Department of Maternal and Child Health

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    “Community Members Question Me And Flaunt Their Children Before Me”: A Call For Psychosocial Support For Women With Infertility In Northern Ghana.
    (Elsevier B.V., 2025-01-10) Armah, D.; Naab, F.; Kyei, J.; et al.
    Infertility is a major health issue that poses threats to women’s lives, marriages, and health. Yet little is known about psychosocial support for women with infertility in Northern Ghana. This study aims to understand the psychosocial challenges faced by women with infertility and evaluate the availability and effectiveness of social support systems in East Mamprusi Municipality, Northern Ghana using a qualitative interpretive descriptive design. In-depth interviews were conducted using a semi-structured interview guide. Ethical approval was received from the Institutional Review Board of Ghana Health Service, Accra. Women who visited the health facility desiring to conceive were recruited and interviewed. Thirteen (13) women were interviewed, with each interview lasting 45 min to an hour. The interviews were audiotaped after obtaining permission from the par ticipants, which were transcribed verbatim and analyzed using content analysis. The findings revealed that women faced numerous mental and social problems. Some of these problems include emotional, behavioural, marital instability, the high cost of infertility treatment, and a strong desire to have children. Although the women reported some social support from the community, they lacked strategies to sustain this support. Women with infertility face numerous mental and social challenges. They lack support systems to improve their mental and social health. Health professionals are required to constitute peer support groups for these women and advocate for external assistance to sustain these support groups.
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    Influence of social media and the digital environment on international migration of health workforce from low- and middle-income countries post COVID-19 pandemic: a scoping review protocol
    (BMJ Open, 2024) Dzansi, G.; Abdul-Mumim, A.; Menkah, W.; Ametefe, V.; Xatse, E.; Azanku, B. A.
    Introduction Migration of the health workforce from low- and middle-income countries (LMCIs) is increasingly becoming a phenomenon of interest within migration governance systems. The COVID-19 pandemic aggravated health workforce shortages that have created job opportunities in high-income countries such as the USA, UK, Canada and Germany among others. Conditions of service in LMCIs are unattractive, leading to the search for better opportunities. The digital environment is becoming one of the facilitators of migration intentions due to the activities of recruitment agencies and the search for job opportunities on the World Wide Web. The digital environment creates opportunities for migration but also poses a security threat, economic loss and a brain drain to departure countries. However, there is a paucity of evidence on how the proliferation of advertisements on health workforce recruitment within social media, unsolicited emails and activities of recruitment agencies in the digital environment influence the migration of the health workforce and the implications of migration governance. Method and analysis This scoping review protocol describes a comprehensive systematic extraction and examination of existing literature to map key concepts and identify previous literature, noting the gaps in how social media and the digital environment are influencing the migration of the health workforce. We lean on Arksey and O'Malley’s scoping framework in developing this protocol. This involves the following: identifying research questions, searching for the literature, selecting articles or studies, charting the data and organising and reporting the outcome of the review. The review question is informed by the population, concept and context framework, which details the population as the health workforce (doctors, nurses, midwives and pharmacists), the key concepts as migration, social media and digital environment, and the context as LMICs. The search strategy was developed with the assistance of an experienced librarian who will work with the team to conduct a Peer Review of Electronic Search Strategies to evaluate titles, abstracts and full-text articles for inclusion from databases such as Scopus, PubMed, MEDLINE and Google Scholar. Additionally, we will search grey literature sources including online news media, social media platforms (Facebook, Instagram and Twitter), web pages of WHO, UN and migration-related agencies, and interfaces like EBSCO host. Two members of the team will screen titles and abstracts, and all team members will screen full text for data extraction. Data from grey sources will be converted to transcripts, coded and grouped into themes and subthemes consistent with thematic analysis strategies. All authors will be involved in the synthesis of the data. We intend to follow Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for Scoping Reviews guidelines in reporting the outcome of peer-review sources. Ethics and dissemination This is a scoping review protocol that addresses a subject of interest that poses no risk to individuals or groups. All the information will be retrieved from open sources only. The protocol was registered with the Open Science Framework registry ( osf.oi/zan3q) to serve as an audit trail. Reports from the review will be published in peer-reviewed journals and presented at conferences.
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    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
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    InspirE5: a participatory, internationally informed framework for health humanities curricula in health professions education
    (BMC Medical Education, 2022) Carr, S.E.; Ani‑Amponsah, M.; Harris, A.; et al.
