The perspectives of caregivers and health service providers on barriers to clubfoot management in Puri-Urban health facility in Ghana.

Purpose: Clubfoot is a common disabling condition that is prevalent across all populations. Approximately, one out of 750 children globally suffers from clubfoot, and around 150,000 to 200,000 children are born with clubfoot every year with 80% of the cases occurring in developing countries. Clubfoot can result in mobility impairments when not properly managed and researchers have argued that understanding knowledge and perceptions are key components to early identification and effective management of clubfoot. The study explored the barriers to clubfoot management from the perspectives of caregivers and healthcare providers in Duayaw Nkwanta, Ghana. Methods: A total of 26 participants made up of 22 caregivers of children with clubfoot and six healthcare providers were purposively sampled for the study guided by a set of inclusion and exclusion criteria. Qualitative data were collected using a semi-structured interview guide through in-depth face-to-face interviews. Interviews were transcribed and analyzed thematically and presented as findings. Results: High cost of treatment, long travel distance, long hours spent at the treatment facility, non-availability of clubfoot treatment services, late reporting of clients for treatment, and non-compliance of parents/caregivers with treatment protocols were identified as the barriers to effective management of clubfoot. Conclusion: These findings have substantial implications for current interventions to effectively manage clubfoot in Ghana.

Factors associated with Covid-19 vaccine acceptance among persons with disabilities: A cross-sectional study in Ghana.

BACKGROUND: While COVID-19 has had a wide-ranging impact on individuals and societies, persons with disabilities are uniquely affected largely due to secondary health conditions and challenges in adhering to protective measures. However, research on COVID-19 and vaccine acceptance has primarily focused on the general population and healthcare workers but has specifically not targeted PwDs, who are more vulnerable within societies. Hence, this study assessed PwDs knowledge of COVID-19 and factors associated with COVID-19 vaccine acceptance. METHODS: A cross-sectional survey was conducted among PwDs in the Atwima Mponua District in the Ashanti Region of Ghana. Respondents were sampled systematically and data was collected using a structured questionnaire. The data were analyzed with STATA version 16.0. Descriptive analysis was done using means and proportions. The chi-square test and Logistic regression were used to assess Covid-19 vaccine acceptance among the respondents. RESULTS: 250 PwDs were recruited for the study. A higher proportion of the respondents were females, physically impaired, and between 30-50 years. The majority (74%) of the PwDs had average knowledge about Covid-19. Factors such as age, educational level and type of disability were significantly associated with PwDs' knowledge of COVID-19. The acceptance rate for COVID-19 among PwDs was 71.2%. Age, religion, knowledge of COVID-19, and educational level were significantly associated with Covid-19 vaccine acceptance. Persons with disabilities with low and average knowledge of COVID-19 were 95% and 65%, respectively, less likely to accept the vaccine compared to those with high knowledge of COVID-19 (AOR = 0.05, 95%CI: 0.01, 0.21; AOR = 0.35, 95%CI: 0.12, 1.03). Older people and those with higher education were more likely to accept the vaccine compared to younger people and those with no or less education. CONCLUSION: Persons with disabilities have average knowledge of COVID-19 and a greater percentage of them were willing to accept the vaccine. The study identified age, religion, knowledge of COVID-19, and educational level as contributing factors to their willingness to accept the COVID-19 vaccine. This suggest that PwDs will lean positive toward COVID-19 vaccine programs and as such, vaccination programs should target them.

The perception of healthcare workers of People with Disabilities presenting for care at peri-urban health facilities in Ghana.

