Perspectives of urban Ghanaian women on vasectomy.

BACKGROUND: Advocacy for male involvement in family planning has been championed over the years after the 1994 International Conference on Population and Development (ICPD). There are a few contraceptive methods for men, and vasectomy uptake has been identified as one of the indicators of male involvement in family planning. Vasectomy also known as male sterilization is a permanent form of contraception. It is a generally safe, quick, easy, effective surgical operation with rare complications to prevent release of sperm. The study explored the vasectomy perspectives of urban Ghanaian women. METHODS: A qualitative approach was used and five focus group discussions were held with women in urban Accra. The study was conducted in the five sub-metropolitan areas of the Accra Metropolitan Health Directorate from September-October 2013. Participants were adult and young adult women who are members of organized groups and unions. Data were analyzed manually after transcribing and coding and themes were sorted using thematic version 0.9. RESULTS: Both adult and young adult participants regarded vasectomy as an easy way for male partners to become promiscuous and cheat on them (women) because the operation renders males incapable of having a child; promiscuity could lead to the women contracting sexually transmitted infections including HIV/AIDS. They were also skeptical about vasectomy and the possibility that it could damage the sexual organs of their partners and affect their sexual relationships. The uptake of vasectomy will not benefit a new wife in case of divorce or death of a previous wife. Some women would allow their partners to undergo the procedure only if both of them will benefit health-wise and also if it would reduce the financial burden on the family. CONCLUSION: The women held mixed perceptions; both negative and positive views were shared on vasectomy uptake. The views were predominantly negative, and they regarded vasectomy as an unacceptable method of contraception. The women virtually had no reasons to encourage their partners to undergo a vasectomy. In order to increase vasectomy uptake in Ghana, innovative efforts to address the misconceptions and superstitions surrounding vasectomy should take centre stage; appropriate and targeted messaging during integrated health services delivery and social/health campaigns would be a good starting point.

Awareness of and participation in mass drug administration programs used for onchocerciasis control in the Atwima Nwabiagya North District, Ghana.

BACKGROUND: Studies on Mass drug administration (MDA) in Ghana targeting various diseases, have mostly focused on factors that affect coverage and compliance to MDA with limited focus on evidence regarding awareness and community perception of the program. Therefore, this study sought to provide empirical evidence on the knowledge of onchocerciasis, and awareness of and participation in the MDA among community members. METHODS: A community-based cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District, Ghana. Data was collected from 2,008 respondents. Bivariate and multivariate logistic regression analyses were performed to measure the associations between socio-demographics, having heard of onchocerciasis and its prevention, and levels of awareness of the MDA program. RESULTS: A total of 1268 respondents (63.2%) were aware of the MDA program. The majority ofMost respondents (74.4%) were of the view that the information given about the program was not enough and 45.4% of the respondents had no idea about the relevance of the MDA program. Respondents who had ever heard about onchocerciasis prevention and persons who had previously participated in the MDA program were more likely to be aware of the MDA program during implementation (AOR = 2.32; 95% CI 1.79-3.01 and AOR = 9.31; 95% CI 7.06-12.26, respectively). CONCLUSIONS: We observed a significant association between being aware of MDA campaigns and knowledge of onchocerciasis and its preventive methods, and participation in previous MDA campaigns. We recommend intensification and improvement of prevention campaigns regarding the onchocerciasis MDA program as key to ensuring increased MDA program participation.

Co-creation and prototyping of an intervention focusing on health literacy in management of malaria at community-level in Ghana.

INTRODUCTION: Collaborating with end-users to develop interventions tailored to fit unique circumstances is proposed as a way to improve relevance and effectiveness of an intervention. This study used a local needs driven approach to develop a health literacy intervention for caregivers in Ghana concerning management of malaria in children under 5 years. METHOD: For the period, November 2017-February 2019, we carried out the study using a three-phase framework including: 1) Needs assessment based on data from questionnaires, focus groups, individual interviews and observations, 2) Co-creation of a board game and brochures for health education at Child Welfare Clinics to address needs in health literacy concerning malaria and 3) Development of a prototype of the game, brochures as well as determining feasibility. In addition to the research team, health administrators, community health workers, designers and caregivers contributed to the development of the intervention. FINDINGS: The needs assessment contributed to the development of interactive and useful materials including a board game and brochures, to help bridge the gaps in health literacy among caregivers. Co-creation of the materials and prototyping yielded a varying sense of ownership among stakeholders. End-users' engagement and participation in developing the intervention resulted in a high interest and adherence to interventions. However, high attrition rates of health workers and caregivers' inconsistent use of the Child Welfare Clinics challenged sustainability of this intervention. CONCLUSION: Co-creation led to an interactive intervention. The interactive nature of the board game and brochures resulted in a better caregiver-health provider relationship and a sense of recognition of a more participatory approach to health delivery. We recommend co-creation as an approach to develop needs-driven interventions in a context like Ghana. Still, a stronger buy-in at the top-level of health management would improve sustainability and reach a larger audience.

INTRODUCTION: To develop useful interventions, it is important to involve the users of the intervention in its development. Such interventions address the unique needs of the users. This study reports on the design and evaluation of an intervention which was designed to meet the health literacy needs of caregivers with children under 5 years in the management of malaria in Ghana. METHOD: The development process involved three phases. Firstly, the study identified the health literacy needs of caregivers using questionnaires, focus group discussions, interviews and observations. Secondly, there was collaboration with stakeholders in the design of a board game and brochures as health education tools to be used at the Child Welfare Clinics and lastly, the practicality of the designed materials as health education tools for caregivers was assessed. FINDINGS: The intervention addressed the identified health literacy needs of caregivers. Stakeholders involved in the development process expressed ownership in varying degrees depending on the extent of their involvement. Users of the board game and brochures showed high interest and participation in the intervention delivery. Sustainability was challenged with periodic transfer and loss of health workers to career development, as well as irregular visits by some caregivers to the Child Welfare Clinics. CONCLUSION: The use of interactive game and brochures at the Child Welfare Clinics improved caregiver and health worker relationship and encouraged a participatory method of healthcare. For long-term sustainability and scale-out of the intervention, there is the need for more support of top-level management of health in the country.