School of Nursing and Midwifery
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Item “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.Item From Aspiration To Achievements: Exploring The Motivational Drives Behind Female Graduate Nursing Students' Pursuit Of Higher Education In Ghana.(Elsevier Inc., 2025-01-20) Poku, C.A.Background: The nursing and midwifery professions are predominantly female. In Sub-saharan Africa, especially in Ghana, females have traditionally been perceived as homemakers who do not require higher education to play their roles. This phenomenon perpetuates gender inequality, underutilises talents, and denies women opportu nities for personal and professional growth. Aim: This study explored the motivational factors influencing the uptake of higher nurse education among female nurses in a resource-constrained setting. Methods: An exploratory, descriptive qualitative approach was adopted with purposive sampling method to re cruit 20 nurses pursuing a postgraduate programme in nursing from October to November 2022. Inductive thematic analysis approach was used to analyse the data. Result: Two main themes and six subthemes were developed from the data. Female graduate students believe the reasons to pursue higher nursing education are attributed to one's workplace, friends and family's demands. Participants pursuing higher education think it will earn them higher-paying jobs. Their primary motivation to pursue higher education was to earn titles like ‘doctor’, ‘the degree nurse’, and ‘the specialist nurse’. Other motivations for some participants include the impact of their higher education, which ranges from workplace promotion to family prestige. Conclusion: Ghanaian female graduate nursing students' motivation to pursue higher nursing education is threefold: personal gains, corporate gains, and family fame. Educational institutions need to assist these nurses with the requisite knowledge to excel in their areas of work, get the maximum benefit they expect from schooling, and make their families and communities proud as expected.Item Intervention to improve adverse event reporting in the emergency department: Protocol of a systematic review and meta analysis(PLOS ONE, 2024) Poku, C.A.; Bayuo, J.; Kwashie, A.A.; Ofei, A.M.A.Background Adverse event reporting is crucial for improving patient safety and identifying areas for improvement in the emergency department. Many interventions have been employed in that regard, and have been found to increase adverse event reporting rates in various settings. All published research that studied the various interventions and their effectiveness on adverse event reporting in the Emergency Department will be reviewed in this paper. Methods CINAHL, PubMed, Medline, Cochrane Reviews Library, EMBASE, Scopus, OVID, Science Direct and Web of Science will all be searched. Studies published since January 2000 that investigated the interventions to improve adverse event reporting will be included. Two inde pendent reviewers will execute the selection and extraction process, and we will carry out a qualitative synthesis. A meta-analysis, if possible, will be undertaken. Discussion The present study will summarize interventions to improve adverse event reporting. It will also determine effective approaches to enhancing adverse event reporting in the emer gency department. The outcome of the study will provide novel dimensions into possible interventions to improve patient safety through adverse event reporting.Item 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.Item Impact of climate change on maternal health outcomes: An evidence gap map review(PLOS Global Public Health, 2024) MeheraliI, S.; Adjorlolo, S.; Aziato, L.; et al.Climate change poses unique challenges to maternal well-being and increases complications during pregnancy and childbirth globally. This evidence gap map (EGM) aims to identify gaps in existing knowledge and areas where further research related to climate change and its impact on maternal health is required. The following databases were searched individually from inception to present: Medline, EMBASE, and Global Health via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost; Scopus; and organizational websites. In this EGM, we integrated 133 studies published in English, including qualitative, quantitative, reviews and grey literature that examined the impact of climate change on maternal health (women aged 15–45). We used Covidence to screen studies and Evidence for Policy and Practice Information (Eppi reviewer)/Eppi Mapper software to generate the EGM. Data extraction and qualitative appraisal of the studies was done using critical appraisal tools. The study protocol was registered in International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) # INPLASY202370085. Out of 133 included studies, forty seven studies were of high quality, seventy nine moderate equality and seven low quality. This EGM found notable gaps in the literature regarding the distribution of research across regions. We found significant research in North America (51) and Asia (40 studies). However, Africa and the Caribbean had fewer studies, highlighting potential disparities in research attention and resources. Moreover, while the impact of extreme heat emerged as a prominent factor impacting maternal well-being, there is a need for further investigation into other climate-related factors such as drought. Additionally, while preterm stillbirth and maternal mortality have gained attention, there is an overlook of malnutrition and food insecurity indicators that require attention in future research. The EGM identifies existing research gaps in climate change and maternal health. It emphasizes the need or global collaboration and targeted interventions to address disparities and inform climate responsive policiesItem 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 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 newbornsItem 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.Item Mental health burden among females living with HIV and AIDS in sub-Saharan Africa: A systematic review(Plos Global Public Health, 2024) Boakye, D.S.; Setordzi, M.; Dzansi, G.Mental health problems, particularly depression and anxiety, are common in women and young girls living with HIV/ AIDS particularly in low- and middle-income (LMICs) countries where women’s vulnerability to psychiatric symptoms is heightened due to the prevalent intersectional stressors such as stigma and intimate partner violence. However, no synthesized evidence exists on the mental health burden of females living with HIV/AIDS (FLWHA) in Africa. This systematic review aimed to synthesize the current evidence on the mental health burden among FLWHA in sub-Saharan Africa. A systematic literature review of articles published from 2013–2023 was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). Five electronic databases; PubMed, MEDLINE with full text, Scopus, Academic Search Complete, and Health Source: Nursing Academic Edition were searched for articles published in English. Nineteen articles (15 quantitative, 3 qualitative, and 1 case study) from over 7 African countries met the inclusion criteria. The majority of the studies’ quality was determined to be moderate. The prevalence of depression ranged from 5.9 to 61% and anxiety from 28.9 to 61%. Mental health burden was a logical outcome of HIV diagnosis. Predic tors of mental health outcomes in the context of HIV/AIDS were identified as intimate partner violence (IPV), stigma, childhood traumas, sexual abuse, poverty, unemployment, and social isolation. Social support and resilience were identified as protective factors against mental illness in FLWHA. Mental illness had a deleterious effect on viral suppression rates among FLWHA, resulting in delayed initiation of antiretroviral therapy treatment and increased mortality but had no impact on immune reconstitution in the face of ART adherence. Given the high prevalence rates of depression and anxiety and their relationship with HIV progression, it is crucial that mental health care services are integrated into routine HIV care.