School of Public Health

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    A 5-Year Content Analysis of Malaria and Hiv and Aids Issues in the Ghanaian Daily Graphic (Newspaper)
    (University of Ghana, 2015-03) Coleman, C.; Ackumey, M.
    Background: Health Communication plays a vital role in public health campaigns to prevent infectious diseases in developing world. Malaria and HIV and AIDS continue to be serious public health problems in Ghana. Faced with human and financial challenges, the healthcare system need to experiment new ways to promote health and create awareness to the greater population. The press therefore can be harnessed to promote the health of their audiences. Objective: This study examined the nature and content as well as spectrum of malaria and HIV issues reported in the Daily Graphic Newspaper from 2006 to 2010. Methods: A 5-year content analysis of health messages (malaria and HIV and AIDS) in the Daily Graphic newspaper was undertaken in a systematic, objective and quantitative manner. 260 editions of the newspaper were selected and reviewed using the composite week sampling technique. A coded checklist was used to guide the data collection process. Results: Malaria and HIV and AIDS issues received very low attention in the paper with coverage of less than 1%. The mean for malaria issues for the period (2006-2010) was 0.22 with a standard deviation of ±0.48 and that of HIV and AIDS news was 0.51 with standard deviation of ±0.79. Coverage of malaria news was low as compared to coverage of HIV news over the 5 year period. 86% of the malaria and HIV issues reported focused on prevention and control strategies. Only 2% of malaria and HIV issues were placed on the front page of the paper. An encouraging 35% of the original authors of health messages were health personnel. The newspaper gave attention to other public health issues over the period. Conclusion: Malaria and HIV continue to be a burden on the health of Ghanaians and there is the need to collectively fight for prevention and further eradication. The media can be harnessed to promote the health of their audiences. Though HIV and AIDS news received much coverage over the period, there is the need to improve on both coverage of all health issues and more attention to the column in which health news are placed. An encouraging number of the authors of health news in the paper were health practitioners. Stronger collaboration between the media and stakeholders in health as well as the government support is critical for improving health communication and reducing the burden of diseases on the populace.
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    Abortion-Related Help - Seeking Behaviours among Females in the Tema Metropolis
    (University of Ghana, 2008-10) Idun – Acquah, J.J; Ofei- Aboagye, E.; Senah, K.; University of Ghana, College of Health Sciences, School of Public Health
    Teenage pregnancies and abortion cases reported to health facilities in the Tema Metropolis have been increasing over the years. Anecdotally, community pharmacies are also reporting of increases in request for medicines that have abortifacient properties. It is against this background that this study seeks to identify abortion help-seeking behaviours of females in the metropolis when saddled with unwanted pregnancies. The study focuses on identifying where women in the metropolis go for abortion services and reasons for resorting to abortion. It also assesses the knowledge and perception of females on abortion. It also determines the extent of pharmaceutical use in inducing abortion, assesses knowledge of provisions of the Abortion Law in Ghana as well as knowledge of contraceptives among females. The study was cross-sectional and involved interviewing three (3) key informants, three hundred (300) women and thirty (30) community pharmacists, chemical sellers, dispensing technicians and pharmacy counter assistants in the metropolis. Structured questionnaire and essay writing on abortion by sixty-five (65) senior high school students were some of the tools used for data collection. Findings The majority of places within the metropolis where women seek abortion services did not guarantee safe abortion. An appreciable proportion of the population knew of a place where abortion services could be obtained and most of these facilities were privately-owned and were in Tema Township. Reasons for resorting to abortion were varied and included financial difficulties, unplanned pregnancy, the need to continue one‟s education, maintaining family reputation in society, immaturity, denial of responsibility for the pregnancy by the male partner and poor child spacing. The average number of abortion requests that pharmacies/chemical shops received per day was two and the most requested medicine was Cytotec. Many women knew of at least one modern method of contraception, with the condom being the most known contraceptive. The knowledge of the provision of the abortion law in Ghana is poor and many women are confused as to what regulates abortion in Ghana. Recommendations The Health Promotion and the Adolescent and Reproductive Health Units of the Tema Metro Health Directorate need to step up education to encourage uptake of contraceptives, especially at the community level. The Adolescent and Reproductive Health Units of the various clinics in the metropolis need to be made friendlier and readily accessible. The units should also team up with the health promotion units to educate the populace, especially the youth, on the consequences of unsafe abortion and the provisions of the law on abortion. The Pharmacy Council and the Food and Drugs Board must step up the monitoring and enforcement of regulations on the supply of prescription-only medicines, especially those with abortifacient properties in the metropolis.
