Interest Groups and COVID-19 in Africa (2019-2022).

The study highlights the crucial roles played by interest groups in shaping the definition and redefinition of policy issues related to the COVID-19 pandemic in Africa. The study focused on selected countries to discuss strategies that were deployed to combat the COVID quandary. The selected countries are Nigeria, Ghana, Kenya, Tanzania, South Africa, Zimbabwe, Egypt, and Tunisia. A purely qualitative research, it relied on existing literature sources to produce thematic analysis which explore the various strategies adopted by interest groups in addressing the COVID-19 pandemic in Africa. The study revealed the challenges posed by the COVID-19 pandemic to the already fragile healthcare system in Africa. Again, it revealed the innovative approaches such as herbal medicine and local production of ventilators developed by African countries to tackle COVID-19 including efforts of other interests groups like government agencies, private institutions and international organizations in the fight against COVID-19 in Africa.

Medicinal use of cannabis: A qualitative study of the perspectives of doctors and pharmacists from six African countries.

We conducted a qualitative study to examine the enablers and barriers influencing the implementation of medical cannabis from the perspectives of practicing doctors and pharmacists within the African context. Interviews were conducted to investigate medical professionals' perceptions and concerns regarding medicinal cannabis. Three major themes were identified: beliefs about consequences, optimism, and environmental resources and context. Depending on the context of use, medical professionals described cannabis as potentially useful as an adjunct medicine and yet problematic owing to knowledge and social barriers, particularly religion. Implementation strategies tailored to address structural and social concerns to providing optimal care are needed to ensure that medical professionals are well versed in policy and clinical aspects.

How do lifestyle choices affect the link between living alone and psychological distress in older age? Results from the AgeHeaPsyWel-HeaSeeB study.

BACKGROUND: Social isolation is widespread and strongly associated with worsening health-related outcomes across the life-course. Despite this broad base of knowledge, there is a paucity of research on the interactive effect of lifestyle choices and living arrangements on later life psychological state particularly in low- and middle-income settings. The aim of this study is to examine the influence of living alone on psychological distress in older people and to explore the protective roles of social participation and physical activity participation. METHODS: We used cross-sectional data from the 2016-17 Aging, Health, Psychological Well-being and Health-seeking Behavior Study (AgeHeaPsyWel-HeaSeeB) involving a representative sample of 1200 adults aged 50+ years in Ghana. The study focused on a latent measure of Kessler Psychological Distress Scale (K10) and on the General Practice Physical Activity Questionnaire (GPPAQ). Ordinary Least Squares (OLS) regression models evaluated the interactive effects of living arrangements and lifestyle choices on the K10 score. RESULTS: Living alone was independent predictor of psychological distress in the overall sample, among females, urban dwellers and all age groups. However, lifestyle choices of physical activity and social participation significantly moderated these associations. Moreover, in the stratified analysis, physical activity moderated the association for males, rural-dwellers and those 65+ years whilst social participation moderated the association for females, urban-dwellers and those 50-64 years. CONCLUSIONS: Lifestyle choices i.e. social participation and physical activity, and demographic factors i.e. age, gender, and residential status strongly attenuate the positive association of living alone with the risk of psychological distress in older age. These findings may inform intervention initiatives targeted at improving mental health of chronically detached and isolated older people.

Sociocultural hegemony, gendered identity, and use of traditional and complementary medicine in Ghana.

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p Ë‚ .0001), and have health insurance (p Ë‚ .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28-47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002-0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22-47.60), while females' TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21-11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78-17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.

Food insecurity and mobility difficulty in middle-aged and older adults: The importance of bio-psychosocial factors.

