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Background Human Immunodeficiency Virus (HIV) is a global public health threat, and all frontline Health care workers (HCWs) are at a higher risk of exposure to body fluids from potential HIV patients and to sharp instruments. Though timely Post Exposure Prophylaxis (PEP) decreases the possibility of seroconversion to HIV after occupational exposure, most HCWs rarely adhere to the PEP protocol. This study aims to determine the predictors of adherence to PEP among frontline healthcare workers in the Ho Teaching Hospital, Ghana. Methods A facility-based cross-sectional study was conducted among 199 frontline HCWs. Data were collected using a pretested self-administered questionnaire and analyzed using STATA version 14 software. Binomial logistic regression was performed at the 0.05 level of significance and 95% confidence interval. Findings Overall, 17.9% of HCWs adhered to PEP. Frontline HCWs who perceived they had low and very low risk of occupational exposure to HIV transmission were 96% [AOR = 0.04 (95% C.I: 0.00, 0.39) P = 0.006] and 94% [AOR = 0.06 (95% C.I: 0.00, 0.62) P = 0.019] respectively less likely to adhere to PEP. HCWs who received training on PEP were 4 times more likely to adhere to PEP compared to those who had never received it [AOR = 4.24 (1.31, 13.19) P = 0.013]. Conclusion Adherence to PEP protocol among HCWs was low. Therefore, there is a need for interventions to increase the perception of risk of occupational exposure to HIV transmission and to intensify training on PEP among frontline HCWs in the Ho Teaching Hospital. This will go a long way to increase their adherence to PEP.

Barbering poses risks of HIV transmission if it is not conducted in a hygienic manner. This study assessed the knowledge, attitudes and prevention practices regarding HIV transmission among barbers in the Ho Municipality, Ghana. A cross-sectional design was employed in Ho Municipality, and data were collected from 121 participants and analysed using Stata version 13.0 at the significance level of 0.05. Knowledge was low (63.6%) and was associated with attitude [COR=4.37 (95% CI: 1.98-9.62); p

The barbing industry poses particular public health risks if it is not conducted in a safe and hygienic manner. These risks can lead to the transmission of infectious diseases like the Human Immunodeficiency Virus (HIV) to the barbers or their clients. This study investigated the knowledge, attitudes and prevention practices regarding HIV transmission among barbers in the Ho Municipality. A descriptive cross-sectional design was employed. A pretested structured questionnaire was administered to a consented sample of barbers sampled using a multistage random sample design. Descriptive and inferential statistics were performed using Stata version 14.0 software programme where 0.05 level was used as a measure of significance. The knowledge level of the barbers regarding HIV/AIDS was inadequate (63.6%). Knowledge was significantly associated with work experience [AOR = 13.56 (95% CI: 2.73–67.25); p = 0.001], with attitude [AOR = 4.07 (95% CI: 1.27–13.08); p = 0.018], with level of education [AOR = 10.22 (95% CI: 2.24–46.64); p = 0.003], with marital status [AOR = 0.07 (95% CI: 0.01–0.50); p = 0.008] and with number of clients per day [AOR = 0.13 (95% CI: 0.03–0.52); p = 0.004]. The attitude of barbers was also inadequate (58.7%). Attitude was significantly associated with the mode of learning the barbing profession [AOR = 0.32 (95% CI: 0.11–0.89); p = 0.029], and with level of knowledge [AOR = 5.48 (95% CI: 2.01–14.93); p = 0.001]. Majority of the participants exhibited poor prevention practices regarding HIV/AIDS (87.6%). Prevention practice was significantly associated with work experience [AOR = 24.92 (95% CI: 2.08–297.86); p = 0.011] and with level of knowledge [AOR = 12.57 (95% CI: 1.35–116.86); p = 0.026]. The barbers in Ho exhibited inadequate knowledge and attitude regarding HIV/AIDS, and also manifested poor prevention practices regarding HIV/AIDS. Programmes aimed at improving the knowledge, attitudes and prevention practices should be implemented among barbers, with focus on those without any formal education, those with less than five years work experience and those with more than ten clients a day.

Despite progress made in the treatment of HIV and AIDS by making available the antiretroviral treatment in Africa, youth are still struggling with inadequate knowledge, a negative attitude towards AIDS and high-risk sexual behaviour. All of these are compounded by a lack of open communication between parents and youths which among others, which impedes on the control of the pandemic in this vulnerable group. Building on ‘Ottawa Charter for Health Promotion’ as one way of breaking all barriers in this communication, we suggest keys points in five different domains of this framework namely: building healthy public policies, creating a supportive environment, strengthening community action, developing personal skills, and reorienting the health services.

