The Ghana Health Service (GHS) is a Ghanaian government body established in 1996 as part of the Health Sector Reform of Ghana. The Health Service is under the Ministry of Health. The Health service primarily administrates the health services provided by the government and in implementing government policies on healthcare. The Director-General of the Health service is Dr. Patrick Kuma-Aboagye.
Abstract Background While access and quality issues in immunization services are well documented, determinants related to social norms and the roles of male and female caregivers remain underexplored in Ghana. This study examined social and behavioral barriers to childhood immunization to inform a family-based intervention to strengthen household engagement in immunization decision-making and improve childhood immunization. Methods A qualitative study was conducted in the Kpone Katamanso district of the Greater Accra Region, Ghana, in April 2023. Data was collected in English, Ga, and Twi through 10 key informant interviews with healthcare workers, 10 in-depth interviews with mothers of fully and under-vaccinated children, and eight focus group discussions with mothers (n=30) and fathers (n=24) of children under two years. Transcripts were coded and analyzed inductively to identify major themes. Results Six themes emerged: (1) diverse household immunization decision-making structures; (2) mothers as the primary actors in vaccination; (3) contrasting perceptions of fathers’ versus mothers’ availability; (4) potential to increase fathers’ engagement through improved knowledge and community influencers; (5) differing interpersonal communication experiences with healthcare workers; and (6) health system barriers disproportionately affecting mothers. Social norms and limited male involvement constrained mothers’ time, autonomy, and support, while healthcare barriers, such as staff shortages, indirect costs, and vaccine stockouts, further impeded access. Conclusion Findings highlight both demand- and supply-side barriers to childhood immunization. The differential valuation of mothers’ versus fathers’ time emerged as a key structural barrier. Promoting male engagement, strengthening interpersonal communication between caregivers and health workers, and addressing health system barriers may improve immunization uptake and advance family-centered immunization strategies in Ghana.
INTRODUCTION:Tobacco use among adolescents is a concern in the Upper East Region of Ghana. We estimated the prevalence and identified factors contributing to single and multiple use of tobacco products among junior high school students in Ghana. METHODS:We conducted a cross-sectional analysis of a baseline survey of a school-based tobacco control intervention among adolescents in the Upper East Region of Ghana in 2022. A multi-stage cluster sampling approach was employed to identify the study sample, and data were collected using self-administered questionnaires. Current use of single tobacco products (at least one: cigarette, e-cigarette, shisha, or smokeless tobacco products) and multiple products (≥2 products) in the past 30 days was assessed. Multinomial logistic regression was used to assess the association of sociodemographic characteristics, perceptions towards tobacco's health risks, and exposure to tobacco products with single and multiple product use. Adjusted relative risk ratios (ARRR) and their corresponding 95% confidence intervals (CI) were computed. RESULTS:We surveyed 1328 adolescents, comprising an equal proportion of males (49.8%) and females (50.4%). One in five (21.7%) reported using tobacco products, with 11.5% using single products and 13.0% using multiple products. Shisha (13.6%), cigarettes (10.6%), e-cigarettes (8.2%), and smokeless tobacco (6.0%) were used. A number of factors were identified to be associated with tobacco use among adolescents. CONCLUSIONS:One in five junior high school students used at least one form of tobacco product. Adolescent tobacco use is impacted by demographic factors and risk perceptions. Further studies are needed to better understand these associations.
