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Background: Diarrhoeal diseases constitute a significant burden on the health and growth of children the world over. Globally, diarrhoeal conditions remain the second leading cause of death among children under 5. Knowledge, attitudes and practice of caregivers are at the heart of diarrhoeal disease prevention and proper management. Objective: This review aimed to assess caregivers' knowledge, attitude, and practice regarding diarrhoea in children under five years old in sub-Saharan Africa, as discussed in the literature. Design: Integrative narrative review Data Sources: The review saw an extensive search on two electronic databases. Search results were screened using inclusion and exclusion criteria. At the end of the screening, 37 studies were included in the review. Review Methods: Inclusion criteria: Only studies whose focus was on caregivers’ knowledge, attitude and practice relating to diarrhoea in children under five were included. Also, only publications reported in the English Language were considered, and publications must have been between 2010-2020. Additionally, the methodological quality of studies was assessed using the Down & Black (1998) checklist for quality evaluation in a systematic review. Results: In this review, it emerged that studies in Sub-Saharan Africa indicate that caregivers display poor overall knowledge about diarrhoea. Also, the attitudes of caregivers towards diarrhoea prevention and treatment was low in many studies. On care practices, prevention practices, and management/treatment practices, including ORS and Zinc usage, were mainly reported to be quiet. Conclusions: The review concluded that there are poor levels of knowledge, attitude and practice of managing diarrhoea among caregivers of children under five (5) years of age in sub-Saharan Africa. The researchers recommended continuous health education to address knowledge gaps of mothers about diarrhoea, its prevention and treatment according to international standards.

Background In Ghana, only 52% of mothers exclusively breastfeed their babies and the rate of increase has been steadily slow across all geographical areas of Ghana. The purpose of this study was to determine the various factors that influence exclusive breastfeeding (EBF) among mothers who visited the child welfare clinic at the Tema General Hospital, Accra, Ghana. Methodology This descriptive cross-sectional study was carried out at the Child Welfare Clinic of the Tema General Hospital, Accra, Ghana. A random sampling technique was used to recruit mothers with children between the ages of 6 months and 24 months attending the Child Welfare Clinic. Mothers were interviewed with the aid of a structured questionnaire. Results Out of the 222 of mothers interviewed, 68.8% of them exclusively breastfed their infants up to 6 months. Mothers who have good knowledge were more than 3 times (AOR = 3.484, 95% CI 1.200, 10.122, P = 0.022) likely to breastfeed their children exclusively. Those who had positive attitudes towards EBF were about 4 times (COR: 4.018, 95% = 1.444, 11.181, P = 0.008) more likely to exclusively breastfeed than those who had poor attitudes towards EBF. Also, mothers whose spouses complained about EBF were about 3 times (AOR: 2.655, 95% CI 0.620, 11.365, P = 0.018) at increased odds of not exclusively breastfeeding their babies. Conclusions High rate of EBF among mothers who visited the child welfare clinic was found. The mothers' level of knowledge and attitude towards EBF significantly influenced the 6 months of EBF. Spouses also showed a high influence on whether or not mothers should exclusively breastfeed their babies.

Background: In Ghana, only 52% of mothers exclusively breastfeed their babies and the rate of increase has been steadily slow across all geographical areas of Ghana. The purpose of this study was to determine the various factors that influence exclusive breastfeeding among mothers who visited the child welfare clinic at the Tema General Hospital.Methodology: This descriptive cross-sectional study was carried out at the Child Welfare Clinic of the Tema General Hospital. A random sampling technique was used to recruit mothers with children between the ages of 6 months and 24 months attending the Child Welfare Clinic. Mothers were interviewed with the aid of a structured questionnaire.Results: About 65.8 % of mothers exclusively breastfed their infants for six months. Mothers who had good knowledge of exclusive breastfeeding had 96.3% increased odds of exclusively breastfeeding their babies (COR: 0.037, p = 0.000, CI = 95%). Also, mothers whose spouses complained of exclusively breastfeeding had decreased odds (COR: 0.205, p = 0.000, CI = 95%). Finally, mothers who had poor attitudes towards exclusive breastfeeding were 8.733 times less likely to exclusively breastfeed their babies for six months (COR = 8.733, p = 0.000, CI = 95%).Conclusions: High rate of exclusive breastfeeding among mothers who visited the child welfare clinic was found. The level of knowledge and attitude of the mothers towards exclusive breastfeeding significantly influenced the six months practice of exclusive breastfeeding. Spouses also showed a high influence on whether or not mothers should exclusively breastfeed their babies.