Background In sub-Saharan Africa, about 80% of young women either use a traditional method or do not use any form of contraception at all. The objectives of this review were to ascertain the barriers and motivators of contraceptive use among young people in Sub–Saharan Africa. Materials and methods We conducted electronic literature searches in PubMed, EMBASE, Ebsco/PsycINFO and Scopus. We identified a total of 4,457 publications and initially screened 2626 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 13 qualitative studies were retained for the final analysis based on the Joanna Briggs criteria for assessing qualitative studies. The systematic review is registered on PROSPERO with identifier CRD42018081877. Results Supportive social networks, respect for privacy and confidentiality, ready availability, affordability and accessibility of contraceptives, as well as the desire to prevent unintended pregnancy and sexually transmitted infections were the motivators of contraceptive use among young people in sub-Saharan Africa. Despite these motivators, myriad of personal, societal, and health systems-based barriers including myths and misconceptions, known side effects of contraceptives, prohibitive social norms, and negative attitude of health professionals were the major barriers to contraceptive use among young people. Conclusion Sub-Saharan African countries with widespread barriers to contraceptive use among young people may not be able to achieve the Sustainable Development Goal 3.8 target of achieving health for all by the year 2030. Interventions intended to improve contraceptive use need to be intersectoral and multi-layered, and designed to carefully integrate the personal, cultural, organizational and political dimensions of contraception.

BackgroundOver the years, there has been a clarion call for legalising marijuana cultivation and trading for commercial purposes in South Africa. Proponents of the call argue that the criminalisation of commercial marijuana cultivation and trading has failed to halt illicit marijuana cultivation and trading. However, the views of those who economically benefit from the illicit marijuana trade on its legalisation remain empirically unsolicited.ObjectiveThis study aimed to solicit the views of illegal marijuana growers and traders from two selected communities in the Eastern Cape Province of South Africa regarding the commercial legalisation of marijuana cultivation and trading to inform policy on the debate.MethodsIn-depth key informant interview approach was used to interview 18 purposively sampled participants that were selected through the snowball sampling technique. The data were analysed using the thematic content analysis approach.ResultsParticipants had both positive and negative perceptions of the possible legalisation of marijuana cultivation and trading. On the positive side, participants indicated freedom from police, the opportunity to grow marijuana on a larger scale, capital acquisition for commercial marijuana cultivation and trading, and regulation of marijuana prices through unionisation as some of the benefits they would derive from the commercial legalisation of marijuana cultivation and trading. On the negative side, loss of their source of livelihood, fall in the price of marijuana and perceived increase in school drop-out rates were the concerns raised.ConclusionWhile participants relished improvement in their economic fortunes upon commercial legalisation of marijuana cultivation and trading, they were also apprehensive about this policy due to the perceived consequences it may have on their livelihoods and communities. We, therefore, recommend that future discussions of the commercial legalisation of marijuana cultivation and trading in South Africa should be done in consultation with illicit marijuana growers and traders to ensure that their interests are safeguarded by such a policy.

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.

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.

BackgroundTo 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.MethodsThis 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.ResultsWhile 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.ConclusionGhana 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.

About 41 million people die of chronic non-communicable diseases (CNCDs) each year, accounting for 71% of all global deaths. The high prevalence of CNCDs is particularly problematic for sub-Saharan Africa (SSA) since CNCDs are already a major cause of mortality in the sub-region. While the case fatality rate of COVID-19 is quite low, it is worth noting that people with underlying CNCDs constitute the majority of those who die from this virus. Underpinned by the chronic care model (CCM), we present a commentary on the implications of COVID-19 for the management of CNCDs in SSA. We realized that despite the World Health Organisation's guidelines for countries to maintain essential services while putting necessary measures in place to prevent and control the spread of COVID-19, myriad of health systems and community-level factors militate against effective management of the CNCDs in SSA. This results in disruptions in management of the conditions as well as possible long-term effects such as the deterioration of the health status of CNCD patients and even deaths. Without immediate interventions to salvage the status quo, SSA countries may not be able to achieve the Sustainable Development Goal 3.4 target of reducing by one-third, premature mortality from CNCDs by the year 2030. We recommend that financial constraints could be ameliorated through short- and long-term loan facilities from the International Monetary Fund and the World Bank to augment national efforts at strengthening health systems while combating COVID-19. We also recommend increased community engagement and public education by COVID-19 response teams to enhance community support for persons living with CNCDs and to reduce social stigmatization.