Healthcare provider attitudes and perceptions of disability may influence the delivery of comprehensive quality care to patients with disabilities. The study was conducted to ascertain healthcare providers' perspectives on access to healthcare by disabled people in a peri-urban district of Ghana. We employed a qualitative approach and selected participants using the purposive sampling technique. Qualitative data were collected from 28 healthcare providers through face-to-face interviews using an interview guide. Data let thematic an alysis was employed to tease out the findings through categorisation and the main themes have been presented as findings with specific quotations to support them. We found that people with disabilities who visited healthcare facilities were perceived as individuals who are stressed up, selfish and inconsiderate, violent, having low self-esteem and also difficult to communicate with. This could affect the interactions between healthcare providers and people with disabilities who visit the facility and subsequently the quality of service provided. It is recommended that the Ministry of Education, Ministry of Health and the Ghana Health Service work closely with the various educational institutions to train healthcare professionals to improve their knowledge on disability issues to improve service delivery.

Personal factors that affect disabled people's access to healthcare in the Bosomtwe District of Ghana.

The health status and quality of life of disabled people are of immense public health concern and the Sustainable Development Goals cannot be achieved if the healthcare needs of disabled people are not met. A qualitative case study was conducted in the Bosomtwe District of Ghana to ascertain personal factors that affect disabled people's access to healthcare in the context of disability stigma. A total of 30 disabled participants were selected through purposive sampling, and data were collected through an interview guide utilizing a face-to-face interview and focus group discussion. Themes were developed and presented as findings and relevant quotes have been provided to support the findings. The study found factors such as self-stigma, knowledge about disability condition, financial challenges, location and accessibility challenges, communication challenges and lack of personal assistants which affect their access to healthcare. The experiences of disabled people have influenced them to construct their meanings regarding their conditions and subsequent health-seeking behavior. It is recommended that the district health directorate in collaboration with the National Commission for Civic Education should intensify public health education in the district which should be custom-made to suit the community's needs and understanding of disability taking into account local culture and belief system.

Effect of Community-Based Functional Aerobic Training on Motor Performance and Quality of Life of Children with Spastic Cerebral Palsy.

BACKGROUND: Efficacies of community-based exercise programmes have been well reported but there is scarce information on the expediency of community-based rehabilitation in a society where many of children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. The study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). METHODS: Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I - II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40-80% maximum heart rate. Gross motor function (GMF), walk distance and quality of life were assessed pre and post CBFAE training. RESULTS: Significant improvement observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking+running+jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in Pain and impact of disability (67.93%, P=.049) and Participation and physical health (60.00%, P=.042). CONCLUSION: CBFAE training contributes majorly to improved standing, walking, jumping and running and selfesteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances.

Effect of Community-Based Functional Aerobic Training on Motor Performance and Quality of Life of Children with Spastic Cerebral Palsy.

BACKGROUND: Efficacies of community-based exercise programmes have been well reported, but there is scarce information on the expediency of community-based rehabilitation in a society where many children with disabilities live in poorly resourced settings with extremely limited rehabilitative services. This study investigated the effects of community-based functional aerobic exercise (CBFAE) on gross motor function, walking distance, and quality of life of children with cerebral palsy (CP). METHODS: Quasi-experimental design was used. Children with gross motor function classification system (GMFCS) levels I - II participated in eight weeks CBFAE training four times/week, 50 minutes/day at 40-80% maximum heart rate. Gross motor function (GMF), walking distance and quality of life were assessed pre and post CBFAE training. RESULTS: Significant improvement was observed in GMF (Dstanding) (8.2%, P=.000), GMF (E-walking + running+ jumping (5.12%, P=.004), walking distance (6.09%, P=.009). Higher significant positive effects of CBFAE were observed in Social wellbeing and acceptance (107.10%, P=.000), and participation and physical health (105.04%, P=.005) by children parent proxy. Self-reported results showed that for CBFAE, significant positive improvements were higher in pain and impact of disability (67.93%, P=.049) and participation and physical health (60.00%, P=.042). CONCLUSION: CBFAE training contributes majorly to improved standing, walking, jumping and running and self-esteem, quality of life of children with spastic CP. Clinicians and exercise therapists should essentially incorporate CBFAE training and activities into the management of children with CP for improved mobility and functional performances.

Knowledge of HIV/AIDS among older adults (50 years and above) in a peri-urban setting: a descriptive cross-sectional study.