Aim and objectives To explore the meaning of living with HIV positive in Ghanaian adolescents. Design Hermeneutic phenomenological approach developed by Van Manen methodology (1990). Method A purposive sampling of 12 adolescents living with HIV was recruited. Data were collected between September 2019–January 2020 using semi‐structured interviews and analysed using thematic analysis. Results Two main themes emerged: Stigmatization and HIV disclosure and Living with a heavy burden. Seven subthemes were also found. Adolescents living with HIV in Ghana face discrimination, rejection and go through psychological distress such as suicidal thoughts, fear of death and hopelessness. Conclusion The problems faced by adolescents living with HIV are a result of the inherent beliefs of the Ghanaian society about HIV. Nurses working with ADLHIV should concentrate on identifying challenges and provide support and care, in addition to their treatment.

Aim This study assessed the practice of pica among pregnant women in the Ho Teaching Hospital. Design Descriptive cross-sectional. Methods Systematic sampling technique was used to recruit 286 pregnant women. Questionnaire was used to collect data. Data entered into Statistical Package for Social Sciences for analysis. Result Of the 286 pregnant women, 21.2% and 17.8% considered white clay and ice respectively as nutritious. Prevalence of pica was 47.5%, while 44.9% of pregnant women who practised pica reported they feel uncomfortable when they do not eat pica as 63.3% considered intake of pica as harmful. Among women who received education against pica practice, 49.4% have ever taken pica as 50.9% of them with education on effects of pica were currently engaged in the activity (χ 2 = 1.93 p = .17). Conclusion Health professionals, especially midwives must intensify education on effects of pica among pregnant women.

Background The relationship of nurses and patients in healthcare settings has been central in ensuring good and efficient healthcare delivery. The total hospital attendance in the Kwahu Government Hospital have reduced in recent years. The study explored patients’ perceptions of the nurse-patient relationship and its influence on hospital attendance at the Kwahu Government Hospital. Methods A phenomenological qualitative study design, with a purposive sampling technique, was used to interview ten participants from the various wards in the hospital on their perceptions of the nurse patient relationship and its influence on hospital attendance. The data were transcribed and analysed using a thematic content analysis approach that embraces three interrelated stages, namely data reduction, data display, and data conclusion drawing. Results Many of the participants had positive perceptions regarding the attitude of nurses, and that influenced hospital attendance while others opined that nurses’ attitudes towards them made them attend a private facility. Almost all the participants suggested that patients should exhibit an equally good attitude and behaviour towards nurses, and better communication between patients and nurses as vital ways of improving the nurse-patient relationship. Nurses in the Kwahu Government Hospital are described as friendly, respectful and attend promptly to patient health care needs adequately. The range of perceived respect differed from patient to patient and include the nurse called patient by name, respond promptly to patient needs, helped “helpless patients” to feed and also assisted them change diapers, listen to patient concerns, linked patient to other professionals, work within the cultural context of hierarchy and that the nurse is sociable and interacted with patient positively. Conclusion Hospital management should conduct regular evaluations of patients' experiences as well as nurses’ experiences to address deficiencies in communication and nurse-patient interactions., Attitude; Relationship; Hospital attendance; Perception; Care; Patient; Nurse; Health.

Background. Despite substantial progress in reducing child mortality, concerted efforts remain necessary to avoid preventable deaths in children under-5 years and to accelerate progress in improving child survival. The patronage of child welfare services is paramount to the attainment of these goals. This study identified the factors that influence the patronage of child welfare services in a rural community in the Ho West District of the Volta region. Methodology. This quantitative descriptive cross-sectional design employed a systematic sampling method to select 310 caregivers of children aged 18 to 59 months in the Abutia Kloe subdistrict using a pretested questionnaire. The data were entered into a Microsoft excel spreadsheet and cleaned and exported to Statistical Package for Social Sciences (SPSS 22) for analysis. Results. The results showed that children (44.2%) had defaulted at a point during the continued growth monitoring process. The reasons for the default included completed major immunization (72.3%), started school (57.4%), and poor staff attitude (3.2%). Mothers have an idea about the purpose of the growth chart (68.0%) as the mothers (86.5%) are able to access a child welfare clinic in less than thirty minutes’ walk from their homes. The cross tabulation on level of education and regular CWC attendance showed a strong association (r2 = 8.071, p ≤ 0.03 ). Cross tabulation on marital status and CWC attendance showed a positive significant association (r2 = 17.307, df = 2, p ≤ 0.001 ). Married caregivers (85.2%) as compared with unmarried ones (60.5%) are more likely to seek child welfare services for their child. Conclusion. Healthcare providers should intensify education on the need to continue growth monitoring up to 59 months even after the completion of major immunization. This goal can be attained if growth monitoring is incorporated into school health activities while policy implementers ensure the full execution.

