Hesitancy towards R21/Matrix-M malaria vaccine among Ghanaian parents and attitudes towards immunizing non-eligible children: a cross-sectional survey.

BACKGROUND: The newly developed malaria vaccine called "R21/Matrix-M malaria vaccine" showed a high safety and efficacy level, and Ghana is the first country to approve this new vaccine. The present study aimed to evaluate the rate of vaccine hesitancy (VH) towards the newly developed malaria vaccine among parents who currently have children who are not eligible for the vaccine but may be eligible in the near future. Additionally, the study aimed to identify the factors that could potentially influence VH. METHODS: A cross-sectional survey using both online-based questionnaires and face-to-face interviews was conducted in Ghana from June to August 2023. The survey specifically targeted parents of ineligible children for vaccination, including those aged less than 5 months or between 3 and 12 years. The Parent Attitudes about Childhood Vaccination (PACV) scale was used to assess parental VH. RESULTS: A total of 765 people participated in this study. Their median age was 36.0 years with an interquartile range of 31.0-41.0 years, 67.7% were females, 41.8% completed their tertiary education, 63.3% were married, 81.6% worked in non-healthcare sectors, and 59.7% reported that their monthly income was insufficient. About one-third (34.5%) of the parents were hesitant to give their children the R21/Matrix-M malaria vaccine. The following predictors were associated with VH: working in the healthcare sector (adjusted odds ratio (AOR) = 0.50; 95% confidence interval (CI) 0.30-0.80; p = 0.005), having the other parent working in the healthcare sector (AOR = 0.54; 95% CI 0.30-0.94; p = 0.034), and not taking scheduled routine vaccinations (AOR = 1.90; 95% CI 1.27-2.84; p = 0.002). CONCLUSIONS: Addressing VH is crucial for optimizing R21/Matrix-M vaccine coverage in Ghana's malaria control strategy. By tackling VH issues, Ghana can effectively safeguard children's health in malaria-prone areas.

Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census.

BACKGROUND: Although there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana. METHODS: The 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance. RESULTS: The results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70-79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition. CONCLUSIONS: The results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.

Loneliness and risky behaviours among mobile fishers in Elmina, Ghana: a convergent parallel mixed-method study.

BACKGROUND: Loneliness affects individuals of all age groups, and mobile fishers are susceptible to loneliness due to the nature of their occupation. However, there is no study examining loneliness and risky behaviours among fishers in Ghana. Therefore, the purpose of this study was to examine fishers' mobility history, prevalence of loneliness, predictors of loneliness, effects of loneliness on fishers, coping strategies to address loneliness, and prevalence of risky behaviour among fishers in Elmina, Ghana. METHODS: This is a convergent parallel mixed-method study involving 385 fishers in Elmina. A questionnaire and interview guides were used to collect data from respondents. Descriptive statistics, Pearson's chi-square and Fisher exact tests, and binary logistic regression were used to analyse the quantitative data, while the qualitative data were analysed thematically. RESULTS: From the quantitative findings, most fishers were mobile (54.5%) and travelled alone (45.7%). Approximately 83% of the fishers experienced loneliness. Male fishers (AOR = 0.049; 95% CI = 0.003-0.741; p-value = 0.030), fishers affiliated with the African Traditionalist religion (AOR = 0.043; 95% CI = 0.002-0.846; p-value = 0.038), and fishers who travelled with their working colleagues (AOR = 0.002; 95% CI = 0.000-0.023; p-value = ≤ 0.001), were less likely to be experience loneliness. Feeling bored, isolated and worried/anxious were the main perceived effects of loneliness. Alcohol consumption and finding a companion to spend time with were the main strategies fishers used to cope with their loneliness. Most male fishers consumed alcohol (92.5%; p-value = ≤ 0.001) and spent time with companions (73.5%; p-value = ≤ 0.001) to cope with their loneliness. The quantitative and qualitative findings showed that fishers engaged in risky behaviours (excessive alcohol consumption, casual sex, and smoking marijuana and tobacco). From the quantitative findings, more male fishers engaged in excessive alcohol consumption (97.6% vs. 74.5%; p-value = ≤ 0.001), casual sex (88.2% vs. 61.7%, p-value = ≤ 0.001), smoking marijuana (43.0% vs. 13.0%, p-value = ≤ 0.001) and tobacco (49.4% vs. 19.1%; p-value = 0.001) than female fishers. CONCLUSIONS: Loneliness and risky behaviours were common among fishers. Therefore, there is an urgent need to design interventions to help reduce loneliness and risky behaviour among fishers.