OBJECTIVE: Food insecurity has been associated with mobility difficulty (MD) in old age. However, there is a scarcity of research on this topic from low- and middle-income countries, while the bio-psychological factors underlying this association are largely unknown. We investigated the food insecurity-MD link in Ghana and explored how sleep, anxiety, loneliness, and physical activity (PA) mediate the association. METHODS: Community-based, representative cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behavior Study were analyzed (N = 1201; Mage = 66.5; women = 63%). MD was assessed with items from the SF-36 of the Medical Outcomes Study. We assessed food insecurity with items on hunger and breakfast-skipping frequency due to lack of food and resources. Adjusted OLS and mediation models via bootstrapping technique evaluated the associations. RESULTS: Results revealed the expected association between food insecurity and MD, such that greater food insecurity was significantly and positively associated with MD across paths (from ß = 0.33 to ß = 0.42, p < .001). Analyses of indirect effects showed that sleep problems (27.8%), anxiety (15.5%), loneliness (17.5%), and PA (18.0%) mediated the association between food insecurity and MD. Cross-level interactions revealed that food insecurity significantly modified the link between each mediator and MD. CONCLUSIONS: Our data provide novel evidence that bio-psychological mechanisms may underlie the food insecurity-MD link and should, therefore, be considered relevant targets for interventions to prevent/manage MD in later life.

The effect-modification of physical activity on the association of pain with impaired physical function in aging adults.

OBJECTIVES: Pain is prevalent among older adults and may result in impairment in physical function. However, little is known about the effect-modification of this relationship by physical activity (PA) participation. This large and representative study sought to estimate the effect of pain on physical function among older adults in Ghana and evaluate whether PA modifies this association. METHODS: Data came from 1201 adults aged ≥50 years participating in the AgeHeaPsyWel-HeaSeeB Study in Ghana. Pain constructs were defined using the Medical Outcomes Study Short Form-36 (MOS SF-36). PA was assessed using the International Physical Activity Questionnaire short form (IPAQ-SF) and physical function impairment was measured by seven-item domains based on the activities of daily living (ADL) and instrumental ADL (IADL). Adjusted hierarchical OLS regressions were fitted to estimate the direct and moderating relationships between pain facets, PA, and impaired physical function. RESULTS: The relationships of pain severity (ß = 0.348, p < .001), and pain interference (ß = 0.424, p < .001) with impaired physical function were robust after full adjustment for confounding variables. Persons with pain experiences had significantly increased impaired physical function risks. PA significantly modified the association between pain severity (ß = -0.232, p < .001) and pain interference (ß = -0.143, p < .001) with impaired physical function. CONCLUSIONS: Our data indicate that the relationships of pain with physical function impairment are modified by PA intensity. Future studies are warranted to understand the indirect effect of pain on functional limitations and how PA promotion could manage pain and improve functional ability in aging adults.

Association between physical activity participation and perceived social isolation at older ages: Do social participation, age and sex differences matter?

BACKGROUND: Physical inactivity is a major risk factor for poor health. However, it is unclear how physical activity (PA) is associated with perceived social isolation (PSI) in older age. This study aims to explore 1) association between PA and PSI among older people in Ghana and 2) if social participation (SP), age and sex modify any associations. METHODS: The study focused on 1,201 men and women aged ≥50 years in the AgeHeaPsyWel-HeaSeeB Study. Multivariate ordinary least squares (OLS) models were specified to estimate the regression coefficients and standard errors for the associations of PA and SP with PSI adjusting for potential confounders. RESULTS: Multivariate OLS regressions showed that engagement in SP (b = -0.442; SE = 0.140; p < 0.001) and regular PA (b = -0.338; SE = 0.152; p < 0.005) were independently associated with decreasing PSI. Also, SP modified the PA-PSI association such that resourceful SP reinforced the link between PA and PSI (b = -0.709; SE = 0.276; p < .005). Finding revealed sex (men: b= -0.712; SE = 0.266; p < 0.005; women: p = 0.083) and age differences (65+: b = -0.437; SE = 0.206; p < 0.005; 50-64: b = -0.502; SE = 0.252; p < 0.05) in the effect of PA on PSI. CONCLUSIONS: Findings provide insight into the importance of specific and combined effects of SP and PA on PSI in older age. Public health, clinical practice, and social policy efforts should target social healing and group PA interventions to improve older adults' emotional health.

The Capabilities of Nurses for Complementary and Traditional Medicine Integration in Africa.