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    Acceptability and Use of Water Filters in Two Rural Communities in Shai-Osudoku District of Ghana
    (University of Ghana, 2016-09) Ofori, A.M.; Ahorlu, C.; University of Ghana, College of Health Sciences, School of Public Health, Department of Behavioural and Social Sciences
    Household water treatment can improve water and make it safe for drinking and may prevent diarrhoea diseases. The acceptability of an intervention is an important condition for its successful implementation. To study the acceptability and use of water filters in the study area, the study was designed to address the following objectives: a) to assess the sources of drinking water in the two communities. b) to assess the knowledge of the people on water filter and its usefulness c) to determine how frequent water filters are used d) to determine the level of acceptability and use of water filters and e) to assess diarrhoea related perceptions in terms of causes, treatment and prevention in the study communities. Quantitative and qualitative research techniques were employed for the study. Households were selected by using purposive sampling. Analysis was done on quantitative data using STATA software while content analysis was done on the qualitative data to determine relevant narratives for presentation. The results revealed high acceptance of water filters in the studied communities. Significant proportion of the study participants had knowledge deficits about causes and prevention of diarrhoea. There were no statistically significant relationship between independent (marital status, level of education and household size) and dependent variables (use of the filters). This study contributes to existing knowledge on acceptability and use of water filters as a means to control diarrhoea disease in Ghana.
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    Acceptability of the Opt-Out Counselling and Test for Pregnant Womenin the Wa Municipality; A Facility Based Study.
    (2008) Nywzachl, J
    Mother-to-child transmission (MTCT) of HIV is a major contributor of paediatric HIV infection. HIV counselling and testing during pregnancy constitutes an important step in prevention. Acceptability of HIV test among women who voluntarily request to know their HIV status (opt-in) has been found to be rather low and yet the number of pregnant women with HIV in the Wa Municipality has almost doubled, from 3.2 per cent in 2006 to 5.8 per cent in 2007. To address this problem, HIV counselling and testing is routinely offered to all pregnant women who seek antenatal care, with an option to opt-out if they don‟t want to test. This study was conducted to determine the acceptability of the opt-out test as a strategy for the prevention of mother-to-child transmission (PMTCT) of HIV.
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    Acceptance and Use of Mobile Payments in Healthcare Delivery among Private Providers in the Ayawaso Municipality
    (University of Ghana, 2018-11) Azietsi-Bokor, W.
    In recent years, mobile phone use in healthcare delivery has been the focus of healthcare research. Of great interest to researchers is to study and understand the acceptance and use of mobile payments in health delivery since mobile payments serves as a complementary service to mobile health. Mobile payments provides a solution to the growing moral hazards and security risks associated with cash payments in healthcare delivery and also lessens the institutionalization of informal payments in health delivery. A census was conducted on all health facilities within the Ayawaso municipality and the results analyzed with the help of structural equation modelling (SEM) via the AMOS software package in SPSS version 22. The constructs were tested and found to have high validity. Fifty-three percent of providers were found to be currently accepting mobile payments at their facilities. The study concluded that performance expectancy and perceived cost are strongly associated with the intention to use mobile payment systems and the actual use of mobile payment systems and recommended that healthcare providers should analyze the task-technology fit of payments and liaise with mobile money operators to shorten the series of steps needed towards completion of mobile payments to save time for patients and providers.
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    Access to Family Planning Services among Women Attending Health Facilities in the Ga South Municipality, Greater Accra Region
    (2018-07) Amedalor, G.K.
