Ghana Health Service

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.

Introduction: Typhoid fever (TF) is a major public health problem in developing countries. Surveillance data from the West Gonja Municipality (WGM) of Ghana have not been analysed to provide an understanding of the disease burden. This study aimed to determine the seroprevalence, trend and distribution of TF in the WGM of Ghana. Method: We conducted a secondary data analysis by collecting data on laboratory-tested cases of suspected TF between January and December 2022. We determined the seroprevalence based on either IgM or IgG or both. We tested associations between demographics and TF antibody status using logistic regression. A p-value less than 0.05 was considered statistically significant at 95% confidence interval (CI). Results: A total of 2,998 suspected and 377 (12.6%) tested TF records were analysed. The mean age of the tested cases was 30.8 years (SD ± 18.2). The overall seroprevalence of TF was 52.3% (197/377), [95% CI (47.1-57.4)]. There was no significant association between typhoid serum antibody status with age groups, sex and sub-municipality. Seroprevalence was highest among individuals aged 61 years and above (63.3%), 51-60 years (61.3%), and children <11 years (55.6%). Males had a higher rate, 56.1% (96/171). The Dass and Canteen Sub-municipalities had the highest positivity rates, 83.3% (5/6) and 55.3% (162/293) respectively. Over the period, cases fluctuated with peaks in March and April. Conclusion: The seroprevalence of TF was high in the municipality with males, the oldest aged groups and children having the highest burden of infection. Although testing was low, there was a high positivity in March and April, with cases positively skewed towards Dass and Canteen areas. The health authorities should improve testing and institute laboratory-based culture testing and surveillance.

ABSTRACT Food insecurity is a prevalent issue in rural communities within Ghana and particularly within the Karaga District (Northern Region), where climate change is intensifying vulnerabilities. Extreme and unpredictable weather events are disrupting agriculture and worsening food insecurity across all four pillars: availability, accessibility, affordability, and utilisation. Despite women's central role in household food decisions, limited evidence exists on their experiences of food insecurity under climate change. This study surveyed 384 women in Pishigu (Karaga District) in March 2025, assessing food insecurity (Food Insecurity Experience Scale), perceived climate impacts (using the Global Strategic Food Insecurity & Nutrition framework), health (RAND SF‐36), and dietary diversity (Global Diet Quality Project). Rasch modelling estimated prevalence, descriptive statistics explored reported climate impacts, and multivariate logistic regression identified factors associated with severe food insecurity. Results revealed that 93.4% experienced moderate or severe food insecurity, and 52.6% were severely food insecure, exceeding national and regional averages. Nearly two‐thirds reported worsening food insecurity over five years, with climate change affecting all pillars: 83.1% cited crop and livestock losses, 86.98% reported reduced storage capacity, and 86.72% noted reduced income. Only 30.2% consumed a sufficiently diverse diet, and mean general health scores (56.12, SD ±18.23) were lower than urban areas. Relative wealth, perceived energy, dietary diversity, knowledge of climate change and nutrition‐related healthcare use were significantly associated with severe food insecurity. Findings underscore the urgent need for gender‐sensitive, climate‐informed policies and education, to strengthen resilience and empower women, ensuring sustainable progress in Karaga District and similar rural communities.