Department of Community Health
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Item Health-Seeking Behavior of Persons with Chronic Hepatitis B in Peri-Urban Ghana: Application of the Health Belief Model(SAGE Open, 2024) Adjei,C.A.; Ampem,K.D.; Dzansi, G.; Tenkorang-Twum, D.; Klutse, K.D.Sub-Saharan African countries, including Ghana, are disproportionately affected by hepatitis B. In Ghana, the burden of hepatitis B is unevenly distributed, with the Brong Ahafo region having the highest prevalence (13.7%). Given that people with hepatitis B (PWHB) in Ghana have previously been found to have a lack of understanding of the impact of the infection, we sought to explore their health-seeking behaviour using the health belief model as an organising framework. A qualitative exploratory design was used. In total, 18 people were purposively selected for face-to-face interviews. The data was processed and analysed using QSR NVivo version 11.0 and the Braun and Clarke thematic analysis procedure. The belief that hepatitis B can cause liver cancer and death was the most important determinant of health seeking. Furthermore, access to accurate hepatitis B information, particularly information about availability of effective hepatitis B treatment, influenced a number of participants to seek formal care. However, the high cost of clinical monitoring and treatment to use herbal medicine, despite their concerns about the effectiveness of herbal medicines in managing hepatitis B. Given that hepatitis B information was a factor in health seeking, it is recommended that a hepatitis B awareness campaign focusing on the availability of hepatitis B treatment and where it can be obtained be carried out in the study area. Counselling PWHB at the point of diagnosis should highlight the relevance of life-long clinical monitoring. To remove financial barriers to hepatitis B care in Ghana, the government should include the cost of hepatitis B laboratory investigations and treatment in the health insurance scheme.Item Factors influencing nurses’ pain assessment and management of road traffic casualties: a qualitative study at a military hospital in Ghana(BMC Emergency Medicine, 2024) Tata, T.K.; Ohene, L.A.; Dzansi, G.A.; Aziato, L.Background Evidence shows that patients who visit the surgical and trauma emergency units may be discharged with untreated or increased pain levels. This study explored nurses’ pain assessment and management approaches at a trauma-surgical emergency unit in Ghana. Methods Seventeen nurses who work in the trauma department participated in this qualitative exploratory descriptive study. In-depth individual interviews were conducted, and the thematic analysis was utilized to identify emerging themes and subthemes. Results Three main themes were identified: patient pain indicators, pain management, and institutional factors influencing pain management. The study revealed that nurses rely on verbal expressions, non-verbal cues, physiological changes, and the severity of pain communicated. The findings highlighted staff shortage, inadequate resources, and lack of standardized guidelines as factors affecting pain and management. Conclusions Although the study offers critical new perspectives on nurses’ experiences regarding pain related issues at the trauma-surgical emergency units, its small sample size limited its generalizability.Item 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.Item 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.Item 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 childlessnessItem Adherence to the three-component Hepatitis B virus vaccination protocol among healthcare workers in hepatitis B virus endemic settings in Ghana(Vaccine: X, 2024) Senoo-Dogbey, V.E.; Adwoa, W.D.; Atoko, M.A.Background: The WHO and CDC recommend that HCWs who are at risk of HBV infection should vaccinate as adults early in their career by receiving 3 doses of HB vaccine at a schedule of months 0,1,6 and perform post vaccination serological testing 1–2 months after vaccination. This study assessed adherence to all three com ponents of the HBV vaccination program. Methods: The study was a hospital-based analytical cross-sectional study involving 340 HCWs who were randomly selected. A pretested questionnaire was used to collect data which was analyzed using SPSS version 21. The proportion of HCWs adhering to the three components of the HBV vaccination protocol was computed. The multivariable analysis procedure identified the factors associated with overall adherence. Odds ratios were estimated with corresponding confidence intervals with the level of significance set at 0.05. Results: HBV vaccination coverage was 60.9 % and adherence to 3-doses, 0,1,6 vaccination schedules and post vaccination serological testing were 46.8 %, 38 % and 13 % respectively. Overall adherence was intermediate at the population level with only 6.2 % of the study participants adhering to all three components of the HBV vaccination protocol. HCWs who had low-risk perception for HBV had the lowest odds of completely adhering to all three indicators recommended for HBV vaccination (aOR = 0.15; 95 %CI = 0.04–0.58). Also, male HCWs have lower odds of adhering to all three components of HBV vaccination compared to their female counterparts (aOR = 0.65; 95 %CI = 1.17–2.50). Conclusion: Adherence to the three components of HBV vaccination recommended for HCWs is low in this study. Failure to receive the recommended three-dose series of HBV vaccine at the recommended 0,1,6 schedule has implications for achieving seroprotection or development of antibodies against HBV. Failure to perform post vaccination testing 1–2 months after HBV vaccination has implications for timely PEP management following occupational exposures. All three components of an ideal HBV vaccination program are important and should be used collectively to guide facility led HCW vaccination programs. Occupational health and safety programs, Infection prevention and control, as well as health promotion campaigns in health facilities, should promote adherence to all three components of HBV vaccination programs.Item Recurrent Vulvovaginal Candidiasis: Assessing The Relationship Between Feminine/Vaginal Washes And Other Factors Among Ghanaian Women(BMC Public Health, 2024) Otoo-Annan, E.; Senoo-Dogbey, V.E.ntroduction Vulvovaginal Candidiasis (VVC) is a public health problem, with approximately 30–50% of women affected at least once during their lifetime. Recurrent