Perceived impact of digital health technology on health professionals and their work: A qualitative study in Southern Ghana.

Background: Digital health technology (DHT) has become an essential part of an effective and efficient healthcare information system. Although DHT promises great potential it does not always meet the expectation of users. Often, in low- and middle-income countries (LMICs), the implemented DHT does not function as intended and impacts negatively on health professionals and their work. Therefore, this study explored the views of participants about the impact of DHTs on the work of health professionals after it has been introduced in Ghana. Methodology: The study used a qualitative research approach where in-depth interviews (IDIs) were conducted with study participants across three health facilities in Ghana. A purposive sampling technique was used to select participants. All interviews were audio recorded, transcribed, and coded into themes using QSR Nvivo 12 software before thematic content analysis. Results: Our findings revealed that DHT reduced the workload on the healthcare providers and also ensures continuity of care. Participants perceived that DHT was fast, and ensures quality and accurate information, which could be easily accessed by health professionals for better decision making. However, poor internet connectivity and erratic power supplies were reported as the main impediments causing delays and frustrations to the staff at the study health facilities. Conclusion: The study found that DHT has a positive effect on the work of health professionals. However, poor internet connectivity and unstable power supply caused delays in the provision of care and disruptions in the work process affecting the smooth operation of the DHT and threatening to erode the potential benefits to the health system and users.

Health professional's readiness and factors associated with telemedicine implementation and use in selected health facilities in Ghana.

Background: Telemedicine, which is the practice of medicine using technology to deliver health care remotely, has a low adoption rate in low- and middle-income countries (LMICs). However, the advent of coronavirus disease 2019 (COVID-19) has forced healthcare systems in these settings to begin implementing telemedicine programs. It is unknown how prepared health professionals and the healthcare system are to adopt this technology. Therefore, this study aimed to assess the readiness of health professionals and explore factors associated with telemedicine implementation in Ghana. Methods: A cross-sectional study was conducted in six health facilities between March and August 2021. Convenience sampling was used to select the six health facilities, and the participants were selected randomly for the study. Questionnaires were self-completed by participants. Data was exported into STATA 15.0 for analysis, and appropriate statistical methods were employed. All statistical tests were performed at a significance level of p < 0.05. Results: Of the 613 health professionals involved in the study, about 579 (94.5%) were comfortable using computers, and the majority, 503 (82.1%) of them, had access to computers at the workplace. Health professionals agreed that the measures outlined by the health facilities supported their readiness to use telemedicine for healthcare services. Analysis revealed a statistically significant positive relationship between health facilities' core readiness and health professionals' readiness, with a correlation coefficient (r) of 0.5484 and a p-value<0.0001. Of the factors associated with health professionals' readiness towards telemedicine implementation, facility core readiness, engagement readiness, staff knowledge and attitude readiness showed a statistically significant relationship with health professionals' readiness. Conclusion: The study revealed that health professionals are ready to adopt telemedicine. There was a statistically significant relationship between health facilities' core readiness, engagement readiness, staff knowledge and attitude readiness, and health professionals' readiness. The study identified factors facilitating telemedicine adoption.

Patients Perceived Knowledge, Attitude, and Practice of Dental Abscess Management in Periurban District, Ghana.

Background: Seeking conventional oral health care for various dental conditions is still a challenge for many worldwide and poses a global public health challenge. It is not until the individual starts experiencing pain and disfigurement of the facial profile that they seek dental care after many self-care interventions have failed. This study sought to determine perceived knowledge, attitude, practice, and satisfaction of dental abscess management among dental abscess patients (DAPs). Methods: The research used a cross-sectional design to collect data from patients who visited the Dental Department of Effiduase Government Hospital with dental abscess from 6 May 2020-27 August 2020. A total sample size of 82 was selected from a population of 377. About 76 DAPs who met the inclusion criteria and consented to participate were interviewed. Results: About 57% of respondents believed that dental caries caused their abscess. However, 46% sought medical treatment between 0 and 2 weeks after the onset of their dental abscess, while the rest did that after 3 weeks. Close to 64.5% have ever had episode of abscess before current one which they managed with alternative treatment. About 95% of respondents saw the hospital as a good place for dental care. A significant association was established between patient's level of education and influence to seek orthodox treatment (p = 0.015, Fisher's exact test (FET)). Another significant association was established between patient's level of education and the kind of alternative treatment they used (p = 0.016, Fisher's exact test (FET)). Conclusions: Most DAPs believe that dental caries was the main cause of dental abscess. DAPs sought late medical care, after they have tried a failed alternative treatment. DAPs expressed satisfaction with reception, equipment and materials, and medicines used. Majority of the patients rated the cost of dental care in the facility as affordable.

Healthcare Providers' Intention to Use Technology to Attend to Clients in Cape Coast Teaching Hospital, Ghana.

