Impact of the COVID-19 pandemic on handwashing practices among community members in the middle belt of Ghana: evidence from a cross-sectional study.

Handwashing is an effective public health intervention for preventing the spread of coronavirus (COVID-19). Maintenance of clean hands is particularly important during the pandemic, to break the cycle of human-to-human transmission of the virus. This study explored the potential impact of the COVID-19 pandemic on the handwashing behaviours of residents before and during the pandemic. A mixed-method cross-sectional design using standardised questionnaire was used to examine hand handwashing behaviours among residents before and during the COVID-19 pandemic in the middle belt of Ghana. However, this paper reports on the quantitative data on handwashing behaviour only. A total of 517 participants between 18 to 60 years were randomly selected from the Kintampo Health and Demographic Surveillance System (HDSS) database. Descriptive statistics were performed and McNamar test was used to estimate the difference in the handwashing behaviour of residents. Majority of the respondents were females (54.6%). The majority of them 77.0% (398) usually wash their hands with soap and water. Those who washed hands 4 to 6 times a day before the pandemic increased from 39.9% (159) to 43.7% (174). About 34.8% (180) had received training on hand washing and television 53.3% (96) emerged as the main source of training. Ownership of handwashing facilities increased from 11.4% (59) to 22.8% (118) during the pandemic. The odds of handwashing after handshaking were lower 0.64 (95% C1: 0.44-0.92,) during the pandemic. Television (53.3%) was the main source of training for respondents who had received training on handwashing (34.8%). The odds of owning a handwashing facility during the pandemic were 3 times higher than before (OR = 2.97, 95% CI: 1.94 - 4.65). The odds of handwashing after sneezing were 1.8 (95% CI: 1.19-2.92) times higher during the pandemic. Handwashing behaviours during the pandemic improved among residents than before. However, there is a need to intensify health education and media engagement on proper handwashing practices to protect the population against infectious diseases.

Did COVID-19 Change the Availability and Use of Clean Energy for Cooking? Evidence From Ghana.

A major part of Ghana's current household energy policy is focused on using a branded cylinder recirculation model (BCRM) to promote the safe use of Liquefied Petroleum Gas (LPG) for primary cooking. The implementation of the BCRM is expected to increase LPG adoption by households to the announced policy goal of 50% of the population by 2030. We investigated the impact of the COVID-19 pandemic on the implementation of the BCRM, availability, and household use of cleaner fuels. This was assessed using existing data on clean fuel use prior to the COVID-19 pandemic. Additional data was collected using questionnaire-based household surveys and qualitative interviews. It was found that the expansion of BCRM was significantly impacted by the COVID-19 pandemic. Planning activities such as baseline data collection and stakeholder engagement were delayed due to the COVID-19 restrictions. Changes in household incomes during the pandemic had the biggest percentage effect on household choice of cooking fuel, causing a regression in some cases, to polluting fuel use. This study provides insights that could be valuable in future understanding of the interactions between pandemic control measures and economic disruptions that may affect household energy choices for cooking.

Prevalence and determinants of caesarean section deliveries in the Kintampo Districts of Ghana.

BACKGROUND: Globally, the increasing rate of caesarean section (CS) delivery has become a major public health concern due to its cost, maternal, neonatal, and perinatal risks. In Ghana, the Family Health Division of the Ghana Health Service in 2016 opted to initiate a program to prevent the abuse of CS and identify the factors contributing to its increase in the country. This study aimed to determine the prevalence and factors influencing CS deliveries in the Kintampo Districts of Ghana. METHODS: The current study used secondary data from the Every Newborn-International Network for the Demographic Evaluation of Populations and their Health (EN-INDEPTH) project in Kintampo, Ghana. The outcome variable for this study is CS delivery. The predictor variables were socio-demographic and obstetric factors. RESULTS: The prevalence of CS delivery in the study area was 14.6%. Women with secondary education were 2.6 times more likely to give birth by CS than those with primary education. Unmarried women were about 2.5 times more likely to deliver by CS compared to those who were married. There was an increasing order of CS delivery among women in the wealthy quintiles from poorer to richest. The likelihood of women with gestational ages from 37 to 40 weeks to give birth by CS was about 58% less compared to those with less than 37 gestational weeks. Women who had 4-7 and 8 or more antenatal care (ANC) visits were 1.95 and 3.5 times more likely to deliver by CS compared to those who had less than 4 ANC visits. The odds of women who have had pregnancy loss before to deliver by CS was 68% higher compared to women who have not lost pregnancy before. CONCLUSIONS: Caesarean section delivery prevalence in the study population was within the Ghana Health Service and World Health Organization ranges. In addition to known socio-demographic and obstetric factors, this study observed that a history of pregnancy loss increased the chances of a woman undergoing a CS. Policies should aim at addressing identified modifiable factors to stem the rise in CS deliveries.