Comprehensive knowledge about HIV/AIDS and associated factors among reproductive age women in Liberia.

INTRODUCTION: Acquired Immune Deficiency Syndrome (AIDS) continues to be a deadly pandemic and a serious threat to public health. Globally, reproductive age women are more likely to be infected with Human Immunodeficiency Virus (HIV). Comprehensive knowledge about HIV/AIDS is pivotal in the fight against AIDS. However, comprehensive HIV/AIDS knowledge is low in Sub-Saharan African (SSA) nations including Liberia, which contributes to the high incidence of HIV in these nations. This study assessed the level of comprehensive knowledge about HIV/AIDS and its associated factors among reproductive age women in Liberia. METHODS: The prevalence and associated factors of comprehensive knowledge about HIV/AIDS among reproductive age women in Liberia were determined using secondary data analysis of 2019-2020 Liberia Demographic and Health Surveys (LDHS). Comprehensive knowledge about HIV/AIDS was a composite variable computed from six variables available in the Demographic and Health Survey (DHS). The study included 7,621 reproductive age women in weighted samples. A generalized linear mixed model with robust error variance was used. For the variables included in the final model, adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) were calculated. RESULTS: The prevalence of comprehensive HIV/AIDS knowledge among Liberian women aged 15-49 was 33.5%. Women's age and education, and distance to health facility were positively associated with comprehensive knowledge about HIV/AIDS among Liberian reproductive age women. In contrast, community poverty level was negatively associated with comprehensive knowledge about HIV/AIDS. CONCLUSION AND RECOMMENDATIONS: This study demonstrates that the prevalence of good comprehensive HIV/AIDS knowledge was relatively low among reproductive age women in Liberia. Hence, health practitioners and policymakers should strengthen HIV/AIDS sensitization programmes to increase women's knowledge about HIV/AIDS.

Acceptance of COVID-19 vaccine booster doses among the Adult Population in Ghana: a cross-sectional study using the Health Belief Model.

BACKGROUND: The Health Belief Model (HBM) is a widely utilised framework for understanding vaccination behaviour against COVID-19. This study assessed the acceptance of COVID-19 vaccine booster doses in Ghana and identified predictors using HBM domains, including perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action. Additionally, it examined the sources of information about COVID-19 vaccines. METHODS: We employed a cross-sectional quantitative design, using convenient and snowball sampling methods to recruit participants. Between March 20 and May 10, 2023, 822 Ghanaians completed a predesigned self-administered online survey via commonly used social media platforms (WhatsApp, Facebook, X (Twitter), and LinkedIn). The study used a binary logistic regression to predict COVID-19 booster dose acceptance. RESULTS: The respondents had a mean age of 29.3 ± 6.2, with 55.5 being males, 53.0% being single/never married, 93.7% having tertiary education, 83.0% being Christians, 59.1% were healthcare workers, 57.8% residing in urban areas, 95.5% having no chronic disease, 90.6% reporting negative COVID-19 history, and 78.3% reporting no reported relative/friend infected with COVID-19. The study showed that 81.1% [95% confidence interval (CI) = 78.4 - 83.8%] of respondents received the COVID-19 vaccine, and 58.3% [95% CI = 54.2 - 62.5%] of respondents were willing to accept the COVID-19 booster dose. The main reasons for non-acceptance of COVID-19 vaccine booster doses were personal reasons (41.7%) and experienced side effects or fear of side effects (32.4%). Regression analysis revealed that perceived benefits and perceived barriers (specifically worrying about serious risk factors) were the significant predictors of accepting COVID-19 booster doses in Ghana. CONCLUSIONS: Many respondents were willing to receive the COVID-19 booster dose. Personal reasons, fear of side effects, and experienced side effects were the main reasons for refusing COVID-19 booster doses. Perceived benefits and perceived barriers predicted COVID-19 booster dose acceptance in Ghana. Policymakers should consider these factors in designing public health interventions to increase the patronage of COVID-19 booster doses.

