Adolescent health and well-being check-up programme in three African cities (Y-Check): protocol for a multimethod, prospective, hybrid implementation-effectiveness study.

BACKGROUND: During adolescence, behaviours are initiated that will have substantial impacts on the individual's short-term and long-term health and well-being. However, adolescents rarely have regular contact with health services, and available services are not always appropriate for their needs. We co-developed with adolescents a health and well-being check-up programme (Y-Check). This paper describes the methods to evaluate the feasibility, acceptability, short-term effects and cost-effectiveness of Y-Check in three African cities. METHOD: This is a multi-country prospective intervention study, with a mixed-method process evaluation. The intervention involves screening, on-the-spot care and referral of adolescents through health and well-being check-up visits. In each city, 2000 adolescents will be recruited in schools or community venues. Adolescents will be followed-up at 4 months. The study will assess the effects of Y-Check on knowledge and behaviours, as well as clinical outcomes and costs. Process and economic evaluations will investigate acceptability, feasibility, uptake, fidelity and cost effectiveness. ETHICS AND DISSEMINATION: Approval has been received from the WHO (WHO/ERC Protocol ID Number ERC.0003778); Ghana Health Service (Protocol ID Number GHS-ERC: 027/07/22), the United Republic of Tanzania National Institute for Medical Research (Clearance No. NIMR/HQ/R.8a/Vol.IX/4199), the Medical Research Council of Zimbabwe (Approval Number MRCZ/A/2766) and the LSHTM (Approval Numbers 26 395 and 28312). Consent and disclosure are addressed in the paper. Results will be published in three country-specific peer-reviewed journal publications, and one multicountry publication; and disseminated through videos, briefs and webinars. Data will be placed into an open access repository. Data will be deidentified and anonymised. TRIAL REGISTRATION NUMBER: NCT06090006.

Women's sexual empowerment and utilization of long-acting reversible contraceptives in Ghana: evidence from the 2014 demographic and health survey.

BACKGROUND: Long-Acting Reversible Contraceptives (LARC) contribute significantly to a decline in unintended pregnancies globally. However, not much is known about women's sexual empowerment and their utilization of Long-Acting Reversible Contraceptives in Ghana. The main objective of this study was to examine the association between women's sexual empowerment and LARC utilization in Ghana. METHODS: We used data from 5116 sexually active women who participated in the 2014 Ghana Demographic and Health Survey. Women's sexual empowerment was defined as women's perception of their right to self-determination and equity in sexual relations, and their ability to express themselves in sexual decision-making. A sum of scores was created with four dichotomous items as sexual empowerment score (0 = low sexual empowerment; 1, 2, and 3 = medium sexual empowerment; and 4 = high sexual empowerment). Multivariable binary logistic regression analyses were performed to establish the association between women's sexual empowerment and the use of LARC. Pearson Chi-square test was used in data analysis. The results are presented as adjusted odds ratios (aOR), with their respective confidence intervals (CIs) at a statistical significance of p < 0.05. RESULTS: The prevalence of LARC utilization among sexually active women in Ghana was 6%. Majority of the women had medium sexual empowerment (91%). Although not statistically significant, the likelihood of utilizing LARC was lowest among women with high level of sexual empowerment (aOR = 0.62; CI = 0.27-1.43). On the other hand, Utilization of LARC increased with an increase in age. Women with parity four or more had higher odds of utilizing LARC as compared to women with zero birth (aOR = 9.31; CI = 3.55-24.39). Across religion, women who belong to the Traditional religion (aOR = 0.17; CI = 0.04-0.71) and Islam religion (aOR = 0.52; CI = 0.36-0.76) had lower odds of LARC utilisation as compared to Christian women. Women who make health decisions with someone else (aOR = 1.52; CI = 1.12-2.09) had higher odds of LARC utilisation as compared to women who make health decision alone. CONCLUSION: Age, health decision maker, parity and religion were found to have a significant relationship with LARC utilization. Specifically, uneducated women, unemployed women and women who practice traditional religion were less likely to utilise LARC. However, women's sexual empowerment did not have a significant relationship with LARC. There is therefore the need for planning interventions for LARC utilization in line with educating women on the benefits and potential side effects of LARC. Also, there is a need for interventions targeted at increasing access to LARC among sexually active women.

