Oral health knowledge, practice and associated factors among Junior High School students of Koforidua, Ghana: a cross-sectional study.

BACKGROUND: Oral disease poses a significant public health burden for many countries and affects individuals throughout their lifetime, causing pain, disfigurement, impairment of function and reduced quality of life. Among children and adolescents globally, there is a recognized trend of poor oral hygiene, attributed to the accumulation of plaque and calculus deposits that increase with age. This study assessed the knowledge, practice and factors associated with the practice of oral hygiene among Junior High School students (JHS) in Koforidua, in the Eastern Region of Ghana. METHODS: A school-based cross-sectional study design was conducted among 233 JHS students in Koforidua township using a multistage sampling technique. Descriptive and inferential statistics, including frequency, percentage, and Pearson's Chi-square test, were conducted. The results were interpreted using tables and graphs. RESULTS: Findings from the study revealed that more than half 126 (54.1%) of the respondents had a good level of knowledge of oral hygiene. The majority 130 (55.8%) of them also had good oral hygiene practice. The findings further indicated that a significant relationship was found between the class or education level of students and good oral hygiene practice (χ2 = 17.36, p < 0.001). CONCLUSION: Overall, the current study found that over half of the JHS students had good knowledge as well as practice of oral hygiene. This reinforces the significance of oral health education and awareness campaigns, especially in school settings, to improve knowledge, attitudes, and behaviours related to oral hygiene. The study however found only class or education level of students to be statistically associated with the practice of oral hygiene. While other variables did not reach statistical significance, our research serves as a starting point for further investigation and exploration of the various factors that may contribute to oral hygiene practices.

Lay beliefs of COVID-19 vaccine refusal among intercity commercial drivers in the Volta region of Ghana: recommendations for improved vaccine uptake.

BACKGROUND: The COVID-19 vaccine has faced increased hesitancy in Ghana and the Volta region in particular since its rollout. Acceptance of the vaccine among intercity commercial drivers is crucial, especially in the Volta region, as they transport people within and outside the country and could fuel the transmission of the virus if not vaccinated. OBJECTIVE: We therefore established lay beliefs surrounding COVID-19 vaccine refusal among intercity commercial drivers in the Volta region of Ghana, as well as their recommendations for improved vaccine uptake. METHODS: We purposively interviewed twenty-five (25) intercity commercial drivers who had not been vaccinated for COVID-19 in the Volta region of Ghana using a semi-structured interview guide and analysed their responses thematically using the ATLAS.ti software. RESULTS: Various (ten) beliefs surrounding COVID-19 vaccine refusal were identified. These include the nonexistence of COVID-19, being immune to COVID-19, and the belief in the nonexistence of vaccines and vaccines being meant for the sick. Other beliefs identified were the belief that the COVID-19 vaccine is meant to reduce Africa's population, that the vaccine triggers other health complications leading to death, the belief that vaccination could cause financial loss, political mistrust, that the COVID-19 vaccine is not permitted by God, and the belief that prayer prevents COVID-19 infection. They also suggested that the adoption of persuasive communication techniques, the publication of information on those who died of COVID-19, providing evidence of tests conducted on the vaccine, testing people before vaccination, provision of care to those who may experience side effects from the vaccine, and being able to explain why varied vaccines are used for the same virus could help improve vaccine uptake. CONCLUSION: Our findings show that there is a general lack of understanding and mistrust surrounding the COVID-19 vaccine among intercity commercial drivers in the Volta region. Hence, health promotion officers and communicators in the region need to be knowledgeable on the vaccine as well as on the conspiracy theories thwarting its uptake to provide comprehensive education to the public and intercity commercial drivers to improve its uptake.

Factors associated with mental health of internal migrants (Kayayei) in Agbogbloshie-Ghana.