    Background: The importance of family planning as a tool and the means to achieving development has been espoused by several studies. However, in Sub-Saharan African, reports show low use of family planning methods, a high unmet need for family planning and subsequently, high fertility rate. Usage of family planning services in developing countries has been found to avert unintended pregnancies and reduce maternal and child mortality. Objective: The study aimed to evaluate access to family planning in the Ga South Municipal Assembly area in the Greater Accra Region of Ghana. Methods: Descriptive cross sectional design using quantitative methods was employed to collect data for the study. The study recruited women within the reproductive age (WIFA) of 15-49 years attending selected health facilities at the time of the study. A systematic sampling method was used to select 270 with a 10% (27) to cater for non-response, which was run up to give a total sample size of 300. A structured questionnaire with close-ended questions was designed to collect responses covering: the range (types) of family planning services provided, predisposing (client) factors, enabling (health provider) factors, and the need (community) factors influencing access to Family planning services at these health facilities. All answered questionnaires were checked, entered and analysed with STATA version 15. Results were presented in frequencies and percentages. Bivariate analysis was used to determine the association between the dependent and independent variables. Multivariable analysis was used to determine the strength of associations between the factors influencing family planning and the level of significance was set at p<0.05. Results: Of the 300 respondents, 31.7% had used a family planning method before. About 95 (31.6%) of the respondents had accessed family planning method in the facilities. About 70 (69.3%) of the respondents who had used family planning method were currently on a family planning method, 30.3% of them had used a family planning method in less than a year, and about 21.2% of them last used a family planning method in 5 to 10 years, and more than 10 years each. The most used family planning method was condom (30.5%) among the respondents who had had access to family planning method while the least used family planning method among this group was morning pills. This implies that condoms were the frequently used family planning methods. Conclusion: The findings of the study revealed that, women in the municipality had access to family planning methods such as: injectable, condoms, and pills among other. In addition, the women who were on family planning had children; perceived provider-level factors as acceptable and encountered little or no restrictions from their partners, culture, religion and community. The study concluded that access to family planning services could be influenced by client, provider and community level factors grouped under predisposing, enabling and need factors. These findings to some extent were consistent with existing literature
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    Access to Family Planning Services among Women Attending Health Facilities in the Ga South Municipality, Greater Accra Region
    (University Of Ghana, 2018-07) Amedalor, G.K.
    Background: The importance of family planning as a tool and the means to achieving development has been espoused by several studies. However, in Sub-Saharan African, reports show low use of family planning methods, a high unmet need for family planning and subsequently, high fertility rate. Usage of family planning services in developing countries has been found to avert unintended pregnancies and reduce maternal and child mortality. Objective: The study aimed to evaluate access to family planning in the Ga South Municipal Assembly area in the Greater Accra Region of Ghana. Methods: Descriptive cross sectional design using quantitative methods was employed to collect data for the study. The study recruited women within the reproductive age (WIFA) of 15-49 years attending selected health facilities at the time of the study. A systematic sampling method was used to select 270 with a 10% (27) to cater for non-response, which was run up to give a total sample size of 300. A structured questionnaire with close-ended questions was designed to collect responses covering: the range (types) of family planning services provided, predisposing (client) factors, enabling (health provider) factors, and the need (community) factors influencing access to Family planning services at these health facilities. All answered questionnaires were checked, entered and analysed with STATA version 15. Results were presented in frequencies and percentages. Bivariate analysis was used to determine the association between the dependent and independent variables. Multivariable analysis was used to determine the strength of associations between the factors influencing family planning and the level of significance was set at p<0.05. Results: Of the 300 respondents, 31.7% had used a family planning method before. About 95 (31.6%) of the respondents had accessed family planning method in the facilities. About 70 (69.3%) of the respondents who had used family planning method were currently on a family planning method, 30.3% of them had used a family planning method in less than a year, and about 21.2% of them last used a family planning method in 5 to 10 years, and more than 10 years each. The most used family planning method was condom (30.5%) among the respondents who had had access to family planning method while the least used family planning method among this group was morning pills. This implies that condoms were the frequently used family planning methods. Conclusion: The findings of the study revealed that, women in the municipality had access to family planning methods such as: injectable, condoms, and pills among other. In addition, the women who were on family planning had children; perceived provider-level factors as acceptable and encountered little or no restrictions from their partners, culture, religion and community. The study concluded that access to family planning services could be influenced by client, provider and community level factors grouped under predisposing, enabling and need factors. These findings to some extent were consistent with existing literature.
