School of Public Health
Permanent URI for this collectionhttp://197.255.125.131:4000/handle/123456789/5056
Browse
1534 results
Search Results
Item Factors Influencing Adherence to Antiretrovirals (ARVS) Among Persons Living With HIV in the Eastern Regional Hospital, Ghana.(University of Ghana, 2023) Wordi,A.A.D.Background: Sub-Saharan Africa continues to bear the brunt of new and prevailing HIV infections and several countries in this region were unable to meet the UNAIDS 90-90-90 target by 2020. Antiretrovirals are free and readily accessible in Ghana yet adherence levels continue to be suboptimal. There is the need to explore the factors that account for adherence to ARVs in order to capitalize on them and improve adherence levels and ultimately achieve the 95-95-95 agenda by 2030. Objectives: The aim of this study was to determine factors that influence adherence to antiretrovirals among adult PLHIVs in the Eastern Regional Hospital in Ghana. Method: This study was a cross sectional one involving 330 participants who were attendants at the ART clinic of the Eastern Regional Hospital, Koforidua. Questionnaires employed in the study were pretested and participants were selected over a 4-week period using consecutive sampling. Factors influencing adherence were categorized as individual, economic, treatment-related and health system factors. Adherence was determined using the self-report 3-day recall and 7-day recall methods. The most recent viral loads of these participants were also recorded and the association between the viral load measurement and the adherence level was determined using the crude odds ratio and the adjusted odds ratio. Level of significance for the study was set at a value of p < 0.05. Results: With a response rate of 100%, a majority (77%) of the respondents were females and the dominant age group was the 40 – 49 age bracket. A majority of the respondents (84.2%) had some form of formal education. Though most of the respondents denied missing their ARVs, those who missed some of their medications cited forgetfulness as the reason for missing their medications. Using the 7-day recall method, adherence was capped at 85% and 84% of respondents were found to have achieved virological suppression with values professionalism among health workers in the HIV sector and reduced pill burden will improve upon ARV adherence. respondents were on the single pill combination of tenofovir/lamivudine/dolutegravir and side effects attributable to the ARVs were not found to affect the adherence levels. There was a positive association between adherence and virological suppression with an adjusted odds ratio of 2.811. Conclusion: Ghana has made strides when it comes to HIV care. There is however room for improvement and this study has revealed that strong social support, decentralization of HIV care with resultant reduced hospital waiting time, professionalism among health workers in the HIV sector and reduced pill burden will improve upon ARV adherence.Item Determinants of Stress among Graduate Students from University of Ghana School of Public Health Amid Covid-19(University of Ghana, 2022) Obeng, A.Background: Before COVID-19, stress among university students was common due to academic work, social life, deadlines, exams, financial burdens, and separation anxiety. The pandemic has caused fear, anxiety, and uncertainty, forcing educational institutions to transition from face-to-face to online learning to minimise virus spread. Aim: The study aimed to determine whether fear of COVID-19 virus contamination, online learning, and other factors contributed to the level of stress among graduate students and to examine how students were coping with the stressors. Methodology: A descriptive cross-sectional design was adopted for this study. This study involved 77 graduate students from the School of Public Health, University of Ghana, selected through stratified and simple random sampling. Data was collected using Google Forms questionnaires and the COVID-19 Student Stress Questionnaire (CSSQ) to determine stress levels. A p-value < 0.005 was considered significant. Results: The graduate students scored average on the CSSQ. It found that fear of contracting COVID-19 and online learning failed to predict a statistically significant association with stress levels. The main coping mechanisms were strict personal protective measures and reading about COVID-19, its prevention, and its transmission mechanisms. Conclusions: Fear of contracting COVID-19, online learning, and other factors influencing stress failed to predict the level of stress of graduate students amid COVID-19. An overall average stress score was obtained, and students adopted multiple coping strategies to cope with the pandemicItem Incidence of Adverse Events Following Immunization (AEFIS) of Covid-19 Vaccines in Ghana(University of Ghana, 2023) Asare, A.F.Introduction: To fight the COVID-19 