Eugene K M Darteh

Issues of abortion are critical in Ghana largely due to its consequences on sexual and reproductive health. The negative perception society attaches to it makes it difficult for young females to access services and share their experiences. This paper examines the pre and post abortion experiences of young females; a subject scarcely researched in the country. Twenty-one clients of Planned Parenthood Association of Ghana (PPAG) clinic at Cape Coast were interviewed. Guided by the biopsychosocial model, the study revealed that fear of societal stigma, shame, and rejection by partners, as well as self-imposed stigma constituted some of the pre and post abortion experiences the respondents. Other experiences reported were bleeding, severe abdominal pain and psychological pain. The Ghana Health Services (GHS) and other service providers should partner the PPAG clinic to integrate psychosocial treatment in its abortion services while intensifying behaviour change communication and communi...

Using data from the 2008 Ghana Demographic and Health Survey, this paper examines the drivers of young people's attitudes towards HIV/AIDS stigma and discrimination in Ghana. Descriptive statistics and binary logistic regression were used to examine these drivers. The odds of low stigma and discrimination attitudes increased with higher education: thus, males [OR = 11.04; 95% CI = 4.59-26.54] and females [OR = 5.12; 95% CI = 2.41-11.28] with higher education were significantly more likely to express positive attitudes towards people living HIV. Controlling for beliefs, myths and knowledge about causes of HIV, the influence of education on HIV-related stigma among males and females reduces considerably but the odds remain statistically significant. Beliefs, myths and knowledge of HIV causes/prevention had varying significant effects on stigma. Ethnic, regional and religious differences also emerged in the results. The findings suggest that people with better and accurate knowledg...

A number of studies have concluded that weak involvement of men in family plan-ning decision-making accounts for the low adoption in countries undergoing fertil-ity transition. Programmes to incorporate men in family planning decision-making have largely focused on married men. However, given the pronatalist nature of such societies, family planning within marriage tends to be low. An alternative is to consider the involvement of unmarried young people. This paper assesses the exposure of young males ’ to specific contraceptive messages and their predictors rather than channels. The study uses data from the 2003 round of Ghana Demo-graphic and Health Survey, a nationally representative survey of people in their reproductive ages. Logistic regression was used to examine predictors of exposure to family planning messages. Generally, levels of exposure to messages on contra-ceptives were high. Messages which positioned family planning messages as ben-eficial to the individual had high ...

Introduction Identifying high risk geographical clusters for neonatal mortality is important for guiding policy and targeted interventions. However, limited studies have been conducted in Ghana to identify such clusters. Objective This study aimed to identify high-risk clusters for all-cause and cause-specific neonatal mortality in the Kintampo Districts. Materials and methods Secondary data, comprising of 30,132 singleton neonates between January 2005 and December 2014, from the Kintampo Health and Demographic Surveillance System (KHDSS) database were used. Verbal autopsies were used to determine probable causes of neonatal deaths. Purely spatial analysis was ran to scan for high-risk clusters using Poisson and Bernoulli models for all-cause and cause-specific neonatal mortality in the Kintampo Districts respectively with village as the unit of analysis. Results The study revealed significantly high risk of village-clusters for neonatal deaths due to asphyxia (RR = 1.98, p = 0.012)...

Background HIV/AIDS is still one of the major public health concerns globally. It is one of the major contributory causes of deaths among women in the reproductive age (15–49 years) and has resulted in about 14 million orphaned children globally. Knowledge of Mother-to Child transmission is one of the strategies to fight against HIV. This study, therefore, sought to assess the knowledge and determinants of women’s knowledge on vertical transmission of HIV and AIDS in their reproductive age in South Africa. Methods Data were obtained from the South Africa Demographic and Health Survey (SADHS) 2016. Both descriptive (frequencies and percentages) and inferential analysis (multilevel mixed-effects complementary log–log regression model) were conducted and the statistical significance was set at p < 0.05. Results The prevalence of knowledge of mother to child transmission of HIV and AIDS during pregnancy, delivery, breastfeeding and at least knowledge of one source are 87.0%, 81.1%, 8...

