Care In Ghana Research Articles

Pediatric critical care nursing empowerment through distance education and simulation in Accra, Ghana

BackgroundThe study assessed a distance simulation and education intervention designed to improve nursing empowerment in the pediatric intensive care unit (PICU) in Korle Bu Teaching Hospital (KBTH) in Ghana. MethodsThis was a single center, mixed methods, longitudinal simulation-based pilot study. A distance pediatric critical care nursing curriculum that combined interactive learning via Zoom and distance simulation using the Virtual Resus Room was designed and delivered from the United States to KBTH PICU nursing staff. ResultsThe Clinical Teamwork Scale, used to assess team performance after each simulation, demonstrated an upward trend over time in all categories. The modified Simulation Effectiveness Tool was utilized to evaluate the learners' perceptions of the effectiveness of the simulation in meeting their learning objectives. Qualitative content analysis of this free-text feedback highlighted the course's educational content, organizational aspects, learning experience, simulation case scenarios and relevance to pediatric critical care in Ghana. ConclusionsA distance pediatric critical care nursing curriculum, relevant to local practice and resources, was implemented through an international partnership and contributed to nursing empowerment through improved learning and confidence.

Hypertension and diabetes control: faith-based centres offer a promise for expanding screening services and linkage to care in Ghana

BackgroundHypertension and type 2 diabetes mellitus (T2DM) are important contributors to noncommunicable disease related morbidity and mortality. Health systems could benefit from exploring the use of Faith-Based Centres (FBC) to screen and link suspected cases for further care in order to help achieve Sustainable Development Goal (SDG) 3. The study investigated the role of faith-based screening for T2DM and hypertension and the linkage of cases to the healthcare system and examined the care cascade in the Kassena Nankana Districts of Northern Ghana.MethodsWe screened individuals from 6 FBCs for elevated blood pressure and hyperglycaemia. Suspected hypertension and T2DM cases were referred to health facilities for confirmation and subsequently followed them up for 3 months. We assessed the prevalence of behavioural and metabolic risk factors, including hypertension and T2DM, and the retention of referred cases in the healthcare system over follow up period. We further assessed levels of awareness, treatment and adequate control of hypertension and T2DM.ResultsA total of 631 participants were screened, (mean age 49 ± 16years, 73% female) from 6 Faith based Centres. More males than females reported smoking tobacco (14.5% vs. 0.7%) and been physically active (64.5% vs. 52.7%) while more females were obese (29.6 kg/m2 vs. 14.5 kg/m2) and had a higher mean waist circumference (89.0 cm IQR 75-116 cm vs. 84.2 cm IQR 72–107 cm), hip circumference (101.5 ± 10.6 cm vs. 96.4 ± 8.6 cm) and waist-to-hip ratio (0.86 ± 0.1 cm vs. 0.87 ± 0.1 cm) than males. The prevalence of confirmed hypertension and T2DM was 27.9% and 3.5% respectively with no observed sex differences. We observed deficits in the hypertension and T2DM care cascade with reported low awareness, treatment and uncontrolled levels. A 3-month follow up showed a retention in care of 100% in month one and 94.9% in the third month. There was an increase in treatment (39.4% in month-1 and 82.8% in month-3) and control (26.3% in month-1 and 76.3% in month-3) of hypertension and T2DM combined.ConclusionFaith-based centres have the potential to enhance the screening, linkage to the healthcare system, and management of hypertension and T2DM. This improvement over the routine system could lead to earlier diagnoses, a reduction in complications, and decreased premature mortality from cardiovascular diseases. Consequently, these efforts would contribute significantly to achieving SDG 3.

