Browsing by Author "Yeboah, I."
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Item Consistency of the determinants of achieving fertility desires in Ghana: insights from 2003, 2008 and 2014 Ghana Demographic and Health Survey data sets(Springer Open, 2021) Yeboah, I.; Kwankye, S.O.; Frempong‑Ainguah, F.Sub-Saharan Africa has entered the early stage of the demographic transition with differences in and between countries. The relation between fertility preference and actual fertility is at the core of the demographic changes during the demographic transition in sub-Saharan Africa. At the current pace of the demographic transition, overachieved fertility (actual fertility being higher than fertility preference) is more prevalent in sub-Saharan Africa although some women do achieve their fertility preference. Our aim is to assess the trends and identify factors that consistently influence women with completed fertility to achieve their fertility desires in Ghana over a 10-year period. We used secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys for the analysis. The sample size was restricted to currently married/living in union women aged 45–49 years. The results indicate that underachieved fertility has increased from 25.1% in 2003 to 35.8% in 2014. Similarly, achieved fertility has also increased from 23.8% in 2003 to 26.0% in 2014. On the contrary, overachieved fertility has decreased from 51.1% in 2003 to 38.2% in 2014. The most persistent determinants of achieved fertility relative to overachieved fertility in Ghana during the last three rounds of the Ghana Demographic and Health Surveys are child survival status, ethnicity and couple’s fertility preference. The study provides support for programmatic interventions targeting improving child survival and regulating men’s fertility preference.Item Maintaining essential health services during COVID-19 in Ghana: a qualitative study(BMJ Global Health, 2024) Yeboah, I.; Dwomoh, D.; Ndejjo, R.; et al.Introduction Evidence suggests that non-pharmaceutical interventions such as lockdown policies, restriction of movement and physical distancing to control the novel COVID-19 contributed to the decline in utilisation of essential health services. We explored healthcare providers’ and policy-makers’ experiences of the barriers, interventions and response actions that contributed to ensuring the continuity of essential health services during the COVID-19 pandemic in Ghana to help inform future practice and policy. Methods We used a qualitative study approach. Data were analysed using thematic analysis. Thirty Four participants composed of 20 healthcare providers and 14 policy-makers who worked across regions with low and high recorded COVID-19 cases in Ghana during the COVID-19 pandemic were involved in this study. Results Participants reported that essential health services including maternal, reproductive and child health services, communicable and non-communicable disease care, and elective surgeries were disrupted during the COVID-19 pandemic. Barriers to the utilisation of essential services were constructed into three subthemes: (1) fear, (2) poor quality of care at the facility and (3) financial limitation. These barriers were mitigated with population based interventions underpinned by the socioecological model at the individual and interpersonal level (including psychosocial care for families and home visits), institutional and community levels (such as allocation of funds, training of health workers, public education, triage stations, provision of logistics, appointment scheduling, telemedicine and redeployment of health workers) and public policy level (tax relief packages, transportation arrangements and provision of incentives), which helped in maintaining essential health services during COVID-19. Conclusion Disruption of essential health services during COVID-19 in Ghana instigated population-based interventions which aided in expanding the populations’ continuous access to essential health services and strengthened health service delivery.Introduction Evidence suggests that non-pharmaceutical interventions such as lockdown policies, restriction of movement and physical distancing to control the novel COVID-19 contributed to the decline in utilisation of essential health services. We explored healthcare providers’ and policy-makers’ experiences of the barriers, interventions and response actions that contributed to ensuring the continuity of essential health services during the COVID-19 pandemic in Ghana to help inform future practice and policy. Methods We used a qualitative study approach. Data were analysed using thematic analysis. Thirty Four participants composed of 20 healthcare providers and 14 policy-makers who worked across regions with low and high recorded COVID-19 cases in Ghana during the COVID-19 pandemic were involved in this study. Results