Background. The World Health Organisation estimates that 1.35 million people die as a result of road traffic crashes. Motorcycles as a means of transport are increasingly becoming the preferred and easiest means of transportation for most people in developing countries despite the associated risk. This study determined the prevalence and pattern of motorcycle crashes in Adidome among commercial motorcyclists. Methods. A descriptive, cross-sectional study design was used as 114 commercial motorcyclists were recruited to respond to a pretested research questionnaire in the Adidome district of the Volta Region. Data were analyzed using SPSS, version 22.0. Data were presented as simple descriptive statistics. A chi-square relationship was determined using the demographic variables, and the history of accident at a 95% confidence interval with 0.05 was considered as statistically significant. Results. The prevalence of road traffic crashes at Adidome was 64.0%. Motorcyclists (74.0%) were reported to have been involved in crashes in the past one year prior to the study. Motorcyclists attributed the last accident to excessive speeding (31.5%) and bad roads (23.3%), this accident as a result of colliding with another motorcycle (50.7%), and slippery surfaces (24.7%). The majority (63.0%) of the respondents had an accident once. The consumption of alcohol was associated with the occurrence of an accident as 34.2% occurred among cyclists who drank alcohol, compared with 29.8% who did not (p<0.05). Conclusion. There should be strict implementation of current road traffic regulations of Ghana by the MTTD of the Ghana Police Service, and penalties should be awarded against anybody caught riding a motorcycle under the influence of alcohol. Helmet and other protective devices must be made compulsory for motorcycle riders to prevent injuries, especially head injuries, if an accident occurs.

ABSTRACT Background: Despite substantial progress in reducing child mortality, concerted efforts remain necessary to avoid preventable deaths in children under-5 years and to accelerate progress in improving child survival further. The patronage of child welfare services therefore remains paramount to the attainment of these goals. This study identified the factors that influence the patronage of child welfare services in a rural community in the Ho West District of the Volta region. Methodology: The study employed a quantitative descriptive cross-sectional design. Systematic sampling method was used to select 310 caregivers of children less than 60 months in the catchment area of the Abutia kloe sub district. Questionnaire was used to collect data from study respondents. The data was entered into a Microsoft Excel Spreadsheet and cleaned and subsequently exported to SPSS (version 22.0) for the data analysis. Data was analysed into simple descriptive statistics Results: The results showed that a significant number of respondents (44.2%) had defaulted at a point during the continued growth monitoring process. The reasons for the default included children had completed major immunization (72.3%), children had started school (57.4%), and poor staff attitude (3.2%). Noteworthy, It depicts that majority of mothers have an idea about the purpose of Growth chart (68%). It is also worth noting that 86.5% of mothers are able to access a Child Welfare Clinic in less than thirty minutes. In addition, the results pointed out that there is a strong association between the level of caregivers’ education and CWC attendance with a chi-square test of 3 and a P-value less than 0.05. Conclusion: Healthcare providers should intensify education on the need to continue growth monitoring up to 59 months even after the completion of major immunization. This goal can be attained if growth monitoring is incorporated into school health activities while policy implementers ensure the full implementation.

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

Background: The presence of anaemia in pregnancy is one of the serious public health concerns across the globe especially in developing countries like Ghana. This study assessed pregnant women's knowledge on factors influencing aneamia in pregnancy in a low-income district of Ghana.Methods: A quantitative descriptive cross-sectional study. Data was collected using a pretested questionnaire. 112 pregnant women seeking antenatal care were recruited using systematic sampling technique in the Wassa East district of Ghana. Data were cleaned and entered into SPSS version 22 and analysed into descriptive statistics.Results: Majority of participants; 72.3% did not know the causes of anaemia in pregnancy. Pregnant women (27.7%) indicated nutritional deficiency as a common cause of anaemia; 18.7% of them could identify appropriately at least one sign of anaemia in pregnancy with 28% asserting that pregnancy-related anaemia can affect labour, despite 72% indicating that anaemia could cause maternal mortality. The reasons for irregular ANC attendance included; perceived non importance of ANC (18.8%), financial difficulties (17.9%), health facility inaccessibility (18.8%) and time constraints (44.5%). There was a strong association between knowledge level on the cause of anaemia in pregnancy and the educational level of pregnant women (p=0.005 chi square = 50.289).Conclusions: Lack of knowledge on the importance of antenatal care and financial constraints were among the reasons leading to a surge in anaemia amongst pregnant women in the district. Health providers should incorporate services which enable pregnant women to access valuable information on anaemia prevention in pregnancy.

