Browsing by Author "Adjei, C.A."

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Barriers to chronic Hepatitis B treatment and care in Ghana: A qualitative study with people with Hepatitis B and healthcare providers
(Plos One, 2019-12-03) Adjei, C.A.; Stutterheim, S.E.; Naab, F.; Ruiter, R.A.C.
Background Hepatitis B viral (HBV) infection remains an important public health concern particularly in Africa. Between 1990 and 2013, Hepatitis B mortality increased by 63%. In recent times, effective antiviral agents against HBV such as Nucleos(t)ide analogs (NAs) are available. These drugs are capable of suppressing HBV replication, preventing progression of chronic Hepatitis B to cirrhosis, and reducing the risk of hepatocellular carcinoma and liver-related death. Notwithstanding, these treatments are underused despite their effectiveness in managing Hepatitis B. This study sought to explore barriers to treatment and care for people with Hepatitis B (PWHB) in Ghana, paying particular attention to beliefs about aetiology that can act as a barrier to care for PWHB. Methods We used an exploratory qualitative design with a purposive sampling technique. Face-toface interviews were conducted for 18 persons with Hepatitis B (PWHB) and 15 healthcare providers (HCP; physicians, nurses, and midwives). In addition, four focus group discussions (FGD) with a composition of eight HCPs in each group were done. Participants were recruited from one tertiary and one regional hospital in Ghana. Data were processed using QSR Nvivo version 10.0 and analysed using the procedure of inductive thematic analysis. Participants were recruited from one tertiary and one regional hospital in Ghana. Results Three main cultural beliefs regarding the aetiology of chronic Hepatitis B that act as barriers to care and treatment were identified. These were: (1) the belief that chronic Hepatitis B is a punishment from the gods to those who touch dead bodies without permission from their landlords, (2) the belief that bewitchment contributes to chronic Hepatitis B, and (3) the belief that chronic Hepatitis B is caused by spiritual poison. Furthermore, individual level barriers were identified. These were the absence of chronic Hepatitis B signs and symptoms,perceived efficacy of traditional herbal medicine, and PWHB’s perception that formal care does not meet their expectations. Health system-related barriers included high cost of hospital- based care and inadequate Hepatitis B education for patients from HCPs. Conclusion Given that high cost of hospital based care was considered an important barrier to engagement in care for PWHB, we recommend including the required Hepatitis B laboratory investigations such as viral load, and the recommended treatment in the National Health Insurance Scheme (NHIS). Also, we recommend increasing health care providers and PWHB Hepatitis B knowledge and capacity in a culturally sensitive fashion, discuss with patients (1) myths about aetiology and the lack of efficacy of traditional herbal medicines, and (2) patients’ expectations of care and the need to monitor even in the absence of symptoms.
Beliefs about children and the psychosocial implications of infertility on individuals seeking assisted fertilization in Ghana
(Reproductive BioMedicine and Society Online, 2021) Kyei, J.M.; Manu, A.; Kotoh, A.M.; Adjei, C.A.; Ankomah, A.
Infertility presents challenges to individuals and couples, particularly in Sub-Saharan Africa. This study aimed to docu ment beliefs about childbearing/children and the psychosocial implications of infertility in individuals seeking assisted fertilization in the Ghanaian context. The study had an exploratory descriptive qualitative design. Six males and 12 females were recruited pur posefully from five private fertility centres in the Greater Accra Region. Face-to-face interviews were performed. In Ghanaian soci ety, couples and individuals with infertility who are seeking assisted fertilization consider having biological children to be important. The quest to have children was broadly centred on the associated benefits of being a parent, including societal recognition, the role of family inheritance, and support. The inability of participants to have biological children was found to have a negative effect on their psychological and social well-being. Anxiety, worry, hopelessness, stigma and suicidal ideations were some of the effects iden tified. It is recommended that those seeking assisted fertilization should be supported through counselling to minimize the potential negative effects of childlessness
Chronic Hepatitis B stigma in Ghana: a qualitative study with patients and providers
(BMJ Open, 2019-05-21) Adjei, C.A.; Stutterheim, S.E.; Naab, F.; Ruiter, R.A.C.