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    Access to Healthcare for Children with Disabilities in the Greater Accra Region
    (University of Ghana, 2017-07) Opeyemi, R.L.
    Background and Objectives: People with disabilities have special healthcare needs that usually remain unmet. Studies have identified barriers encountered by people with disabilities in accessing healthcare. This study was aimed at identifying factors that both facilitate and hinder access to healthcare for children with disabilities [with focus on Autism, cerebral palsy (CP) and Down syndrome (DS)] in the Greater Accra region of Ghana. Method: The study employed a cross sectional study design and it used a mixed method approach; involving quantitative and qualitative methods. The quantitative component involved administration of semi-structured questionnaires to parents/caregivers of children with Autism, CP and DS in seven (7) special schools in the Greater Accra Region. The qualitative component involved the use of in-depth interviews with parents/caregivers of children with Autism, CP and DS and key informant interviews with specialist healthcare providers. Results: Results of a one-way analysis of variance showed that mean access score was significantly different for categories of educational level [F (2, 35) =5.79, p=0.0067] and household income range [F (2, 35) = 5.94, p=0.0060]. Children who attended private schools had a higher mean access score [difference (S.E) = 14.03% (4.62)] compared to those who attended public school, Welch‟s t-test, t (16.7) = 3.0372, p=0.0075. Qualitative results identified influential health service factors as: availability of specialist healthcare provider; availability of disability friendly structures; attitude of healthcare providers; lack of coordination of care; and inappropriate service delivery processes. Individual factors influencing access were found to be cost of affording services/medications, and iv perception of child‟s condition. Other factors identified qualitatively were; social factors such as stigmatization and factors related to the child‟s condition. Conclusion: Findings from this study highlights challenges related to both access and utilization of needed healthcare services for children with disabilities. Improving access to healthcare services would thus involve a coordinated, concerted and deliberate effort on the part of the government, parents and all stakeholders involved in care for children with autism, cerebral palsy, and Down syndrome.
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    Accuracy and Completeness of Hypertension Data in the Dhims-2 in Selected Health Facilities in the Greater Accra Region
    (University of Ghana, 2018-07) Doku, E.T.
    Background: Hypertension is a major public health challenge in Ghana and with the prevalence increasing over the years, accurate estimation of the burden of the disease is required for effective prevention and control measures. The GHS in 2012, introduced a web-based database; DHIMS-2, to ensure quality health data however, aspects of this database; the maternal and neonatal data was reported to be good and reliable, yet the EPI data was poor, aside the lack of evidence based research on the morbidity data. The aim of this study therefore was to determine the quality of Outpatient Hypertension Data in the DHIMS-2 by assessing how accurate and complete hypertension data reported into the database is, and factors influencing hypertension data management in health facilities. Methodology: Through a mixed method approach using secondary data from patient’s folders for the third quarter of 2016, two hospitals and two polyclinics were randomly selected out of highly ranked administrative units in the Greater Accra region. A structured Data Abstraction form and a semi-structured interview guide were used to extract information in relation to the study objectives. Hypertension data were assessed for accuracy (error rate) and completeness (% missing data). Primary source data from patient’s folders and consulting room registers were totalled, gathered and comparison was made with facility aggregate forms as well as the DHIMS-2. Twelve health staff were interviewed and through thematic analysis, factors influencing hypertension data quality were assessed. Results: A total of 2268 of data from consulting room registers and patient folders were inspected. The mean completeness of hypertension data among the four health facilities was 60.69% (95% C. I =49.32%–72.06%). Comparing new cases of hypertension in consulting room registers to patient folders, the mean percentage error was 72.9% (95% C.I=52.20% - 93.62%). The study found an overall of 21.5% (95% C.I= 4.49% – 38.48%) error rate in the transfer of hypertension data from consulting room registers to the monthly OPD morbidity form. There was 100% accuracy in transferring hypertension data from facility monthly aggregate form to the DHIMS-2, however, in comparing the DHIMS-2 data to new cases of hypertension captured in patient folders, the mean error detected was 79.2% (95% C.I= 49.02% - 109.42%). Factors contributing to incomplete and inaccurate hypertension data included, lack of understanding on indicators, less priority on hypertension data quality and lack of validation activities focusing on hypertension. Conclusion: Over 50% of data captured into the consulting room registers were accounted for in the web-based database, but the accuracy of hypertension data in the DHIMS-2 did not reflect what existed in primary sources and this disparity was wide. Factors affecting hypertension data quality in hospitals and polyclinics were related to inadequate data verification, poor data management and inadequate training of staff on data management, therefore there is the need to regularly validate hypertension data and consistently train staff directly linked to managing hypertension data.
