A mixed method study on the impact of COVID-19 on mental healthcare in Ghana: rethinking mental health service delivery.

BACKGROUND: Since its emergence, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused severe health, social and economic challenges. Mental healthcare has been significantly affected globally, and even worse in developing countries. An emerging economy like Ghana in West Africa was not spared its disruptive effects. This study aimed to elucidate the impact of the coronavirus disease 2019, the COVID-19 pandemic (caused by SARS-CoV-2), on Ghana's mental healthcare system. METHODS: This is a mixed-method study using an emergent sequential exploratory design. A total of 15 front-line healthcare professionals were recruited from the three psychiatric hospitals, including the mental health department of a new teaching hospital in Ghana. Purposive sampling techniques and a semi-structured interview approach were used for recruitment and data collection. Quantitative data from hospital registries were collected and analysed to triangulate qualitative findings. RESULTS: Fifteen mental health workers were enrolled in the study. The mean age of participants was (34.47 ± 4.07) years, average work experience of (6.23 ± 3.64) years and the majority as males (60%). This study found an average decline of 23% in hospital attendance and a 35% decline in admissions in all four facilities compared to the previous year, 2019. The lived experiences shared by mental healthcare providers were grouped under 3 main themes: Adjustments to workplace regulations, accessibility to mental healthcare, and psychological wellbeing of mental healthcare workers. The fear of contracting SARS-CoV-2 among healthcare workers, medication shortages, and logistical challenges were also reported to affect Mental Health services during the pandemic. CONCLUSION: This study highlights the challenges in mental healthcare during the COVID-19 pandemic in Ghana. The experiences encountered present an opportunity to gain insights into future pandemic preparedness and establish a framework for optimal mental healthcare delivery in Ghana.

Disparities in cervical cancer screening programs in Cameroon: a scoping review of facilitators and barriers to implementation and uptake of screening.

BACKGROUND: Cervical cancer is the fourth most common cancer worldwide. Organized screening has achieved significant reductions in cervical cancer incidence and mortality in many high-income countries (HICs). But the gap between HICs and low-and-middle-income countries (LMICs) is still substantial as the highest burden of the disease is in LMICs. Cameroon is a LMIC, where cervical cancer is the leading cause of cancer-related deaths among women, only 3-5% of eligible women have been screened and there is no effective national cervical cancer prevention program. OBJECTIVE(S): Identify facilitators and barriers to the implementation and uptake of existing cervical cancer screening programs in Cameroon to inform the implementation of a comprehensive national program. METHODS: We conducted a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis, extension for Scoping Reviews (PRISMA-ScR). Google Scholar and five electronic databases (PubMed, CINAHL, Embase, Cochrane library and Web of Science) were searched systematically from 2012 to 2022. Articles on cervical cancer screening programs in Cameroon were eligible for inclusion. Two reviewers independently screened search results and extracted relevant data. RESULTS: A total of 182 articles were identified using our search strategy, and 20 were included. There was scarcity of publications from the North, Adamawa, East and South regions of Cameroon. Barriers and facilitators found were presented using the World Health Organisation framework for health systems. Cross-cutting barriers were: (1) the lack of a national training curriculum for screening providers with no elaborate, harmonized screening and treatment algorithm for cervical precancers; and (2) women's lack of information about cervical cancer screening activities. Conversely, provision of screening services at a low or no cost to women in some programs and the feasibility of using novel point of care screening methods like the Human Papillomavirus DNA test were identified as facilitators. CONCLUSION: This scoping review indicates that there are knowledge and research gaps concerning the state of cervical cancer screening services in some regions of Cameroon. Moreover, it underlines the need for comprehensive cancer control policies and practices integrating all six-health system building blocks to reduce disparities between regions, and rural versus urban areas in Cameroon.

Comprehensive Criteria for Reporting Qualitative Research (CCQR): Reporting Guideline for Global Health Qualitative Research Methods.

Globally, the demand for qualitative research has risen, driven by the health sector's need for in-depth investigation of complex issues behind any phenomenon that may be inadequately comprehended and that other research methods cannot explore, uncover, or describe. The authors aimed to improve the accessibility and comprehensiveness of reporting guidelines for qualitative research. A comprehensive review of scientific articles was conducted on PubMed, Medline, CINAHL, and Embase, and it retrieved 1989 articles plus 13 more articles through the snowball method. After screening, 17 key articles were identified, which led to the development of Comprehensive Criteria for Reporting Qualitative Research that comprises 14 categories, offering key elements in an organized table. This novel guideline complements the two widely used guidelines, Consolidated Criteria for Reporting Qualitative Research and Standards for Reporting Qualitative Research, by including additional aspects like objectives, existing knowledge, rationale behind methodologies, conclusions, recommendations, and reference citations. The study responds to the rising need for improved qualitative research reporting guidelines in global health.

Incidental Findings of Bacterial Vaginosis and Other Infections in Papanicolaou Smears of HIV-infected and HIV-uninfected Adolescent Females in South Africa.

Bacterial vaginosis (BV) is a widely prevalent infection that is associated with a range of adverse outcomes. We compared the rates of incidentally identified BV and other cervico-vaginal infections on Papanicolaou (Pap) smears of HIV-infected and HIV-uninfected adolescent females in South Africa. Cervical specimens from 50 HIV-uninfected and 32 HIV-infected sexually active South African adolescent females age 17-21 were collected and analyzed in accordance with the Bethesda system. We found a high overall prevalence of BV (54.9%) in our cohort. While previous research has found an increased prevalence of BV among HIV-infected women, the difference in the prevalence of BV between our HIV-infected group (62.5%) and HIV-uninfected group (50.0%) was not found to be statistically significant. The high rate of BV in both of these groups has significant implications for their risk of HIV acquisition and/or transmission in addition to other associated risks of BV. Given that the Pap smear is specific in incidentally diagnosing BV, it may be utilized as a screening method for BV in the adolescent population.