The Novel Coronavirus (2019-nCoV) was detected in December 2019 in the Hubei Province of China. Also known as COVID-19, the outbreak was declared a pandemic by the World Health Organization (WHO) in March 2020. Sub-Saharan Africa (SSA), which is the region hardest hit by HIV, is also highly affected by COVID-19. The fight against COVID-19 in SSA might threaten the continuous management of persons living with HIV (PLHIV). This commentary uses the five action areas of the Ottawa charter for health promotion to address the issue. If the issues raised in this commentary are not addressed quickly by SSA governments, every single link of the supply chain in the HIV response will be disrupted. This disruption might result in more stock-outs, shortages and a lack of access to ART in the months ahead. The SSA governments must ensure that HIV treatment adherence is not compromised owing to a shift of focus to the fight against COVID-19. They should ensure that everyone on HIV treatment gets an adequate supply of antiretroviral therapy (ART).

HIV Testing and Counselling (HTC) is a critical strategy to reduce the rate of new HIV infections and the key entry point to HIV treatment, care and support services. This study aimed to determine the uptake of HTC among students of tertiary institutions in the Hohoe Municipality of Ghana. This was a quantitative cross-sectional study. A structured questionnaire was used to collect data among a proportionate stratified sample of students from tertiary institutions. Chi-square and Logistic regression analyses were performed using Stata version 12.0 at the 0.05 level of significance. Only 30.6% of the total respondents had ever tested for HIV/AIDS of which, only 22.9% tested less than 6 months before the current study. Students above twenty-four years of age were 3 times more likely to go for HTC than those below 20 years [OR=2.56 (95% CI: 1.07-6.11; p=0.034)]; those in the fourth year of study were 3 times more likely get HTC than those in the first year [OR=3.05 (95%CI: 1.10-8.49; p=0.033)]; and those attending THERESCO, the Midwifery training college and UHAS were more than 2 times more likely to get tested for HIV than those attending FRANCO [OR =2.67 (95% CI: 1.14-6.15; p=0.024)], [OR=2.40 (95% CI: 1.04-5.54; p=0.040)] and [OR=2.63 (95% CI: 1.13-6.13; p=0.026)] respectively. The uptake of HTC among tertiary institution students in Hohoe municipality was considerably low. Policymakers should design programs and interventions that would increase uptake of HTC among tertiary students, with focus on those aged less than 20 years, those at the lower level of study and those in the non-health related institutions.

Background. The Community-based Health Planning and Services (CHPS) initiative is Ghana’s flagship strategy for achieving universal health coverage (UHC). Community involvement in and perceptions of CHPS capacity to improve health outcomes of communities are examined. Methods. This community-based descriptive cross-sectional study recruited 1008 adults aged 18 years and above in two System Learning Districts of the CHPS+ project. Data collected were analysed using descriptive and inferential statistics. Results. The level of community involvement in CHPS activities was 48.9% of the population studied. The overall level of positive perception of CHPS services was 51.7%. Community members who were involved in identifying resources (AOR = 1.86 (95% CI = 1.17, 2.97), p=0.009), organising durbars (AOR = 2.09 (95% CI = 1.12, 3.88), p=0.020), and preparing sites for outreach services (AOR = 3.76 (95% CI = 2.23, 6.34), p<0.001) were significantly more likely to have positive perceptions of the relevance of CHPS to improving the health status of communities compared to those who were uninvolved. Conclusion. The level of community involvement in CHPS services is low. Ghana may not be able to attain the UHC goal by 2030 through CHPS implementation unless its level of community involvement is markedly improved. Ghana’s health sector stakeholders should implement community engagement mechanisms that foster improved worker outreach, expanded use of community gatherings, and more active participation of traditional leaders and grassroots political representatives.

BackgroundIn 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.MethodsThis 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.ResultsNegative 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.ConclusionHealth-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.