BACKGROUND: The United Nations (UN) Sustainable Development Goal (SDG) Eight (8) advocates for decent work and improved economic outcomes for all. However, internal migrant workers in Ghana, especially female head porters, commonly known as "Kayayei", work in exploitative and hazardous conditions exposing them to physical and mental health risks. Yet, mental health among this vulnerable group of migrants has not been given the needed attention it deserves in the country. We, therefore, examined the factors associated with mental health challenges among internal migrants (Kayayei) in Ghana. METHODS: A cross-sectional study among a systematic random sample of 352 Kayayei was conducted in Agbogbloshie-Accra, Ghana. An interviewer-administered questionnaire was used to collect data on the factors impacting the mental health of Kayayei. The study used binary logistic regression in predicting factors impacting mental health distress at a 0.05 level of significance and 95% confidence interval. RESULTS: The prevalence of depression, anxiety, and stress were, 305 (86.6%), 332 (94.4), and 149 (42.4), respectively, with 147(41.1%) of respondents having all three mental health issues. The difficult nature of work significantly predicted depression, anxiety, and stress. Respondents who perceived their work as very difficult were 4.3 times, (aOR = 4.36, 95% CI = 2.17, 8.76, p = < 0.001), 3.66 times (aOR = 3.66, 95% CI = 1.37, 9.76, p = 0.009), and 1.73 times (aOR, = 1.73, 95% CI = 1.04, 2.85, p = < 0.009) more likely to be depressed, anxious, and stressed respectfully as compared to those who rate their work as just difficult. CONCLUSION: The majority of the Kayayei suffered from mental health distress (depression, anxiety, and Stress) due to their work circumstances. This study suggests that the Ghana Labour Commission must extend the Labour Act 2003(Act 651) to cover the informal sector and create awareness among the Kayayei community to know their rights and report any abuse to law enforcement agencies. It is also suggested that the government, NGOs, and other benevolent organisations train the Kayayei to attain alternative and sustained livelihoods that will not negatively impact their mental health as has been found in the current study. Finally, the government should fully implement the 2012 Mental Health Act to increase awareness and access to quality mental health care.

Prevalence and predictors of depression, anxiety, and stress among adults in Ghana: A community-based cross-sectional study.

INTRODUCTION: Over the past two decades, there have been several global interventions including the Sustainable Development Goals (SDGs), aimed at improving health outcomes. Despite efforts by countries to achieve the SDG targets, mental health challenges remain major public health concerns globally. We examined the prevalence and predictors of depression, anxiety, and stress as well as the comorbidities of these mental health issues among adults. MATERIALS AND METHODS: This was a community-based cross-sectional study conducted among 2456 adults in four districts of the Volta Region of Ghana using data from the UHAS-Yonsei University Partnership Project. We analysed the data using frequency, percentage, mean, standard deviation, correlation, and binary logistic regression. RESULTS: Overall, 51.8% of the participants had at least one of the mental health issues examined. The prevalence of a mental health issue was 25.2%, 53.3%, and 9.7% for depression, anxiety, and stress respectively. Participants constituting 8.3% experienced all three mental health issues as comorbidities. Participants' level of formal education and income significantly predicted depression, anxiety, and stress respectively at the multivariable level. Adults with a tertiary level of education were, for instance, 68% (AOR = 0.32, 95%CI = 0.15-0.66), 65% (AOR = 0.35, 95%CI = 0.17-0.73), and 50% (AOR = 0.50, 95%CI = 0.33-0.76) less likely to experience depression, anxiety, and stress, respectively compared with those who had no formal education. CONCLUSION: The majority of our study participants either experienced depression, anxiety, or stress. There were quite high comorbidities of the mental health issues among the adult population. To accelerate progress towards the achievement of SDG 3.4 target of promoting mental health and wellbeing for all by the year 2030, there is a need for effective implementation of the country's 2012 Mental Health Act which makes provisions for the establishment of a Mental Health Fund. This could improve the financial circumstances of indigenes as income has been realised in the present study as an important factor influencing depression, anxiety, and stress among the adult population.