Gendering Ocean Management for Sustainable Ocean Care in Ghana

UNESCO presently offers a universal regime and policy environment for the identification and management of natural and cultural heritages. However, heritage does not merely signify cultural diversity; it can also facilitate greater equity and equality. The research problem addressed in this article is that in Ghana, the national government perceives and treats the small-scale fishing (SSF) sector as a masculine space and endeavour, ignoring the gendered aspects of this environment, of SSF practice and ocean care. In the article, it is hypothesized that if the SSF sector is treated as a socially differentiated space, and if the concern of ocean care is prioritized as a key imperative in Ghanaian ocean management, it is likely that a more inclusive and sustainable ocean management process and SSF sector will emerge in Ghana. Mindful of the socially differentiated nature of the SSF sector in Ghana, the goal of the research presented in this article is to use mixed qualitative research methods (participant-observation and semi-structured interviews) to investigate gendered knowledge forms and gendered practices in ocean care in the central region of Ghana. A key finding of the research is that gendered ritual practices, including canoe building and use in Ghana, are critical to long-term, sustainable, and inclusive ocean management in the country. Recognition of the gendered dimensions of ocean management in Ghana may also result in more inclusive ocean governance policies and nature management policies in Ghana in general. The conclusion of the article is that ocean governance in Ghana should consider and mainstream a gendered perspective of the SSF sector, to advance transformative, sustainable, and inclusive ocean care. The article draws on theories of intersectionality, African indigenous feminist thought, and critical heritage studies to analyse the data gathered, to support the discussion, and to propose the way forward for the national government.

Poverty as a Hindrance to Accessing Quality Healthcare in Ghana: A Theological and Pastoral Reflection

Access to quality healthcare is a key requirement in every modern society. In developed countries, majority of the populace has access to quality and affordable healthcare. However, in developing countries such as Ghana, hospitals with quality infrastructure, healthcare equipment, drugs, and well-trained health practitioners are limited and expensive to access. Given the significant number of people living in extreme poverty in Ghana, it is not surprising that many people experience deterioration in their health and eventually die due to the inability to access and/or afford quality healthcare. In the current situation, where economic hardship keeps increasing in the country, there is a need to engage in a discussion on how healthcare can be made available and affordable to people of all economic classes. The purpose of this paper, therefore, is to assess the limitations that poverty places on people in their quest to access healthcare and offer solutions from theological and pastoral perspectives. This paper employed qualitative and historical descriptive research designs to describe the current state of affairs of the impact that poverty has on access to health care in Ghana. The paper used data collected from secondary sources such as books, journal articles and dissertations. After a careful analysis of the subject matter from the Ghanaian and biblical perspectives, the paper made recommendations for the nation (Ghana), the church, and all stakeholders to contribute to the provision of quality, accessible, and affordable healthcare for all irrespective of one’s financial background or economic status. Keywords: Poverty, Hindrance, Quality Health, Ghana

Perceptions of Antenatal Care among Ghanaian Mothers

In Ghana, some pregnant women may not seek antenatal care due to the unavailability of such services in their communities, although preventive service can help reduce maternal mortality with high-quality care. This study aimed to understand the antenatal care opinions of Ghanaian mothers who sought antenatal care, the barriers they faced, and their suggestions for improvement in antenatal care in Ghana. This study’s data were collected in the Central and Ashanti regions in Ghana from June 2023 to January 2024. Four hundred and fifty mothers in Ghana who indicated that they had given birth within the last 10 years of the data collection period took part in the study. Our findings revealed that 93.6% of Ghanaian mothers perceived their antenatal care to be of good quality due to proper examinations, friendly provider–patient interactions, reassurance, fair treatment, and proper education, whereas 6.5% of Ghanaian mothers perceived their care to be of poor quality due to long wait times, impersonal interactions, inadequate facility resources, and barriers to communication. For Ghanaian mothers to receive better outcomes for themselves and their children, it is worth improving healthcare facilities, healthcare provider preparedness, local transportation, and addressing financial constraints to go from suboptimal to optimal health services.

Knowledge, Acceptance, and Uptake of Family Planning: A Cluster Randomized Controlled Trial of Group Antenatal Care in Ghana.