Background: Malaria remains a dominant health issue among children in Ghana. We monitored the trend of long lasting insecticide net (LLIN) ownership and use and its impact on malaria and anaemia among children under five over the past decade in an area of intense, prolonged and seasonal malaria transmission. Methods: A total of 1717, 2155 and 1915 children were surveyed in June and 1717, 2155 and 1697 in November in 30 communities of the Hohoe Municipality in 2006, 2010 and 2015 respectively. The primary outcomes monitored were the trend of LLIN ownership, use and prevalence of malaria and anaemia through cross-sectional surveys. Findings: Results showed a significantly positive trend (p < 0.001) in ownership of LLIN at 20.8%, 64.8% and 83.2% for 2006, 2010 and 2016 respectively. The sharp increase in ownership between 2006 and 2010 accounted for a highly significant departure from trend (p < 0.001). Similarly, the prevalence of LLIN use was 15.1%, 42.2% and 68.3% for 2006, 2010 and 2016 respectively with a significant positive trend (p < 0.001). The prevalence of malaria parasitaemia in June showed no significant drop over the three years studied. Anaemia prevalence was 7.9%, 5.3% and 11.1% for 2006, 2010 and 2015 respectively—Anaemia significantly increased (p < 0.001) between 2010 and 2015 accounting for a significant departure from the initially decreasing trend (p < 0.001). Malaria parasitaemia over the November surveys was 40.4%, 33.2% and 26.6% for 2006, 2010 and 2016 respectively, depicting a significant decline over the years of the study (p < 0.001). A significant decrease (p = 0.006) in anaemia was observed at 12.0%, 4.3% and 8.9% for 2006, 2010 and 2015 respectively. A significant departure from the decreasing trend (p < 0.001) was noted with increasing anaemia between 2010 and 2016. Interpretation: Ownership of LLIN and its use together with other indicators of malaria prevalence generally improved five years after the implementation of a malaria control programme. Ten years after programme implementation, consistent improvement was only in LLIN ownership and use. Also malaria prevalence indicators improved in the post as compared to the pre-rainy season in the study communities.

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.

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.

Background: In Ghana, youths aged 15–24 years constitute the group most vulnerable to HIV infection. Inadequate knowledge, negative attitudes and risky practices are major hindrances to preventing the spread of HIV. Aim: This study sought to investigate the knowledge, attitudes and practices regarding HIV/AIDS among senior high school (SHS) students. Setting: Sekondi-Takoradi metropolis, Ghana. Methods: A descriptive, cross-sectional design was adopted, using a validated self-administered questionnaire, to collect data from a stratified sample of 294 senior students selected from three participating high schools in August 2017. The data collected were analysed using Stata version 12. Descriptive and inferential statistics were at a significance level of 0.05. Results: Among the participants, 61.6% had good knowledge about HIV/AIDS, 172 (58.5%) showed positive attitudes towards people living with HIV (PLHIV) and 79.1% reported HIV-related risky practices. We found a significant association between age and attitudes ( p < 0.05). Poor knowledge was associated with being Muslim (aOR = 1.51 and 1.93; CI 1.19–1.91; p = 0.00) and being a student from school ‘F’ senior high school (F SHS) (aOR = 1.93; CI 1.71–2.18; p = 0.00). Bad attitude towards PLHIV and HIV was associated with ages 15–19 years (aOR = 3.20[2.58–3.96]; p = 0.03) p confirmed; and single marital status (aOR = 1.79[1.44–2.23]; p = 0.00). Bad practices were associated with ages 15–19 years (aOR = 1.72[1.41–2.11]; p = 0.08), belonging to the Akans ethnic group (aOR = 1.57[1.26–1.97]; p = 0.00) or being single (aOR = 1.79[1.44–2.23]; p = 0.00). Associations between misconceptions and HIV transmission were found: HIV can be transmitted by a handshake (aOR = 3.45[2.34–5.68]; p = 0.000), HIV can be cured (aOR = 2.01[2.12–5.04]; p = 0.004) and HIV/AIDS can be transmitted by witchcraft (aOR = 3.12[3.21–7.26]; p = 0.001). Conclusion: Participants generally had inadequate knowledge regarding HIV/AIDS, manifested negative attitudes towards PLHIV and also engaged in risky practices that might predispose them to HIV transmission. Our findings underscore the need for culturally adapted and age-oriented basic HIV information for youths in the metropolis on misconceptions about HIV transmission, negative attitudes of students towards PLHIV as well as the risky practices of students regarding HIV.

