Pregnant adolescents' lived experiences and coping strategies in peri-urban district in Southern Ghana.

BACKGROUND: Adolescence, a transition period from childhood to adulthood forms the foundation of health in later life. The adolescence period which should have been characterised by good health is often marred with life-threatening and irreparable consequences of public health concern. Teen pregnancy is problematic because it could jeopardise adolescents' safe transition to adulthood which does not only affect adolescents, but also their families, babies and society. There is ample evidence about the determinants and effects of teen pregnancy, but it is fragmented and incomplete, especially in Sub-Sahara Africa. This study presents pregnant adolescents' voices to explain significant gaps in understanding their lived experiences and coping strategies. METHODS: This narrative inquiry, involved in-depth interviews with 16 pregnant adolescents, who were recruited from a peri-urban district in Southern Ghana using purposive and snowball techniques in health facilities and communities respectively. The audio recorded interviews were transcribed verbatim and analysed manually using content analysis. RESULTS: Many pregnant adolescents are silent victims of a hash socio-economic environment, in which they experience significant financial deprivation, parental neglect and sexual abuse. Also, negative experiences of some adolescent girls such as scolding, flogging by parents, stigmatisation and rejection by peers and neighbors result in grieve, stress and contemplation of abortion and or suicide. However, adolescents did not consider abortion as the best option with regard to their pregnancy. Rather, family members provided adolescents with critical support as they devise strategies such as avoiding people, depending on God and praying to cope with their pregnancy. CONCLUSION: Adolescent pregnancy occurred through consensual sex, transactional sex and sexual abuse. While parents provide support, pregnant adolescents self-isolate, depend on God and pray to cope with pregnancy and drop out of school. We recommend that the Ministries of Education and Health, and law enforcement agencies should engage community leaders and members, religious groups, non-governmental organisations and other key stakeholders to develop interventions aimed at supporting girls to complete at least Senior High School. While doing this, it is also important to provide support to victims of sexual abuse and punish perpetrators accordingly.

Socioeconomic inequalities in access and use of skilled birth attendants during childbirth in Ghana: a decomposition analysis.

BACKGROUND: Equitable access to skilled birth attendance during delivery is vital for reducing global maternal deaths to 70 deaths per 100, 000 to achieve the Sustainable Development Goals (SDGs) by 2030. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequalities in access to skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assesses the socioeconomic inequalities in access and use of skilled birth attendants during delivery in Ghana. METHODS: Research was conducted through literature reviews and document reviews, and a secondary data analysis of the 2014 Ghana Demographic and Health Survey (GDHS), a nationally representative survey. A total of 1305 women aged 15-49 years, who had a live birth the year before to the survey in the presence of a skilled birth attendant were analysed using concentration indices and curves. The indices were further decomposed to identify the major socioeconomic factors contributing most to the inequalities. RESULTS: The results found that access to skilled birth attendants was more among women from rich households showing a pro-rich utilization. The decomposition analysis revealed that household wealth index, educational level of both mother and husband/partner, area of residence and mother's health insurance coverage were the major contributing factors to socioeconomic inequalities in accessing skilled birth attendants during child delivery among Ghanaian women. CONCLUSION: This study confirms that a mother's socioeconomic status is vital to reducing maternal deaths. Therefore, it is worthy to focus attention on policy interventions to reduce the observed inequalities as revealed in the study.

Practices of Adults in a Periurban Community of the Ho Municipality on Prevention of Hypertension.