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    Acute Respiratory Infections in Under Fives: A Study of the Determinants of Care Seeking And Home Management Practice in Akatsi District
    (University of Ghana, 2000-09) Addico, G. N. L.; Awuah, E.; Antwi P.; University of Ghana, College of Health Sciences, School of Public Health
    Acute Respiratory Infections (ARIs) include infections in any part of the respiratory system lasting less than 3 days. They are a major cause of childhood deaths worldwide. Though the vast majority of ARIs are harmless, there are a few severe ones, which usually cause death within a short time and must therefore be recognised early. Available evidence shows that in Akatsi District about half of ARIs are managed at home. Since this care may be inappropriate there is the need for further investigation into what is actually being done and what determines this action. This work is a descriptive study, conducted in July 20000, to assess the determinants of care seeking and home management practices of ARIs in under fives in Akatsi District. Perceptions of importance, cause, prevention and treatment of ARIs, knowledge of severity, home management practices, the time and sequence of care seeking and socioeconomic factors influencing these were studied, in order to make recommendations for development of appropriate health intervention programmes. Qualitative and quantitative methods were used through FGDs with community members and administration of semi-structured questionnaire to 210 caretakers selected through cluster sampling. The study showed that ARIs are perceived to be important for such reasons as cost of ewe and inconvenience to caretaker and child and not because of their associated mortality. Knowlegde of modes of prevention was high. Severity was related to duration of episode and not signs and symptoms, implying that a severe ARI could be identified rather late. Food is not completely withheld from a child with an ARI, however certain foods may be withheld on grounds that they worsen the condition. Though most people would attempt to seek some form of care quite early, self-medication with herbal preparations and drugs from chemical shops is common. There is also a sequential resort, which can lead to delays in receiving appropriate care. The main constraint to care seeking is financial. The study therefore recommends Health Education by health staff on recognition of signs of severe ARIs for early care seeking and a reinforcement of the positive practices identified. The District Health Administration should also collaborate with the alternative health providers in the communities and explore alternative methods of health care financing.
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    Adherence to Anti-Diabetic Medication among Adults Receiving Care at Korle-Bu Polyclinic
    (University of Ghana, 2015-07) Adu-Mintaah, D.
    Diabetes is a chronic disease that requires long term management to prevent complications. It is a growing public health problem. Adherence to treatment has been recognized as a major problem in patients with chronic diseases despite the compelling evidence about effectiveness of medication. About 50% chronic care patients in the developed countries are non adherent and it is estimated to be higher in developing countries such as Ghana. Diabetes mortality and morbidity have increased substantially at the Korle Bu polyclinic. This high level of mortality and morbidity was due to high glycaemic levels which can be caused by low or non adherence to therapy. This study determined the adherence level, factors that affect adherence to medication among adults receiving care at Korle-Bu polyclinic.
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    Adherence to Anti-Hypertensive Medication among Adults Attending Out-Patients Clinic at the Maamobi General Hospital.
    (University of Ghana, 2018-07) Voegborlo, E.A.