Objective This study explored beliefs contributing to Hepatitis B stigma, and the ways in which Hepatitis B stigma manifests, from the perspectives of people with chronic Hepatitis B as well as healthcare providers in Northern and Southern Ghana. Design We used an exploratory qualitative design with a purposive sampling technique. Face-to-face interviews and focus group discussions were conducted. Data were processed using QSR Nvivo V.10.0 and analysed using inductive thematic analysis. Settings Participants were recruited from one tertiary and one regional hospital in Ghana between February and November 2017. Participants Overall, 18 people with chronic Hepatitis B (PWHB) and 47 healthcare providers (primary care physicians, nurses and midwives) between the ages of 21 and 57 years participated in the study. Results PWHB face stigma in their sociocultural context and the healthcare environment. Three main beliefs underlying stigma were found: (1) the belief that Hepatitis B is highly contagious; (2) the belief that Hepatitis B is very severe and (3) the belief that Hepatitis B is caused by curses. Stigmatisation manifested as avoidance and social isolation (discrimination). In healthcare settings, stigmatisation manifested as excessive cautiousness, procedure postponement or avoidance, task-shifting and breaches of confidentiality. Conclusions Given the prevalence of incorrect knowledge, as reflected in the beliefs about Hepatitis B, we recommend public awareness campaigns that emphasise Hepatitis B transmission routes. Also, given the manifestations of the stigma in healthcare settings, we recommend the development and implementation of a continuing professional development programme on Hepatitis B and adjusted policy on Hepatitis B vaccination for Healthcare providers (HCPs).
Correlates of hepatitis B testing in Ghana: The role of knowledge, stigma endorsement and knowing someone with hepatitis B
(Health & Social Care in the Community, 2022) Adjei, C.A.; Naab, F.; Stutterheim, S.E.; et al.
Hepatitis B testing is the gateway for prevention and care. However, previous studies document low hepatitis B testing uptake in sub-Saharan Africa. This study investigated knowledge, stigma endorsement and knowing someone with hepatitis B as correlates of hepatitis B testing behaviours among people in the Greater Accra and Northern regions of Ghana. A cross-sectional survey was completed by 971 participants (Greater Accra = 503 and Northern region = 468) between October 2018 and January 2019. Approximately 54% of the participants reported having been tested for hepatitis B. The logistic regression analyses showed that having greater hepatitis B knowledge was positively associated with hepatitis B testing (OR = 1.22, 95% CI: 1.14–1.30). Higher hepatitis B stigma endorsement was negatively related to hepatitis B testing (OR = 0.97, 95% CI: 0.96–0.99). Also, participants who knew someone (i.e. parent, sibling, and/or friend) with hepatitis B were more likely to have tested compared to those who did not know someone with hepatitis B (OR = 7.15, 95% CI: 5.04– 10.14). This study demonstrates that knowing someone with hepatitis B increases the likelihood of testing, highlighting the need to create safe and non-judgmental contexts for people with hepatitis B (PWHB) to disclose if they want to. Also, given that greater hepatitis B knowledge increases testing and hepatitis B stigma endorsement impedes testing, interventions that increase knowledge and reduce stigma should be incorporated in efforts to promote testing in Ghana.
Hepatitis B Infection among Parturient Women in Peri-Urban Ghana
(American Journal of Tropical Medicine and Hygiene, 2018-10) Adjei, C.A.; Atibila, F.; Apiribu, F.; Ahordzor, F.; Attafuah, P.A.; Ansah-Nyarko, M.; Asamoah, R.; Menkah, W.
Global evidence suggests that hepatitis B viral (HBV) infection is endemic in Africa and perinatal transmission remains one of the most important modes of HBV transmission in this area. This cross-sectional survey examined the seroprevalence and knowledge of hepatitis B among pregnant women attending antenatal clinic (ANC) in a mission hospital in Ghana. Systematic sampling technique was used to recruit 196 pregnant women. The level of statistical significance was set at 0.05 alpha level. The hepatitis B prevalence estimate (hepatitis B surface antigen) was 10.2% (N = 20) and the entirety of the participants were aware of HBV infection. Majority cited media (radio) as their main source of information. Approximately 86% of the participants (N = 168) associated HBV infection with a curse and 88.8% (N = 174) indicated witches and wizards as possible causes of the infection. Those with higher level of school education had high hepatitis B knowledge score (P < 0.01). Implementation of a health education program on the route of hepatitis B transmission is required in the study setting. Also, inclusion of hepatitis B education as part of ANC activities will enable HBV-positive pregnant women to appreciate the need for hepatitis B vaccination of their newborns at birth.
The Image of Nurses and Midwives in Ghana: Patient and Family Perspectives
(Global Qualitative Nursing Research, 2022) Ohene, L.A.; Acheampong, A.K.; Dzansi, G.; Kyei, J.; Adjei, C.A.; Adjorlolo, S.; Asante, I.N.A.; Woolley, P.; Nyante, F.; Aziato, L.