The use of family planning (FP) methods significantly contributes to improved outcomes for mothers and their offspring. However, the use of FP remains low, particularly in low- and middle-income countries. A cluster randomized controlled clinical trial was implemented in Ghana, comparing group antenatal care (ANC) with routine care. The group ANC intervention included eight meetings where the seventh group meeting incorporated information and discussion regarding methods of FP. Data collection occurred at five time points: baseline (T0), 34 weeks' gestation (T1), 6-12 weeks post birth (T2), 5-8 months post birth, and 11-14 months post birth (T4). At T1, there was a significantly greater increase in the knowledge of FP methods as well as the intention to use FP after the birth among the intervention group. The uptake of FP was significantly higher in the intervention group for all post-birth timepoints except for T4 where the control group had significantly higher rates. The reasons for the diminishing effect are unclear. An increasing uptake of FP methods requires a multifaceted approach that includes increasing accessibility, knowledge, and acceptability as well as addressing societal and cultural norms.

Exploration of family caregivers’ experiences on coping in dementia care in Ghana: a phenomenological study

BackgroundDementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are often supported and cared for by family caregivers in the community. In the execution of these services to the persons living with dementia, family caregivers are overwhelmed and experience heightened stress that results in serious repercussions. Therefore, the aim of this study was to explore family caregivers’ experiences on coping in dementia care in Ghana.MethodsAdopting a descriptive phenomenological design, individual face-to-face interviews were conducted among thirty unpaid family caregivers of persons living with dementia in Ghana. Semi-structured interview guides were used. The data analysis process followed Clarke and Braun’s framework analysis.ResultsSix themes were generated from the textual data. These themes were captioned as: (1) empathy and perspective-taking; (2) family support and cohesion; (3) coaxing and pampering of persons living with dementia; (4) humour and positive communication; (5) spiritual support; and (6) ethical/moral consideration in dementia caregiving.ConclusionWe conclude that unpaid family caregivers of persons living with dementia in Ghana adopt varied strategies to cope with the strains of caregiving. Healthcare facilities that provide services to persons living with dementia could incorporate caregiver preparatory training or education for family caregivers. This training should focus on briefing family caregivers about the potential strains that they are likely to encounter. Also, the training could focus on equipping family caregivers with the knowledge and skills to effectively communicate and care for the persons living with dementia using person-centered approaches. Key stakeholders such as the Ghana Health Service and Alzheimer’s Ghana must raise awareness about the dangers of caregivers’ violation of the autonomy and freedom of persons living with dementia as they navigate through the challenges of caregiving. Lastly, faith-based institutions need to be considered as key stakeholders in dementia interventions since they could play a critical role.

The Potential of Ketamine in Palliative Care: Ethical and Legal Considerations in Ghana

This study delves into exploring how ketamine could be beneficial, in providing care in Ghana investigating the legal considerations surrounding its usage. By utilizing the CRuPAC method (Context, Rule, Principle, Application and Conclusion) the research assesses how effective and safe ketamine is in addressing pain and depression identifies principles at play and reviews the legal frameworks regulating medication use within Ghana. The results underscore the potential of ketamine in enhancing symptom management and quality of life for patients receiving care while underscoring the importance of an approach to ensure its safe ethical and fair utilization. The study puts forth suggestions such as establishing protocols offering training initiatives and incorporating ketamine, into the National Health Insurance Scheme. Its significance lies in guiding policy making based on evidence and practices that prioritize welfare and independence.

The Potential of Ketamine in Palliative Care: Ethical and Legal Considerations in Ghana

This study delves into exploring how ketamine could be beneficial, in providing care in Ghana investigating the legal considerations surrounding its usage. By utilizing the CRuPAC method (Context, Rule, Principle, Application and Conclusion) the research assesses how effective and safe ketamine is in addressing pain and depression identifies principles at play and reviews the legal frameworks regulating medication use within Ghana. The results underscore the potential of ketamine in enhancing symptom management and quality of life for patients receiving care while underscoring the importance of an approach to ensure its safe ethical and fair utilization. The study puts forth suggestions such as establishing protocols offering training initiatives and incorporating ketamine, into the National Health Insurance Scheme. Its significance lies in guiding policy making based on evidence and practices that prioritize welfare and independence.

A national audit of facilities, human and material resources for the comprehensive management of diabetes in Ghana-A 2023 update.