    Hypertension is one of the non-communicable diseases that is on the rise and has been recognized as a major public health problem that is associated with relatively low levels of awareness, drug treatment, and blood pressure control. Treatment adherence is the degree of compliance with prescribed therapeutic measures, which can be medicinal or not, aiming at maintaining blood pressure levels. This study sought to determine the level of adherence among adults attending the outpatients’ clinic of the Maamobi General Hospital. The study employed a descriptive cross sectional research design and quantitative research approve which was used in converting data into numerical form so that the data could be analysed. A structured questionnaire was randomly distributed to 417 hypertensive outpatients 18 years and above out of the population that visited the hospital. The primary data collected was coded and entered in a Microsoft Excel 2010 spreadsheet and STATA version 15. Percentages, frequency tables, pie chart, and cross tabulations were the statistical tools used for describing the data while Multiple Logistic Regression and Chi-squared Test were used to analyze the data. The results obtained demonstrated that socio-demographic and clinical characteristics of hypertensive patients respectively affect the adherence to medication as well barriers that inhibit adherence to medication treatment among which side effects of medication in take was principal. It was found out that the level of adherence to antihypertensive medication among these adults was 68.45%.
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    Adherence To Anti-Retro-Viral Treatment (Arv) Among People Living With HIV/AIDS In Montserrado County, Liberia
    (University of Ghana, 2017-07) Pewu, I.P.
    Though antiretroviral treatment (ARV) is known to be helpful to people living with HIV (PLHIV) globally, knowledge gaps in relation to adherence to ARV treatment among PLHIV do exist in Liberia. Thus, the aim of the study was to assess adherence to ARV treatment among PLHIV in Liberia. A cross-sectional study was done in 2016 among Liberian HIV-positive individuals receiving antiretroviral treatment. A sample size of 270 was calculated using two-stage sampling (first by strata, and then by simple random sampling in each stratum. A semi-structured questionnaire was administered to participants. Participants were considered highly adherent if they reported following their medication per prescription by health providers. Reasons for non-adherence to ARV treatment were recorded while logistic regression modeling was developed using significant factors influencing non-adherence to ARV treatment. There were no significant differences between highly adherent and less adherent patients with regard to age, education and employment status. Reasons associated with high non-adherence were unavailability of drugs, side effects, busy work schedule and travels, no money for transportation to collect drugs, funerals and others. Non-adherence to ARV treatment was higher in respondents within the age range 20-35 years. Educated respondents was higher in non-adhering to treatment as compared to non-educated. From the logistic model developed, non-adherence was more likely among patients with multiple pills (pills burden), difficulty in remembering medication time and side effects. However, adherence was more likely among patients who experience short stay at the health care center as well as patients who view ART medication as easy. Despite the importance of ARV treatment to PLHIV, the study revealed high level of non-adherence among HIV patients in Liberia. Regarding reasons provided for non-adherence, some recommendations for promoting adherence to ARV treatment in Liberia include continuous counseling by trained counselors should be carried out at all times when patients visit the hospital for medication.
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    Adherence To Antihypertensive Medications Among Patients Attending Ridge Hospital
    (University of Ghana, 2017-07) Twumasi-Ankrah, B.
    Introduction Accurate medication adherence and self-efficacy to properly adhere to treatment is essential for every hypertensive patient. Poor adherence to hypertensive treatment regime is the most important single reason for disease complications such as cardiovascular and renal failures. Method The study was a cross-sectional study involving 350 hypertensive patients attending Ridge Hospital. The Morisky Medication Adherence Scale, health and facility related tool was used to obtain information from respondents. Data obtained were summarized as frequencies and percentages. Associations were then tested using Pearson’s chi-square test. Results About 50% of the hypertensive patients attending Ridge Hospital had low adherence rates. Patient related factors (p=0.001), and health facility related factors (p=0.001), adversely influenced patients’ ability to adhere to hypertensive medications. Medication adherence was also associated with some demographic features such as age (p=0.001), sex (p=0.001), educational level (p=0.001), employment type (p=0.001), and income level (p=0.001), Conclusion This study has shown that hypertensive patients attending Ridge Hospital have low adherence rates. Patient and health related factors adversely affected patients’ ability to adhere to hypertensive medication. Intensifying health education across users and providers may improve adherence rates among this population.
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    Adherence to Antiretroviral Medicines among Adult Hiv/Aids Patients at the Korle Bu Teaching Hospital in Accra, Ghana.
