Cross-Sectional and Medico-Legal Investigations of Covid-19 Response, Ghana

Abstract

From the 12th of March 2020, Ghana took bold steps against Covid-19, aimed at controlling the spread among the population, protecting against community infections, treating those with the disease and ensuring public trust in the healthcare delivery system. This cross-sectional survey, assessed the effectiveness of Ghana’s risk communication, legal framework and response approaches to the Covid-19 Pandemic. The first part was a Cross-Sectional approach. The authors used data collected on-line via a self-reported questionnaire between 16th March and 16th April from [127] participants. Differences in mean scores and other factors associated with awareness; as a function of risk communication; to Covid-19, knowledge of safety protocols, and practices towards the disease, were conducted using univariate and multivariate data analytical methods. The second approach was a literature review of Ghana’s legal framework existing prior to the outbreak of Covid-19 and those enacted by Parliament during the emergency period towards the management of the pandemic. A content analyses of the legal framework, to assess official compliance with the framework in relation to the aim of this study was conducted. The majority of the study participants were knowledgeable about how Covid-19 was transmitted. An independent samples t-test was performed to determine if a difference existed between the mean scores of COVID-19 knowledges for males and females. The outcome variable was found to be normally distributed and equal variances are assumed based upon results of Levene’s test (F (125) = 0.097, p-value = 0.756). There was no significant difference in knowledge scores (with minimum = 1, and maximum = 3) for males (mean = 1.61, standard deviation = 0.665) and females (mean = 1.56, standard deviation = 0.698; t- value t (125) =0.374, p-value = 0.709, two-tailed). The magnitude of the difference in the means (mean difference = 0.054, 95% confidence interval: -0.234, 0.343) and the effect size was very small (Cohen d = 0.08). The independent samples t-test was also performed to test the hypothesis that males and females were associated with statistically significant different COVID-19 awareness mean scores. The test showed no significant difference in the awareness scores for males and females. The results from the content analyses of the legal framework show there was lax adherence of government to the legal framework for Pandemic response on these dimensions: Planning and Coordination; Surveillance, Situation monitoring and Assessment; Prevention, Containment and Management; Communications; and Social Mitigation. It further shows that neither the existing legislation nor the Executive Instruments, E. I. 63 - 66, and 164 directed at Covid-19 administrative and epidemiologic controls, have helped to stop the spread of Covid-19, considering the uptick of new infections of Covid-19. Covid-19 has exposed the lack of effective risk communication modalities in Ghana and the government’s lack of adherence to the legal framework on disasters and emergencies in general, a vacuum which is filled by social media.