Participants reported that essential health services including maternal, reproductive and child health services, communicable and non-communicable disease care, and elective surgeries were disrupted during the COVID-19 pandemic. Barriers to the utilisation of essential services were constructed into three subthemes: (1) fear, (2) poor quality of care at the facility and (3) financial limitation. These barriers were mitigated with population based interventions underpinned by the socioecological model at the individual and interpersonal level (including psychosocial care for families and home visits), institutional and community levels (such as allocation of funds, training of health workers, public education, triage stations, provision of logistics, appointment scheduling, telemedicine and redeployment of health workers) and public policy level (tax relief packages, transportation arrangements and provision of incentives), which helped in maintaining essential health services during COVID-19. Conclusion Disruption of essential health services during COVID-19 in Ghana instigated population-based interventions which aided in expanding the populations’ continuous access to essential health services and strengthened health service delivery.Item Multiple sexual partnership among adolescent boys and young men in Ghana: analysis of the 2003–2014 Ghana Demographic and Health Survey(Tropical Medicine and Health, 2022) Yeboah, I.; Okyere, J.; Dey, N.E.Y.; Mensah, R.O.; Agbadi, P.; Essiaw, M.N.Background: Multiple sexual partnership (MSP) is a major cause of HIV/AIDS epidemic and unplanned pregnancies in sub-Saharan Africa. We investigate how individual, household, interpersonal, community and structural factors correlate with multiple sexual partnership of adolescent boys and young men in Ghana. Methods: We pooled secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys (GDHS). Analytic sample of 1422 males aged 15–24 years who are sexually active and never married were used for the study. The outcome variable for the study was two or more sexual partners in the last 12 months preceding the sur vey. Five models were fitted using multilevel mixed effects logistic regression to identify predictors of multiple sexual partners. Results were presented using adjusted odds ratios (ORadj) with its corresponding 95% confidence interval. Results: The pooled data prevalence of multiple sexual partnership was 28.1%, with 18.7%, 30.0% and 33.3% of adolescent boys and young men involved in multiple sexual partnerships in 2003, 2008 and 2014, respectively. Results of the study showed that young men aged 20–24 years [ORadj=1.39, 95% CI=1.01–1.91], being from household with richest wealth index [ORadj=1.76, 95% CI=1.01–3.06] and those with secondary/higher education [ORadj=2.94, 95% CI=1.44–6.06] were more likely to have multiple sexual partners. On the other hand, those who delayed their frst sex [ORadj=0.45, 95% CI=0.29–0.70] and those currently using modern contraceptive methods [ORadj=0.37, 95% CI=0.28–0.50] were less likely to have multiple sexual partners. Conclusion: The findings provide support for the social ecological argument that sexual health behaviours are influenced by individual, interpersonal, community and contextual characteristics. Future policies and interventions seeking to address the increasing prevalence of multiple sexual partnerships among adolescent boys and young men should take into consideration family planning programmes and sexual education in affluent communities, secondary and higher institutions.Item Predictors of underachieved and overachieved fertility among women with completed fertility in Ghana(PLOS, 2021) Yeboah, I.; Kwankye, S.O.; Frempong-Ainguah, F.A woman’s ability to achieve her preferred family size is critical in addressing issues of high fertility in sub-Saharan Africa. The socio-cultural context in sub-Saharan Africa presents some difficulty for the attainment of preferred fertility for many women. Few studies in subSaharan Africa have examined the extent to which women are unable to achieve their preferred family sizes. This study, therefore, examines the factors that are associated with the non-attainment of women’s preferred fertility by the end of their reproductive years. The study analyzed pooled cross-sectional data with a sub-sample of 1,888 currently married women aged 45–49 years from five rounds of the Ghana Demographic and Health Survey, 1993 to 2014. Test of associations and multinomial logistic regression analysis were used to examine the predictors of underachieved and overachieved fertility relative to achieved fertility. Results The results indicate that 44 per cent of the women recorded overachieved fertility while about 36 per cent underachieved their fertility. Partner wants more, experiencing child loss and married more than once were significantly associated with overachieved