This study aims to explore the perceptions of patients and family caregivers on the image of nurses and midwives in Ghana. The study adopted a qualitative exploratory descriptive approach. A total of 25 participants were interviewed during data collection. Content and thematic analysis were applied in the data analysis to develop themes. The findings are captured under two major themes that describe the primary influences on participant images of nurses: Thus, (1) nurses’ and midwives’ attributes with four subthemes; staff appearance, communication strategies and behaviors, work attitudes, and professional competence and (2) patients’ status and subthemes were; uneducated poor and educated rich. We conclude that patients and families in Ghana recognize the professional attributes of the nurse and midwife, which reflect in their personality, grooming, communication, competencies, and attitudes. However, low publicity of the professional roles of nurses and midwives may have negative repercussions for their professional image. A policy to perform a regular public audit on the image of the Nurse/Midwife is important for professional advancement.
Informational and Practical Needs of Expectant Mothers with Chronic Hepatitis B in Ghana
(SAGE Open Nursing, 2024) Lanyo,T.N.; Adjei, C.A.; Ani-Amponsah, M.
Hepatitis B virus infection is a global public health problem with disproportionately high endemicity in Africa and Ghana. The current national prevalence of hepatitis B among pregnant women in Ghana stands at 7.44%, highlighting the considerable threat of chronic hepatitis B on pregnant women and their general well-being. The study explored the informational and practical needs of pregnant women with chronic hepatitis B in Ghana. Fourteen pregnant women were selected purposefully using the exploratory descriptive qualitative design. Data were analyzed using thematic analysis. The findings showed that pregnant women with chronic hepatitis B lacked knowledge about the infection and were in great need of hepatitis B-related information. The study also revealed significant financial implications for treating the infection, necessitating policy reforms and stakeholder actions. To achieve effective coping, better health-seeking, and health-promoting behaviours for better health outcomes, it is crucial to provide targeted care that comprehensively covers the specific needs of pregnant women with chronic hepatitis B. It is also essential to consider including hepatitis B management in the National Health Insurance package to improve care quality.
Interventions impacting the accessibility of sexual reproductive health services for head porters in sub-Saharan Africa- A scoping review protocol
(PLOS ONE, 2023) Adjorlolo, S.; Adjei, C.A.; Torpey, K.; et al.
Head porters working in markets in sub-Saharan Africa (SSA) are one of the world’s most vulnerable and socioeconomically disadvantaged groups. They consist predominantly of uneducated women and girls seeking to escape poverty, early marriage, and other issues of domestic violence. Most female head porters are in their reproductive years and often lack access to sexual reproductive health services (SRHS) despite being at high risk for sexually transmitted infections (STIs), unplanned pregnancies, and gender-based vio lence. The low priority for women and girls’ SRH in many SSA countries highlights the need to explore the factors influencing the accessibility of services for failure to do so restrains human development. An initial search of the literature was conducted and revealed no current scoping or systematic reviews on the accessibility to SRHS for female head porters in SSA. We outline a scoping review protocol, using the Joanna Briggs Institute methodology, to determine the interventions that influence the accessibil ity of SRHS for female head porters in SSA. The protocol is registered with Open Science Framework (https://osf.io/hjfkd). Findings will not only be valuable for female head por ters but for all vulnerable female groups in SSA who experience high SRH risks and social disparities.
Mother-to-child transmission of hepatitis B: Extent of knowledge of physicians and midwives in Eastern region of Ghana
(BioMed Central Ltd., 2016) Adjei, C.A.; Asamoah, R.; Atibila, F.; Ti-Enkawol, G.N.; Ansah-Nyarko, M.
Background: Mother -to -Child transmission of hepatitis B infection remains a major public health concern particularly in Africa. Adequate knowledge of physicians and midwives is crucial in averting most of the hepatitis B viral transmissions from mothers to their new-borns. However, there is a dearth of evidence on extent of knowledge of physicians and midwives in Ghana inspite of the increasing incidence of hepatitis B infection in the country. This study therefore assessed the knowledge level of physicians and midwives regarding Mother-to-Child transmission of hepatitis B in the Eastern region of Ghana. Methods: A Cross sectional survey was conducted between August to November, 2015 using semi-structured self-administered questionnaire. Study participants were recruited from five health facilities and their level of awareness and knowledge about Mother-to-Child transmission of hepatitis B were assessed. The level of statistical significance was set at 0.05 alpha level. Results: The findings showed that both physicians and midwives had good knowledge on Mother-to-Child transmission of hepatitis B infection. However, there were some knowledge gaps regarding effective hepatitis B prevention from mother to their newborns such as the use of hepatitis B vaccine and immunoglobulin. Additionally, 49.2 % (n = 62) of the participants had never attended any workshop on Mother-to-Child transmission of hepatitis B since completion of formal training. Conclusions: Developing appropriate periodic training programmes on current issues of hepatitis B for physicians and midwives in Eastern region will further enhance their knowledge. It is recommended that, further study examine if the knowledge of the respondents is translated into practice.