Community utilisation and satisfaction with the community-based health planning and services initiative in Ghana: a comparative study in two system learning districts of the CHPS+ project.

BACKGROUND: To strengthen the implementation of the Community-based Health Planning and Services (CHPS) programme which is Ghana's key primary health care delivery strategy, the CHPS+ Project was initiated in 2017. We examined community utilisation and satisfaction with CHPS services in two System Learning Districts (SLDs) of the project. METHODS: This community-based descriptive study was conducted in the Nkwanta South Municipality and Central Tongu District of Ghana. Data were collected from 1008 adults and analysed using frequency, percentage, chi-square, and logistic regression models. RESULTS: While the level of utilisation of CHPS services was 65.2%, satisfaction was 46.1%. Utilisation was 76.7% in Nkwanta South and 53.8% in Central Tongu. Satisfaction was also 55.2% in Nkwanta South and 37.1% in Central Tongu. Community members in Nkwanta South were more likely to utilise (AOR = 3.17, 95%CI = 3.98-9.76) and be satisfied (AOR = 2.77, 95%CI = 1.56-4.90) with CHPS services than those in Central Tongu. Females were more likely to utilise (AOR = 1.75, 95%CI = 1.27-2.39) but less likely to be satisfied [AOR = 0.47, 95%CI = 0.25-0.90] with CHPS services than males. Even though subscription to the National Health Insurance Scheme (NHIS) was just 46.3%, NHIS subscribers were more likely to utilise (AOR = 1.51, 95%CI = 1.22-2.03) and be satisfied (AOR = 1.45, 95%CI = 0.53-1.68) with CHPS services than non-subscribers. CONCLUSION: Ghana may not be able to achieve the goal of universal health coverage (UHC) by the year 2030 if current levels of utilisation and satisfaction with CHPS services persist. To accelerate progress towards the achievement of UHC with CHPS as the vehicle through which primary health care is delivered, there should be increased public education by the Ghana Health Service (GHS) on the CHPS concept to increase utilisation. Service quality should also be improved by the GHS and other stakeholders in Ghana's health industry to increase satisfaction with CHPS services. The GHS and the National Health Insurance Authority (NHIA) should also institute innovative strategies to increase subscription to the NHIS since it has implications for CHPS service utilisation and satisfaction.

Volunteer responsibilities, motivations and challenges in implementation of the community-based health planning and services (CHPS) initiative in Ghana: qualitative evidence from two systems learning districts of the CHPS+ project.

BACKGROUND: Community volunteerism is essential in the implementation of the Community-based Health Planning and Services (CHPS) in Ghana. We explored the responsibilities, motivations and challenges of community health management committees (CHMCs) in two CHPS+ Project districts in Ghana. METHODS: We used a qualitative approach to collect data through 4 focus group discussions among a purposive sample of community health volunteers in December 2018 and analysed them thematically. RESULTS: Community health management committees (CHMCs) were found to provide support in running the CHPS programme through resource mobilisation, monitoring of logistics, assisting the Community Health Officers (CHO) in the planning of CHPS activities, and the resolution of conflicts between CHOs and community members. The value, understanding and protective functions were the key motivations for serving on CHMCs. Financial, logistical and telecommunication challenges, lack of recognition and cooperation from community members, lack of motivation and lack of regular skill development training programmes for CHMC members who serve as traditional birth attendants (TBAs) were major challenges in CHMC volunteerism. CONCLUSION: Community health volunteerism needs to be prioritised by the Ghana Health Service and other health sector stakeholders to make it attractive for members to give off their best in the discharge of their responsibilities.

Community-Based Health Planning and Services Plus programme in Ghana: A qualitative study with stakeholders in two Systems Learning Districts on improving the implementation of primary health care.