pandemic, vaccines form part of an important public health tool in this quest. In Ghana, five (5) COVID-19 vaccines (COVISHIEDTM (AstraZeneca), SPIKEVAXTM, COMIRNATYTM, Gam-COVID-Vac and Janssen) which were given Emergency Use Authorization (EUA) have been used in the mass vaccination campaign since March 2021. Since early phase trials of the vaccines were mostly not conducted in Africans, assessing safety data during their deployment under real-life conditions in the Ghanaian population is important. Methods: This study was a retrospective study involving secondary safety data analyses of AEFI reports from active (cohort study) and passive surveillance (spontaneous reporting) of the 5 COVID-19 vaccines deployed in the mass vaccination campaign involving adults in Ghana since March 2021. Data obtained from the primary data host institution (FDA) in Microsoft Excel spreadsheets and on paper forms, were cleaned and imported into STATA I/C 16 (Stata Corp LLC, Texas, USA) for analyses. Descriptive characteristics of study participants were done using frequency and percentages for categorical variables, and median and interquartile range for continuous variables. Bar- and pie charts were also used to describe characteristics such as chronic medical conditions, the cumulative incidence of adverse events following immunization (AEFIs), the various forms and number of AEFIs experienced, as well as the latency of AEFIs experienced. For the cohort event study, the cumulative incidence, the incidence rate per 100,000 person days, and the incidence rate ratios were estimated using the dose of vaccines as the unit of analysis. The Pearson chi-square test was used to assess the factors associated with the cumulative incidence of AEFIs among study participants. The Cox proportional hazard regression model was used to assess the factors associated with the risk of AEFIs among the study participants. For the analysis of the spontaneous (self-reporting) data, descriptive analysis was performed across the various vaccine types. The Pearson chi-square test was also used to assess the association between the severity of AEFIs experienced and the background characteristics. The binary logistic regression model was also used to assess the factors associated with severe AEFIs and deaths following the occurrence AEFIs among vaccine recipients. Similarly, the outcome of the AEFIs experienced was also described across the background characteristics and the Pearson chi-square test was used to assess the association. All statistical analyses were considered significant with p-values less than 0.05. Approval was obtained on 13th June 2022 from the FDA to use the AEFI data and ethics approval was obtained from the Ghana Health Service Ethics Committee on 18th October 2022. Results: The overall incidence of AEFIs among the 6,100 vaccine recipients in the cohort study was 14.0% (851/6,100). For the spontaneous reports, of the 10,733,719 vaccinated population, 8,498 AEFIs were reported giving an incidence of about 0.049% (49 per 100,000 persons). In the cohort study, most AEFIs (88.7%) occurred by the following day after vaccination and the proportion of females who experienced AEFIs (15.6%) was higher than that of males (12.4%) and this was statistically significant (p<0.001). Also, in both the cohort study and the spontaneous reports, the incidence of AEFIs was higher in the younger age groups compared with those in the 60 years and older age group with the most common AEFIs being headache, body pain, fever and injection site pain. These events were mostly mild and resolved within a few days. The occurrence of AEFIs was found to be dependent on the age, vaccine type, vaccine dose as well as the enrolment site of vaccine recipients in the cohort study. Also, in terms of severity of the AEFIs, age and vaccine type were factors found to be associated with having a severe adverse event in spontaneous reports. Conclusion: There was a low incidence of AEFIs following all 5 COVID-19 vaccines used in Ghana since the mass immunization with the events being generally mild and resolving within a few days. The public should be made aware that the vaccines are safe and encouraged to get vaccinated to increase vaccine coverage across the country.Item Knowledge, Attitudes and Practices of Medical Abortion Amongst Doctors at the Greater Accra Regional Hospital, Accra Ghana(University of Ghana, 2023) Ackon, A.Background: Unsafe abortion is a major contributor to maternal morbidity and mortality in Ghana and other developing countries. Safe termination of pregnancy is very crucial to reducing Ghana’s maternal mortality ratio of 15 to 30% maternal deaths with 308 per 100, 000 live births according to the World Bank. Medical abortion is preferred to surgical method of termination of early pregnancy because the procedure is non-invasive with greater privacy and often does not involve hospitalization. Understanding