BACKGROUND: In the absence of vaccine or cure, public knowledge about Human Immune Virus (HIV) is a central tool for curbing HIV epidemic. This study sought to assess the knowledge of HIV among older adults (50 years and above) at the Methodist Faith Healing hospital, Ankaase, Ghana. METHODS: Using a descriptive study design, older adults (50 years and above) who visited the Ankaase Methodist Faith Healing hospital were randomly sampled for the study. A structured questionnaire was administered to collect data which was analyzed quantitatively using Statistical Package for Social Sciences (SPSS version 16.0). RESULTS: A total of 100 respondents who were aged 50 to 68 (54 ± 2.3) were recruited. Most of the respondents had average knowledge of the mode of HIV transmission (62%) as well as HIV prevention (58%) and signs and symptoms of HIV (60%). HIV status was significantly associated with HIV knowledge among older adults as HIV positive respondents were 2.25 times more knowledgeable in terms of signs and symptoms, mode of transmission and prevention of HIV [AOR (95% CI) 2.25(1.02-8.68)]. CONCLUSION: Most older adults (50 years and above) have average knowledge of the mode of transmission, prevention as well as signs and symptoms of HIV. The National Commission for Civic Education should collaborate with various key stakeholders to educate older adults on issues related to HIV/AIDS.

Biomarkers in heart failure: the past, current and future.

Despite the enhanced knowledge of the pathophysiology of heart failure (HF), it still remains a serious syndrome with substantial morbidity, mortality, and frequent hospitalizations. These are due to the current improvements in other cardiovascular diseases (like myocardial infarction), the aging population, and growing prevalence of comorbidities. Biomarker-guided management has brought a new dimension in prognostication, diagnosis, and therapy options. Following the recommendation of natriuretic peptides (B-type natriuretic peptide and N-terminal-proBNP), many other biomarkers have been thoroughly studied to reflect different pathophysiological processes (such as fibrosis, inflammation, myocardial injury, and remodeling) in HF and some of them (like cardiac troponins, soluble suppression of tumorigenesis-2, and galectin 3) have subsequently been recommended to aid in the diagnosis and prognostication in HF. Consequently, multi-marker approach has also been approved owing to the varied nature of HF syndrome. In this review, we discussed the guidelines available for HF biomarkers, procedures for evaluating novel markers, and the utilities of both emerging and established biomarkers for risk stratification, diagnosis, and management of HF in the clinics. We later looked at how the rapidly emerging field-OMICs, can help transform HF biomarkers discoveries and establishment.

Use and completion of partograph during labour is associated with a reduced incidence of birth asphyxia: a retrospective study at a peri-urban setting in Ghana.

BACKGROUND: Morbidity of birth asphyxia has been estimated to be 42 million disability-adjusted life years. The study sought to assess the impact of the use and completion of partograph during labour on reducing birth asphyxia at the St Anthony's Hospital, Dzodze, in the Volta Region of Ghana. METHODS: A retrospective study design using a quantitative approach was adopted for the study. A simple random sampling technique was used to select a total of 200 folders of labouring women who were admitted and delivered at St Anthony's Hospital, Dzodze, between 1st May 2015 and 30th April 2016. A structured checklist, which was developed by using labour and foetal monitoring parameters based on the standards of the World Health Organization partograph usage, was used to review all the 200 existing maternal records. RESULTS: The findings revealed that partographs were used by midwives at St Anthony's Hospital with the majority of the maternal folders fully completed. The use and completion of partograph were found to be associated with less non-asphyxiated birth outcomes. Labours which were monitored with partograph were 4.29 times less likely to result in birth asphyxia [AOR (95% CI) 4.29 (1.35-14.81)], and those that were monitored with a completed partograph were 5.3 times less likely to result in birth asphyxia [AOR (95% CI) 5.31 (2.011-16.04)]. CONCLUSION: Midwives used partographs during labour at St Anthony's Hospital. The use and completion of partograph were significantly associated with a reduced incidence of birth asphyxia at the hospital. Birth asphyxia could be reduced if partographs are used and completed by midwives during labour in all cases.