BACKGROUND: In 1999, Ghana introduced the Community-Based Health Planning and Services (CHPS) as the key primary health care strategy. In this study, we explored the challenges, capacity development priorities, and stakeholder perspectives on improving the CHPS concept as it has been fraught with a myriad of challenges since its inception. Our study is the outcome of the national programme for strengthening the implementation of CHPS Initiative in Ghana (CHPS+) introduced in 2017. METHODS: This exploratory research was a qualitative study conducted in two Systems Learning Districts (SLDs) of CHPS+ in the Volta Region of Ghana from March to May, 2018. Four focus group discussions and two general discussions were conducted among 60 CHPS+ stakeholders made up of health workers and community members. Data analyses were conducted using conceptual content analysis. Statements of the participants were presented as quotes to substantiate the views expressed. RESULTS: Negative attitude, high attrition, inadequacy and unavailability of health professionals at post when needed were challenges associated with the health professionals. Late referrals, lack of proper community entry and engagement, non-availability of essential logistics, distance of CHPS compounds from communities, and inadequate funding were challenges associated with the health system. Lack of community ownership of the CHPS programme, lack of security at CHPS compounds, and late reporting of cases by the community members were also realised as challenges emanating from the community members. Priority areas for capacity development of health workers identified included logistics management, community entry and engagement, emergency delivery, managing referrals at the CHPS level, and resuscitation of newborns. CONCLUSION: Health-worker, community, and health systems-based challenges inhibit the implementation of CHPS in Ghana. Capacity development of health professionals and continuous community engagement are avenues that can improve implementation of the programme.

University students' alcohol use behaviour and self-efficacy to abstain from alcohol use: data from Ghana.

OBJECTIVES: The university students' alcohol use behaviour and alcohol use self-efficacy data were collected among Ghanaian university students. This survey had two main objectives: (a) to examine the factorial validity, structure, and reliability of the 20-item alcohol abstinence self-efficacy scale among undergraduate students and (b) to examine the role of alcohol abstinence self-efficacy in the pros and cons of alcohol use. These two objectives have been published as separate research articles without the data (including data management) that were used for analyses. As the data are not already available as part of these published papers, this data note provides a composite and integrated data grounded on these published research articles with detailed information on the instruments used to collect data, raw data in statistical software, managed/coded data in statistical software, and generated correlation matrix used to perform complex analysis. DATA DESCRIPTION: The data includes information on two major dimensions: (a) alcohol abstinence self-efficacy-negative affect, social interactions and positive states, physical pain/illness, and alcohol craving (thoughts about using) and (b) decisional balance-measuring the benefits (pros) of alcohol use and the costs (cons) of alcohol use. In addition, data were collected on socio-demographic characteristics of students including their age, sex, level/year in school, stream of study, place of residence and religious affiliation. The data collected is more representative of students in private universities.

Community Contribution to Tuberculosis Care in the Krachi West District of Ghana: A Qualitative Study.

BACKGROUND: Eradicating tuberculosis (TB) is one of the targets of the recently constituted Sustainable Development Goal (SDG) Three. In the light of limitations inherent in prevailing tuberculosis care and the global urgency to improve TB care, decentralising TB care beyond health facilities by harnessing the contribution of communities is essential in ensuring effective tuberculosis care. In this paper, we explored community contribution to TB care in the Krachi West District of Ghana. METHODS: In this qualitative study, 24 TB stakeholders made up of 7 health workers, 9 tuberculosis patients, 4 community health volunteers, 2 treatment supporters, and 2 opinion leaders were interviewed. Data collected were analysed manually, but thematically. Statements of the participants were presented as quotes to substantiate issues discussed. RESULTS: Community contribution to TB care was low. Most of the community members were not aware of any community level activity towards tuberculosis care. Though patients were mainly the ones responsible for the selection of their treatment supporters, there were instances where health workers selected supporters for them without their consent. Some treatment supporters were also not given any education concerning their roles in supporting their patients, resulting in some patients defaulting treatment and others taking their medications wrongfully. CONCLUSION: Our study revealed low community involvement in tuberculosis care in the Krachi West District of Ghana. Community sensitisation on the World Health Organisation's Directly Observed Treatment Strategy (which Ghana adopted in 1994) to increase community involvement in tuberculosis activities is, therefore, recommended.