Background: Emergency contraception (EC) is one option for preventing unplanned pregnancy when it is available and properly used. Unsafe abortions are responsible for nearly one third of maternal deaths in sub-Saharan Africa and about quarter of unsafe abortions are among teenagers.Methods: A quantitative descriptive cross-sectional study. Data was collected using a pretested questionnaire. 260 senior high students were selected using a systematic sampling method in the Volta Region, Ghana. Data were cleaned and entered into SPSS version 22 and analysed into descriptive statistics.Results: Respondents acquired awareness about EC from friends (36.9%), family members (5.6%) and the mass media (41.6%). The required time for EC to be taken were stated as immediately after sex (57.9%), 24 hours after sex (1.2%) and (30.6%) did not know. 28.4% of participants indicated they would not use EC in the future as their faith was against it, 18.0% believed EC is ineffective and 24.9% consider it dangerous to their health. Reasons for use of EC included condom slipped (35.7%), inability to be on daily pill (33.7%), forced unprotected sex (8.2%) and miscalculation of the safe menstrual period (22.4%). There was a significant relationship between age and history of use of EC (p=0.000, c2=8.128, n=260).Conclusions: Strengthening education in Senior High Schools on sexual and reproductive health, with special emphasis on emergency contraceptives as a pregnancy preventive procedure will remain imperative to reducing the canker of maternal mortality attributed to adolescent abortions while improving understanding of the appropriate use of EC.

Background and objectives: This study aimed to assess the level of HIV disclosure to children in sub-Saharan Africa as it relates to prevalence of disclosure, barriers, merits and demerits, timing of disclosure, and factors that promote parents and caregivers’ decisions to disclose the information. Materials and Methods: A systematic literature search was performed using the following online databases: PubMed, Google Scholar, Web of Science, Scopus, and Embase, to obtain relevant articles on HIV disclosure to children in sub-Saharan Africa. The following search terms were used: “HIV” AND “Disclosure” AND “Sub-Saharan Africa” AND “Children”. Results: A total of 18 articles were included in this systematic review. The studies on HIV status disclosure to children in sub-Saharan Africa included a total of 1343 HIV-positive children and 1879 caregiver/child or healthcare worker-child dyads, from the following countries: Ethiopia, South Africa, Ghana, Kenya, Cote d’Ivoire, Burundi, Cameroon, Democratic Republic of Congo, Uganda, Burkina Faso, and Zambia. The prevalence of HIV disclosure ranged from as low as 9% to 72%. Age was a major factor associated with disclosure. Conclusions: HIV status disclosure to children is quite low in sub-Saharan Africa. This is a result of multiple factors such as parents’/caregivers’ fear of the child disclosing status to others, a lack of knowledge on how the disclosure should be made, and the assertion that the children are young and cannot withstand the psychological impact of diagnosis.

Background: Many maternal deaths occur as a result of delivery that takes place in the home or late referral of women in labour to the health facility. This situation is further worsened in remote poor communities of the northern region of Ghana; where health care services are inequitably distributed. This study determined the factors in low income rural communities that are responsible for the high numbers of homebirths using the Bunkpurugu Yunyoo district as a case study . Methods: The study employed mixed method study that used both qualitative and quantitative methods. Three hundred women who delivered within the last one year were made to respond to a research questionnaire while four health care workers (three midwives and a general registered nurse) were engaged in an in-depth interview . Results: The study identified poor road network, inequitable distribution of health facilities, inadequate family support during labour, cultural factors like taboos and the stigma associated with FGM to be responsible for the high numbers of home deliveries. Even though women intended to give birth in the health facility during pregnancy, they are unable to do so as labour occurs when they were not expecting it . Conclusions: The study recommended the use of equipment like the ultrasound during the first trimester of pregnancy to measure accurately the expected date of delivery of each pregnant woman so as to enable them plan for birth .