Background:The global tuberculosis (TB) burden remains high, though several interventions have been instituted to fight the TB epidemic. Community perception and understanding play a critical role in health-seeking behaviors, ultimately influencing the acceptance and effectiveness of control efforts. In observance of World Tuberculosis (TB) Day in 2022 and 2023, we engaged the community and sought their understanding of TB and diabetes mellitus (DM). Methods:Interactive educational sessions were held in the outpatient department, basic schools, nursing college, and the market. A validated questionnaire was administered to consenting adults to evaluate their knowledge and views on TB and DM. Responses from participants were gathered using the KoboToolbox data collection program. Participants also underwent health screening, and those identified with TB and or DM were sent to Korle-Bu Teaching Hospital (KBTH) for appropriate management. Results:The survey documented responses from 285 individuals. The majority of the participants (63.5%) were women, aged 36-59 (38.3%), and had only basic school education (50.9%). Among the 179 individuals aware of TB, 48% accurately recognized bacteria or germs as its causative agents. Nonetheless, certain myths persisted, with around 6% attributing the disease to witchcraft or curses and 21% unclear of its genesis. Approximately 85% of individuals were aware of DM, while around 72% ascribed its etiology to dietary factors. Concerning community members' engagement with patients diagnosed with TB, only 52.3% indicated they would have contact with those living with TB, whereas 82.5% expressed willingness to engage with those with diabetes mellitus. Approximately 55% of the participants perceived that both TB and DM are incurable. Conclusion:Our findings reveal critical knowledge gaps and widespread misconceptions about TB and DM. These gaps can be reduced through health education campaigns and community engagement that foster timely health-seeking behaviors, improving disease outcomes.
Digital Health Interventions (DHIs) refer to discrete technological functionalities designed to achieve specific objectives in addressing health system challenges. These interventions are considered tools for strengthening health systems, particularly in low- and middle-income countries. This study consolidates findings from Ethiopia, Ghana, and Zimbabwe, examining how three distinct digital health applications with varying intervention components implemented in primary healthcare settings contribute to health system strengthening. The interventions analyzed include Ethiopia's District Health Information System 2 (DHIS2), Ghana's District Health Information Management System (DHIMS) and the Lightwave Health Information Management System (LHIMS), and Zimbabwe's Impilo Electronic Health Record (E-HR) system. In Ethiopia, DHIS2 enhanced health system accountability and data quality by streamlining district-level data aggregation, reporting, and performance monitoring. This led to more informed decision-making and improved resource distribution. In Ghana, DHIMSs functions as a public health-level DHI, facilitating national data-driven performance monitoring, while LHIMS operates at the patient level, supporting patient tracking and management, improving patient workflows and resource tracking. However, a lack of interoperability between these two systems has led to data duplication challenges. Zimbabwe's Impilo E-HR, a patient-level DHI, has streamlined clinical workflows, improved information sharing, and enhanced decision-making at the point of care. Despite these successes, challenges persist across the three contexts: infrastructure limitations, high staff turnover, and insufficient user technical capacity. Interoperability issues, particularly in Ghana and Ethiopia, hinder seamless data exchange, while sustainability concerns such as funding gaps and inadequate government support undermine the systems' full potential. The study findings demonstrate that investments in DHIs in primary healthcare may not result in health systems strengthening without addressing baseline conditions for their implementation and sustainability.
Evidence on how social and school-level contexts shape pediatric vision screening outcomes is limited, particularly in sub-Saharan Africa. We examined the association between individual and contextual factors and vision screening outcomes in a pilot enhanced school-based vision screening program (ESVSP) in Kumasi, Ghana. We conducted a cross-sectional study using data from an ESVSP to detect suspected eye disorders in school-children aged 4-22 years. Outcomes were the presence of suspected eye disorders and referral adherence. Exposure variables were individual [(age, sex, socioeconomic status (SES)], and contextual [school type (public vs private)] factors. Logistic regression was used to estimate unadjusted (OR) and adjusted (aOR) odds ratios with 95% confidence intervals (CI). We analyzed data for 1,123 children screened and 299 referred. The average age was 10.2 (±2.6) years. Overall, 34.0% (n = 382) had suspected eye disorders, and 32.8% (n = 98) adhered to the referral. After adjusting for key variables, children attending public (32.2%) compared to private (67.8%) schools had 45% lower odds of suspected eye disorders (aOR= 0.55; 95% CI 0.37, 0.83). Children with low (13.3%) compared to high (28.6%) SES had 70% lower odds of referral adherence (aOR= 0.30; 95% CI 0.12, 0.80). In this pilot school-based program, school context and SES (an individual-level factor) were associated with suspected pediatric eye disorders and referral adherence, respectively. These findings highlight equity-relevant gaps in referral adherence and underscore the need for context-specific strategies to strengthen referral pathways in low-resource settings.