A qualitative assessment of perceived barriers to effective therapeutic communication among nurses and patients.

BACKGROUND: Therapeutic communication is essential in the provision of quality healthcare to patients. The purpose of this study was to explore the perceived barriers to effective therapeutic communication among patients and nurses at Komfo Anokye Teaching Hospital,Kumasi. METHODS: An exploratory study design was employed using a qualitative approach. A purposive sampling technique was used to select 13 nurses and patients who were interviewed using an unstructured interview guide. Interviews were audio-taped, transcribed verbatim and analyzed using thematic content analysis. RESULTS: Patient-related characteristics that were identified as barriers to effective therapeutic communication included socio-demographic characteristics, patient-nurse relationship, language, misconception, as well as pain. Nurse-related characteristics such as lack of knowledge, all-knowing attitude, work overload and dissatisfaction were also identified as barriers to effective therapeutic and environmental-related issues such as noisy environment, new to the hospital environment as well as unconducive environment were identified as barriers to effective therapeutic communication among patients and nurses at Komfo Anokye Teaching Hospital,Kumasi. CONCLUSION: Nurse-patient communication is an inseparable part of the patients' care in every health setting; it is one of the factors that determine the quality of care. Several patient-related characteristics, nurse- related characteristics and environmental-related issues pose as barriers to effective therapeutic communication at Komfo Anokye Teaching Hospital,Kumasi and have ultimately; resulted in reducing effective communication at the wards. Therefore, all the barriers must be eradicated to promote effective therapeutic communication.

Perception of childhood anaemia among mothers in Kumasi: a quantitative approach.

BACKGROUND: Anaemia is the world's second cause of disability and it affects over half of pre-school children in developing countries and at least 30-40% in industrial countries. In poorer malaria-endemic countries, anemia is one of the commonest preventable causes of death in children under 5 years. This study sought to determine the perceived causes, signs and symptoms as well prevention of childhood anaemia among mothers of children under 5 years in Kumasi, Ghana. METHODS: A descriptive hospital-based cross-sectional study design with a sample of 228 patients attending the University Hospital, KNUST was used. A simple random sampling technique was applied in sampling and a structured questionnaire was used to collect data which was analyzed using SPSS statistical tools. RESULTS: The study found that anemia was mostly perceived to be caused by poor feeding practices (43%) and fever (37%). The signs and symptoms mentioned mostly were pale conjunctiva (47%) and pale palm (44%). It was suggested that it could be prevented by giving adequate nutrition (23%), regular deworming (19%) as well as exclusive breastfeeding (25%). Mothers education and the number of children were found to be associated with the perception regarding anaemia as respondents who had completed SHS/A level were 5.14 times likely to have a higher knowledge score on Anaemia (AOR = 5.14; 95% CI; 1.01-21.8). Also, mothers who had 5 to 6 children were 1.65 times likely to have higher knowledge score on Anaemia (AOR = 1.65; 95% CI; 0.02-2.32). CONCLUSION: Previous experience with Anaemia and higher educational level results in better understanding of Anaemia. Therefore, extensive health education on anemia should be undertaken by the hospital authorities in collaboration with the Ministry of Health to improve knowledge of Anaemia.

Socio-demographic determinants of childhood immunization incompletion in Koforidua, Ghana.

OBJECTIVE: Immunization saves more than 3 million lives worldwide each year, and it saves millions from suffering illness and lifelong disability. The study sought to assess the socio-demographic factors that influence childhood immunization incompletion. A cross-sectional descriptive design was employed for the study conducted at the Child Welfare Clinic in the Regional Hospital, Koforidua. A total of 280 caregivers/mothers who have children aged between 0 and 59 months were included in this study. Data were entered and analyzed using SPSS. RESULTS: The study found that being divorced (p = 0.048) and working part-time (p = 0.049) has a significant and positive association with immunization incompletion. Women who were divorced [AOR (95% CI) 3.01 (1.59-58.2)] were 3 times less likely to complete immunization than those who were cohabiting, married and widowed taken into account the effect due to all the additional confounder variables included in the analysis. Women who were working part-time were 2.28 times less likely to complete immunization schedule than those working full-time; [AOR (95% CI) 2.28 (1.031-9.11)]. This study has documented socio-demographic factors influencing childhood immunization incompletion in the Regional Hospital, Koforidua. The Ministry of Health should, therefore, put in measures like public education to encourage mothers to complete each immunization schedule.