Background. Anaemia is one of the major causes of death among children under five years in Ghana. We examined the risk factors of anaemia among children under five years in the Hohoe Municipality, Ghana. Methods. This facility-based matched case control study recruited 210 children (70 cases and 140 controls) aged 6 to 59 months. Stratified and simple random sampling techniques were used to select mothers attending Child Welfare Clinic (CWC) for the screening of their children. Data were collected using a semistructured questionnaire. Finger prick blood was collected to estimate the haemoglobin (Hb) level and thick film was prepared to determine malaria parasitaemia. Axillary temperature was measured using an +electronic thermometer and anthropometric measurements were done using a weighing scale and inelastic tape measure. Continuous variables were presented as means and standard deviations and categorical variables as frequencies and proportions. Conditional logistic regression was used to determine the strength of association between the dependent and the independent variables. Statistical significance was considered at p value of Results. The prevalence of anaemia was high (53.8%), while children whose mothers received iron supplementation during pregnancy were 7.64 times more likely to be anaemic compared with those who did not [AOR=7.64 (95% CI:1.41-41.20.93); p=0.018]. Children with poor dietary diversity were 9.15 times more likely to have anaemia [AOR=9.15 (95% CI: 3.13-26.82); p< 0.001]; and children whose mothers were farmers and traders were 83% [AOR = 0.17 (95% CI: 0.05-0.60); p=0.006] and 79% [AOR=0.21 (95% CI: 0.06-0.74); p=0.014], respectively, less likely to have anaemia. Conclusion. The biologic, intermediate, and underlying factors that were significantly associated with anaemia comprised maternal iron supplementation, poor dietary diversity, farmers, and traders. Given that iron supplementation during pregnancy did not protect children against anaemia, we recommend the child’s nutritional dietary diversity is encouraged.

The recent Lancet Commission-International AIDS Society report: Advancing Global health and strengthening the HIV response in the Era of the Sustainable Development Goals; clearly highlights the fact that the world is NOT on track in ending the AIDS pandemic by 2030. Emphasis on massive and early diagnosis and placement on Combined Anti- Retroviral Therapy (cART) remain key cornerstones in reaching these goals. Effective viral load informed care remains very promising in reducing drug resistance, and improving outcomes in infected persons. The authors argue that the current funding trends, management paradigms, research agendas, data collection and information system models, as well as the overall appreciation of the evolution of the pandemic in low and middle- income countries, lead to a logical conclusion that this pandemic will not end, especially in these countries by 2030. Major action areas are proposed for policy makers and researchers for appreciation and action.

Scholarly publication in a peer-reviewed journal is the highest form of disseminating research findings. However, the process of publishing in peer-reviewed journals remains a daunting task for researchers and academics in Africa. This commentary will assist authors in Africa to understand the peer-review process, to appreciate the length of time it takes for a manuscript to be published and to encourage them to publish in local peer-review journals. The authors argue that the peer-review process is essential because it acts as a quality control mechanism to ensure that valid and reliable research is published. Although peer review does not guarantee exclusive publication of reliable and valid research, it remains central in the scientific activity. Authors need to take the comments from reviewers and editors, even in cases of rejection seriously and in the positive sense, inorder to improve upon the quality of their work. Rejections by some journals happen not to be scientifically grounded. It happens that African authors suffer more from this flaw. This could justify why some naïve authors easily turn to publish in predatory journals. The authors argue that publishing in local journals is imperative for Africans scholars. Therefore, initiatives to encourage publication in these journals are highly needed.

INTRODUCTION:The objectives of this study was to investigate and compare levels of acceptability of pre-marital HIV testing; and intention to sero-sort future marital and its associated factors among unmarried adults in two cities in Cameroon. METHODS:A population-based survey was conducted simultaneously in the cities of Kumba and Buea, located in the Southwest region of Cameroon. Data were collected from September to October 2016 by trained interviewers who administered questionnaires to eligible and consenting unmarried adults aged 21-35 years. Data were weighted and logistic regression analyses performed to identify significant predictors. The level of statistical significance was set at p< = 0.05. RESULTS:A total of 1,406 respondents (767 in Kumba and 639 in Buea) participated in the study. In the pooled sample, the median age of respondents was 26 years (IQR = 23-29) and over half (54.8%) were males. Over 90% of respondents in both cities indicated their willingness to accept pre-marital HIV testing. Respondents who had previously tested for HIV in Kumba (AOR = 7.87; 95%CI, 4.02-15.44) were significantly more likely to accept premarital HIV testing than those who had never tested for HIV. In Kumba, older age (AOR = 0.42; 95%CI, 0.18-0.96) and those unemployed (AOR = 0.22; 95% CI, 0.06-0.76) were significantly less likely to accept pre-marital HIV testing. In Buea males (AOR = 0.64 95% CI, 0.45-0.89) who would test HIV negative would be significantly less likely to accept to marry an HIV positive partner. In Buea, respondents who indicated a moderate risk of contracting HIV (AOR = 1.71; 95%CI, 1.09-2.66, p = 0.018) were significantly more likely to accept to marry an HIV positive partner. The major limitation of the study was that a hypothetical situation was used to ask respondents about their willingness to accept pre-marital HIV testing rather than actual HIV test acceptance. CONCLUSIONS:Most respondents expressed their willingness to undergo pre-marital HIV testing. However, majority of respondents who would test HIV negative would refuse to marry their partner who tests HIV positive. These findings suggest that interventions to reduce HIV infection and fight against stigma and discrimination should be reinforced at community level.