    (University of Ghana, 2009-08) Ocansey, D; Antwi, P.; Lartey, M.; University of Ghana, College of Health Sciences, School of Public Health
    It is very important to assess adherence to ARTs to understand why treatment fail. However, measurement of adherence especially in the clinic setting is very difficult as there is no single method that best measures it. The main objective of this study was to measure adherence to ART among HIV patients (PLWHA) at the Korle Bu Teaching Hospital (KBTH) using, pill counts and Self-report and also to identify factors that contributes to optimal adherence. The design was a cross sectional descriptive study which used systematic sampling to collect quantitative and qualitative data from adult ARV users who have been on ARTs for at least three months and attended clinic between May and July 2009. A t-test was performed to compare mean adherence and Multivariate logistic regression was used to determine factors that were associated with adherence. Analysis included 229 patients. Of the three methods used, optimal adherence rate (≥95%) was highest for 7- day recall (100%), followed by three-month pill count method (98%), and three-month visual line self report recorded the least adherence rate (77%). Overall rate of adherence was found to be 92%. This is higher than what some studies in developing countries have found. However, the overall adherence was below the minimum expected adherence of 95% which experts in ART management recommend. Three month pill count recorded high optimal adherence compared to a visual line self report optimal adherence which was low but matched results from most African countries. Pill count method of measuring adherence should be used routinely to monitor patients on ARTs while self reported adherence should be used to identify patients who need extra support for adherence. Quality of care was found to be a factor that contributes to optimal adherence, a finding that was also buttressed during the qualitative study.
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    Adherence to Antiretroviral Therapy (ART) Among HIV Positive Women at Antiretroviral Centers in Tema
    (University of Ghana, 2012-07) Awittor, R.J.E.; Akweongo, P.; University of Ghana, College of Health Sciences, School of Public Health
    Introduction: Sub-optimal adherence is known to be one of the most common causes of poor treatment outcomes and /or lack of sustained treatment benefits. In the use of ARVs for the management of HIV infection in PMTCT, adherence is key for therapeutic success to be achieved and to ensure undetectable viral load at time of delivery. This reduces the risk of HIV transmission to the infant. In 2011, HIV/AIDS estimation for Ghana indicated that 2,933 babies were infected with HIV through vertical transmission. It is unclear how many of these mothers were on ART and the adherence levels among mothers of these children. Objective: The main objective of the study was therefore to determine the levels of adherence and assess the factors affecting adherence to Anti-retroviral therapy in PMTCT. Methods: This was a cross -sectional study which was carried out at the two ART centers offering comprehensive PMTCT programs in Tema; Tema General Hospital and Tema Polyclinic. Purposive sampling was used to collect quantitative data using a structured questionnaire for 141 HIV positive pregnant and breastfeeding women on PMTCT and an interview guide was used to conduct 10 in-depth interviews with these women who had been on ARVs for at least one month and attended clinic between May and June 2012. A chi-test was performed to compare adherence levels and logistic regression was used in assessing the determinants of adherenceThe level of optimal adherence measured as ≥95% for 7-day recall self reported adherence was 85.1% followed by one month visual analogue scale recall of 75.2%. The one month pill count recorded the least adherence level of 63.1%. Results: Sharing pills (OR=0.054, p<0.016) was found to be the factor that affected optimal adherence. In the qualitative study, the desire to live longer and be strong to take care of family was the most expressed factors that motivated adherence. Adherence levels were lower in pregnant and breastfeeding women who had no formal education, lived very far from the facility, shared pills with a family member and had a relative to remind them to take their pills. Conclusion: Sharing pills negatively affects adherence to ART. There is the need to review the content of pre-adherence counseling and to promote post-adherence counseling for women on ART for PMTCT to help ensure optimal levels of adherence to therapy.