The human and material resources as well as the systems for managing diabetes in Africa are inadequate. This study or needs assessment, aimed at updating the human and material resources, identifying the gaps and unmet needs for comprehensive diabetes care in Ghana. We conducted a national audit of 122 facilities in all 16 administrative regions of Ghana. Information obtained covered areas on personnel and multidisciplinary teams, access to medications, access to laboratory services, financing, screening services, management of diabetes complications, and availability/use of diabetes guidelines or protocols. Data was analysed using STATA version 16.1. P-values <0.05 were set as significant. Only 85(69.7%) out of the 122 surveyed facilities had a dedicated centre or service for diabetes care. Twenty-eight (23%) had trained diabetes doctors/specialists; and whilst most centres had ophthalmic nurses and dieticians, majority of them did not have trained diabetes educators (nurses), psychologists, ophthalmologists, podiatrists, and foot/vascular surgeons. Also, 13.9% had monofilaments, none could perform urine dipstick for microalbumin; 5 (4.1%) and just over 50% could perform laboratory microalbumin estimation and glycated haemoglobin, respectively. Access to and supply of human insulins was better than analogue insulin in most centres. Nearly 100% of the institutions surveyed had access to metformin and sulphonylurea with good to excellent supply in most cases, whilst access to Sodium Glucose Transporter-2 inhibitors and Glucagon-like peptide-1 analogues were low, and moderate for Dipeptidyl peptidase-4 inhibitors and thiazolidinediones. Majority of the health facilities (95.1%) offered NHIS as payment mechanism for clients, whilst 68.0% and 30.3% of the patients paid for services using out-of-pocket and private insurance respectively. Fifteen facilities (12.3%) had Diabetes Support Groups in their locality and catchment areas. An urgent multisectoral collaboration, including prioritisation of resources at the facility level, to promote and achieve acceptable comprehensive diabetes care is required.

Enhancing stroke care in Ghana: A systematic review of stroke rehabilitation services

ObjectiveIn Ghana, the shifting demographics of stroke incidence towards young adults have prompted the expansion of stroke care and rehabilitation efforts. Nevertheless, the precise impact of stroke rehabilitation remains unclear. We conducted a systematic review to explore the landscape and effects of stroke rehabilitation in Ghana. MethodWe identified articles on stroke rehabilitation services in Ghana through searches of PubMed, Scopus, Embase, and Web of Science from inception until February 2024. The Critical Appraisal Skills Programme (CASP) Qualitative Checklist was employed to assess the risk of bias in the included studies, supplemented by qualitative synthesis. ResultsAmong the 213 articles screened, 8 were deemed suitable for review. These studies primarily focused on two groups: stroke survivors (n = 335) and healthcare professionals (HCPs) (n = 257). Many stroke survivors reported significant benefits from telerehabilitation, with increased participation in rehabilitation activities correlating with improved physical and cognitive outcomes. The findings also underscored a lack of knowledge about stroke rehabilitation among HCPs, alongside variations in the availability of protocols and guidelines for stroke management across different hospital levels. ConclusionsThe review reveals several challenges in stroke rehabilitation in Ghana, including disparities in HCPs' perceptions and utilization of rehabilitation services. The findings emphasize the need for comprehensive, patient-centered approaches, standardized training for HCPs, improved resource allocation, and the integration of telehealth to overcome barriers and enhance stroke rehabilitation in Ghana. These insights hold significance not only for Ghana but also for guiding strategies in similar contexts worldwide, aiming to improve stroke rehabilitation outcomes.

Gait speed and its associated factors among older black adults in Sub-Saharan Africa: Evidence from the WHO study on Global AGEing in older adults (SAGE).