BACKGROUND: Hypertension remains a rising health threat among developing countries and it is due to poor knowledge and lifestyles. Integrated knowledge and practices are central towards the control of hypertension, especially in the developing world. OBJECTIVES: This study assessed the practices of adults in a periurban community in the Ho Municipality of the Volta region on the prevention of hypertension. Methodology. A cross-sectional descriptive research design was carried out in a periurban community in the Volta region. Adults were recruited using a systematic sampling technique in the Ahoe community. Pretested questionnaires were used to collect information on sociodemographic, knowledge, and lifestyle practices regarding hypertension prevention. The data were entered into Microsoft excel 2013 spreadsheet, cleaned, and transported to the Statistical Package for Social Sciences (SPSS) version 22 software for analyses. The data were analysed using simple descriptive statistics. RESULTS: In this study, 49.3% explained that hypertension means the increased force of blood through the blood vessels as 90.8% indicated that taking antihypertensive medications can control hypertension. In describing the associated effects of hypertension, adults in the Ahoe community described the effects of hypertension as stroke (89.8%), heart attack (84.0%), diabetes (56.5%), and heart failure (82.3%). Also, 54.1% described hypertension as a lifelong disease while 55.8% indicated hypertension can be cured. Also, 92.2% identified exercising as an important factor in controlling hypertension as 32.7% use herbal preparations to control hypertension. Only 3.7% of adults in the Ahoe community were smokers and 54.5% smoked less than a year. The majority (61.6%) of the respondents did not drink alcohol as 69.7% engage in active exercises. CONCLUSION: Education on hypertension should be intensified, and emphasis should be laid on regular exercised and strict dietary restrictions that ensure reduction in hypertension risk. Healthcare authorities should engage hypertensive clients to desist from the intake of herbal medications whose actual composition has not been scientifically determined.

Factors Influencing Information and Communication Technology Knowledge and Use Among Nurse Managers in Selected Hospitals in the Volta Region of Ghana.

This study adopted a cross-sectional design to examine the factors that influence the use of information and communication technology among 108 nurse managers in selected hospitals in the Volta Region of Ghana. A self-administered questionnaire was used to gather data. A χ test of association identified sex (P < .0001), age (P < .0001), years of work experience (P < .0001), rank of the respondents (P < .0001), computer training (P < .0001), computer ownership (P < .0001), and previous use of computers before appointment as a unit manager (P < .0001) as the factors that significantly influenced the use of information and communication technology among nurse managers.

Effects of parents training on parents' knowledge and attitudes about adolescent sexuality in Accra Metropolis, Ghana.

BACKGROUND: Attitudes of parents about discussing sexuality issues with adolescents may or may not be influenced by their level of knowledge on such issues. This study seeks to examine parents' training and its effects on parent knowledge and attitudes about sexuality in Accra Metropolis, Ghana. METHODS: This was an intervention study consisting of 145 parents who were recruited through their wards from 12 public junior high schools in Accra Metropolis. Parents were randomized equally into intervention and control groups and the intervention group received a 4 weeks training on adolescent sexuality topics. At pre-intervention and 3 months after parent training, parents answered questions on knowledge and attitudes about adolescent sexuality. Changes in baseline and follow-up within and between groups were compared using the difference- in-difference model and logistic regression. RESULTS: The ages of the parents ranged from 26 to 63 years and 44.1% of them completed middle school. There were 69.9% and 59.7% mothers in the intervention and control groups respectively. At pre-intervention, 21.9% of parents in the intervention group had very good knowledge but this increased significantly to 60% three months after the training. Knowledge about sexuality increased to a lesser degree from 18.1% to 34.7% in the control group. Parents' positive attitudes towards adolescents' sexuality increased by 50% in the intervention group compared to 20% in the control group. There were significant differences in knowledge on adolescent sexuality as parents in the intervention group had a greater positive effect than parents in the control group (28.7%, p-value = <0.001). Regarding attitudes of parents towards allowing adolescents to use family planning services (FPS), there was a greater positive effect on parents in the intervention group compared to those in the control group (37.4%; p- value  = <0.001). Being part of the intervention group increased the odds of parent knowledge on adolescent sexuality by 16-fold (p-value = <0.001), whilst being in the intervention group increased the likelihood of parents' attitudes towards allowing adolescents to use FPS by four fold (p-value = 0.039). CONCLUSION: Training parents for a relatively short period of time can positively impact parents' knowledge and attitudes about adolescent sexuality. This may have beneficial effects on adolescent reproductive health.