 1.041(0.377)    Middle   1.106(0.464) 0.672(0.313)    Poor   0.901(0.404) 0.377(0.186)**    Poorest   0.603(0.286) 0.296(0.156)** Table 2: Multivariate complementary log-log regression esti-mating HBV voluntary testing  RA interviewing a household head in Wa Municipality  Picture of a household in Wa West District Discussion  CHPS, clinics and health centres may be meeting their community outreach mandates resulting in the voluntary uptake of HB testing. Hospitals in the UWR may be concentrating on curative care to the neglect of community outreach There are financial barriers to HBV voluntary testing as higher socioeconomic status was a deter-minant of voluntary testing among residents.   Policy Recommendation Need for a comprehensive national policy on HB prevention and treat-ment in Ghana  Remove financial and other barri-ers to voluntary HBV testing. Clinics, Health Centres and CHPS should be resourced to intensify community outreach programs Acknowledgement 

The Influence of Primary Health Care (PHC) on Hepatitis B Voluntary Testing in the Upper West Region of Ghana

https://ir.lib.uwo.ca/cgi/viewcontent.cgi?article=1010&amp;context=wheceg

The Influence of Primary Health Care (PHC) on Hepatitis B Voluntary Testing in the Upper West Region of Ghana

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