"You cannot stay with one person once you begin having sex at a young age": the prevalence, correlates and effects of early sexual debut among children in Ghana.

BACKGROUND: Children's initiation of early sex has several negative implications on their sexual and reproductive health, growth and development. In Ghana, few studies on early sexual debut have focused on adolescents. Therefore, this study examined the prevalence, causes, correlates and effects of early sexual debut among children aged 8 to 17 in Ghana using secondary data from the Department of Children of the Ministry of Gender, Children, and Social Protection. METHODS: A convergent parallel mixed-method approach guided the study. Descriptive statistics and multivariable binary logistic regression were used to analyse the quantitative data, while thematic analysis was used to analyse the qualitative data. RESULTS: The study found that the prevalence of early sexual debut among children was 13.2%, which is more predominant among female children. The main causes of early sexual debut include engaging in sex after watching pornography, self-desire to have sex, and being influenced by alcohol consumption. Also, age, sex, education, marital status, religion, ecological zone, living arrangements, and access to the Internet were significant correlates of early sexual debut. Early sexual debut increases children's risk of unwanted pregnancy, which leads to the termination of children's education or induced abortion. Also, early sexual debut had adverse impacts on the wellbeing of pregnant children and increased children's risk of multiple lifetime sexual partners. CONCLUSIONS: This study demonstrated that socio-demographic characteristics of children (e.g., age, sex, education, and marital status) were significant correlates of early sexual debut. Policymakers need to design appropriate interventions, considering the socio-demographic characteristics of children, to curb its occurrence in Ghana.

Alcohol consumption and risky sexual behaviors among fishers in Elmina in Ghana.

BACKGROUND: Alcohol consumption is part of human social behavior and constitutes a routine part of social life in many countries. Prior studies have found over-indulgence of fishers in alcohol in fishing communities. The study uses the Alcohol Myopia Theory (AMT) to analyze and explain the phenomena of fishers engaging in sex after alcohol consumption, and condom use with sexual partner(s) after alcohol consumption. The study investigated alcohol consumption, predictors of alcohol consumption, and the reasons for drinking alcohol among fishers. It also examined fishers' engagement in sex after alcohol consumption, the use of condoms with sexual partners after drinking alcohol, and predictors of the use of condoms with sexual partners after drinking alcohol. METHODS: A cross-sectional convergent parallel mixed-method design was used to study 385 fishers in Elmina. Also, two focus group discussions were conducted among male and female fishers. Descriptive statistics were used to analyze the quantitative data, while the qualitative data was analyzed thematically. RESULTS: Generally, 59.2% of participants indulged in alcohol consumption. Most male participants (70.6%) indulged in alcohol consumption than female participants (48.5%). Also, 48.5% of participants indulged in binge alcohol consumption, while 38.1% indulged in moderate alcohol consumption. The predictors of alcohol consumption were sex, religion, and type of fishing occupation. Participants identified consuming alcohol to kill loneliness and boredom, to forget family and work-related issues, and to have fun as reasons why fishers consume alcohol. Sixty-four percent of participants have ever engaged in sexual intercourse after consuming alcohol in the past 12 months. However, 70% of participants did not use a condom the last time they had sex after drinking alcohol. Only ethnicity of participants predicted their use of a condom the last time they had sex after drinking alcohol. The primary reasons for the non-use of condoms were do not like using condoms (37.9%), forgetting to use a condom (33.0%), and had sex with a trusted regular partner (15.5%). CONCLUSIONS: This study demonstrated that alcohol consumption was prevalent among fishers, especially among male fishers, which contributes to risky sexual behaviors among them as espoused by the AMT. It is recommended that fishers are targeted for alcohol use and risky sexual behavior programs and interventions since alcohol use is prevalent among them and most of them also engage in unprotected sexual intercourse after consuming alcohol.