I write to submit our revised manuscript for your consideration and publication. We have improved the written English and revised the entire manuscript for typo errors. We are sure that the manuscript has been improved and look forward to your acceptance for publications. We have included a point-by-point response to the reviewers comments below. Once again, we wish to thank the reviewers for their comments. Response: The English has been improved and changes made have been highlighted in yellow Below are the specific changes we have made to the written English Abstract Background

Sub-Saharan Africa is a region that is severely affected by the HIV and AIDS pandemic with females disproportionately affected. Having accurate and comprehensive knowledge about HIV and AIDS is a major strategy in the fight against the pandemic. This study sought to examine the individual and contextual predictors of comprehensive HIV and AIDS knowledge among young women in Ghana. The study used the females’ file from the 2014 Ghana Demographic and Health Survey dataset. A total of 1 407 young women were used for the analysis. Both bivariate and multivariate analyses were done. The results showed that about 22% of the respondents had comprehensive HIV and AIDS knowledge. Young women with secondary and higher levels of education (AOR = 2.85, p < 0.01) and those from the Upper East Region (AOR = 7.15, p < 0.001) had higher odds of comprehensive HIV and AIDS knowledge. However, those cohabiting (AOR = 0.57, p < 0.01) and those who do not watch TV at all (AOR = 0.50, p < 0.01) had lower odds of comprehensive HIV and AIDS knowledge. Comprehensive HIV and AIDS knowledge is low among young women in Ghana and the predictors are both individual (marital status and education) and contextual (region, watching television and listening to radio). A concerted effort is needed to improve the HIV and AIDS knowledge of young people. Mass media campaigns aimed at improving comprehensive HIV and AIDS knowledge should appreciate the individual and contextual factors that influence the comprehensive HIV & AIDS knowledge of young women.

Background Tobacco consumption – including smoking, chewing tobacco and snuff has been recognized as a global public health issue and a major cause of premature mortality and morbidity. An annual estimated figure of more than 7 million people dies due to tobacco consumption with more than 6 million of those deaths attributed to direct tobacco use and about 890, 000 resulting from exposure to second-hand smoke. This paper seeks to examine the prevalence and drivers of tobacco use among young men in sub-Saharan Africa.Methods Using pooled data from the most recent Demographic and Health Survey (DHS) conducted between January 1, 2010, and December 3, 2018, in 21 countries that had data on tobacco use in SSA this paper examines tobacco use among young men in sub-Saharan Africa. A chi-square was conducted at the bivariate level to test for the significance of tobacco use across the socio-demographic characteristics. A binary logistic regression test was conducted at the multi-variate lev...

Background Communities and their composition have an impact on neonatal mortality. However, considering the smallest health administrative units as communities and investigating the impact of these communities and their composition on neonatal mortality in Ghana have not been studied. Therefore, this study aimed to investigate the effect of community-, household- and individual-level factors on the risk of neonatal mortality in two districts in Ghana. Methods This was a longitudinal study that used the Kintampo Health and Demographic Surveillance System as a platform to select 30,132 neonatal singletons with 634 deaths. Multilevel cox frailty model was used to examine the effect of community-, household- and individual-level factors on the risk of neonatal mortality. Results Regarding individual-level factors, neonates born to mothers with previous adverse pregnancy (aHR = 1.38, 95% CI: 1.05–1.83), neonates whose mothers did not receive tetanus toxoid vaccine (aHR = 1.32, 95% CI: 1....