Knowledge of mental health legislation in Ghana: a case of the use of certificate of urgency in mental health care.

INTRODUCTION: Mental illness can affect anyone irrespective of race, gender or personal characteristics. The study sought to investigate health workers' Knowledge on Mental Health Legislation in Ghana focusing on the Certificate of Urgency. METHODS: A descriptive study design was employed for this study. The study population included medical doctors, physician assistants, and nurses/midwives. A simple random sampling technique was used to select 384 respondents for the study. Data was collected through the use of semi-structured questionnaires. RESULTS: Respondents who were psychiatrists were 9.56 times more knowledgeable in the use of Certificate of Urgency than those in other specialties like primary care, obstetrics and gynaecology, surgery and internal medicine; adjusted odds ratio (AOR) = 9.56 [95% confidence interval (CI) 1.57-65.2]. Respondents who had used the Certificate of Urgency before had 4.7 times more knowledge as compared to those who had not used it at all; adjusted odds ratio (AOR) = 4.77 [95% confidence interval (CI) 1.021-14.01]. CONCLUSION: Knowledge of Certificate of Urgency was generally low. Authorities of the various hospitals should organize regular in-service training to enlighten all healthcare workers on the legislation governing mental healthcare in Ghana.

Prevalence of postpartum depression and interventions utilized for its management.

INTRODUCTION: Postpartum depression is a mood disorder that affects approximately 10-15% of adult mothers yearly. This study sought to determine the prevalence of postpartum depression and interventions utilized for its management in a Health facility in Ghana. METHODS: A descriptive cross-sectional study design using a quantitative approach was used for the study. The study population included mothers and healthcare workers. Simple random sampling technique was used to select 257 mothers, while a convenience sampling technique was used to select 56 health workers for the study. A Patient Health Questionnaire was used to screen for depression and a structured questionnaire comprising closed-ended questions was used to collect primary data on the interventions for the management of postpartum depression. Data were analyzed using statistical software SPSS version 16.0. RESULTS: Postpartum depression was prevalent among 7% of all mothers selected. The severity ranged from minimal depression to severe depression. Psychosocial support proved to be the most effective intervention (p = 0.001) that has been used by the healthcare workers to reduce depressive symptoms. CONCLUSION: Postpartum depression is prevalent among mothers although at a lower rate and psychosocial support has been the most effective intervention in its management. Postpartum depression may affect socialization behaviors in children and the mother, and it may lead to thoughts of failure leading to deeper depression. Frequent screening exercises for postpartum depression should be organized by authorities of the hospitals in conjunction with the Ministry of Health.

The experiences of people with diabetes-related lower limb amputation at the Komfo Anokye Teaching Hospital (KATH) in Ghana.

OBJECTIVE: Lower limb amputation not only causes major disfigurement, but renders people less mobile and at risk of loss of independence. Yet with appropriate rehabilitation, many people can learn to walk or function again and live high quality lives. This study sought to explore the experiences of patients with diabetes-related lower limb amputation at the Komfo Anokye Teaching Hospital. An exploratory study design was adopted using a qualitative approach and a purposive sampling to select 10 participants for the study. A semi-structured interview guide was used with an in-depth face-to-face interview. The interview was tape-recorded with an audio recorder while notes were taken in addition to the audio recording. RESULTS: There were varying degrees of experiences ranging from physical as well as psychological and economic challenges. Amputees had to cope with playing entirely new roles after the amputation. They also experienced some economic challenges which were as a result of their inability to work. Some of the amputees consoled themselves with the fact that, despite their condition, they were better than other people. Others believed that whatever happened was Gods doing and nothing could be done about it. This self-consolation and the belief in God helped them to cope.

