Challenges and support experienced by family caregivers seeking antiretroviral therapy services for children living with HIV/AIDS: a phenomenological study in Ghana.

BACKGROUND: Family caregivers of children living with HIV/AIDS in most cases are found to be overwhelmed and under-resourced, yet they are believed to be the primary source of support for children living with HIV/AIDS. Family caregivers experience different challenges that affect their children's antiretroviral therapy (ART) adherence. AIM: This study explored the lived experiences of family caregivers of children living with HIV/AIDS who sought ART services for these children at the St Joseph's Hospital of Jirapa, Ghana. METHOD: Using a qualitative phenomenology design and a semistructured in-depth interview guide and using purposive sampling, data were gathered from 13 family caregivers of children living with HIV/AIDS receiving ART treatment at St Joseph's Hospital, Jirapa following ethical approval. All interviews were audio-taped and transcribed verbatim. Reflexive thematic analysis was used to analyse the transcribed data. FINDINGS: Six themes were generated: five challenges and one support. Family caregivers of children living with HIV/AIDS experienced: (1) Financial challenges, (2) Human-related challenges, (3) Challenges at HIV testing and counselling (HTC) centres, (4) Challenges with transportation, (5) Challenges in disclosing children's HIV status to them and (6) Support received from HTC and their family members. CONCLUSION AND RECOMMENDATION: Family caregivers of children living with HIV/AIDS experience daunting challenges in their quest to care for their children. Governmental and non-governmental HIV/AIDS programme support should include small business skills training and acquisition including capital to help set up small-scale businesses for such caregivers to reduce their financial challenges. Access to ART at clinics closer to caregivers is also key to promoting adherence. Family and community support has been recognised as key to enhancing ART adherence. Education of caregivers on policy regarding disclosure of the HIV/AIDS status of children, the need to work to reduce the time spent by caregivers at HTC, and ensuring privacy by limiting access to HTCs to only caregivers and their children, are important to enhancing adherence.

Factors Contributing to Malnutrition among Children Under 5 Years at St. Elizabeth Catholic Hospital, Ahafo Hwidiem.

Background: Nutrition among children under 5 plays an important role in the overall development of children physically and psychologically. Nutritional deficiencies and malnutrition generally affect children. In this study, we estimate the prevalence of 3 malnutrition indicators underweight, stunting and wasting and to assess factors associated with them. Objective: The main objective of the study was to assess the factors contributing to malnutrition among children under 5 years old. Design: The study employed a descriptive cross-sectional study design to assess the factors contributing to malnutrition among children under 5 years of age. Methods: This is quantitative cross-sectional facility-based study of 245 children aged 11 to 49 months. A structured questionnaire was used, and anthropometric measurements were taken to collect data. The Pearson chi-square test was used to assess the bivariate association between the outcomes and the characteristics. The binary logistic regression model was employed to estimate the crude and adjusted odds of malnutrition indicators among the characteristics observed in the study. Results: The prevalence of underweight, stunting, and wasting were 35.9, 13.9, and 33.9%, respectively. Underweight was significantly higher among females compared to males (42.0% vs. 24.1%) and highest among children aged 11 to 23 months (53.6%). Female children had 3 times more odds of being underweight (AOR: 3.09, 95% CI: 1.56-6.12). Compared to children aged 11 to 23 months, the odds of being underweight were less among children aged 24 to 35 months (AOR: 0.26, 95% CI: 0.13-0.51, P < .001), and 36 to 47 months (AOR: 0.9, 95% CI: 0.03-0.29, P < .001). Wasting was less prevalent among children aged 11 to 23 months (4.8%). Also, wasting was high among children aged 24 to 35 months (AOR: 27.41, 95% CI: 9.12-82.37, P < .001), 36 to 47 months (AOR: 28.23, 95% CI: 7.59-104.94, P < .001), and 48 to 59 months (AOR: 18.10, 95% CI: 3.04-107.76, P < .001). None of the observed factors were associated with stunting in the study. Conclusion: This study concludes that child malnutrition was high among under-five children. Promoting the use of healthy complementary feeding, preventing diarrheal diseases, and vaccinating children integrated with access to nutrition education programs are vital interventions to improve the nutritional status of children.

The birthing experiences of mothers with clinical healthcare professionals and community birth attendants in rural northern Ghana.

BACKGROUND: The use of non-professional birth attendants, such as untrained family members and traditional birth attendants, contributes to birth-related complications such as neonatal and maternal mortality. Strategies such as professionally conducted home births and placement of community health professionals close to homes to ensure easy access to skilled birth attendants aim to reduce complications. However, women in labour continue to access the services of unskilled birth attendants in developing settings. AIM: To explore the experiences of women in labour who received care from professional birth attendants and community birth attendants to understand the reasons for continued use of non-professional community birth attendants. METHODS: A qualitative approach was used to explore the birthing experiences of nine mothers, aged 20-45 years. In-depth face-to-face interviews were conducted to generate data with the help of an interview guide. A content analysis approach was used to organise and interpret the data. FINDINGS: The participants reported hostile interactions with professional birth attendants, imposition of birthing positions by professional birth attendants, high cost of birthing services by professional birth attendants, and safety risks with non-professional community birth attendants. CONCLUSION: There is a need for explicit health financing systems that ensure mothers are aware and adequately prepared for labour-related costs. Mothers wish to receive care from professional birth attendants, but feel compelled by negative experiences to choose family members and non-professional birth attendants instead. The adherence of health professionals to the fundamental principles of 'Respectful Maternity Care' could reduce their negative attitudes towards women in labour.