Introduction the use of modern contraception helps couples and individuals realize their basic right to decide freely and responsibly if, when and how many children to have. The current study assessed the factors influencing the use of modern contraception among married women in Ho West District, Ghana. Methods the study adopted a descriptive cross-sectional design, using a standardized validated pretested interviewer-administered questionnaire adapted from previous studies to collect data from a systematic sample of 225 married women and analyzing them using Stata version 14 software program at the level 0.05. Results the majority, 202 (89.8%) had used modern contraception before, and the proportion currently using some form of family planning (FP) was 130 (64.4%), majority (46.2%) of whom were currently using injectable. Majority (66.1%) used modern contraception in order to ensure proper care of children. Most (64.2%) of the women who were not using modern contraception were not doing so because of their partner's disapproval. Private employees were 0.20 times less likely to use modern contraception (AOR=0.20 (95% CI: 0.04-0.91); p=0.038) compared to housewives, while women who did not have problems with decision-making were 4 times more likely to use modern contraception (AOR=4.40 (95% CI: 1.25-14.44); p=0.021) compared to their counterparts who had problems with decision-making at home. Conclusion the use of modern contraception is low. Health promotion interventions to increase modern contraception use among married women in Ho West District of Ghana should focus on the privately employed and those with problems in decision-making at home.

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.

Introduction A significant proportion of road construction workers are migrants and prone to HIV infection. This study investigated the psychosocial predictors of consistent condom use among migrant road construction workers in the South-west region of Cameroon using the Health Belief Model (HBM) as the theoretical framework. Methods A cross-sectional survey of a stratified sample of 254 road construction workers was conducted at construction sites along the Kumba-Mamfe road in the South-west region of Cameroon in December 2015. Data were collected using a pretested structured questionnaire and binomial logistic regression was performed to test the strength of association between the independent and the dependent variables using SPSS version 20 at the level 0.05. Results Only 67 (43.5%) reported consistent condom use. Perception of risk of contracting HIV was also low, 109 (42.9%). None of the constructs of the HBM was significantly associated with consistent condom use. However, perception that road construction workers are prone to HIV (perceived susceptibility) was associated with an increased likelihood of using condom consistently, OR = 2.1 (95% CI 0.72-6.12, p = 0.17); perception that consistent condom use could prevent HIV transmission (perceived benefit) was associated with an increased likelihood of using it consistently, OR = 1.9 (95% CI 0.74-4.80, p = 0.18); perception by workers that they can refuse sex with their partners if they refuse to use condoms (perceived self-efficacy) was associated with an increased likelihood of using condoms consistently, OR = 1.5 (95% CI 0.62-3.53, p = 0.38). However, the perception that condom reduces sexual pleasure (perceived barriers) was associated with a reduced likelihood of using it consistently, OR = 0.84 (95% CI 0.35-2.01, p = 0.698). Conclusion There were no significant associations between the psycho-social constructs of the HBM and consistent condom use. Therefore, interventions to increase the perception of risk of contracting HIV, which is assumed to be the immediate antecedent of consistent condom use is highly recommended.