Globally, young people in sub-Saharan Africa continue to be the population at the greatest risk for sexually transmitted infections (STIs) such as HIV and AIDS, Syphilis, and Gonorrhoea. Research has shown significant relationship between young peoples risky sexual behaviours and their vulnerability to these STIs. The study examined risky sexual behaviours among the youth in Ghana and Kenya in relation to socio-demographic characteristics. The paper uses data from the 2014 Demographic and Health Surveys of Ghana and Kenya. Young people between the ages of 15 to 24 years who were not married or living with a man/woman were included in the study. They comprised 2545 females and 1437 males from Ghana and 3546 females and 4317 males from Kenya. Descriptive analyses and binary logistic regression estimation technique were used to analyse the data. While awareness of AIDS was universal among the youth of both countries, utilisation of condoms on last penetrative sex was low. Risky sexual behaviour among young people was significantly associated with age, level of education, wealth status and religion. Among males and females in Ghana, the odds of sexual risk taking behaviour were higher among those who were employed than those who were unemployed. The reverse of this, however, occurred in Kenya, where males and females who were employed were less likely to engage in risky sexual behaviours than their counterparts who were unemployed. Our findings underscore the need for the relevant stakeholders in the two countries; Ministries of Health, Ghana/KenyaHealth Service, and NGOs concerned with sexual and reproductive health of young people, to intensify education on consistent and proper use of condoms and, position condom use as an acceptable behaviour especially among young people who are sexually active; with multiple partners and who may have STIs. Health literacy, which is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions, should be given priority. The governments of the two countries, especially Kenya, should promote youth entrepreneurship to reduce unemployment and strengthen job creation as a way of ensuring that young people engage on productive economic activities. With productive economic activities, females for instance may not have to engage in transactional multiple sexual relationships which is risky and, therefore, predisposes them to STIs such as gonorrhoea and HIV.

Prevention of sexual violence among young people has become a priority area in Ghana, although few initiatives have focused on this topic. The ADAPT-ITT (Assessment, Decisions, Administration, Production, Topical experts, Integration, Training staff, and Testing) framework was used to systematically adapt an evidence-based sexual violence prevention program developed in the United States to a university in Ghana. Results from cognitive interviews, focus groups, beta testing, and topical experts indicate the adapted primary prevention program is promising for use in Ghanaian universities. To our knowledge, this is the first study that has used the ADAPT-ITT framework for a sexual violence program.

Background: The International Safe Motherhood initiative provides a focus for programmes and research to improve maternal health in low – income countries. Antenatal care is one of the key pillars of the initiative. This study sought to examine the association between background characteristics and choice of skilled providers of antenatal care services in Ghana.

Background. The responsiveness of health professionals to patients in the provision of abortion services is essential to influencing patients' perceptions and expectations regarding the quality of medical care to be received and their general satisfaction. This, in turn, determines if patients will revisit a particular health facility to access abortion services. In this study, we examine the responsiveness of health professionals in providing postabortion care at a regional level health facility in Ghana. Methods. Qualitative data collected from 20 female patients who assessed abortion services at a regional level health facility in Ghana were used. The sample was achieved through saturation while a systematic qualitative orientated text analysis was adopted in analysing the data. Results. Health professionals were responsive to postabortion care at the facility. Most women who sought postabortion care at the facility were referred from other health facilities which could not h...

Due to a number of biological, social, developmental, and behavioural factors young people are disproportionately affected by STIs including HIV and AIDS. Using the Health Belief Model, the study investigated factors influencing perception of risk of HIV among adolescents living in an urban slum in Ghana. Data were obtained from 902 adolescents, aged 10-19 years living in Kwesimintsim Zongo, an urban slum in the Western region of Ghana. A multi-staged sampling technique was used to select the respondents and both bivariate and multivariate analyses were carried out to examine the factors influencing perception of risk of HIV among adolescents. Adolescents' perception of risk of HIV was generally low and was predicted by age, ethnicity, membership of social groups and exposure to the print media. The low risk perception might cause adolescents to engage in behaviours, which are likely to endanger their health in general, and reproductive health in particular. Considering the effe...