Assessment of prevalence, predictors, reasons and regulations of substance smoking among children in Ghana.

BACKGROUND: In Ghana, it is against the law for children to smoke. Nevertheless, a portion of children in the country do smoke. However, there is a paucity of research on young smokers in Ghana and other sub-Saharan African nations. This study, therefore, investigated the prevalence of smoking, the kinds of substances children smoke, predictors of smoking, reasons for and factors that lead children to smoke, and regulation of smoking among children in Ghana. METHODS: In total, 5024 children aged 8-17 were studied using a cross-sectional convergent parallel mixed method. Descriptive statistics, Person's Chi-square test, Fisher Exact test, and binary logistic regression were used to analyse the quantitative data. In contrast, thematic analysis was used to analyse the qualitative data. RESULTS: The results showed that 3.2% of children had ever smoked. Male children smoked more often than female children. The prevalence of cigarette, marijuana, and shisha smoking was 78.3%, 18%, and 3.7%, respectively. While more male children than female children smoked cigarettes and marijuana, more female children than male children used shisha. Children mainly smoked for fun and due to group culture. In addition, children were influenced by friends; parents, family members, and neighbours who smoke; curiosity; and advertisements and videos to initiate smoking. Despite the availability of regulations and laws regulating tobacco products in public places, tobacco advertisement, promotion, and sale to persons under 18, children are still smoking. CONCLUSIONS: Children who have ever engaged in smoking reported using cigarettes, marijuana, and shisha. Policymakers urgently need to strategise and strengthen their policies, programmes, and interventions to address smoking among children.

Assessment of the availability, accessibility, and quality of sexual and reproductive health services for young people in conflict affected zones of Cameroon: a mixed method study.

INTRODUCTION: Despite ongoing programs to improve young people's Sexual and Reproductive Health Services (SRHS) in the conflict plagued North West and South West Regions of Cameroon, there is limited evidence-based information evaluating SRHS. This study, therefore, aims to investigate the availability, accessibility, and quality of SRHS provided to young people in the North West and South West Regions of Cameroon. METHOD: This is a cross-sectional mixed-methods sequential explanatory study conducted among healthcare providers and young people between 10 and 24 years in 6 selected urban and rural areas in North West and South West regions. Data was collected between December 2021 and September 2022 using an adopted checklist. A descriptive analysis was conducted for quantitative data. An inductive analysis was conducted for the qualitative data to construct themes. The findings from the quantitative and qualitative responses were triangulated. RESULTS: There were 114 participants, 28 healthcare providers and 86 young people. Most provider participants were nurses (n = 18, 64.3%), working in religious facilities (n = 14, 50.0%), with diplomas as state registered nurses (n = 9, 32.1%). Also, more than half of young people (51.2%) were less than 20 years old, while there were more male young people (51.2%) than female young people (48.8%). Most respondents agreed that SRHS services were available, though they think they are not designed for young people and have limited awareness campaigns about the services. Reasons such as limited use of written guidelines, affected quality of SRHS. Participants revealed shyness, resistance from religious groups and families, insecurities from political instability, and inadequate training, among others, as barriers to SRH accessibility. CONCLUSION: The study shows that SRHS are available but are not specifically designed for young people. Inadequate publicity for these services, coupled with the political crises and the ongoing COVID-19 pandemic, has increased young people's inaccessibility to SRHS. Young people usually have to finance the cost of most of the SRHS. The quality of service delivery in the facilities is inadequate and must therefore be improved by developing safe, youth-friendly centers staffed with well-trained service providers.

Prevalence, predictors and consequences of gambling on Children in Ghana.