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.Keywords: HIV/AIDS, out-of-school youths, socio-demographic characteristics, sexual risk behavior, urban Cameroon

Introduction The purpose of this study was to examine the relationship between socio-demographic characteristics, risky sexual behaviour, alcohol use and transactional sex among female bar workers in Yaounde, Cameroon. Materials and methods A cross-sectional survey was conducted among a representative sample of 410 female bar workers, recruited through a modified version of venue-based cluster sampling technique from May to June 2017. Transactional sex was defined as having received money/gifts in exchange for sex with any sexual partner in the past 12 months. Logistic regression models were performed to identify the factors associated with transactional sex. The level of statistical significance was set at p< = 0.05. Results About 14.9% (n = 61) of respondents reported to have engaged in transactional sex, 83.7% (n = 338) had multiple sexual partners at the time of the study, 14.4% (n = 55) had sex with one or more of their male customers in the past 6 months. Almost 73.4% (n = 301) reported alcohol use. Of these, 37.2% (n = 112) were frequent alcohol consumers. About 17.6% (n = 72) reported to have had unprotected sex under the influence of alcohol in the past 6 months. Multivariate logistic regression analysis showed that those who engaged in transactional sex were more likely to have had sex with a male customer in the past 6 months (aOR = 7.34; 95% CI, 3.63–16.98), had sex under the influence of alcohol in the past 6 months (aOR = 2.42; 95% CI, 1.18–4.96) and frequent alcohol consumers (aOR = 2.06; 95%CI, 1.04–4.10). Respondents who had their last sexual intercourse 4 weeks or more prior to the study (aOR = 0.26; 95% CI, 0.08–0.84) were less likely to have engaged in transactional sex. Conclusions Our study concludes that female bar workers are exposed to male customers and engage in risky sexual practices including transaction sex. Most of them also consume alcohol which increases their risk of HIV and STI acquisition. They are a high-risk group that need to be targeted with HIV prevention interventions.

Background:Anemia in children continues to be a major public health challenge in most developing countries.This study determined the prevalence of anaemia and its associated risk factors among children under five in four rural communities in the HohoeMunicipality.Method: A descriptive community-based cross-sectional study was carried in November 2015. Interviews with semi-structured questionnaires were used to obtain information from mothers of childrenon socio-demographic characteristics, dietary and feeding practices of the children. Axillary temperature and anthropometric indices were measured using standard methods. Finger-prick blood samples were collected for Haemoglobin concentration measurement and blood film for malaria parasites. Chi-squared test and logistic regression were used to determine theassociation between dependent and independent variables. Results:Of the 235 children surveyed, 113 (48.1%) were anaemic (Hb

Dissemination of research findings through the publication of one’s work or a group of contributors is an important part of the research process, as this allows the passing on of benefits to a much wider community. In whatever evocative form this dissemination may take, the onus lies on the author(s) to ensure adherence to the code of ethics as it pertains to the integrity of the information being put out. We publish because we want our findings to be adapted into practice and application, or in some cases may be relevant to policy makers in decision-making. To a large extent in the field of academia, successful publication improves opportunities for academic funding and promotion whilst enhancing scientific and scholarly achievement and repute. A situation may be compromised where intellectual contributions to a scientific investigation do not adhere to the four key guidelines of scholarship, authorship, approval and agreement as well as the protocols of ensuring good publication ethics. The objective of this review is to lay emphasis on universal standards for manuscript authorship and to fostering good practices. This in our view will bring authorship credit and accountability to the attention of our colleagues and readers at large. To achieve this, a systematic and critical review of the literature was undertaken. Electronic databases, academic journals and books from various sources were accessed. Several key search terms relating to responsible authorship, common authorship malpractices, conflict of interest, universal publication guidelines and other authorship related issues, were used. Only references deemed useful from relevant texts and journal articles were included. In this paper, the authors have sought to highlight the pitfalls researchers sometimes entangle themselves within an act of compromise thereby impinging on the ethical and professional responsibilities for the content of a paper under consideration. This article presents the case that authorship has a strong currency that brings not only personal satisfaction but also career rewards based on publication counting. In all cases described here, a universal standard for manuscript authorship will be critical in fostering good practices. As you write and review manuscripts, keep these good practices in mind, and consider ways to bring authorship credit and accountability to the attention of your colleagues and readers.

