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.

COVID-19 information-related digital literacy among online health consumers in a low-income country.

BACKGROUND: The internet has become an important source of health information among people across the globe. However, the novel coronavirus outbreak has led to a broader dissemination of fake and misleading health information. While health professionals may be able to critically evaluate internet-based information, the skills at finding, appraising, and using COVID-19-related online information may be problematic for laypeople in low-income countries. The purpose of this study was to examine the digital literacy of lay consumers of online COVID-19-related information in Ghana. METHOD: A cross-sectional survey was conducted among online health consumers across five regions in Ghana. Participants were conveniently recruited through social media, and the survey was based on the eHealth Literacy Scale (eHeals) and administered through Qualtricsxm software. We calculated the overall mean eHeals score to determine the literacy levels and performed descriptive statistics to describe the characteristics of the sample. Linear regression analysis was performed to determine the factors associated with respondents' digital literacy. RESULT: Out of 700 respondents sent with a survey link, 325 responded (46.4 % response rate). The majority of the respondents were: younger than 31 years (M = 28.42, SD = 6.98), males (59.7 %), use the internet daily (94.4 %), engaged in social media activities (65 %), and frequently search the internet for information related to COVID-19. The overall eHealth literacy was quite high (M = 4.01, SD = 0.95), but respondents' scores on items 1 and 6 were relatively low. Sex, age, frequently searching the internet for COVID-19 information, using the internet for educational purposes, and having a little/adequate knowledge of COVID-19 was predictive of digital literacy. CONCLUSION: The study revealed a high overall digital literacy as well as sex and age differences in literacy levels among online health consumers in Ghana. However, respondents' ability to locate COVID-19 related informaion and their skills in differentiating scientific from unscientific internet-based information remain relatively low. These findings offer useful insight that can inform the design of inclusive internet-based preventive resources that would be accessible and understandable to laypeople across all age groups and sexes in low-income countries.