Nurses’ and midwives’ perspectives on participation in national policy development, review and reforms in Ghana: a qualitative study
(BMC Nursing, 2021) Acheampong, A.K.; Ohene, L.A.; Asante, I.N.A.; Kyei, J.; Dzansi, G.; Adjei, C.A.; Adjorlolo, S.; Boateng, F.; Woolley, P.; Nyante, F.; Aziato, L.
Background: The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana. Methods: A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures. Results: Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raised. Conclusion: The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.
Perceived Supportive Care Needs of Adolescents With Chronic Hepatitis B in a Resource-limited Setting
(Journal of Patient Experience, 2022) Kolbila, L.; Adjei, C.A.; Kyei, J.M.; et al.
In Ghana, adolescents are disproportionately affected by hepatitis B. However, studies into adolescents’ supportive care needs are lacking. The purpose of this exploratory qualitative study was to explore the supportive care needs of 18 adolescents with chronic hepatitis B who were receiving care at a tertiary hospital in Ghana. The data were processed using QSR Nvivo version 11.0 and analyzed using the Braun and Clarke procedure for thematic data analysis. According to the findings, adolescents with chronic hepatitis B have unmet supportive care needs ranging from information to financial need, psychological support, and social support. Explicitly, participants reportedly had a dilemma as to whether to keep or terminate their pregnancy to prevent transmission of the virus to their newborns. Physicians and nurses were perceived to be preoccupied with medication prescription and laboratory request writing rather than giving pretest and posttest counseling following diagnosis. This study highlights the need to have tailor-made liver care for adolescents. Pretest and posttest counseling for adolescents with hepatitis B is also required.
Perceptions and Cues to Action as Predictors of Nurses’ Vaccination Intentions at Two Primary Health Care Facilities in Ghana
(American Journal of Tropical Medicine and Hygiene, 2023) Tagbor, S.; Ohene, L.A.; Adjei, C.A.; Kyei, J.
Uptake of hepatitis B vaccination by health care providers remains suboptimal in Ghana, although it is considered an effective strategy against the hepatitis B virus. This study aimed to identify the predictors of nurses’ hepatitis B vaccination intentions at two municipal health care facilities in Ghana. A descriptive cross-sectional survey was adopted. A section of the health belief model-based questionnaire was administered to 181 nurses conveniently sampled from the two facilities. Data analysis was done using Statistical Product and Service Solutions software version 23.0. Frequencies and percentages were used to assess the demographic characteristics of participants. Pearson r coefficients were used to assess the intercorrelations between individual perceptions, and the cues to action on vaccination intentions. Simple and multiple regression was used to estimate the prediction of individual perceptions, and the cues to action on hepatitis B vaccination intentions of nurses. The findings showed that nurse-perceived benefits and cues to action were positive and significantly related to hepatitis B vaccination intentions of nurses (r 5 0.14, P , 0.05; r 5 0.17, P , 0.05). Perceived susceptibility and perceived barrier were negative and significantly related to vaccine intentions (r 5 20.13, P , 0.05; r 5 20.24, P , 0.01). Notably, perceived barrier predicted hepatitis B vaccination intentions (b520.22, t 5 22.48, P 5 0.01). Nurses’ vaccination behavioral intentions were positive. It was recommended that perceived barriers to hepatitis B vaccination such as vaccination ineffectiveness, time constraints, high costs, and side effects should be addressed to increase nurses’ vaccination uptake.
Physical and social wellbeing of family caregivers of persons with hepatitis B associated chronic liver disease in Ghana: a qualitative study
(BMC Primary Care, 2023) Abaah, D.; Ohene, L.A.; Adjei, C.A.