    Background: Reporting on the effect of health humanities teaching in health professions education courses to facilitate sharing and mutual exchange internationally, and the generation of a more interconnected body of evi‑ In the area surrounding health, humanities curricula are needed. This study asked, what could an internationally informed curriculum and evaluation framework for the implementation of health humanities for health professions education look like? Methods: The participatory action research approach applied was based on three iterative phases 1. Perspective sharing and collaboration building. 2. Evidence gathering 3. Development of an internationally relevant curriculum and evaluation framework for health in the humanities. Over 2 years, a series of online meetings, virtual workshops and fol‑ Low-level communications resulted in the production of the curriculum framework. Results: Following perspective sharing and evidence gathering, the InspirE5 model of curriculum design and evaluation framework for health humanities in health professions education was developed. Five principal foci shaped the design of the framework. Environment: Learning and political environment surrounding the program. Expectations: Graduate capabilities that are clearly articulated for all, integrated into core curricula and relevant to graduate destinations and associated professional standards. Experience: Learning and teaching experience that supports learners’ achievement of the stated graduate capabilities. Evidence: Assessment of learning (formative and/or summative) with feedback for learners around the development of capabilities. Enhancement: Program evaluation of the students and teachers learning experiences and achievement. In all, 11 Graduate Capabilities for Health in the humanities were suggested along with a summary of common core content and guiding principles for assessment of health and humanities learning. Discussion: Concern about objectifying, reductive biomedical approaches to health professions education has led to a growing expansion of health humanities teaching and learning around the world. The InspirE5 curriculum and evaluation framework provides a foundation for a standardised approach to describe or compare health in the humanities education in different contexts and across a range of health professions courses and may be adapted around the world to progress health humanities education.
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    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.
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    Exploring the experiences of mental health nurses in the management of schizophrenia in the Upper East Region of Ghana: a qualitative study
    (BMJ Open, 2024) Daliri, D.B.; Laari, T.T.; Abagye, N.; Afaya, A.
    Objective Schizophrenia is a chronic condition, of which the diagnosis and management require comprehensive care. The role mental health nurses play in this management cannot be overemphasised. In an effort to give their best, several challenges confront them which need to be sought and addressed. This study aimed to explore the factors that influence the management of schizophrenia by mental health nurses in the Upper East Region. Design and participants A descriptive phenomenology design was used in this study. Individual in-depth interviews were conducted among 18 purposively sampled mental health nurses using a semistructured interview guide. Audio-recorded interviews were transcribed verbatim and analysed thematically using Colaizzi’s approach. Setting The study was conducted in five primary and secondary-level health facilities in the Upper East Region of Ghana. Findings Five themes were deduced from the theoretical framework, which were as follows: individual factors, interpersonal factors, organisational factors, community-level factors, and policy-level factors. At the individual level, factors such as the condition of the patient at presentation, medication side effects, inadequate knowledge, and poor adherence were identified. Interpersonal factors identified were poor communication, lack of mutual respect, and poor communication, while organisational factors such as inadequate staff, inadequate infrastructure and logistics, and unavailability of antipsychotics were reported. Moreover, the study identified community-level factors such as stigma and cultural beliefs, while policy-level factors such as laws regarding suicide, patient rights, and non-inclusion of mental health services into the National Health Insurance Scheme were reported as factors influencing the management of schizophrenia by mental health nurses. Conclusions Addressing these factors is essential to ensure sustainable improvements and the effective management of schizophrenia. It is imperative to consider these factors when designing interventions and policies to optimise the management of schizophrenia by mental health nurses in Ghana.
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    Female adolescent sexual reproductive health service utilization concerns: A qualitative enquiry in the Tema metropolis of Ghana
    (Female adolescent sexual reproductive health service utilization concerns, 2024) Agbenu, I.; Naab, F.; Kyei, J.
    Background Evidence globally indicates that female adolescents face numerous sexual and reproductive health (SRH) risks. Utilization of sexual reproductive health services among adolescents is of global health importance and plays a crucial role in adolescent sexual and reproductive health outcomes and their quality of life. Aim The current study explored sexual reproductive health service utilization concerns among female adolescents in the Tema Metropolis in Southern Ghana using the Anderson and Newman Behavioral model of Health Service Utilization as a guiding framework. Methods The study utilized a qualitative exploratory-descriptive design. Purposive sampling was used to recruit female adolescents. In-depth face-to-face interviews were conducted using a semi-structured interview guide. In all, 12 interviews were conducted. Each interview lasted between 45 and 60 minutes. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Thematic analysis was guided by the constructs of Anderson and Newman Behavioral model of health service utilization. Results Utilization of sexual reproductive health services among female adolescents is low in the Tema metropolis. Factors such as unprotected non-consensual sexual activity or an unwanted pregnancy sometimes triggered the use of these services. Barriers to utilization identified include lack of awareness on sexual reproductive health services, unreliable sources of SRH information, underestimation of the severity of sexual reproductive health problems faced, unmet expectations and poor experiences with service providers.Conclusion The current study identified poor utilization of sexual reproductive health services among female adolescents within the Tema metropolis of Ghana. There is a need to increase the number of adolescent health corners, increase awareness about SRH services among adolescents, improve parent-child SRH communication and provide adequate training for healthcare providers to improve provider attitude towards adolescent SRH service delivery in order to increase utilization of sexual reproductive health services among female adolescents in the Metropolis.
