Understanding the burden and contextual risk factors is critical for developing appropriate interventions to control undernutrition. This study used data from the 2014 Ghana Demographic and Health Survey to estimate the prevalence of underweight, stunting, and wasting. Single multiple logistic regressions were used to identify the factors associated with underweight, wasting and stunting. The study involved 2720 children aged 0–59 months old and mother pairs. All analyses were done in STATA/IC version 15.0. Statistical significance was set at p<0.05. The prevalence of underweight, wasting and stunting were 10.4%, 5.3%, and 18.4% respectively. The age of the child was associated with underweight, wasting and stunting, whereas the sex was associated with wasting and stunting. Normal or overweight/obese maternal body mass index category, high woman’s autonomy and middle-class wealth index were associated with a lower odds of undernutrition. The factors that were associated with a higher odds of child undernutrition included: low birth weight (<2.5 kg), minimum dietary diversity score (MDDS), a higher (≥4^th) birth order number of child, primary educational level of husband/partner and domicile in the northern region of Ghana. There is still a high burden of child undernutrition in Ghana. The age, sex, birth weight, birth order and the MDDS of the child were the immediate factors associated with child undernutrition. The intermediate factors that were associated with child undernutrition were mainly maternal related factors and included maternal nutritional status and autonomy. Distal level factors which were associated with a higher odds of child undernutrition were the wealth index of the household, paternal educational status and region of residence. We recommend that interventions and policies for undernutrition should address socioeconomic inequalities at the community level while factoring in women empowerment programmes.

Background: The service industry has been an evolving sector and a great concern to providers ensuring continuously that clients’ satisfaction is met. Hence, the importance of patient satisfaction in the healthcare sector. This study focused on the satisfaction of women with the delivery of health services in Ghana and aims to be different from other studies which has focused on patient satisfaction with urban and rural health services, regional health services and health insurance. Our study examines the percentages of satisfaction with the multiple outcomes defined and identifies the key health system and demographic related factors associated with women satisfaction. Methods: This study used data from the 2014 Ghana Demographic and Health Survey and a total of 12,831 households were systematically selected with reproductive women aged 15–49 years eligible for interview. Data for this study was analysed quantitatively using descriptive statistics, chi square and regression analysis. A total of 3648 women were included in this study and the final analysis thus involved a weighted sample of 3507 women. Satisfaction indicators were put together into SERVQUAL dimensions in the study and reliability test run using Cronbach Alpha (α). All data analyses were carried out in STATA 13.0. The adjusted odds ratios (AOR) with their corresponding 95% confidence intervals (CI) were calculated. Results: Analysis showed that independently, education and religion were significantly associated with service reliability, overall satisfaction and responsiveness. Payment option was also associated with responsiveness and tangibility dimensions. Furthermore, place of residence was independently associated with responsiveness, tangibility and overall satisfaction. Finally, maternal age, region, provider friendly, ease of getting care and opening hours were all independently associated with reliability, responsiveness, tangibility and overall service satisfaction at the multivariable level. Conclusions: Dimensions of service quality which focus on patient-centered atmosphere and efficient service delivery system should be integrated and strengthened by hospital management in order to increase patient satisfaction. Key maternal characteristics and health system related factors were revealed to have positive association with patient satisfaction with health services delivery and this cannot be ignored by health care managers in ensuring that systems are improved for better health care.

Research has shown that use of antenatal services by pregnant women and delivery in health facilities with skilled birth attendants contribute to better delivery outcomes. However, a gap exists in Ghana between the use of antenatal care provided by health facilities and delivery in health facilities with skilled birth attendants by pregnant women. This study sought to identify the predictors of health facility delivery by women in a rural district in Ghana. This was a cross-sectional study conducted in June 2016. Women who delivered in the past 6 months preceding the study were interviewed. Data on socio-demographic characteristics, use of antenatal care, place of delivery and reasons for home delivery were collected from study participants. Chi-square test and multiple logistic regression analysis were used to assess an association between women’s socio-demographic and obstetric characteristics and place of delivery at 95% confidence interval. The study found that 98.8% of women received antenatal care services at least once during their recent pregnancy, and 67.9% attended antenatal care at least four times before delivery. However, 61.9% of the women delivered in a health facility with a skilled attendant. The frequently mentioned reason for home delivery was “unaware of onset of labour and delivery”. The odds for delivery at a health facility were reduced among women with four living children [(AOR = 0.07, CI = 0.15–0.36, p = 0.001)], with no exposure to delivery care information [(AOR = 0.06, CI = 0.01–0.34, p = 0.002), who started their first ANC visit from the second trimester of pregnancy[(AOR = 0.003, CI = 0.01–0.15, p < 0.001)] and increased among women who made at least four ANC visits before delivery [(AOR = 17.53, CI = 6.89–44.61, p < 0.001)]. Findings from this study revealed a low rate of delivery at health facilities although visits to antenatal care sessions were high, an indication that there was the need to intensify health education on early initiation of antenatal care, signs of labour and delivery, and importance of health facility delivery.