Involvement of Male Partners in Skilled Birth Care in the North Dayi District, Ghana.

BACKGROUND: With more than half of the global maternal deaths occurring in sub-Saharan Africa, skilled attendance during childbirth is essential in achieving safer births and lower maternal mortalities. Given that societal ascriptions of gender roles strongly influence the utilisation of skilled care by women, male partner involvement in skilled birth is essential. We explored male partner involvement in skilled birth at the North Dayi District of Ghana. METHODS: This qualitative study interviewed 14 mothers and their male partners, together with two health professionals. The participants were purposively recruited using in-depth interviews. Data collected were analysed manually, but thematically. RESULT: Male partners had inadequate knowledge of childbirth and the skilled birth process as well as possible complications arising during delivery. Even though the male partners demonstrated positive perception towards skilled birth and their involvement in the process, their actual involvement in skilled birth care was generally low. Factors which inhibited most of the male partners from getting involved in skilled birth care were health facility nonconduciveness and occupation. However, motivations to do so were marital commitment and sense of responsibility, past experience, nearness to health facility, and safety and survival of partner and baby. CONCLUSION: These findings imply that Ghana may not be able to meet the Sustainable Development Goal Three target of reducing its maternal mortality ratio from 216 to below 70 per 100,000 live births by 2030. Stakeholders in Ghana's health industry need to develop male accommodating skilled birth policies and approaches to promote male involvement in skilled birth care.

Prevalence and associated risk factors of anaemia among women attending antenatal and post-natal clinics at a public health facility in Ghana.

BACKGROUND: Anaemia among pregnant women and post-partum mothers is a public health challenge in Ghana, especially in the Volta Region. While literature abounds on anaemia among pregnant women, the same cannot be said for anaemia among post-partum mothers in the region. This study, therefore, examined the prevalence and associated risk factors of anaemia among women attending antenatal care and post-natal care. METHODS: This descriptive cross-sectional survey recruited 409 pregnant women and 194 post-natal mothers attending antenatal and post-natal care, at the Hohoe Municipal Hospital. Background characteristics were collected using a semi-structured questionnaire, blood samples were analysed for the presence of anaemia and malaria parasitaemia and folders were reviewed for estimated blood loss. RESULTS: We found the prevalence of anaemia among pregnant women and post-partum mothers to be 33 and 16% respectively. Higher malaria parasitaemia (2%) was found in pregnant women compared with postpartum mothers (1%). We found that 4% of post-partum mothers had abnormal blood loss (301mls-500mls) whereas 5% of them had postpartum haemorrhage (>500mls) during child birth. A univariate logistics regression of anaemia status on some risk factors in pregnant women showed no significant association between anaemia and any of the risk factors. Among post-partum mothers, only mothers' age was statistically significant in the univariate analysis [COR = 0.27 (95% CI:0.103, 0.72);0.008]. Mothers aged 20-29 were 73% less likely to be anaemic. CONCLUSION: The prevalence of anaemia among pregnant women found in this study points to a situation of moderate public health problem according to WHO cut-off values for the public health significance of anaemia. Strategies should therefore be put in place to encourage thorough health education and promotion programmes among both pregnant and post-partum women.

Highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon.

