Malaria poses a significant threat to pregnant women in sub-Saharan Africa, necessitating effective interventions like the intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). However, challenges persist in the uptake and effectiveness of this intervention. This scoping review aims to explore IPTp-SP uptake in African countries, identify influencing factors, and assess its effectiveness in preventing malaria and adverse outcomes in pregnancy. This scoping review follows Arksey and O’Malley’s framework, employing the PRISMA-ScR guidelines for reporting. Searches were conducted in PubMed, Embase, Scopus, JSTOR, Web of Science, Google Scholar, and ProQuest, focusing on studies post-2000 published in the English language. The search produced 15,153 records, of which 104 full-text records were eligible and 101 papers were included in this review. The findings suggest varying IPTp-SP uptake rates, spanning from 5.3% to 98.9%, with their effectiveness supported by longitudinal studies, randomised controlled-trials (RCTs), cross-sectional surveys, and mixed-method studies. IPTp-SP demonstrates efficacy in reducing malaria during pregnancy, placental parasitaemia, and anaemia episodes, alongside improved birth outcomes. Common adverse effects of IPTp-SP include prematurity and low birth weight. Facilitators of IPTp-SP uptake include education and ANC attendance, while commonly reported barriers included inadequate knowledge and healthcare system challenges. The findings also suggest adverse effects such as prematurity, low birth weight, and maternal and perinatal mortality associated with IPTp-SP uptake. It is vital to strengthen antenatal care services by integrating comprehensive counselling on IPTp-SP and address healthcare system challenges. Community engagement, women’s empowerment, and context-specific interventions are necessary for promoting IPTp-SP uptake and improving maternal and neonatal health outcomes in Africa.

Objective To explore how the COVID-19 pandemic affected access to antiretroviral therapy (ART) services from the perspective of the persons living with HIV (PLWH). Design The study adopted an exploratory-descriptive qualitative design that used in-depth interviews as the technique for the data collection. Data analysis was done using conceptual content analysis, following the traditions of Elo and Kyngäs on deductive and Hsieh on inductive content analysis. Setting ART clinic, Cape Coast Teaching Hospital, Ghana. Participants Twelve participants who had at least 1 year history of accessing ART care before the COVID-19 pandemic and at least one clinic visit during the pandemic were purposively sampled from the ART clinic. Results Five concepts of accessing healthcare proposed by Penchansky and Thomas were explored: accessibility, availability, affordability, accommodation and acceptability. The ART unit in the study setting remained open for service delivery throughout the pandemic. However, fear of contracting the virus while patronising services affected the participants’ decision to use the facility. Although all the participants in this study reportedly honoured their refill appointments, they indicated knowledge of other PLWH defaulting. With reference to the availability of resources, a shortage of antiretrovirals was reported, affecting the refill appointment intervals. In spite of the challenges, several strategies were implemented to accommodate the patients’ needs while protecting them from contracting the virus by instituting the stipulated COVID-19 protocols. The study found that some of the strategies impacted the acceptability and affordability of the services as transportation costs increased. Varying levels of accessibility to health workers providing ART services in the study setting was also recorded. Conclusion Strategies were implemented to accommodate the effects of the pandemic on ART provision. However, these had deficiencies that must be addressed using appropriate Differentiated Service Delivery (DSD) interventions that will ensure continuous access to service delivery in the ongoing and any similar future occurrences.

Objective: The preconception health (PCH) strategy provides a unique opportunity to reduce risk factors for adverse reproductive outcomes before pregnancy. However, many reproductive-aged individuals continue to miss opportunities to improve their health before pregnancy occurs. This study, qualitatively explored strategies required for integrating PCH promotion interventions into routine reproductive health services from university students’ perspectives. Materials and methods: We conducted eight mixed-gender focus group discussions (FGDs) with students in eight schools and faculties in the University from March 2019 to June 2019. Audio-taped data were transcribed verbatim and analyzed manually using inductive content analysis. Results: Three major themes emerged from the analysis of transcripts: interpersonal behavior change strategies, institutional policy directives, public policy interventions, and three main categories with eight sub-categories. The study showed that PCH promotion awareness campaigns, context-relevant service delivery initiatives, institutional and public policy directives are critical approaches for the delivery and uptake of PCH interventions. Participants also recommended prepayment schemes, walk-in services, mobile PCH clinics, and PCH incorporation into university curricula as context-specific strategies for PCH promotion among university students. Conclusion: PCH promotion could be feasible as an integral component of routine reproductive health services for university students. However, multi-level interventions at the student, health service, and institutional levels are necessary to increase awareness and facilitate the request and delivery of PCH services.