Perceived causes and risk factors of Buruli ulcer among patients at Agogo Presbyterian hospital in Ashanti Region of Ghana.

OBJECTIVE: The incidence of Buruli ulcer has been recorded in about 30 countries globally and Africa seems to be the most affected area. The study sought to determine perceived causes and risk factors of Buruli ulcer among patients who visit the Agogo hospital in Asante-Akim North District in the Ashanti region of Ghana. A descriptive study design was adopted using a simple random sampling technique to select 400 patients attending The Presbyterian Hospital at Agogo. Data was collected using a structured questionnaire and analysed using SPSS version 16.0. RESULTS: Buruli ulcer was perceived as a disease caused by witchcraft (38%), enemies (15%), as well as not pouring libation or praying (16%). Also, increased appetite (30%), oedema or swelling on the skin (29%) and over weight (23%) was perceived as signs and symptoms of Buruli ulcer and a section of the respondents (53%) did not know any risk factor. The age of respondents, gender and level of education were found to determine knowledge of Buruli ulcer (P ≤ .05). Public Educations and campaigns should focus on causes and risk factors to ensure that there is adequate knowledge among the general public on Buruli ulcer.

Psychosocial effects of infertility among couples attending St. Michael's Hospital, Jachie-Pramso in the Ashanti Region of Ghana.

OBJECTIVE: Infertility is a life crisis with a wide range of socio-cultural, emotional, physical and financial problems. This study sought to determine the psychosocial effects of infertility among couples attending St. Michael's hospital, Jachie-Pramso. A descriptive study design was adopted using a quantitative approach. A simple random technique was used to select 100 respondents and a structured closed ended questionnaire was administered to couples who visited the St. Michaels Hospital at Jachie-Pramso. RESULTS: The study has revealed that the social effects of infertility on couples included exclusion, verbal and physical abuse, divorce as well as stigma. There is high level of despondence among couples who are considered infertile. Reliance on family members for emotional support as well as avoidance of sensitive conversations was the main coping strategies adopted by the couples to cope with their conditions. Infertility has psychological, emotional and social consequences on individuals as well as couples. Families should support infertile individuals in every way that they can so that they will not be isolated.

Factors influencing the practice of exclusive breastfeeding among nursing mothers in a peri-urban district of Ghana.

BACKGROUND: Exclusive breastfeeding (EBF) is one of the optimal infant and young child feeding practices. Globally, <40% of infants under 6 months of age are exclusively breastfed. In Ghana, 63% of children <6 months are exclusively breastfed which is far less than the 100% recommended by the United Nation Children Emergency Fund. This study was carried out to find out the factors that influence the practice of exclusive breastfeeding in the district. METHODS: A cross-sectional quantitative study was conducted using structured questionnaires. A convenience sampling technique was employed to select 380 nursing mothers who attended postnatal care at the postnatal clinic in all the 13 health facilities with child welfare clinics (both public and private) and were available on the day of data collection. Data were analysed using frequency and CHISQ tables. RESULTS: There was a significant association between socio-demographic characteristics of mothers such as age (p = 0.129), religion (p = 0.035) type of employment (p = 0.005) and the practice of exclusive breastfeeding. Again, there was significant relationship between mothers' knowledge on EBF in terms of sources of information about EBF (p = 0.000), steps taken by mothers who perceived not to have breast milk (p = 0.000), some medical conditions of nursing mothers (p = 0.000) and the practice of EBF. CONCLUSION: Most nursing mothers use infant formula feeds as either supplement or substitute for breast milk based on their perception that breast milk may not be sufficient for the babies despite the high cost of these artificial milk. This puts the babies at a higher risk of compromised health and malnutrition which has the potential of increasing infant mortality. Most mothers are not practicing exclusive breastfeeding because their spouses and family members do not allow them.