Gait speed is an essential predictor of functional and cognitive decline in older adults. The study aimed to investigate the gait speed of older adults in Ghana and South Africa and to determine its associated factors, as the Sub-Saharan representatives in the World Health Organization's Study on Global AGEing in Older Adults (SAGE). A secondary analysis of data from the SAGE study which consists of nationally representative data involving participants aged ≥50+ years with smaller samples of younger adults aged 18-49 years in Ghana and South Africa was conducted. SAGE study employed a multistage, stratified clustered sample design and involved the use of a standardised questionnaire to obtain participants' (n = 5808) demographic, anthropometric and gait speed information. The standard 4 metre-gait speed was used. Median gait speed for the study group, which comprised African/Black participants aged ≥50+ years was 0.769(Q1 = 0.571, Q3 = 0.952)m/s for males and 0.667 (Q1 = 0.500,Q3 = 0.833)m/s for females. For every unit increase in age, the odds of being in a higher-ranked gait speed category was 0.96(95%CI 0·96, 0·97, p<0.001) times that of the previous age. Females had odds of 0.55 (95%CI 0.50, 0.61, p<0.001) of recording higher gait speed, as compared to males. Rural dwellers had odds of 1.43 (95%CI 1.29, 1.58, p < 0.001) of being in a higher-ranked category of gait speed compared to urban dwellers. Underweight (OR = 0.85, 95%C1 = 0.73-1.00, p<0.05) and obesity (OR = 0.53, 95%CI = 0.46-0.61, p<0.001) were associated with slower gait speed. Amongst functional indices, the World Health Organization Disability Assessment Schedule (WHODAS) score was the biggest determinant of gait speed. Having a "Severe/Extreme" WHODAS score had the strongest association with gait speed (OR = 0.18, 95%CI = 0.14-0.23, p<0.001). These gait speed results provide an essential reference for older adults' care in Ghana and South Africa.

Stakeholder opinions on perceived sub-standard emergency obstetric and newborn care in Ghana

BackgroundSub-Saharan Africa is unlikely to achieve sustainable development goal (SDG) 3 on maternal and neonatal health due to perceived sub-standard maternal and newborn care in the region. This paper sought to explore the opinions of stakeholders on intricacies dictating sub-standard emergency obstetric and newborn care (EmONC) in health facilities in Northern Ghana.MethodsDrawing from a qualitative study design, data were obtained from six focus group discussions (FGDs) among 42 health care providers and 27 in-depth interviews with management members, clients and care takers duly guided by the principle of data saturation. Participants were purposively selected from basic and comprehensive level facilities. Data analysis followed Braun and Clarke’s qualitative thematic analysis procedure.ResultsFour themes and 13 sub-themes emerged as root drivers to sub-standard care. Specfically, the findings highlight centralisation of EmONC, inadequate funding, insufficient experiential training, delay in recruitment of newly trained essential staff and provider disinterest in profession.ConclusionSetbacks in the training and recruitment systems in Ghana, inadequate investment in rural health coupled with extent of health provider inherent disposition to practice may be partly responsible for sub-standard obstetric care in the study area. Interventions targeting the afore-mentioned areas may reduce events of sub-standard care.

Health-Seeking Behavior of Persons with Chronic Hepatitis B in Peri-Urban Ghana: Application of the Health Belief Model

Sub-Saharan African countries, including Ghana, are disproportionately affected by hepatitis B. In Ghana, the burden of hepatitis B is unevenly distributed, with the Brong Ahafo region having the highest prevalence (13.7%). Given that people with hepatitis B (PWHB) in Ghana have previously been found to have a lack of understanding of the impact of the infection, we sought to explore their health-seeking behaviour using the health belief model as an organising framework. A qualitative exploratory design was used. In total, 18 people were purposively selected for face-to-face interviews. The data was processed and analysed using QSR NVivo version 11.0 and the Braun and Clarke thematic analysis procedure. The belief that hepatitis B can cause liver cancer and death was the most important determinant of health seeking. Furthermore, access to accurate hepatitis B information, particularly information about availability of effective hepatitis B treatment, influenced a number of participants to seek formal care. However, the high cost of clinical monitoring and treatment to use herbal medicine, despite their concerns about the effectiveness of herbal medicines in managing hepatitis B. Given that hepatitis B information was a factor in health seeking, it is recommended that a hepatitis B awareness campaign focusing on the availability of hepatitis B treatment and where it can be obtained be carried out in the study area. Counselling PWHB at the point of diagnosis should highlight the relevance of life-long clinical monitoring. To remove financial barriers to hepatitis B care in Ghana, the government should include the cost of hepatitis B laboratory investigations and treatment in the health insurance scheme.

