Expanding access to early medical abortion services in Ghana with telemedicine: findings from a pilot evaluation.

Abortion in Ghana is legally permissible under certain conditions. Updated in June 2021, the National Comprehensive Abortion Care Services Standards and Protocols included telemedicine as a recognised option for early medical abortion (EMA). Subsequently, Marie Stopes Ghana launched this pilot project to understand the feasibility and acceptability of providing EMA services through telemedicine. The pilot evaluation drew on two research protocols - a process evaluation and a qualitative study. The process evaluation focused on existing routine data sources and additional pilot-specific monitoring, while the qualitative protocol included in-depth interviews with a range of key stakeholders, including telemedicine and in-person patients, healthcare managers, and service providers. Telemedicine for EMA is feasible, acceptable, and has likely expanded access to safe abortion in Ghana. The MSIG telemedicine service package enabled 97% of patients to have a successful EMA at home. Thirty-six per cent of the total 878 patients during the pilot reported that they had no other option for accessing an abortion. Patients described telemedicine EMA services as a highly acceptable and appealing service option. Eighty-four per cent reported they would opt for the telemedicine service again and 83% reported they were very likely to recommend the service. There is potential for telemedicine to expand and improve access to critical SRH services. EMA via telemedicine can be delivered effectively in a low-resource setting. This pilot also showed how telemedicine provides access to patients who feel they do not have other safe service options, meeting specific patient needs in terms of discretion, convenience, and timing.

Implications of COVID-19 Innovations for Social Interaction: Provisional Insights From a Qualitative Study of Ghanaian Christian Leaders.

Responses to the COVID-19 pandemic prompted people and institutions to turn to online virtual environments for a wide variety of social gatherings. In this perspectives article, we draw upon our previous work and interviews with Ghanaian Christian leaders to consider implications of this shift. Specifically, we propose that the shift from physical to virtual interactions mimics and amplifies the neoliberal individualist experience of abstraction from place associated with Eurocentric modernity. On the positive side, the shift from physical to virtual environments liberates people to selectively pursue the most fulfilling interactions, free from constraints of physical distance. On the negative side, the move from physical to virtual space necessitates a shift from material care and tangible engagement with the local community to the psychologization of care and pursuit of emotional intimacy in relations of one's choosing-a dynamic that further marginalizes people who are already on the margins. The disruptions of the pandemic provide an opportunity to re-set social relations, to design ways of being that better promote sustainable collective well-being rather than fleeting personal fulfillment.

The Impact of COVID-19 and Religious Restrictions on the Well-Being of Ghanaian Christians: The Perspectives of Religious Leaders.

In response to the COVID-19 pandemic, the Ghana government instituted a ban on social gatherings, including religious gatherings. To understand how the unanticipated restrictions and interruption in normal church routines affected the well-being of congregants in Ghana, we interviewed 14 religious leaders. Thematic analysis revealed psychospiritual impacts including decline in spiritual life, loss of fellowship and community, financial difficulties, challenges with childcare, as well as fear of infection. Religious leaders intervened by delivering sermons on hope, faith, and repentance. Some religious leaders sensitized their members on health hygiene and COVID-19-related stigma. The study sheds light on the perceived impacts of COVID-19 and restrictions of religious gatherings on congregants in Ghana.

Ban of Religious Gatherings during the COVID-19 Pandemic: Impact on Christian Church Leaders' Well-Being in Ghana.

This study was conducted during a period of lockdown and ban on social gatherings, including religious gatherings, in Ghana. The restrictions were instituted in response to the COVID-19 pandemic. The purpose of the study was to understand how the well-being of Christian church leaders was impacted during the prohibition in terms of aspects of their vocation and religious practices. Fourteen Christian church leaders located in urban and rural settings in Ghana, with 5 to 32 years of experience, discussed how they and their families were impacted by the ban on religious gatherings in Ghana. Findings revealed negative impacts of the COVID-19 restrictions, including spiritual slacking, loss of fellowship, disruption of normal routine, pandemic anxiety, and financial stress. Positive impacts included increased faith, relief/reduced stress, and increased family time. These findings are discussed from psychological trauma and disaster response perspectives.

Cultural Models of Well-Being Implicit in Four Ghanaian Languages.

This contribution to the collection of articles on "African Cultural Models" considers the topic of well-being. Reflecting modern individualist selfways of North American and European worlds, normative conceptions of well-being in hegemonic psychological science tend to valorize self-acceptance, personal growth, and autonomy. In contrast, given the embedded interdependence of everyday life in many West African worlds, one can hypothesize that cultural models of well-being in many Ghanaian settings will place greater emphasis on sustainability-oriented themes of material sufficiency and successful navigation of normative obligations. To explore this hypothesis, we interviewed local cultural experts who function as custodians of religion and an important source of support for well-being in many Ghanaian settings. We asked participants to identify and explain models of well-being implicit in four Ghanaian languages (Akan, Dagbani, Ewe, and Ga). Participants were 19 men and 15 women (age range 32-92 years; Mean = 59.83; SD: 14.01). Results reveal some features of local models, including good health and positive affective states, that appear to resonate with standard understandings of well-being in hegemonic psychological science. However, results also provide evidence for other features of local models - specifically, good living (including moral living, material success, and proper relationality) and peace of mind - associated with a sustainability or maintenance orientation to well-being.