Vulvovaginal Candidiasis (RVVC) is diagnosed following three or four repeated episodes of VVC in a calendar year. This condition poses health concerns with significant impacts on the quality of life for women. This cross-sectional study estimated the prevalence of RVVC and assessed the relationship between feminine and vaginal washes and other factors on RVVC among Ghanaian women in the Sekondi and Takoradi Metropolis. Methodology A cross-sectional study was employed to gather data from 304 women. Data were collected using a pretested questionnaire. Bivariate and multivariate analyses, including chi-square, Fisher's exact test and logistic regression, were performed using Jamovi (R Core Team 2021) software. Proportions were calculated, and odds ratios and their corresponding 95% confidence intervals were computed with the level of significance set at 0.05. Results The prevalence of RVVC was estimated at 48.4% (95% CI, 42.6%, 54.1%). Feminine Vaginal wash use (aOR=3.86; 95% CI=2.18, 6.84); age 36–45 years (aOR=0.36; 95% CI=0.17, 0.76) marital status (aOR = 2.37; 95% CI=1.17, 4.79) and sexual activity (aOR:0.43: 95%CI=0.21, 0.88) were significantly associated with RVVC with p<0.005. Conclusion: RVVC is prevalent among women in the Sekondi/Takoradi Metropolis of Ghana. Feminine/Vaginal washes could be cautiously linked to the development of RVVC.Item Nursing Workforce Retention in Rural Ghana: The Predictive Role of Satisfaction, Rural Fit, and Resilience(Journal of Nursing Management, 2023) Poku, C.A.; Mensah, E.; Kyei, J.; Ofei, A.M.A.Introduction. High turnover of nurses in rural healthcare settings contributes to challenges in healthcare delivery. Various incentive packages have been introduced in rural healthcare settings to curb this phenomenon, but the canker still exists. The study aimed at assessing the predictive role of job satisfaction, rural fit, and resilience on nurses’ retention in rural Ghana. Materials and Methods. A multicenter cross-sectional design was adopted to collect data from 462 nurses. Analysis through descriptive statistics, one-way ANOVA, Pearson moment product correlation, and multiple regression was done. Results. There was low resilience and rural fit among nurses with higher turnover intention, which was predicted by average daily attendance (β 0.108), rural fit (β −0.144), resilience (β −0.350), satisfaction with prospects (β −0.187), and satisfaction with prospect and pay (β −0.171) at the significance of 0.05. Conclusion. Policymakers can be assured that not just improving financial incentives to nurses, but the integration of nurses to rural settings, commensurate workload and improving pay and prospects for professional growth and resilience are needed for rural retention. Implications for nursing management, nurse managers, and policymakers have a role to develop sustainable strategies to integrate rural fit, resilience, and job satisfaction to help reduce turnover among nurses.Item Prevention of mother to child transmission of Human Immunodeficiency virus (HIV): What do Ghanaian Midwives know?(International Journal of Africa Nursing Sciences, 2023) Donkor, D.G.; Senoo-Dogbey, V.E.Background: Prevention of Mother to Child Transmission (PMTCT) is an important public health intervention that has significantly reduced the risk of mother-to-child transmission of Human Immunodeficiency Virus (HIV) from 40% to close to 5%. Midwives need to have good knowledge of this important preventive strategy to be able to contribute to global efforts aimed at the elimination childhood HIV infections and all other forms of HIV infection. Methods: This research employed an analytical cross-sectional study design and recruited 179 Midwives through purposive sampling. A self-administered questionnaire was completed by participants to test their knowledge regarding PMTCT for HIV. Analysis of data was done through STATA using ANOVA, binary logistic regression analysis with a level of significance set at < 0.05. Findings: The knowledge levels observed in this study include High (48%), moderate (35.2%), and Low (16.8%) with an overall mean score of 67.82 indicating a moderate level of knowledge among the studied sample. Having a master’s degree (aOR = 1.3; 95 % CI = 0.1–0.9). and age (aOR = 14.9; 95 % CI = 0.6–0.9) were factors that showed statistically significant association with having good knowledge of the guidelines. Conclusions: Even though most of the participants were within the level of high knowledge of the guidelines, overall knowledge at among the studied sample was level moderate. Knowledge improved with increasing age. Midwives with master’s degree demonstrated good knowledge of the guidelines. Support in the form of training is needed to achieve optimum knowledge of the PMTCT guidelines among midwives who are the main imple menters of the PMTCT strategy in GhanItem Beliefs and misconceptions about hypertension disease: A qualitative study among patients in a peri-urban community in Ghana(Original Research Article, 2023) Otemah, J.; Ohene, L.A.; Kyei, J.; Owusu-Darkwa, I.Objective: This study aims to explore beliefs and perceptions about hypertension among patients living with hypertension in a local district in the Eastern region of Ghana. Methods: A descriptive qualitative approach was adopted, and the Health Belief Model was used to guide the data collection, analysis, and organization of the study findings. Overall, seventeen participants were interviewed. In-depth interviews were conducted using a semistructured interview guide. Participants were conveniently selected from a district local Government Hospital. Data gathered were transcribed verbatim and analyzed using thematic analysis. Results: Almost all the participants acknowledged hypertension as a severe but chronic illness that can cause sudden death. They also identified that lifestyle practices and individual attitudes were associated with the hypertension condition’s causes, management, and control. The findings revealed several unscientific misconceptions and beliefs about hypertension, which could influence their disease management and control decisions. Discussion: Patients’ decisions on alternative treatment for hypertension are primarily based on beliefs and misconceptions based on the information they receive from unregulated media and peers. The prevention and control of hypertension should focus on behavior and lifestyle modification which needs reinforcement through health education and promotion.