INTRODUCTION: Cameroon has a high prevalence of out-of-school youths. Therefore, research relating to out-of-school youths and HIV/AIDS is imperative, since they might engage in high risk sexual behaviours. The current study investigated the highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon. METHODS: A cross-sectional design was adopted using a self-administered questionnaire to collect data from a cluster sample of 405 out-of-school youths, aged 15-24 years. Statistics was calculated using SPSS version 20 at the level 0.05. RESULTS: By age less than 16 years, more females, 90.2% than males, 71.8% had experienced sex (p < 0.001); more females, 40.4% than males, 23.2% used condoms during first sex (p < 0.01); more males, 70.8% than females, 46.0% had multiple sequential sexual partners during the last one year prior to this study (p < 0.001); more males, 42.6% than females, 18.0% had multiple concurrent sexual partners during the study period (p < 0.01); more youths who did not belong to a well-defined social network, 80.8% had experienced sex than those who belonged, 55.8% (p < 0.001); more youths who did not belong to a well-defined social network had multiple sequential sexual partners, 46.7% than those who belonged, 32.3% (p < 0.01); more youths who belonged to a well-defined social network, 24.3% used condoms consistently than those who did not belong, 15.4% (p < 0.01). CONCLUSION: Sexual risk behaviours exist among out-of-school youths in urban Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change especially among those with low socioeconomic status. Youths should be encouraged to join well-defined social networks.

The Ubuntu concept, sexual behaviours and stigmatisation of persons living with HIV in Africa: A review article.

Stigma and discrimination and risky sexual behaviours have been major stumbling blocks to the efforts by implementers to mitigate the effects of HIV amongst communities in Africa. A key cultural resource, based on evolving South African cultural traditions, is the notion of Ubuntu, which is grounded in respect, ethics, humanity and the interconnectedness of beings. This concept can be a useful resource in upholding confidentiality, a central requirement in research ethics and the deliverance of health promotion interventions regarding HIV/AIDS. This article explored the applicability of the Ubuntu concept in enhancing safe sexual practices and positive attitudes towards persons living with HIV, with the view of achieving Zero new infections, Zero discrimination against persons living with HIV (PLHIV), and Zero AIDS-related deaths. A review of literature was undertaken. Electronic databases, academic journals and books from various sources were accessed. Several key search terms relating to the tenets of Ubuntu, stigma and discrimination towards PLHIV, and sexual behaviours were used. Only references deemed useful from relevant texts and journal articles were included. Going therefore by the Ubuntu tradition of basic respect and compassion for others, one will expect positive attitudes towards PLHIV. This review therefore advocates positive attitudes towards PLHIV. Also, according to the Ubuntu tradition that prescribes a rule of conduct and social ethics, one would expect the sexual behaviours of youths in Africa to be good. This review article also advocates safe sexual behaviours of adolescents in Africa. With this in mind, from a critical Ubuntu-centric philosophical perspective, this article breaks new ground by advocating the use of the Ubuntu concepts in enhancing safe sexual practices and positive attitudes towards PLHIV in Africa. This could in turn bring about safe sexual practices among youths, and curb the discrimination and stigmatization against PLHIV in Africa.

Assessing alcohol abstinence self-efficacy in undergraduate students: psychometric evaluation of the alcohol abstinence self-efficacy scale.

BACKGROUND: Alcohol use is a major public health concern with respect to its impact on youth morbidity and mortality. Self-efficacy to abstain from alcohol use in young people is an important prevention and intervention strategy in future alcohol dependence. However, research on the assessment of self-efficacy to abstain from alcohol use among undergraduate students is almost non-existent in Ghana, apparently due to the unavailability of a standardised testing instrument. The purpose of this study was to examine the factor validity, structure, and reliability of the 20-item Alcohol Abstinence Self-efficacy Scale (AASES) in undergraduate students in Ghana. FINDINGS: Two hundred and fifteen undergraduate students studying in a private university with a mean age of 23.5 years participated in the study by completing the AASES. Results of a confirmatory factor analysis showed that the data did not fit the initial four-factor AASES model. Subsequent exploratory factor analysis showed that the AASES is a unidimensional construct (in the total sample and a subsample of drinkers), contrary to findings found in western cultures. The AASES also had a high Cronbach's alpha. Although the AASES was unidimensional in this study, each of the original four-factor model also had high and acceptable Cronbach's alpha. CONCLUSION: The original AASES structure was not confirmed in this study but a unidimensional factor was found suggesting that the AASES could be used as an instrument for assessing alcohol abstinence self-efficacy in undergraduate students in Ghana, although further validation research is needed in larger as well as in different samples.