Background. Preceptorship constitutes an important component of the educational process of training nursing students. The purpose of this study was to assess the knowledge, perceived motivators, and perceived inhibitors to precepting nursing students at the clinical placement sites in the Cape Coast Metropolis of the Central Region of Ghana. Methods. A descriptive cross-sectional study was conducted among 442 nurses and midwives aged 27–56 years with at least three years of work experience. Data were collected with a questionnaire and analyzed using frequency counts, percentages, exploratory factor analysis, and point biserial correlation. Results. The results indicate that the participants had a high knowledge of preceptorship of up to 91.2% (n = 404). A significant proportion of up to 88.2% (n = 390) had an intention to precept nursing students in the near future. The three important perceived motivational factors to precepting nursing students were the learning and professional needs of students, helping students to develop skills, and experience and formal recognition of the role of preceptorship. The main perceived inhibitors to engage in a preceptorship role were lack of preparation for the role, lack of support from faculty and nurse managers, and additional work burden. The results further indicate a significant strong positive correlation between experience and professional recognition of preceptorship and the intention to precept nursing students in the near future (r = 0.99, ). Conclusions. The nurses and midwives who participated in the study are knowledgeable about preceptorship and have the intention to precept nursing students. Having enough experience on the job and being formally recognized as a preceptor may motivate these professionals to precept nursing students. However, there are critical perceived barriers that need to be addressed, to enable more nurses and midwives with the desire to precept students to engage in the preceptorship role.

Introduction Sickle cell disease (SCD) poses a significant global health burden, particularly affecting individuals in developing countries with constrained healthcare resources. While research on self-management in the context of SCD is emerging, it has predominantly focused on primary studies. The aim of the scoping review was to identify and map self-management needs of individuals living with SCD, the strategies they employed to meet those needs, and the support interventions available to them. Methods and analysis The review was conducted following the Askey and O’Malley’s framework to examine the landscape of SCD self-management research. Searches were conducted in PubMed, Scopus, Embase and Dimensions AI, with additional searches in other databases from inception to June 2024 included. Evidence from 14 studies was synthesised to identify self-management needs, strategies and interventions for individuals with SCD. Results The review identified diverse self-management needs among individuals with SCD, including knowledge deficits, emotional challenges, physical limitations and barriers to healthcare access. Various self-management strategies were reported, such as nutritional management, psychological coping techniques and proactive healthcare management. Self-management interventions, predominantly delivered by healthcare professionals, focused on providing education, skills training and support to individuals with SCD. The outcomes of self-management interventions consistently demonstrated significant improvements across various dimensions, including self-efficacy, knowledge enhancement, self-care practices and psychological well-being among individuals with SCD. Conclusion This scoping review underscores the importance of addressing the diverse self-management needs of individuals with SCD through tailored interventions and support systems to enhance overall well-being and disease management. Healthcare professionals should prioritise the implementation of multidisciplinary self-management interventions that encompass medical, emotional and social aspects of care to effectively support individuals with SCD in managing their condition. Future research should focus on longitudinal studies to assess the long-term effectiveness of self-management interventions in improving patient outcomes.

This study investigated the prevalence and predictors of episiotomy among puerperal women accessing postnatal care in the Kumasi Metropolis. A cross-sectional survey was conducted among 1750 postnatal mothers who had spontaneous vaginal using a questionnaire. Descriptive statistics were conducted to show the rate of episiotomy. Chi-square and binary logistic regression analyses were conducted using Jamovi software version 2.5.3. The prevalence of episiotomy among the study population was 49.7% compared to the 10% of all deliveries recommended by World Health Organisation (WHO). Among those who had an episiotomy, 88.5% gave consent, and 77.6% required repairs. In the bivariate analysis educational status, age, perineal tearing, marital status, household monthly income, spontaneous vaginal deliveries and previous episiotomy had a significant association with episiotomy risk. In the multivariate analysis, married women, lower education levels, moderate household incomes, grand multiparous women, spontaneous vaginal delivery (SVD), instrumental deliveries, longer second stages of labour, and attending more antenatal care (ANC) sessions were all associated with a reduced likelihood of episiotomy. Higher one-minute Apgar scores and anemia also lowered the odds. Conversely, hypertensives, women with four or more previous vaginal deliveries, and those with a history of episiotomy were more likely to undergo the procedure. Episiotomies conducted was high, indicating potential overuse compared to WHO’s recommendations. Antenatal attendance and timing should be prioritised to improve maternal preparation and outcomes. Policy interventions to reduce unnecessary episiotomies are needed. Midwifery education must also emphasise the importance of respectful maternity care.