the perspectives of doctors on medical abortion service delivery is pertinent to identifying barriers and enablers to the successful integration of medical abortion into general practice and is critical to increasing access to these services for women. The study sought to determine the knowledge, attitudes, and practices of medical abortion amongst doctors at the Greater Accra Regional Hospital. Method: A hospital-based cross-sectional study was carried out among medical doctors at the Greater Accra Regional Hospital. A self-administered structured questionnaire was used to collect the data. Part one of the questionnaire was used to collect information on the demographics, part two involved questions on knowledge of medical abortion whereas part three included information on the attitude of doctors towards medical abortion The data was analyzed using STATA version 16. Categorical variables were analyzed using frequencies and percentages. Bivariate and multiple regression analysis were used to establish the relationship between factors influencing the practices of medical abortion among the doctors. Results: The mean (± SD) age of the respondents was 35 (± 7.67) years, with a range of 18-50 years. One hundred and sixteen 116 (53.5%) of the participants were male and the majority (60.4%) were married. The majority of the participants (81%) have adequate knowledge about medical abortion, while a few (3.7%) have low knowledge about medical abortion. Results of the study revealed that about (57%) of participants do not carry out elective medical termination of pregnancy. The major reason given for not carrying out elective early medical termination of pregnancy was outside of the scope of practice (48%) and against religious practice (35%). There was significant difference between doctors at the Greater Accra Regional Hospital who practice medical abortion and those who do not practice medical abortion based on age (χ2= 30.44, p<0.0001), marital status (χ2= 11.26, p=0.001), specialization (p<0.0001), grade (p<0.0001), number of years of practice (p<0.0001), comfortable working in medical abortion facility (χ2=8.77, p=0.003), willingness to provide evidence-based dosing regimen (χ2=26.64, p<0.0001), experience complication while administering medical abortion (χ2= 20.59, p<0.0001) and experience of complication of medical abortion offered by another doctor (χ2= 30.25, p<0.0001). After adjusting for confounders, participants who experienced complications while administering medical abortion were 5.56 times more likely to practice medical abortion compared to participants who had not experienced complications while administering medical abortion[AOR=5.56, CI= (2.05-15.10), p value=0.001)] Conclusion: Doctors generally have adequate knowledge about medical abortion. Attitudes of medical doctors and their practice of medical abortion is significantly influenced by personal, religious, and cultural beliefs. Those who have been trained in abortion procedures were more comfortable practicing or referring patients. The study recommends that the Ministry of Health must ensure that health professionals are trained on medical abortion.Item Prevalence and Factors Associated with Depression Among Students in the Akwapim South District(University of Ghana, 2023) Abbotsi, A.A.Background: Cases of depression and its resultant effect have been reported in different times at different levels. For instance, in early 2022, graphiconline.com reported a case of a depressed man who committed suicide for fear of the future which is unknown. Similar cases of depression and its consequences have been reported from different parts of the Eastern Region with a few in Akwapim South. Unfortunately, detail assessment of the prevailing situation in the region and specifically in Akwapim South has not been done to estimate the prevalence of depression among in-school adolescents. Aim: The main objective of the study is to determine the factors that are associated with depression among in-school adolescents in Akwapim South district. Method: The study employed a cross-sectional in-school survey as the main study design. Adolescents who were aged 10-24 years and were in Junior and Senior High Schools comprised the study participants. Simple random sampling method was employed to select adolescents at different levels. Regression analysis to determine association between factors and depression was conducted using STATA version 17.0. The results were obtained at 95% confidence level. Results: The mean age of the in-school adolescents was 16.4 years (± 2.0 SD). Of the study participants, 57.3% had minimal depression, 30.9% had mild depression, 6.3% moderately depressed, 4.0% had moderately severe depression while 1.5% had severe depression. The prevalence of depression among the adolescents was therefore computed to be 11.8%. After controlling for all significant variables, age (AOR = 7.13, 95% CI: 1.58, 32.23), sex (AOR = 3.65, 95% CI: 1.38, 9.63), smoking (AOR = 4.44, 95% CI: 1.30, 15.15), access to learning materials (AOR = 2.7, 95% CI: 1.27, 5.87), family history of depression (AOR = 2.45, 95% CI: 1.08, 5.58) and marital abuse (AOR = 2.05, 95% CI: 1.03, 4.08) were factors that influenced the rate of depression among the adolescents. Conclusion: The study observed relatively lower rate of depression among in-school adolescents. There were however some of the adolescents who had either severe or moderately severe depressive condition. Factors such as socio-demographic, environmental and behavioural conditions contributed to the outcome of the adolescent depressive conditions. Strengthening counselling units at the various schools by the District Directorate of Education of Akwapim South is critical in addressing challenges of depression among in-school adolescents. The school and the home environment play significant influence in the life of an adolescent. Adolescents at their early formative stage needs a conducive environment to grow and develop.Item Sexual Abuse Among Adolescents in Public Junior High Schools Within Sekondi-Takoradi Metropolitan Area(University of Ghana, 2023) Amankwah, A.Background: Sexual abuse is a major public health, human rights, and developmental issue that needs urgent attention, especially among adolescents and young people globally. Among adolescents, sexual abuse has tremendous direct and indirect consequences on the physical, psychological, and psychosocial health of the victims. Yet, little or no study has been conducted to explore sexual abuse among in-school adolescents in the Sekondi-Takoradi Metropolis. The present study sought to examine sexual abuse and its associated factors among in-school adolescents in public junior high schools (JHS) in the Sekondi-Takoradi Metropolis. Methods: The study utilised an institution-based cross-sectional design to examine sexual abuse among in-school adolescents in public JHS. The study was conducted in the Sekondi-Takoradi Metropolis. A total sample of 400 adolescents in public JHS were recruited using a multistage sampling technique. Pretested semi-structured questionnaires were used to collect data from the adolescents. Frequencies and percentages were used to summarise the results of the categorical variables. A multivariable binary logistic regression analysis was performed to examine the factors associated with sexual abuse among in-school adolescents. The results of the logistic regression analysis were presented using crude odds ratio (COR) and adjusted odds ratio (AOR) with their respective 95% confidence interval (CI). Statistical significance was set at p sexual abuse compared to Akan females [AOR=3.92, CI: 1.09, 14.12]. Females who had ever drunk alcohol had lower odds of experiencing sexual abuse than those who had never drunk alcohol [AOR=0.01, 95%CI: 0.00, 0.008]. Females who had adequate knowledge about sexual abuse had higher odds of experiencing sexual abuse than those who did not know [AOR=8.31, 95%CI: 1.41, 0.019]. Males who lived in self-contained apartments were more likely to experience sexual abuse compared to those in a singled room apartment [AOR=3.14, CI: 1.44, 6.80]. Conclusion: The study has shown that sexual abuse is prevalent among in-school adolescents in the Sekondi-Takoradi Metropolis. Majority of the in-school adolescents were knowledgeable about sexual abuse. The age of the adolescent, ethnic group, living arrangement, ever engaged in sexual intercourse, consumption of alcohol, and knowledge about sexual abuse were associated with sexual abuse. Age-appropriate comprehensive sexual education should be implemented in every basic school. Also, the Ghana Education Service together with the Family Health Unit at the Ghana Health Service should develop reproductive health curricula for basic schools.Item Factors Affecting The Utilization Of Antenatal Care Services In New Juaben South Municipality In Eastern Region(University of Ghana, 2022-03) Dodd, R.D.Background: It is estimated that a global average of 500,000 deaths, caused by various pregnancy and childbirth complications, are recorded every year. In 2013, 99% of maternal deaths occurred in low-income countries, with sub-Saharan Africa contributing about 62%. These maternal deaths attributed in part to the lack of quality antenatal care services for pregnant women. Objective: The main objective of the study was to determine the factors that affect the utilization of antenatal care services in New Juaben South. Method: The study employed an explanatory cross-sectional, mixed methods design. The study targeted 590 women within reproductive age and administrative staff of healthcare facilities. Data were collected using structured questionnaires, as well as face-to- face interviews with women attending child welfare clinics, and administrative staff in four healthcare