OBJECTIVE: Despite the political commitment of national governments and collaborative efforts by the World Health Organization (WHO) toward the actualization of intercultural healthcare system over the past decades, sub-Saharan African countries feature medical cohabitation rather than a truly integrated medical system. This hospital-based cross-sectional study analyzed the capabilities of nurses for complementary and traditional medicine (CTM) integration in Africa. METHOD: Practicing nurses (n = 210) were recruited to respond to the CTM Health Belief Questionnaire (CHBQ) in December 2016. Normality of data was evaluated using Kolmogorov-Smirnov statistic with a Lilliefors significance correction. The authors assessed the relationship among nurses' knowledge, personal use, and clinical practice of CTM, using Spearman's Rank Order Correlation (rho). The differences and associations in continuous and categorical baseline variables were determined with Mann-Whitney U test/Kruskal-Wallis H test and Pearson's Chi-square test, respectively, at p < 0.05 as statistically significant. RESULTS: The overall mean score of nurses' knowledge of CTM therapies was 38 (interquartile range [IQR] 16). This low CTM-related knowledge reflected in the poor mean performance score of 30 (IQR 17) and 22 (IQR 6) for personal use and clinical practice of CTM, respectively, among nurses. Nurses, therefore, lacked the confidence to recommend CTM therapies to patients. Yet, nurses exhibited a high positive attitude to CTM (72.7 ± 12.5). In addition to significant associations among CTM-related knowledge, education (p = 0.023), and religion (p < 0.001), the study found a positive and statistically significant correlation among CTM-related knowledge, personal use (r = 0.556, p < 0.001), and professional practice of CTM (r = 0.349, p < 0.001). CONCLUSION: Given their substantial role in the primary and public healthcare system, improving nurses' knowledge of CTM through evidence-based nursing education and training remains the surest way to achieve appropriate CTM integration in Africa as outlined in the WHO Traditional Medicine Strategy 2014-2023.

Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare.

OBJECTIVE: The aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana. METHOD: Using convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p < 0.05. RESULTS: The mean score of nurses' knowledge on CAM therapies was low (mean ± SD, 38.39 ± 10.11; possible range, 18-72) which was built on nurses' personal experiences. Nurses, therefore, lacked the confidence to recommend CAM therapies to patients. Despite the isolated cases of non-herbal supplements, relaxation techniques, massage and prayer healing, the study found an overall low personal use of CAM (mean ± SD, 32.97 ± 10.78; possible range, 18-72) among nurses over the last 12 months. Yet, nurses exhibited a positive attitude towards CAM (mean ± SD, 72.7 ± 12.5, possible range, 67-110). We observed significant associations among nurses' CAM knowledge and education [χ2 (2) = 6.69, p = 0.035] and religion [χ2 (2) = 7.96, p = 0.019]; nurses' personal use of CAM and income [χ2 (2) = 16.07, p < 0.001] and religion [χ2 (2) = 18.65, p < 0.001]; and nurses' clinical CAM use and income [χ2 (2) = 7.01, p = 0.030]. CONCLUSION: Despite the overall positive attitude towards CAM therapies, Ghanaian nurses do not perceive themselves to have sufficient knowledge of CAM. Integrating CAM education into the nurses' training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana.

Nursing in Ghana: A Search for Florence Nightingale in an African City.

Nursing in Ghana is a crucial subject that permeates almost every issue in the society especially the field of hospital care. To a large extent, the frontiers of nursing have expanded since the time of Florence Nightingale. Globally some studies have been done to study nursing icons like her. The values in nursing practice however continue to preoccupy our minds. The need to accentuate the gains made by historical figures in nursing in present times as well as the nature of interactions between practitioners and patients continues to be of paramount concern to many across the globe and Ghana in particular. This study does an analysis of existing literature on Florence Nightingale and the nature of nursing in Ghana from the colonial times. Additionally, it analyzes responses concerning the activities of nurses and their interactions with patients in Kumasi. The varied information has been thematically pieced together to make inferences that are of great interest to nursing practitioners, policy makers, administrators, and educators among others. The findings to the study suggest among other things that the challenges faced by the nursing institution in modern times are similar to those of the earlier period. The study calls for the emulation of the positive ideas of Florence Nightingale to promote the interest of patients, a core objective championed by a revered nurse.