BACKGROUND: Patient records' relevance is associated with a variety of needs and objectives. Substantiating the health of patients perpetually and allowing professionals in the medical field to assess both signs and symptoms that fall in a relatively wider temporal point of view and contributions that lead to enhanced diagnoses and treatment are all quintessential of patient records. The advancement of information technology systems has led to the anticipation that development will be put into digitization and electronic means of storing patient records in order to grease their handling. Cape Coast Teaching Hospital (CCTH) is piloting implementation of patient's electronic health record system. The introduction of the electronic health record system known as Lightwave Hospital Information Management System (LHIMS) was to provide a permanent solution to patients' continuity of care. User's acceptance of new information technology is seen to be one of the most challenging issues in information system. This study assesses healthcare providers' (HP') behavioural intention to use LHIMS to attend to clients in Cape Coast Teaching Hospital and other factors influencing it. METHODS: A nonexperimental cross-sectional study was used to obtain information from 84 HP recruited from the various departments and units in CCTH who use LHIMS to attend to clients. The sample size of 90, representing 8% of HP in CCTH, was randomly selected from the various departments and units. However, 84 (indicating 93.3% response rate) of the selected HP were available during the period of the research. RESULTS: Perceived ease of use (PEOU) of LHIMS had the strongest direct effect on perceived usefulness (PU), with a highly significant path coefficient of 0.75. PU had the greatest impact on attitude about HP' behavioural intention to use (BIU) LHIMS to attend to patients' healthcare delivery in CCTH (0.91). This relationship was highly significant at p < 0.001. PEOU did not have a significant direct effect on attitude about LHIMS use, as hypothesized in the original technology acceptance model. However, attitude towards use had a strong significant effect on HP' BIU of LHIMS, with a strong statistically significant path coefficient of 0.98 at p < 0.001. CONCLUSIONS: We conclude that attitude towards use have a significant influence on HP' behavioural intention to use LHIMS to attend to clients in Cape Coast Teaching Hospital.

Evaluation of neonatal mortality data completeness and accuracy in Ghana.

BACKGROUND: Cause-specific mortality data are required to set interventions to reduce neonatal mortality. However, in many developing countries, these data are either lacking or of low quality. We assessed the completeness and accuracy of cause of death (COD) data for neonates in Ghana to assess their usability for monitoring the effectiveness of health system interventions aimed at improving neonatal survival. METHODS: A lot quality assurance sampling survey was conducted in 20 hospitals in the public sector across four regions of Ghana. Institutional neonatal deaths (IND) occurring from 2014 through 2017 were divided into lots, defined as neonatal deaths occurring in a selected facility in a calendar year. A total of 52 eligible lots were selected: 10 from Ashanti region, and 14 each from Brong Ahafo, Eastern and Volta region. Nine lots were from 2014, 11 from 2015 and 16 each were from 2016 and 2017. The cause of death (COD) of 20 IND per lot were abstracted from admission and discharge (A&D) registers and validated against the COD recorded in death certificates, clinician's notes or neonatal death audit reports for consistency. With the error threshold set at 5%, ≥ 17 correctly matched diagnoses in a sample of 20 deaths would make the lot accurate for COD diagnosis. Completeness of COD data was measured by calculating the proportion of IND that had death certificates completed. RESULTS: Nineteen out of 52 eligible (36.5%) lots had accurate COD diagnoses recorded in their A&D registers. The regional distribution of lots with accurate COD data is as follows: Ashanti (4, 21.2%), Brong Ahafo (7, 36.8%), Eastern (4, 21.1%) and Volta (4, 21.1%). Majority (9, 47.4%) of lots with accurate data were from 2016, followed by 2015 and 2017 with four (21.1%) lots. Two (10.5%) lots had accurate COD data in 2014. Only 22% (239/1040) of sampled IND had completed death certificates. CONCLUSION: Death certificates were not reliably completed for IND in a sample of health facilities in Ghana from 2014 through 2017. The accuracy of cause-specific mortality data recorded in A&D registers was also below the desired target. Thus, recorded IND data in public sector health facilities in Ghana are not valid enough for decision-making or planning. Periodic data quality assessments can determine the magnitude of the data quality concerns and guide site-specific improvements in mortality data management.

Relation Between Religious Perspectives and Views on Sickle Cell Disease Research and Associated Public Health Interventions in Ghana.

Sickle cell disease (SCD) is highly prevalent in Africa with a significant public health burden for under-resourced countries. We employed qualitative research methods to understand the ethical, legal, and social implications of conducting genomic research in SCD under the Human Heredity and Health in Africa (H3Africa) initiative. The present study focused on religious and cultural aspects of SCD with the view to identifying beliefs and attitudes relevant to public health interventions in Ghana. Thematic analyses from individual and group interviews revealed six key areas of importance, namely, reliance on a supreme being; religion as a disruptive influence on health behaviors; role of religious leaders in information sharing and decision-making; social, religious, and customary norms; health and religious/supernatural beliefs; and need for social education and support through church and community. Findings suggest that public health programs in Ghana should not only aim at increasing knowledge and awareness about SCD and its management but also create an understanding of the relevance of genomics and alternative technological advancement to diagnosis and ethical decision-making around available options for health seeking. Future research should engage communities to help address the ethical and social implications of a persuasive religious influence on SCD-related health decisions.