Background: Human rabies, often contracted through dog bites, is a serious but neglected public health problem in the tropics, including Ghana. Due to its high fatality rate, adequate knowledge and vaccination of domestic dogs against the disease are very crucial in reducing its burden. We examined dog owners&rsquo, knowledge level on rabies and factors that influenced anti-rabies vaccination of dogs in the Upper East Region of Ghana. Methods: This descriptive cross-sectional study was conducted among 260 randomly sampled dog owners in six communities from six Districts using a multistage sampling technique, in the Upper East Region of Ghana. An interviewer-administered questionnaire was used to collect data from the respondents. Descriptive and inferential analyses were done using STATA 14.1. Results: While knowledge about rabies was 199 (76.5%), that about anti-rabies vaccination was 137 (52.7%). District of residence (&chi, 2 = 112.59, p &lt, 0.001), sex (&chi, 2 = 6.14, p = 0.013), education (&chi, 2 = 20.45, p &lt, 0.001) as well as occupation (&chi, 2 = 11.97, p = 0.007) were significantly associated with rabies knowledge. District of residence (&chi, 2 = 57.61, p &lt, 0.001), Educational level (&chi, 2 = 15.37, p = 0.004), occupation (&chi, 2 = 11.66, p = 0.009), religion (&chi, 2 = 8.25, p = 0.016) and knowledge on rabies (&chi, 2 = 42.13, p &lt, 0.001) were also statistically associated with dog vaccination against rabies. Dog owners with good knowledge on rabies for instance, were more likely to vaccinate their dogs against rabies compared to those with poor knowledge [AOR = 1.99 (95% CI: 0.68, 5.86), p = 0.210]. Dog owners with tertiary level of education were also 76.31 times more likely (95% CI: 6.20, 938.49, p = 0.001) to have good knowledge about rabies compared to those with no formal education. Conclusions: Dog owners in the Upper East Region of Ghana had good knowledge about rabies. This, however, did not translate into correspondingly high levels of dog vaccination against the disease. Rabies awareness and vaccination campaigns should, therefore, be intensified in the region, especially among the least educated and female dog owners.

Introduction : Malaria remains one of the top five killer diseases in sub-Saharan Africa (SSA) and its burden is skewed towards pregnant women and children under five. Insecticide Treated Bed-Net (ITN) usage is considered one of the most cost-effective, preventive interventions against malaria. This study sought to assess ownership, usage, effectiveness, knowledge, access and availability of ITNs among mothers with children under five in the Hohoe municipality. Methods : in August 2010 a cross-sectional survey was carried out in 30 communities, selected using the WHO 30 cluster sampling technique. In the selected communities, mothers/caregivers with children under five years were selected using the snowball method. Data were collected through questionnaires and direct observation of ITN. Descriptive statistics was used to analyse the data collected. Results : A total of 450 mothers/caregivers were interviewed and their mean age was 30 ± 7 years. ITN ownership was 81.3%, and usage was 66.4%. The majority (97.8%) of the mothers/caregivers said ITNs were effective for malaria prevention. Awareness about ITNs was high (98.7%) and the majority (52.9%) had heard about ITNs from Reproductive and Child Health (RCH) Clinic and antenatal care ANC clinic (33.6%). Over 60% of the ITNs were acquired through free distribution at RCH clinics, clinic and home distribution during mass immunization sessions. The majority of the mothers/caregivers (78.6%) knew the signs and symptoms of malaria, what causes malaria (82.2%) and who is most at risk (90%). Conclusion : Behaviour change communication strategies on ITN use may need to be further targeted to ensure full use of available ITNs.

Persons with disabilities have been identified as one of the groups vulnerable to HIV, due to several challenges posed by their disabilities. They also suffer external stigma from their able bodied peers. However, they have largely been ignored as part of HIV prevention programs, largely due to the perceptions that they are not at risk, and information is not being accessible. About 5.4% of the Cameroon population lives with a disability. In Cameroon, no official statistics exist on perception of factors associated with condom use to prevent HIV among persons with disabilities, which creates a challenge for understanding the extent of the pandemic in this population. The objective of this study was therefore to investigate perceptions of factors associated with condom use among persons with physical disability in an urban town of Cameroon. The qualitative study from which this paper is based, used semi-structured in-depth interviews, conducted with a purposive sample of ten (5 male and 5 female) persons with physical disability, aged 18 years and above, in April 2015. The findings of this study as interpreted according to the components of the Health Belief Model, indicated that perceived susceptibility to HIV, perceived severity of HIV, perceived benefit of condom use, perceived barriers to condom use and perceived self-efficacy for condom use were the factors perceived by persons with physical disability, to be associated with condom use. It is therefore recommended that there should be educational programs in HIV/AIDS targeted specifically at persons with physical disability. These programs should pertinently promote the understanding and perceptions of persons with physical disability of the real threat of HIV/AIDS, and also equip them with condom negotiation skills and strategies to overcome barriers to condom use.