BACKGROUND: Gambling is illegal for children in Ghana. However, young people, including children, are increasingly engaged in gambling across the country. Gambling is harmful and poses developmental implications for the youth, including children. There are limited studies on child gambling in Ghana and other sub-Saharan African countries. This study examined the prevalence of gambling participation, predictors of gambling participation, and perceived harm of gambling on children. METHODS: A cross-sectional convergent parallel mixed methodology was used to study 5024 children aged 8 to 17 in the three ecological zones of Ghana. Binary logistic regression was used to examine the predictors of gambling participation while the qualitative data was analysed thematically. RESULTS: Overall, 3.1% of children aged 8 to 17 had ever engaged in gambling activities. Also, being a female (AOR = 0.210, Wald test = 34.413, 95% CI: 0.125-0.354), having attained primary education (AOR = 4.089, Wald test = 18.643, 95% CI: 2.158-7.749), doing paid work (AOR = 2.536, Wald test = 10.687, 95% CI: 1.452-4.430), having a friend who gambles (AOR = 1.587, Wald test = 4.343; 95% CI: 1.028-2.451), having access to radio (AOR = 1.658, Wald test = 6.694, 95% CI: 1.130-2.431) and having access to mobile phone (AOR = 0.590, Wald test = 6.737, 95% CI: 0.396-0.879) were predictors of gambling participation. Gambling is perceived as harmful by children since it is addictive, affects learning and class attendance, and makes them steal from their families to gamble. CONCLUSIONS: This study demonstrated that socio-demographic characteristics (sex, age, educational attainment, ecological zone, persons taking care of children, living arrangement, engagement in paid work, radio access, mobile phone access) and gambling-related information (having friends who gamble) make children more susceptible to gambling. Researchers and policymakers should consider these socio-demographic characteristics and gambling-related information when designing interventions to curb gambling among children aged 8 to 17 in Ghana.

Exploring the Motivations of Family Caregivers Caring for Older Persons in Urban Poor Accra, Ghana.

There is a general paucity of studies on family caregivers' motivations for providing care to older persons in the urban poor context in Ghana. This study seeks to explore family caregivers' motivations for providing care to older persons in urban poor Accra, Ghana. A qualitative descriptive design was used and in-depth interviews were conducted with thirty-one family caregivers. The QSR NVivo 10 software was used to analyze the data thematically. We found that autonomous motivation inspired family caregivers to provide care. Empathy and affection intrinsically motivated some caregivers to provide care to their care recipients, while others were extrinsically motivated by filial responsibility, reciprocity, and obligation to provide care. These findings showed that family caregivers were autonomously motivated to provide care to older persons. We recommend the need for future studies to explore changes in family caregivers' motivations to provide care over time.

Motivations and perspectives on the use of corporal punishment at home: A qualitative study of Ghanaian parents.

BACKGROUND: The Convention on the Rights of the Child acknowledges the fundamental rights of children. Despite the adverse effects of corporal punishment, it continues to be prevalent, especially among sub-Saharan African countries, including Ghana. OBJECTIVE: This study explored whether parents ever used corporal punishment on their children at home and their motivations for doing so. It also explored whether parents perceive corporal punishment as a violation of children's rights and their views on continuing or discontinuing corporal punishment at home. PARTICIPANTS AND SETTING: This study involved (100) parents across the ten regions of Ghana. METHODS: A semi-structured interview guide was used to conduct interviews with parents. Thematic analysis was used to analyse the qualitative data using the aid of QSR NVivo version 10. RESULTS: All parents reported that they had ever punished their children. Three sub-themes emerged under the motivation of parents to punish their children. These include (a) building a sense of discipline in the child to prevent future misbehaviour, (b) releasing frustrations on children, and (c) toughening up the child to confront life challenges. Also, parents had mixed opinions on whether corporal punishment violates children's human rights and whether corporal punishment should be practiced at home. CONCLUSIONS: This study demonstrated that parents perceived corporal punishment as beneficial for their children's development. There is a need for community mobilisation programmes to change parents' and society's attitudes, norms, and beliefs regarding corporal punishment.