Satisfaction levels and associated influencing factors among inpatients and outpatients with breast cancer at a tertiary health facility in Ghana.

To uncover variables linked to breast cancer patient satisfaction in order to improve policy choices and actions for breast cancer care in Ghana. We employed a cross-sectional design using a quantitative approach. The Radiotherapy, Oncology and Surgery Departments of the Korle Bu Teaching Hospital, Accra. Inpatient and outpatient breast cancer patients. The level of inpatient and outpatient satisfaction was measured using descriptive and inferential statistical analyses. The Shapiro-Wilk test was employed to assess normality, while the Heckman selection model assessed significance with outcomes of interest. A total of 636 participants, with a mean age of 52.64±14.07 years, were recruited. The measured inpatient and outpatient levels of satisfaction out of 100 were 74.06±7.41 and 49.99±1.00 respectively, while the self-reported satisfaction levels out of 5 were 4.22±0.63 and 4.11±0.85 respectively. The level of inpatient satisfaction was significantly influenced by age, marital status, income level, and number of previous facilities visited (p<0.05). Outpatient satisfaction level was significantly associated with place of residence and income level (p<0.05). The study offers insight into the satisfaction levels of breast cancer patients receiving inpatient and outpatient services at the largest tertiary referral centre and teaching hospital in Ghana, as well as the factors influencing attendance and satisfaction levels. Understanding and improving breast cancer patients' levels of satisfaction is a way that providers can safeguard their emotional well-being. Improvement in patient satisfaction at our institution among outpatients is an area for future growth. Gardner-Holt Women's Health Grant program, Centre for Global Surgery 2021.

Participant Evaluation of a Multi-disciplinary Oncology Preceptorship Training Program for Oncology Health Professionals from Kumasi, Ghana

A critical shortage of skilled healthcare workers is a primary cause of disparate global cancer outcomes. We report participant evaluation of a multidisciplinary preceptorship program. In collaboration with the city of Kumasi, Ghana, Mayo Clinic and the City Cancer Challenge hosted a preceptorship program for comprehensive multidisciplinary breast and cervix cancer training. A total of 14 healthcare workers from Kumasi received two weeks of training at Mayo Clinic in November and December 2021. Each participant and preceptor were requested to complete an anonymous post-participation survey. Of the 14 trainee participants, 10 (71%) completed the survey. All respondents found the program “valuable and applicable to their clinical practice.” Ninety percent reported they were able to “review effective and critical elements in the development and expansion of the multidisciplinary team” and able to “solve practical clinical cases as a team”. General themes of satisfaction included: (1) organization and administration, (2) clinical observations and demonstrations, (3) guidelines development, and (4) recognizing the central importance of cultivating a team-based approach. Of the 40 preceptors, 16 (40%) completed the survey. All respondents reported they felt the training would meaningfully “influence patient care in Ghana”, that participation “added value or joy to their clinical practice,” and all wished to “participate in future preceptorship programs”. After a focused two-week program, trainees reported high satisfaction, usefulness from observing specialized cancer care, and value in closely observing a multidisciplinary oncology team. Preceptors reported the experience added joy and perspective to their clinical practice and wished to participate in future programs.

Adult Perceptions of Child Adjustment in Institutional versus Family Care in Ghana

Research on institutional child care consistently has documented detrimental developmental outcomes. However, recent work in Ghana revealed a range in patterns of adjustment among children living in institutional care. The developmental patterns of children living in institutional care often were not significantly different from patterns seen among children living in families. A grounded-theory approach was used to understand Ghanaian adults’ perceptions of adjustment of children living in both institutional care and with families, and their beliefs about contributions to positive functioning. Qualitative semi-structured interviews were conducted with 38 caregivers, social workers, and teachers recruited from the Accra region in Ghana. Thematic analysis of responses was used to identify common themes described in the interviews. Interviews with participants revealed beliefs that children may struggle in one or more areas while still having strengths. Having basic needs met, a stable home, and a high level of adult support were the most common factors believed to contribute to positive functioning in both groups of children. Future studies or interventions targeting these areas will likely gain buy-in from stakeholders.