Family caregivers' experience of care with a child with cerebral palsy: the lived experiences and challenges of caregivers in a resource-limited setting in northern Ghana.

INTRODUCTION: Caring for a child with cerebral palsy may be more emotionally and physically exhausting than caring for a typical growing child. The family caregivers' perspective of this phenomenon needs exploring to facilitate the development of services. Our study explored the challenges family caregivers face with children with cerebral palsy in a resource-limited context in northern Ghana. METHODS: We conducted a qualitative study underpinned by phenomenological principles where it is believed that the reality of a phenomenon is tied to caregivers' perspectives of their own experiences. In this study, we unearthed caregivers' experiences/challenges from their own perspectives. The method of data analysis used was to allow the issues to emerge from the data (inductive process) using the content analysis approach. We recruited 13 caregivers of children with cerebral palsy from the physiotherapy unit at Tamale Teaching Hospital, and conducted individual in-depth interviews supported by an open-ended topic guide. Interviews were audio recorded, transcribed, and translated and coded inductively before conducting a content analysis of the data when grouped into themes. RESULTS: We have identified barriers to managing a child with cerebral palsy, including sociocultural barriers (values, attitudes and belief systems within society), economic challenges and immediate physical care burdens. Specific barriers included discrimination and isolation, lack of family and societal support, with poor access to health information and formal education. Others were lack of information on the cause and course of cerebral palsy, caregivers' loss of jobs, increased healthcare expenditure and struggles in lifting and moving children, which resonate with evidence-based multidimensional model of caregiving process and caregiver burden. CONCLUSION: Caregivers have the arduous task of caring for a child with cerebral palsy. Social support interventions and policy initiatives that seek to ameliorate caregivers' finances and make formal education accessible to this marginalised child population may be beneficial in this context.

Adverse events reported after first dose of SARS-CoV-2 vaccine in the Northern Region of Ghana.

AIM: The study examined the associated adverse events following SARS-CoV-2 vaccination among healthcare workers during the first dose of the vaccine in the Northern Region of Ghana. DESIGN: The study was a cross-sectional survey involving 463 healthcare workers. METHOD: The data were collected using a structured questionnaire. The data were analysed descriptively, and binary logistics was performed using SPSS version 25. RESULTS: The mean age was 33.4 ± 9.7 years, the majority (43.6%) being ≤30 years and males (57.2%). The self-reported prevalence of SARS-CoV-2 vaccine adverse events was 75.5%. Common systemic adverse events comprised headache (47.5%), dizziness (18.4%) and local adverse events included generalized body pains (44.0%) and abscess around the injection sites (11.2%). The study found a high prevalence of self-reported SARS-CoV-2 vaccine adverse events involving both systemic and local adverse events. Our study gives useful information that can be used for public health-targeted interventions to boost public confidence in SARS-CoV-2 vaccines.

Factors impacting on childhood nutrition: The experience of mothers in a rural Ghanaian community.

Despite globally recommended infant and young child feeding (IYCF) practices, inadequate Child feeding remains a global challenge and the root cause of undernutrition. Most mothers who primarily feed children in most developing settings appear to have received information on the IYCF practices. We explored mothers' limitations to provide children optimally in a rural Ghanaian community. We interviewed 42 family members, including parents and grandparents of thirty-two children under five years, from fifteen households using an ethnographic fieldwork approach. We observed and participated in food preparation and child feeding and interviewed religious leader, diviners. Households' decision-making arrangements, mothers, emerging roles and inconsistency of fathers' roles, competing sources of knowledge poverty, food insecurity and the nature of the community's social interactions and policing of women's child feeding practices are issues mothers have to navigate to feed children in the study community. Cultural custodians should be given child nutrition and providing information. Mothers should be empowered to manage child feeding and emerging roles.

Qualitative exploration of the challenges and the benefits of the nursing process in clinical practice: A study among registered nurses in a municipal hospital in Ghana.

AIM: This study aims to explore the challenges and benefits of using the nursing process in a Ghanaian Hospital. DESIGN: The study employed a qualitative descriptive design to explore the challenges and the benefits of the utilization of the nursing process. METHODS: Twelve (12) Registered Nurses were recruited for the study using purposive sampling. Recorded in-depth interviews were conducted and data were analysed using thematic analysis. RESULTS: The study found a low nurse-to-patient ratio, inadequate knowledge, apathy, inadequate logistics, poor supervision as challenges. However, quality and cost-effective care improved nurse-patient relationships, and job satisfaction was found to be the benefits of nursing process use. Interventions to improve its utilization should be targeted towards improving the nurse-to-patient ratio, provision of adequate resources and inclusion of the nursing care plan in patient folders.

Child feeding in rural northern Ghana: Carer's perceptions of food and their children's diets.

A child's diet should be composed of appropriate nutrients to achieve optimal nutritional status, and though there is a substantial evidence base for child feeding recommendations, developing countries continue to face challenges regarding optimal child feeding. This paper describes an ethnographic study undertaken in rural northern Ghana to explore community perceptions of what 'counts' as food for children and the impact this had on the nutrients they received. Fifteen households with children under 5 years were purposively selected. In-depth interviews were held with 25 mothers, 7 fathers and 8 grandparents within these households as well as 2 diviners. Participant observations were also undertaken. Findings show that satiety rather than nutrition was the key consideration in adult choices about a child's diet. The community regarded carbohydrate-based meals as food, but considered protein, vitamins and mineral-based foods as nonessential elements of a child's diet, and important sources of these nutrients were regarded as treats.