A Global Crowdsourcing Open Call to Improve Research Mentorship in Low- and Middle-Income Countries: A Mixed Methods Analysis.

Research mentoring programs are limited in many low- and middle-income countries (LMICs). The TDR Global initiated a global crowdsourcing open call soliciting proposals on how to improve research mentorship in LMICs. The purpose of this study is to examine ideas submitted to this open call to identify the ways to improve research mentorship in LMICs. Open calls have a group of individuals solve all or part of a problem and then share solutions. A WHO/TDR/SESH crowdsourcing guide was used to structure the open call. Each submission was judged by three independent individuals on a 1-10 scale. Textual submissions were extracted from eligible proposals and qualitatively analyzed via inductive and deductive coding techniques to identify themes. The open call received 123 submissions from 40 countries in Asia (49), Africa (38), Latin America (26), and Europe (10). Among all participants, 108 (87%) had research experience. A total of 21 submissions received a mean score of 7/10 or higher. Our thematic analysis identified three overarching themes related to prementoring, facilitation, and evaluation. Prementoring establishes mentor-mentee compatibility to lay foundations for mentorship. Facilitation involves iterative cycles of planning, communication, and skill improvement. Evaluation creates commitment and accountability within a framework of monitoring. This global crowdsourcing open call generated numerous mentorship ideas, including LMIC-contextualized facilitation tools. The open call demonstrates a need for greater focus on mentorship. Our data may inform the development of formal and informal mentoring programs in LMIC settings.

Participation and attitudes towards gambling in Ghanaian youth: an exploratory analysis of risk and protective factors.

PURPOSE: There is little information on youth gambling in Ghana even though there is an unprecedented emergence of various types of gambling and gambling venues throughout the country. The aim of this cross-sectional exploratory study was to examine the role of perceived social difficulties and perceived protective social factors in participation and attitudes of Ghanaian youth towards gambling using data from a school-based survey (n = 770). METHODS: Participants completed measures on perceived social difficulties, perceived protective social factors, attitudes towards gambling and participation in four types of gambling. RESULTS: Sports betting was the most common form of gambling. There were significant differences in gambling participation with males gambling more than females. Youth who reported more perceived social difficulties from family and friends had a more positive attitude and a negative attitude towards gambling, respectively. Youth who reported higher protective social factors from family and teachers were less likely to have a negative attitude towards gambling. In all situations, high frequency gambling resulted in a more positive attitude towards gambling. CONCLUSION: Perceived social difficulties influences Ghanaian youths to have a positive attitude towards gambling, however, protective social factors from family and teachers may help youth to have a negative attitude towards gambling, gamble less and consequently achieve academic success.

Parental involvement could mitigate the effects of physical activity and dietary habits on mental distress in Ghanaian youth.

INTRODUCTION: Parental involvement in physical activity and dietary habits have been found to play a substantial role in the mental health of young people. However, there is little evidence about the associations between parental involvement, health behaviours and mental health among Ghanaian youth. This study sought to examine the role of parental involvement in the association between physical activity, dietary habits and mental health among Ghanaian youth. METHODS: Data were obtained from the 2012 Ghana Global School-based Student Health Survey (GSHS). The study population consisted of 1,984 school going youth in high schools with a median age of 15 years old, (53.7%) males. Bivariate and multivariate logistic regression statistical models using complex samples method were performed. RESULTS: The prevalence of mental distress was 18.1%, 16.6% and 23% for loneliness, feeling worried and suicidal ideation respectively. Younger students were more likely to feel lonely, worried and have suicidal ideation than older students. Students from low socio-economic backgrounds were significantly more likely to report loneliness, worry and suicidal ideation. After adjusting for socio-demographic characteristics, some physical activity and eating habits were associated with experiencing loneliness, worry and suicidal ideation but after introducing parental involvement, there was a decrease in the likelihood of some health behaviour factors in both physical activity and dietary habits to be associated with loneliness, worry and suicidal ideation. CONCLUSION: Physical inactivity and poor dietary habits could have a negative effect on mental distress, however, parental involvement could mitigate the impact of these lifestyle habits on mental distress and should therefore be taken into consideration in efforts aimed at encouraging positive lifestyle habits for good mental health among Ghanaian youth.