Background Hepatitis B is one of the most common viral (HBV)infections that affect the liver. Infection with the virus may result in varying severity of liver disease which may be acute or chronic. Though most people recover from the infection, about 5 −10% of cases lead to chronic infection. Persons who develop HBV-related debilitating liver disease will likely require informal care from family caregivers. Aim This study sought to explore the physical and social wellbeing of family caregivers of persons with hepatitis B-associated chronic liver disease in a tertiary hospital in the Central region of Ghana. Methods This study adopted an exploratory, descriptive qualitative research design. We used a purposive sampling technique and a semi-structured interview guide to interview eighteen participants. The Quality of Life (QoL) model applied to family caregivers underpinned the study and guided the formulation of study objectives. Data analysis followed Braun and Clarke’s procedure for thematic content analysis. Similar codes were grouped into subthemes, and similar subthemes were grouped into major themes. The consolidated criteria for reporting qualitative research (coreq) checklist was used as a guide for writing the study. Results Two major themes emerged from the study: physical wellbeing and social wellbeing. Seven subthemes were also identified: physical body changes and physiological body changes (physical wellbeing) and role strain, social isolation, financial impact, affection/sexual function, and support social wellbeing). These central themes aligned with two domains of the QoL model applied to family caregivers. Conclusion Family caregivers of persons with HB-associated liver disease suffer ill health due to the burden of physical care for their sick relatives and neglect their health due to time constraints. They also experience role strain as they cannot attend to other family responsibilities and feel socially isolated since they spend all their time caring for a sick family member
We are willing, but we have challenges’: Qualitative enquiry on midwives’ views on factors influencing the prevention of mother to-child transmission of hepatitis B program
(SAGE Open Nursing, 2024) Atoko, A.M.; Naab,F.; Adjei, C.A.; Senoo-Dogbey, V.E.
Introduction: Mother-to-child transmission of hepatitis B infection is one of the major routes of hepatitis B virus (HBV) infection in Africa. Amusingly, Africa is the only region yet to meet the World Health Organization’s target of reducing the prevalence of HBV infection to less than 1% among children under 5 years of age by 2020. In Ghana, little has been doc umented about midwives’ views on the factors impacting the successful implementation of mother-to-child transmission via HBV prevention programs. Objective: This study explored midwives’ views on the challenges associated with the prevention of mother-to-child trans mission of HBV infection in the La-Nkwantanang municipality. Methods: The study adopted an exploratory descriptive qualitative design and involved 14 midwives who were purposively recruited from a primary-level health facility in the La-Nkwantanang Municipality, Accra. Individual face-to-face interviews were conducted using an in-depth interview guide. The data were content analyzed using the six steps recommended by Braun and Clark. Results: Three main themes, namely, health professional or midwife factors and patient and health facility factors, negatively impacted the prevention of maternal-to-child transmission program. The five subthemes identified in this study included lack of awareness, financial constraints, and unavailability of logistics and protocols. The study recognized that midwives face many challenges even though they have a strong desire to prevent vertical transmission of HBV. Conclusion: The implementation of a mother-to-child transmission program is negatively impacted by many intrinsic, client, and health facility factors. Midwives who act as major stakeholders need to be periodically trained on the components and protocols for managing pregnant women living with HBV. The necessary logistics and management protocols need to be urgently provided. The skills and education obtained from the training will empower midwives to be knowledgeable about how to deliver quality care and provide education and support for HBV-infected pregnant women. The provision of logistics needed for the successful implementation of the program could avert delays associated with the administration of the hepatitis B birth dose vaccine and immunoglobulin to exposed newborns
"We'll check vital signs only till we finish the school": Experiences of student nurses regarding intra-semester clinical placement in Ghana
(BioMed Central Ltd., 2018-05) Adjei, C.A.; Sarpong, C.; Attafuah, P.A.; Amertil, N.P.; Akosah, Y.A.
Background: Clinical practicum is an integral part of nursing education because it provides students with opportunities to perform nursing care and practice specific nursing tasks. In Ghana, little is known about the experiences of baccalaureate student nurses with regard to intra-semester clinical practicum. This study therefore, explored perceptions, challenges, and how the intra-semester clinical practicum affects the learning process of student nurses in a private university in Ghana. Methods: Exploratory descriptive phenomenological design was used. Nine in-depth interviews and three focus group discussions were conducted for baccalaureate student nurses in their second, third and fourth years of study. Only those who have attended intra-semester clinical practicum for at least two semesters in the course of their study were recruited. Purposive sampling technique was used to select the participants. The sample size was based on data saturation, however, a total of 33 participants were recruited. Data was analysed using content analysis technique. Results: The findings show that baccalaureate student nurses perceive the intra-semester clinical practicum as beneficial. It affords the opportunity to translate theoretical knowledge into practice concurrently. However, students recounted their stressful experiences during the clinical period which negatively affected their academic work. Additionally, staff nurses assigned the students to do menial jobs instead of appropriate nursing tasks. Conclusions: A review of the "block" method in which students will go to clinicals for a stipulated number of consecutive days in a month and then resume lectures, is worth considering. © 2018 The Author(s).