Inverting the deficit model in global mental health: An examination of strengths and assets of community mental health care in Ghana, India, Occupied Palestinian territories, and South Africa.

Global mental health [GMH] scholarship and practice has typically focused on the unmet needs and barriers to mental health in communities, developing biomedical and psychosocial interventions for integration into formal health care platforms in response. In this article, we analyse four diverse settings to disrupt the emphasises on health system weaknesses, treatment gaps and barriers which can perpetuate harmful hierarchies and colonial and medical assumptions, or a 'deficit model'. We draw on the experiential knowledge of community mental health practitioners and researchers working in Ghana, India, the Occupied Palestinian Territory and South Africa to describe key assets existing in 'informal' community mental health care systems and how these are shaped by socio-political contexts. These qualitative case studies emerged from an online mutual learning process convened between 39 academic and community-based collaborators working in 24 countries who interrogated key tenets to inform a social paradigm for global mental health. Bringing together diverse expertise gained from professional practice and research, our sub-group explored the role of Community Mental Health Systems in GMH through comparative country case studies describing the features of community care beyond the health and social care system. We found that the socio-political health determinants of global economic structures in all four countries exert significant influence on local community health systems. We identified that key assets across sites included: family and community care, and support from non-profit organisations and religious and faith-based organisations. Strengthening community assets may promote reciprocal relationships between the formal and informal sectors, providing resources for support and training for communities while communities collaborate in the design and delivery of interventions rooted in localised expertise. This paper highlights the value of informal care, the unique social structures of each local context, and resources within local communities as key existing assets for mental health.

Legal and Ethical Issues in Geriatric Care in Ghana

Legal and Ethical Issues in Geriatric Care in Ghana

Utilization of Perinatal Depression and Anxiety Assessment Tools in Routine Perinatal Care: a Call for the Integration and Implementation of Maternal Mental Health Services into Perinatal Care in Ghana

Background: This study intends to stimulate critical thinking and generate impactful discussions on the provision of holistic perinatal care. The rationale is to promote the exchange of ideas and collaboration among stakeholders to ensure that the training and practice of midwifery in Ghana become more robust and meet global standards. Additionally, it is meant to inform, prepare competent, resourceful, knowledgeable, and most importantly adaptable midwives who can contribute to and promote the overall health of the women in their care. Objective: To explore midwives’ knowledge and understanding on soliciting the requisite information that impacts the psychological health of the perinatal women in their care during the perinatal period using globally validated and reliable assessment tools for depression and anxiety. Methods: A structured questionnaire was used to collect data from the participants (midwives). The study was conducted in selected hospitals across all 16 regions in Ghana. A total of 319 midwives with varying degrees and experience working at different levels (teaching, municipal, regional and district hospitals) of the health care system in Ghana participated in the study. Basic descriptive quantitative analysis was used based on frequency tables, pie chart and graphical illustration to interpret the data. Results: The participants have adequate knowledge on the impact of perinatal anxiety and depression on birth and maternal outcomes. However, the remains a huge deficit in their ability to use the validated and reliable assessment tools in recognizing clinical cues related to anxiety and depression among perinatal women. Surprisingly, over 50% of the midwives were unfamiliar with the commonly used assessment tools for depression and anxiety such as the EPDS and PHQ-9. Additionally, nearly 40% of the participants lack the requisite assessment skills for assessing perinatal anxiety and depression. Conclusion: Perinatal mental health should be made a critical component of perinatal care, with midwives being well situated to recognize the manifestations of deteriorating mental health among the perinatal women in their care and provide the needed support and required level of supervision. It is therefore imperative to train midwives on basic mental health assessment skills and encourage them to incorporate mental health care into the delivery of routine perinatal care and services.