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    Unveiling contextual influences of maternal satisfaction with labour care services in Nigeria: A qualitative inquiry
    (African Journal of Primary Health Care & Family Medicine, 2024) Awotunde, T.A; Ani-Amponsah, M.; Ajala, D.E.; et al.
    Background: In light of the rising global effort to lower maternal mortality rates, it is crucial for low- and middle-income countries with poor maternal indices to investigate the problem of maternal satisfaction and the key elements that affect it. To this effect, this study explored the experiences of postnatal women in relation to labour services and investigated the factors that contribute to their overall satisfaction. Aim: The study set out to explore factors influencing maternal satisfaction with labour care services in Ogbomoso, Oyo State, Nigeria. This study ultimately seeks to advance our understanding of this phenomenon to impact labour care and policy. Setting: The study was conducted among multiparous women who had their antenatal care and delivery in Ogbomoso, Oyo State, Nigeria. Methods: A qualitative study was performed using in-depth interviews among postnatal women. Results: The results revealed a number of variables that could affect the women’s satisfaction with labour care, including the choice of health facility, healthcare providers, environment of the facility, assurance of privacy, treating patients with dignity, provision of needed amenities and having a well-planned postnatal care assessment. Conclusion: The study revealed that the costs of care, the skill of the caregiver, the provision of confidential and dignified care, and the availability of supplies all have an impact on maternal satisfaction. Hospital administration should address these issues to enhance the experience of women and labour care services. Contribution: The study’s findings provide insights that will inform strategies to improve the quality of care being provided to parturients in Nigeria.
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    Nutrition education programs for burn survivors: A scoping review
    (Nutrition and Health, 2023) Bayuo, J.; Pwara, J.; Davids, J.; et al.
    Background: Despite the importance of nutrition education for burn survivors, only limited work has been done to ascertain what is known about these education programs. Aim: To scope the existing literature to ascertain what is known about the nature and outcomes associated with nutrition education programs for burn survivors, their families and caregivers. Methods: Arksey and O’Malley scoping review approach were utilized with searches across peer-reviewed databases and gray literature sources. Results: Six studies were retained. Five studies focused on burn survivors and one focused on healthcare professionals. One study reported improved knowledge regarding postburn nutritional support following the implementation of the nutrition counseling program. Three studies reported on the inclusion of a nutrition education component in comprehensive postdischarge rehabilitation programs albeit no nutrition-specific out-comes were reported. Conclusion: The review affirms the limited literature, highlighting a need for more work to implement and evaluate outcomes of nutrition education programs for burn survivors.
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    Health-seeking experiences of women with obstetric fistula: a qualitative study at two fistula centres in Ghana
    (BMJ Open, 2023) Asiedua, E.; Maya, E.; Ganle, J.K.; Eliason, S.; Ansah-Ofei, A.M.; Senkyire, E.K.; Adanu, R.
    Objectives The study explored the health-seeking experiences of women with obstetric fistula from the onset of the condition until surgical treatment was obtained. It also describes their interactions with health staff and traditional healers. Design Exploratory, descriptive qualitative study. Setting Two secondary-level health facilities in the northern and central regions of Ghana; data collection took place in 2018–2019. Participants A purposive sample of 37women who had experienced fistula resulting from childbirth and were awaiting fistula repair at the two fistula centres in Ghana was obtained. Data analysis Thematic analysis was used to analyse the data. Results Health-seeking experiences and behaviours of women with obstetric fistula were identified. Six major themes were generated: attribution and perceptions of fistula; competing alternatives/multiple sources of care; limited awareness and access to care; financial barriers; psychosocial challenges, and abuse by healers. The results indicate that the health-seeking experiences of women with obstetric fistula were characterised by long delays in care-seeking. The major themes and subthemes are presented with quotes from participants. Conclusion The women experienced winding pathways of treatment-seeking due to lack of awareness and incorrect attribution. The major barriers to health-seeking included poverty, challenges with transportation and inadequate repair centres. Increased awareness of obstetric fistula and access to repair centres could shorten the suffering women go through while awaiting fistula treatment. Improved awareness of obstetric fistula and establishment of more fistula centres would be beneficial.