"Do we register our deaths?": Motivations and barriers to death registration in Ghana.

Death registration is generally low in sub-Saharan African countries, including Ghana. This study investigated the factors that motivate and serve as barriers in registering for a death certificate. A cross-sectional qualitative study design was used to interview twelve birth and death registration officers in Ghana. The interviews were analysed using Atlas.ti version 7.5. The results show that death registration in Ghana is generally low. Processing of a deceased person's estate emerged as the main motivation for the registration of death. Other motivators included the obligation to register deaths and the requirement of death certificates for burial. The barriers to death registration included the governance system at the cemetery, the hastiness in burying the dead, the perception of cost of death certificates, and less importance attached to death registration. Policymakers should consider these factors in the design of interventions to increase the rate of death registration in Ghana.

Infant and young child feeding practices among mothers in the pilot Micronutrient Powder Initiative in four geographically and ethnically diverse districts in Ghana.

In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age. The KIIs and FGDs were audio-taped, transcribed verbatim, and analyzed thematically using NVivo 10. Three themes emerging from the KIIs and FGDs were: level of adherence to IYCF recommendations among mothers and caregivers; IYCF recommendations perceived as the hardest to follow; and perceived motivators, facilitators, and barriers to IYCF practices. Mothers in the four districts generally followed the eight IYCF recommendations. Mothers in the Tolon district demonstrated adherence to IYCF practices, often citing the need for early initiation of breastfeeding, timely introduction of complementary feeding, and feeding children aged 9-23 months 3 times daily in addition to breastfeeding. In contrast, mothers in other districts faced challenges that hindered adherence. Giving children 4 or more food groups and timely introduction of complementary feeding were perceived as the hardest practices to follow. The main facilitators of IYCF practices include midwives and frontline nurses teaching mothers how to breastfeed, and midwives ensuring mothers initiate breastfeeding immediately after delivery. The main barriers to IYCF practices identified were insufficient breastmilk; mothers-in-law giving water to children before six months; resumption of work; and lack of financial means. Mothers in the Ho West district reported more barriers to IYCF practices, followed by mothers in the Tain, Talensi, and Tolon districts. Health practitioners, stakeholders, and policymakers should design targeted interventions that address the contextual barriers to improve IYCF practices in the various districts.

Multilevel predictors of anaemia among pregnant women in Ghana: New evidence from the 2019 Ghana Malaria Indicator Survey.

Anaemia in pregnant women is a major public health concern. A number of multilevel factors have been attributed as contributors to anaemia in pregnancy. The purpose of this study was to examine the multilevel factors predicting anaemia among pregnant women in Ghana. Data for this study were obtained from the 2019 Ghana Malaria Indicator Survey (GMIS) conducted between September 25 and November 24, 2019 in all regions in Ghana. The weighted sample comprised 353 pregnant women aged 15-49 years. Data were analysed with SPSS version 25 using descriptive statistics, Pearson's chi-square test and binary logistic regression modelling. In this study, the outcome variable was anaemia status among pregnant women, while the predictor variables included individual, household, community, and health system level factors. The overall prevalence of anaemia among pregnant women was 28.7%. Of these, 14.5% had mild anaemia, and 13.2% and 1.1% had moderate and severe anaemia, respectively. The results indicate that a higher probability of anaemia in pregnancy is likely to be found among pregnant women less than 35 years (15-24 years, aOR = 3.31; C.I: 1.13-9.73) (25-34 years, aOR = 2.49; C.I:1.06-5.84). A higher likelihood of anaemia was found among pregnant women who did not take SP drug (aOR = 3.70; C.I:1.20-11.43) and also among household heads aged 30-39 years (aOR = 4.51; C.I:1.09-18.71). However, a lower odd of being anaemic was found among pregnant women who had attained secondary or higher education (aOR = 0.19; C.I:0.05-0.76), women in the richest households (aOR = 0.02; C.I:0.00-0.42) and those accessing unimproved drinking water (aOR = 0.37; C.I:0.14-0.95). Furthermore, pregnant women with health insurance coverage had lower probability (aOR = 0.24; C.I: 0.06-0.94) of being anaemic. The results highlight the importance of varying factors at different levels in understanding the prevalence of anaemia among pregnant women. Understanding these factors will play a major contributor to developing strategies and programmes aimed at addressing anaemia among pregnant women.