fertility. Nonetheless, increased years of a woman’s education and delaying her at first birth were negatively associated with overachieved fertility. On the other hand, underachieved fertility was significantly associated with having a partner with fewer fertility preference, being of the Islamic faith and ever use of modern contraception. Partner’s fertility preference, child loss experience, marrying more than once and ever use of modern contraception were important predictors of a woman’s inability to achieve her fertility preference. Policies to regulate men’s fertility behaviour, delaying age at first birth, use of modern contraception, encouraging longer years of education, and reducing infant and child mortality are important strategies to achieve fertility preference in Ghana.Item The role of social support in antiretroviral therapy uptake and retention among pregnant and postpartum women living with HIV in the Greater Accra region of Ghana(BMC Public Health, 2024) Ameyaw, E.K.; Thompson, R.G.A.; Yeboah, I.; et al.Introduction The role of social support in antiretroviral therapy (ART) uptake and retention among pregnant and Postpartum women in Ghana’s capital, Accra, have received limited attention in the literature. This cross-sectional study extends existing knowledge by investigating the role of social support in ART adherence and retention among pregnant and postpartum women in Accra. Methods We implemented a cross-sectional study in eleven (11) public health facilities. Convenience sampling approach was used to recruit 180 participants, out of which 176 with completed data were included in the study. ART adherence in the three months preceding the survey (termed consistent uptake) and ART retention were the outcomes of interest. Initial analysis included descriptive statistics characterized by frequencies and percentages to describe the study population. In model building, we included all variables that had p-values of 0.2 or less in the bivariate analysis to minimize negative confounding. Overall, a two-sided p-value of <0.05 was considered statistically significant. The data were analyzed using Stata version 14.1 (College Station, TX). Results In the multivariate model, we realized a lower odds trend between social support score and consistent ART adherence, however, was insignificant. Similarly, both the univariate and multivariate models showed that Social support has no relationship with ART retention. Meanwhile, urban residents had a higher prevalence of ART adherence (adjusted prevalence ratio (aPR) = 2.04, CI = 1.12–3.73) relative to rural and peri-urban residents. As compared to those below age 30, women aged 30–34 (aPR=0.58, CI=0.34–0.98) and above 35 (aPR=0.48, CI=0.31–0.72) had lower prevalence of ART adherence Women who knew their partner’s HIV status had lower prevalence of ART adherence compared to those who did not know (aPR = 0.62, CI = 0.43–0.91). Also, having a rival or co-wife was significantly associated with ART retention, such that higher prevalence of ART adherence among women with rivals relative to those without rivals (aOR = 1.98, CI = 1.16–3.36) Conclusion Our study showed that social support does not play any essential role in ART adherence among the surveyed pregnant and postpartum women. Meanwhile, factors such as having a rival and being under the age of Thirty play an instrumental role. The study has signaled the need for ART retention scale-up interventions to have a multi-pronged approach in order to identify the multitude of underlying factors, beyond social support, that enhance or hinder efforts to achieve higher uptake and retention rates.Item Use of any contraceptive method among women in rural communities in the eastern region of Ghana: a cross-sectional study(BMC Public Health, 2023) Yeboah, I.; Agyekum, M.W.; Christian, A.K.; et al.Background In Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. This study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana. Methods A community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview women in rural Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods). Results The prevalence of contraceptive use was 27.8%. In the adjusted analysis of binary logistic regression, contraceptive use was significantly lower (aOR=0.24; 95%CI=0.10–0.56; p=0.001) among respondents aged 41–49 years compared to those aged 18–35 years. Contraceptive use was significantly lower among migrants (aOR:0.53; 95%CI:0.28–0.99; p=0.048) compared with non-migrant. Conclusion The prevalence of any contraceptive use among rural women was low. Government and other stakeholders need to create awareness about contraception in the rural areas of Eastern region of Ghana and that would help increase contraceptive methods utilization. In addition, family planning programs should target migrants to design an intervention to increase contraceptive use in rural areas.