This study aimed to describe the attitudes toward abortion of Ghanaian University students and to determine factors which are associated with supporting a woman's right to an abortion. This cross-sectional survey was administered to residential students at the University of Cape Coast. Participants were posed a series of 26 statements to determine to what extent they were supportive of abortion as a woman's right. An exploratory factor analysis was used to create a scale with the pertinent factors that relate to abortion attitudes and a multivariable linear regression model explored the relationships among significant variables noted during exploratory factor analysis. 1038 students completed the survey and these students had a generally negative view of abortion. Two factors emerged: (1) the Abortion as a Right scale consisted of five questions (α = .755) and (2) the Moral Objection to Abortion scale consisted of three questions (α = .740). In linear regression, being older (β = 1.9), sexually experienced (β = 1.2), having a boyfriend/girlfriend (β = 1.4), and knowing someone who has terminated a pregnancy (β = 1.1) were significantly associated with a more liberal view of a right to an abortion. This work supports the idea that students who have personal exposure to an abortion experience hold more liberal views on abortion than those who have not had a similar exposure.

Understanding Adolescents’ sexual and reproductive health behaviour is paramount if the attainment of improved health outcomes and ultimately, the realisation of Sustainable Development Goals are to be achieved. However, the extant literature appears to be disproportionately focused on adolescents in the rural context. Using both qualitative and quantitative data collected from adolescents aged 15-19 years living in Kwesimintsim zongo – an urban slum, this paper attempts to examine early sexual relationships and age mixing among older adolescents. The results point to the presence of risky sexual behaviour among the respondents. Specifically it was found that about a fifth of the respondents were engaged in both early sexual relationships and age mixing. These findings provide useful insight on urban adolescents and their sexual reproductive health in Ghana and it is recommended that preventive measures such as educational campaigns be deployed to dissuade adolescents from engaging ...

Issues of abortion are critical in Ghana largely due to its consequences on sexual and reproductive health. The negative perception society attaches to it makes it difficult for young females to access services and share their experiences. This paper examines the pre and post abortion experiences of young females; a subject scarcely researched in the country. Twenty-one clients of Planned Parenthood Association of Ghana (PPAG) clinic at Cape Coast were interviewed. Guided by the bio-psychosocial model, the study revealed that fear of societal stigma, shame, and rejection by partners, as well as self-imposed stigma constituted some of the pre and post abortion experiences the respondents. Other experiences reported were bleeding, severe abdominal pain and psychological pain. The Ghana Health Services (GHS) and other service providers should partner the PPAG clinic to integrate psychosocial treatment in its abortion services while intensifying behaviour change communication and commun...

Contraceptive use is an important strategy for the prevention of unwanted pregnancy and avoidance of induced abortion. Of all the contraception methods, emergency contraceptive (EC) offers the last chance to achieve this. However, few studies have documented the use of EC among young people in Ghana. This study explored knowledge and usage of EC as well as the factors associated with it among University of Cape Coast students. Data were obtained on the knowledge and usage of ECs among University of Cape Coast students in 2013. Logistic regression analysis was used to investigate the association between students' socio-demographic characteristics and EC knowledge and use. More male students (72 %) than females (59 %) were sexually active. Fifty-seven percent of the respondents had ever heard of EC and 36 % had ever used EC. Although males were more likely to be sexually active, females were more likely to have knowledge of EC use compared to males. The study underscores the need to increase awareness regarding EC among University students in order to offer them the opportunity that EC provides if other forms of contraceptives are missed.

Using data from the 2008 Ghana Demographic and Health Survey, this paper examines the drivers of young people's attitudes towards HIV/AIDS stigma and discrimination in Ghana. Descriptive statistics and binary logistic regression were used to examine these drivers. The odds of low stigma and discrimination attitudes increased with higher education: thus, males [OR = 11.04; 95% CI = 4.59-26.54] and females [OR = 5.12; 95% CI = 2.41-11.28] with higher education were significantly more likely to express positive attitudes towards people living HIV. Controlling for beliefs, myths and knowledge about causes of HIV, the influence of education on HIV-related stigma among males and females reduces considerably but the odds remain statistically significant. Beliefs, myths and knowledge of HIV causes/prevention had varying significant effects on stigma. Ethnic, regional and religious differences also emerged in the results. The findings suggest that people with better and accurate knowledg...