Prevalence, correlates, and reasons for substance use among adolescents aged 10-17 in Ghana: a cross-sectional convergent parallel mixed-method study.

BACKGROUND: Substance use among adolescents poses significant risks to their health, wellbeing, and development, particularly in low- and middle-income countries, including Ghana. However, little is known about the outlets and reasons for substance use among Ghanaian adolescents. This study examined the prevalence, correlates, reasons for substance use, and outlets of these substances among adolescents aged 10-17 in Ghana. METHODS: Data were obtained from the Department of Children, Ministry of Gender, Children, and Social Protection, Ghana, which employed a cross-sectional convergent parallel mixed-methods technique to collect quantitative and qualitative data from children aged 8-17, parents or legal guardians and officials of state institutions responsible for the promotion and protection of children's rights and wellbeing. Overall, 4144 adolescents aged 10-17 were interviewed for the quantitative data, while 92 adolescents participated in 10 focus group discussions. Descriptive statistics, Pearson's chi-square test, and multivariable binary logistic regression were used to analyse the quantitative data, while the qualitative data was analysed thematically. RESULTS: The prevalence of substance use was 12.3%. Regarding the types of substance use, alcohol (56.9%) and cigarettes (26.4%) were the most common substances. Being a male and currently working are significant risk factors, whereas being aged 10-13, and residing in the Middle- and Northern-ecological belts of Ghana are significant protective factors of substance use. Peers, household members who use substances, drug stores, and drug peddlers are the major outlets. The reasons for substance use were fun, substance as an aphrodisiac, boosting self-confidence, dealing with anxiety, and improved social status. CONCLUSIONS: There is a relatively high substance use among adolescents in Ghana, and this calls for a multi-sectoral approach to addressing substance use by providing risk-behaviour counselling, parental control, and effective implementation of substance use laws and regulations.

Examining Vaccine Hesitancy Among Ghanaian Parents for the R21/Matrix-M Malaria Vaccine.

INTRODUCTION: This study aimed to assess Ghanaian parental attitudes toward a new malaria vaccine, R21/Matrix-M, and its associated determinants. METHOD: A cross-sectional survey was conducted anonymously in July and August 2023 using snowball and convenience sampling techniques, using the Parental Attitude about Children Vaccination Scale. RESULTS: A total of 818 individuals were included, 67.2% were females, their median age was 32 years, and 29.01% were hesitant to vaccinate their children. People living in forests, with younger children, having the youngest child aged 1-3 years, skipping antenatal care or scheduled vaccinations, and not being willing to give the R21/Matrix-M vaccine to children, were vaccine-hesitant. However, healthcare workers, those having a relative who died from malaria, and those who vaccinated their child against malaria were less hesitant. DISCUSSION: A large sector of parents expressed willingness to vaccinate their children against malaria. Addressing parental hesitancy requires intervention programs targeting the identified factors and enhancing parental knowledge.

Prevalence, Reasons, Predictors, Perceived Effects, and Regulation of Alcohol Use among Children in Ghana.