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    Adherence to Community Directed Treatment with Ivermectin for Onchocerciasis Elimination in Abekwai, Tain District, Ghana
    (University of Ghana, 2016-07) Sumboh, J.G.; Anto, F.; University of Ghana, College of Health Sciences, School of Public Health
    Introduction Onchocerciasis is one of the debilitating neglected tropical diseases that manifests in blindness at later stages. Ivermectin has been proven to clear microfilariae and is therefore being distributed in endemic communities. Adherence to ivermectin treatment is a major challenge in the implementation of the community directed treatment strategy. Some individuals do not adhere to the bi-annual treatment accounting for the continuity of onchocerciasis transmission. Objective The objective of this study was therefore to determine the level of adherence to ivermectin treatment under the community directed treatment strategy in the Abekwai community in the Tain district. Methods A population-based cross-sectional study involving community members in Abekwai was conducted to determine the proportion of community members who swallowed ivermectin during the 2015 mass distribution treatment round. Two hundred and fifty one participants were selected randomly to take part in the study. Factors likely to influence adherence was elicited from the community members using a pre-tested structured questionnaire. Data were analyzed using Stata version 13. Chi square test was used to determine significance of the individual level factors against drug uptake. Results Out of the total of 251 participants (age range 18-75, mean age 37.6, SD 14.3), 94% (236/251) received ivermectin; while 86.9% (205/236) adhered by swallowed it. The most common reason for not receiving or swallowing the drug was that the CDD did not come to their houses 63% (29/46). Individual level factors found to be significantly associated with adherence to taking the drug included: knowledge of onchocerciasis as a disease, its vector and mode of transmission. Other factors were knowledge of the signs and symptoms of the disease, its seriousness and how common they perceived it to be in their community, their perceived level of risk and perceived importance of Community Directed Treatment with Ivermectin (CDTI) as well as whether they knew any Community Directed Distributor (CDD). Conclusion It has been established that 18.3% of the participants did not swallow ivermectin. Educational activities and mop-ups are therefore needed to be carried out on regular bases by the district health directorate to encourage regular uptake while implementation research be carried out for an overall improvement in uptake.
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    Adherence To Covid-19 Preventive Measures Among University Of Ghana Undergraduate Students
    (University Of Ghana, 2022-11) Nyamadi, A.A.
    Introduction: The COVID-19 pandemic has caused a lot of morbidity, mortality, and socio-economic losses globally. With no cure in sight, and limited understanding of the vaccines developed against it, adherence to the WHO recommended preventive measures is still necessary to manage the pandemic. Young adults are known to exhibit low adherence toward these measures, although they rapidly spread the disease when infected due to their highly active social networks, and they largely asymptomatic when infected. The paucity of data on adherence behaviour of young Ghanaian adults to the preventive measures warranted this study. Objective: To investigate adherence to COVID-19 preventive measures and associated factors among University of Ghana undergraduate students. Methods: This was a quantitative cross-sectional study involving 303 conveniently sampled on-campus resident undergraduate students of the University of Ghana, using an online self-administered questionnaire. Data was analysed with Stata 16 software. Bivariate analysis using Chi-square/Fisher’s exact tests were performed to test associations between independent variables and adherence to COVID-19 respiratory hygiene, hand hygiene and physical distancing measures. Multiple and Penalized binary logistic regression analysis was done to determine the factors associated with adherence to these measures. A p-value <0.05 was considered significant. Results: 72.9% of students had adequate knowledge of COVID-19 preventive measures, 25.7% had excellent knowledge, and 1.3% had poor knowledge. Respiratory hygiene adherence was the highest (59.1%), followed by physical distancing (21.5%) and hand hygiene (8.9%), while adherence to over 75% of the ten preventive measures assessed was 29%. Positive risk perception (fear of infection) was the only variable significantly associated with hand hygiene adherence; being slightly worried and extremely worried about getting COVID-19 gave 3.8- and 4.4-times odds of adherence to hand hygiene respectively, over never being worried about contracting the disease. (AOR = 2.9, 95% CI = 1.28-11.00, p = 0.016 and AOR = 4.4, 95% CI = 1.44-13.59, p = 0.009 respectively). Conclusion: UG undergraduate students’ adequate knowledge levels of COVID-19 measures did not translate into their adherence behaviour. Authorities can positively influence students’ adherence when they lead by example in adherence, reinforce students’ trust and belief in authorities and science, ensure constant availability of pro-adherent resources, and intensify education on the pandemic.