Background. Unsafe induced abortion is a major contributor to maternal morbidity and mortality in Ghana. Objective. This study aimed to explore the predictors of unsafe induced abortion among women in Ghana. Methods. The study used data from the 2017 Ghana Maternal Health Survey. The association between women’s sociodemographic, obstetric characteristics, and unsafe induced abortion was explored using logistic regression. The analysis involved a weighted sample of 1880 women aged 15-49 years who induced abortion in the period 2012-2017. Analysis was carried out using STATA/IC version 15.0. Statistical significance was set at p <0.05. Results. Of the 1880 women, 64.1% (CI: 60.97-67.05) had an unsafe induced abortion. At the univariate level, older women (35-49 years) (odds ratio=0.50, 95% CI: 0.28-0.89) and married women (odds ratio=0.61, 95% CI:0.44-0.85) were less likely to have an unsafe induced abortion while women who did not pay for abortion service (odds ratio=4.44, 95% CI: 2.24-8.80), who had no correct knowledge of the fertile period (odds ratio =1.47, 95% CI: 1.10-1.95), who did not know the legal status of abortion in Ghana (odds ratio =2.50, 95% CI: 1.68-3.72) and who had no media exposure (odds ratio =1.34, 95% CI: 1.04-1.73) had increased odds for an unsafe induced abortion. At the multivariable level, woman’s age, payment for abortion services, and knowledge of the legal status of abortion in Ghana were predictors of unsafe induced abortion. Conclusion. Induced abortion is a universal practice among women. However, unsafe abortion rate in Ghana is high and remains an issue of public health concern. We recommend that contraceptives and safe abortion services should be made available and easily accessible to women who need these services to reduce unwanted pregnancies and unsafe abortion rates, respectively, in the context of women’s health. Also, awareness has to be intensified on abortion legislation in Ghana to reduce the stigma associated with abortion care seeking.

Cheteu Wabo TM, et al. Nutr Res Pract. 2022 Feb;16(1):74-93. https://doi.org/10.4162/nrp.2022.16.1.74

Background: Antiretroviral therapy (ART) has helped reduce the burden of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the majority of countries. Its contribution to the HIV/AIDS burden in Ghana is still understudied. This study examined HIV/AIDS trends in Ghana before (1990–2004) and after (2004–2020) the implementation and expansion of ART. Methods: We obtained HIV/AIDS epidemiology and treatment data for the years 1990–2020 from the United Nations Programme on HIV/AIDS. We investigated the impact of the ART rollout on HIV/AIDS in Ghana using Joinpoint regression models. Results: The HIV incidence, prevalence, and AIDS-related deaths decreased significantly after 2004, as ART coverage increased from 1% to 2004 to 60% in 2020. The HIV incidence decreased by approximately 3% (AAPC = -2.6%; 95% CI: -3.2, -1.9) per year from 1990 to 2004 and approximately 5% (AAPC = -4.5%; 95% CI: -4.9, -4.2) per year from 2004 to 2020. Between 1990 and 2004, the HIV prevalence increased by approximately 5% (AAPC = 4.7%; 95% CI: 3.6, 5.8) per year but decreased by 2% (AAPC = -1.9%; 95% CI: -2.1, -1.6) per year between 2004 and 2020. Between 1990 and 2004, the annual increase in AIDS-related mortality was 14% (AAPC = 13.8%; 95% CI: 12.6, 15.0), but between 2004 and 2020, it decreased at nearly a 4% (AAPC= -3.6%; 95% CI: -4.7, -2.5) annual rate. Conclusions: We found trends indicating progress in Ghana’s fight against HIV/AIDS. However, the most significant declines occurred after the introduction of ART, suggesting that the scale-up of ART may have contributed to the decline in HIV/AIDS in Ghana. We advocate for the rapid expansion of ART in Ghana.