Early initiation of alcohol consumption increases the risk of alcohol dependence and adverse health outcomes. Consequently, nations have enacted laws to make alcohol unlawful to be purchased by, sold to, or used in public by children. This study examined the lifetime prevalence of alcohol use among children and their reasons for consuming alcohol. In addition, the study investigated predictors of alcohol consumption and the effects of alcohol use on children. Finally, it examined the effectiveness of measures in place for regulating the sale and use of alcohol by children in the country. A total of 5024 children between the ages of 8 and 17 were sampled across the ten regions of Ghana using a cross-sectional convergent parallel mixed method. Children were interviewed with a semi-structured questionnaire, while focus group discussions were held with children, parents, and key informants. Lifetime prevalence of alcohol consumption was measured by "have you ever taken alcohol?". The study revealed that lifetime alcohol consumption was less prevalent (6.6%) among children. Sex, age, and region of residence were significant predictors of lifetime alcohol use among children. More than half of the children who reported ever taking alcohol were first introduced to drinking by friends, and more than six in ten children claimed having been intoxicated after drinking alcohol. The findings further revealed that efforts to control the sale and consumption of alcohol by children have proven difficult despite the existence of laws, policies, and national regulatory structures. While regulations on alcohol sales and consumption have been difficult to implement in rural areas, they have been successful in urban areas because institutions there ensure rigorous adherence to the regulations. The study encourages national organizations with responsibility for child protection and development to step up their regulation, investigation, and information-sharing efforts to discourage and limit children from purchasing and consuming alcohol.

Perceptions about COVID-19 preventive measures among Ghanaian women.

Though the advent of COVID-19 vaccines has significantly reduced severe morbidity and mortality, infection rates continue to rise. Therefore, adhering to COVID-19 preventive measures remains essential in the fight against the pandemic, particularly in Africa, where vaccination rates remain low. However, the perceived risk associated with COVID-19 and public education and awareness campaigns has waned over time. COVID-19 vaccine hesitancy is consistently high among women globally. This study, therefore, assessed the facilitators, and barriers to adherence to COVID-19 preventive measures. A qualitative descriptive study was conducted among Ghanaian women. Twenty-seven in-depth interviews were conducted with women in the Greater Accra and Ashanti regions. All interviews were audio-recorded and transcribed verbatim into English. The data were analysed using NVivo 10 software. While some participants found the use of face masks as the easiest, others found it as the most difficult. In addition, institutional and policy decisions such as access to water and the use of public transport impacted individual level adherence to preventive measures. In conclusion, the fight against COVID-19 is not over; hence public education and the provision of facilities that would enhance compliance with preventive measures should continue to be prioritised.

Bodily Pain in Physical Function and the Role of Physical Activity Among Community-Dwelling Adults Aged 50-69 Years in Ghana.

BACKGROUND: Older adults who experience pain are likely to report higher functional limitations (FL) and lower physical activity (PA) levels. However, the extent to which PA explains the association of pain with FL is largely unknown, particularly in low- and middle-income countries. This study estimates whether and how much pain in FL is mediated by PA engagement. METHODS: We used cross-sectional data from 770 adults aged 50-69 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana. FL and pain characteristics were defined using the Medical Outcomes Study Short Form-36. PA was assessed by the International Physical Activity Questionnaire-Short Form. Bootstrapped mediation analyses estimated the direct and indirect hypothesized associations. The control variables included age, sex, residential type, level of education, monthly income, social isolation, emotional distress, multimorbidity, and self-rated health. RESULTS: After adjusting for potential confounders, higher pain interference (ß = 0.091, p < .05) and higher pain severity (ß = 0.075, p < .05) were associated with greater FL. The bootstrapping analyses showed that PA mediated the pain interference-FL association, accounting for approximately 58% (ß = 0.124, Boots 95% confidence interval (CI): 0.078-0.175) of the total effect (ß = 0.215, Boots 95% CI: 0.095-0.335). Similarly, PA mediated the association between pain severity with FL, accounting for approximately 37% (ß = 0.044, Boots 95% CI: 0.001-0.094) of the overall effect (ß = 0.119, Boots 95% CI: -0.011 to 0.249). CONCLUSIONS: Our data suggest that the higher pain severity and pain interference may lead to higher FL in middle and old age, and the associations are partially explained by PA. Effective and low-cost PA participation could be targeted in efforts to reduce the effect of pain on physical functioning among middle-aged and older adults.