facilities. Four focus group discussions were held with women. Systematic sampling method was employed to select women who attended child welfare clinics. Logistic regression analysis was conducted using STATA version 15.0 and statistical significance of results were determined at 95% confidence level. Results: The mean age of the women who participated in the study was 28.0 years ± 6.8SD. The antenatal care utilization rate was 29.6%. The age of the mother (AOR = 0.4; 95% CI: 0.1, 0.9) and (AOR = 3.1, 95% CI: 1.5, 6.8), marital status (AOR = 2.4, 95% CI: 1.3, 4.5), religion (AOR = 3.4, 95% CI: 1.2, 9.8), place of residence (AOR = 3.1, 95% CI: 1.6, 5.9), educational status (AOR = 3.5, 95% CI: 1.1, 11.2), timing of start of antenatal care visits (AOR = 4.4 95% CI: 1.8, 10.9), time spent at the facility (AOR: 2.5, 95% CI: 1.2, 5.4) and (AOR: 8.7, 95% CI: 2.4, 30.7) and the distance to the nearest health facility (AOR: 3.8, 95% CI: 1.8, 8.1) were significantly associated with utilization of ANC services. Conclusion: The factors identified in this study as influencing ANC utilization included age, marital status, place of residence, educational status, timing of start of antenatal care visits, time spent at the facility, and the distance to the nearest health facility. The use of ANC is a fundamental entry point for improved maternal health services. Strategies that facilitate an improved uptake of ANC services should take into consideration the identified factors.Item Assessment of Incentive Packages for Frontline Health Workers and Job Satisfaction in Selected Covid-19 Isolation Centres in Greater Accra, Ghana(University of Ghana, 2023) Puplampu, A.A.Background: Healthcare workers, particularly frontline healthcare workers, have been at the forefront of helping in contact tracing, treating, and administering of vaccines with the emergence of the novel coronavirus in 2020. Thus, governments across the globe have taken initiatives to motivate healthcare workers, particularly those at the frontline. There is however limited empirical evidence on how these incentives motivated healthcare workers to serve at the frontline and how this influenced job satisfaction. This study sought to assess incentive packages for frontline healthcare workers and the perceived job satisfaction in selected COVID-19 Isolation Centres in Greater Accra, Ghana. Method: This was a mixed-method study involving both quantitative and qualitative methods with 178 participants. A survey was conducted among 165 health workers using a self-administered questionnaire to collect data on job satisfaction and the effect of incentives on health workers’ job satisfaction. In-depth interviews were also conducted among 13 health workers to elicit their perspectives of frontline health workers on appropriate incentive packages for frontline health workers in future pandemics. Descriptive and inferential statistics and thematic content analysis were used to analyze the quantitative and qualitative data respectively. Results: Overall, 60.1% acknowledged personal receipt of incentives provided by government which included training (54%), financial incentives (49%), logistics (41%) and salary increase (31%). Among the 60.1% who received incentives, 48% rated them as bad/poor while 37% rated them good and the remaining 15% were indifferent. Of those who received COVID-19 incentives, older participants were more likely to be satisfied with their jobs compared to their younger counterparts (AOR: 7.19; 95% CI= [1.20-43.12], p=0.031). Also, participants who worked at the Ghana Infection Disease Center were more likely to be satisfied with their jobs compared to participants at the other isolation centers (AOR: 5.59; 95% CI= [1.77- 17.71], p=0.003). University of Ghana http://ugspace.ug.edu.gh xiv Furthermore, participants who received training as part of their incentive package were more likely to be satisfied with their jobs compared to those who did not receive any training (AOR: 3.18; 95% CI= [1.20-8.45], p=0.020). Conclusion: Though more than half of health workers were satisfied with their jobs, incentives provided by government to frontline health workers in the fight against COVID-19 was rated by majority of respondent as poor. Generally, healthcare workers were not satisfied with these incentives due to factors such as inconsistencies in the delivery of incentives and the fact that their risk was not equally matched with incentives. Major stakeholders directly involved in mitigating strategies of pandemics and outbreaks should ensure the provision of acceptable incentive packages and identify more welcoming methods of distribution.Item Exploring the Perception of Death and Health Related Quality of Life in the Ghanaian Context(University of Ghana, 2023) Essel, A.A.Background: In many healthcare systems around the world, quality-adjusted life years (QALYs) is a pivotal and influential metric in the complex