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A long essay or dissertation or thesis involving personal research, written by postgraduates of University of Ghana for a university degree.
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Item Factors Contributing to Antiretroviral Therapy Adherence Among Adolescents and Young Persons Living with HIV in Five Healthcare Settings in Greater Accra Region(University of Ghana, 2020-12) Lawson, F.O.Item Factors of Rapid Repeat Pregnancy and Its Consequences on Depression among Adolescents in the Greater Accra Region, Ghana.(University Of Ghana, 2018-07) Amuasi, S.A.Rapid repeat pregnancy (RRP) is defined as pregnancy onset within 24 months of the previous pregnancy outcome. RRP has been identified to result from different situations and as such might create different risks to the individual. Several studies have shown an association between RRP and mental health issues such as anxiety, emotional stress, depression, aggression and poorer education attainment. There is a pint-size consensus as to which risk factors are the very key predictors of RRP and whether the outcome (RRP) may lead to depression. This study seeks to identify the main risk factors that could lead to RRP and its consequences on depression among adolescents. METHODS: A mixed method approach (quantitative and qualitative) was used for this study which was conducted in 12 public health facilities in the Greater Accra Region. An unmatched case-control study design was used for the study. The cases were adolescent girls aged between 15 and 19 years who have had more than one pregnancy within two years. Controls were adolescent girls aged between 15 and 19 years who have had one pregnancy which either ended an abortion or delivery with more than twenty-four months spacing. The sample size for the quantitative method was n= 417 with 209 controls and 208 cases. Both the qualitative and quantitative components were hospital-based. Six FGDs were conducted among the control group in six of the selected hospitals and involved a total of forty-six adolescents. Eleven In-depth Interviews (IDI) were also held with every eligible adolescent who had experienced RRP (case) in six of the twelve health facilities selected for the research. STATA 15 MP (StataCorp, College Station, TX, USA) was used to analyze the quantitative aspect of the work. Univariate, bivariate and multivariate logistic regression analyses were conducted with p-value of <0.05 considered as significant. Composite score analysis was used in estimating the level of depression among the participants using Beck’s Depression Inventory scale. The qualitative data were audio recorded, translated into English and transcribed verbatim. Thematic content analysis was adopted for the analysis. Data triangulation was done to support the quantitative data using the qualitative data. RESULTS: There were two outcome variables in the study. The first one was the risk factors for RRP and the second was the effect of RRP on depression. Risk factors for RRP: The median ages at menarche between cases and controls were 12 and 13 years respectively and it was observed that most of the girls who experienced menarche at age 12 years and below were involved in early sexual activity (age at first sexual intercourse) than those who did not. It was also revealed in the study that the number of times a pregnant adolescent visits the hospital for ANC had some form of influence on the risk of RRP. The peers of the adolescents were the main source of information on issues of sex among the cases as compared with the control group. Transactional sex was more common among the cases than the controls. In a univariate analysis variables that showed significance as risk factors for RRP were planning of last pregnancy, history of miscarriage, married or living with partner, parental care, and at least 4 ANC visits. All these variables were significantly associated with odds of RRP. There was an evidence that the odds of RRP for the adolescents who have ever had a miscarriage was about eight times more than that among those who have never had a miscarriage (aOR=7.92; 95%CL: 3.18-19.71; p<0.0001). Effect of RRP on depression: The risk of being depressed among cases were 19% higher than the control group (crude RR=1.19; 95%Cl=0.99 to 1.43; p=0.070). After adjusting for the confounding variables, this increased significantly to 36% higher risk of being depressed (adjusted RR=1.36; 95%Cl=1.11 to 1.67; p=0.003) suggesting an evidence of association between RRP and depression. CONCLUSION: This research has identified the main risk factors of RRP to be, age at menarche, marital status, parental care and support, number of times of ANC visits, sex education and transactional sex. Again the study has investigated the extent to which having subsequent birth in less than 24 months (Rapid Repeat Pregnancy) could adversely affect psychological state of an adolescent mother. The results from this study could provide an insight into designing targeted interventions by policy makers and other stakeholders. Key words: Rapid Repeat Pregnancy, depression, unmatched case-control, mixed method, Antenatal visits transactional sex, menarche, cases, controls.Item Adolescents’ Knowledge, Attitudes and Perceptions Regarding Sexual and Reproductive Health and Teenage Pregnancy in La, Greater Accra Region(University of Ghana, 2018-12) Abdul-Hamid, I.This study came about as a result the identification of the persisting problem of teenage pregnancy in La. The study sought to assess adolescents’ knowledge, perception and attitudes of sexual and reproductive health (SRH) in the La community. To achieve this purpose, 386 teenagers (15-19 years) living in La were purposively selected from schools as well as some key informants (counsellors and peer educators) through a multi stage sampling technique. Data was gathered from the students through the use of a structured questionnaire whilst data was obtained from the key informants through the use of interviews. The data that was gathered was analysed using inferential and descriptive statistics. Results from the study showed that majority of the respondents did not have much knowledge about modern family planning methods, how to use contraceptives and the menstrual cycle. Majority of them had begun consuming alcohol, watching pornographic films, engaging in sexual activities as well as not using contraceptives whilst having sex. Also, most of the respondents had the perception that becoming pregnant or impregnating someone was a way of proving one’s fertility. They also had the perception that their families would support them in case they either got pregnant or impregnated someone. In relation to the teenage pregnancy situation in La, it was found that there was an association between teenage pregnancy and the adolescents’ knowledge of STDs/STIs, how to prevent STDs/STIs, knowledge of contraceptives, entering into sexual relationships, engaging in sex, not using contraceptives whilst having sex and the perception that pregnancy proves one’s fertility. A probit regression that was run further showed that sex of the respondents, educational backgrounds of the respondents and living with non-relatives all had marginal effects on the teenage pregnancy situation in La. It also showed that there was a positive relationship between teenage pregnancy in La and the risky sexual behaviour exhibited by the teenagers of La.