process of resource allocation decision-making. Conversely, traditional measures like life expectancy and causes of death, while important for population health analysis, lack the ability to gauge the quality of life in physical, mental, and social dimensions. Physical symptoms, poor functional performance, psychological problems, social concerns, and existential issues typically contribute to a person's suffering in advanced. At the terminal stage of suffering from these diseases, where treatment and palliative care are not viable, people normally believe it is better to die than to live, which has led to the concept "worse than death" (WTD) health state. There is little evidence that has qualitatively elucidated people’s perception of death, what is being considered as worse than death health state and factors that influence people’s perception of considering some conditions to be WTD in Ghana. Aim: This study explored the perception of worse than death and health-related quality of life among Ghanaian adults in the three ecological zones. Methods: This study employed a phenomenological design approach to explore the understanding of health-related quality of life and worse than death health states. A convenience sampling method was used to sample Twenty-Eight (28) participants. Participants of the study were healthy adult menand women who participated in an EQ-VT protocol valuation survey (a quantitative study) and considered some health states as worse than death. These included 17 males and 11 females. Then, in-depth interviews were used to collect data from the participants. At least 10 participants were interviewed from the three ecological zones (Coastal Zone, Middle Belt, Northern Zone) to better understand Ghanaians' perception of health and well-being and death considering the contextual, religious, and cultural influences on their 'worse than death' health status. Interviews were audio recorded with consent from participants, transcribed, and analyzed using an inductive thematic analytical technique. Results: Findings from the study revealed that participants were knowledgeable about health-related quality of life, how they felt it affected health on the various domains (mobility, self-care, regular activities, pain/discomfort, and anxiety/depression) of life. Health states people considered worse than death included physical pain, social, mobility, and emotional functions and their corresponding severity levels. Findings from the study revealed that reasons for stating those conditions as worse than death were from what they have observed and experienced. Most of the experiences were either personal, from family members and community members. In addition, pains, suffering, being a nuisance, mistreatment, useless, helpless, lifeless and not happy were some of the factors that participants would not want to be in a state worse than death. Conclusion: The study concludes that the participants understand that their health states can affect their quality of life. The worse than death states where participants feel uncomfortable, perceive wasting of the productive time of those who take care of them, dependent, bedridden and disgraced are factors contributing to the decisions in worse than death states. The study recommends that worse than death health states should be taken into consideration by policy-makers and relevant stakeholders in the health sector to enhance the quality of life of people who are suffering some terminal illness.Item Impact Evaluation of the Quality of Antenatal Care (ANC) Offered by Health Care Providers at Kintampo North Municipality.(University of Ghana, 2022) Kwarteng, A.A.Background Antenatal Care (ANC) is an essential component of safe motherhood programme, involving systematic medical supervision of the pregnant woman until labour or until delivery through elective caesarean section. Adhering to the ANC guidelines, it was expected that maternal mortality issues become solved. However, issues of maternal mortality persist. Objective The study was to assess an impact evaluation of quality ANC offered by ANC nurses in Kintampo North Municipality. Method A cross sectional descriptive study was employed in a quantitative approach. Convenient sampling method was used in selecting 79 nurses and midwives who work in ANC at selected health facilities within the Kintampo North Municipality. Conclusion The data revealed that 87.3% of the total participants‘ responses depicted high knowledge on ANC guidelines, 97.3% showed high knowledge on danger signs associated with pregnancy and 96.3% demonstrated quality ANC practices. The study found that nurses and midwives who work at the ANC in the Kintampo North Municipality have high knowledge level on ANC guidelines and danger signs associated with pregnancy. It was found that nurses and midwives who work at the ANC in the Kintampo North Municipality adhere to quality ANC practices.