International organizations and governments have argued that animal health service providers can play a vital role in limiting antimicrobial resistance by promoting the prudent use of antimicrobials. However, there is little research on the impact of these service providers on prudent use at the farm level, especially in low- and middle-income countries where enforcement of prudent-use regulations is limited. Here, we use a mixed-methods approach to assess how animal health-seeking practices on layer farms in Ghana (n = 110) and Kenya (n = 76) impact self-reported antimicrobial usage, engagement in prudent administration and withdrawal practices and perceptions of antimicrobial resistance. In general, our results show that the frequency of health-seeking across a range of service providers (veterinarians, agrovets, and feed distributors) does not significantly correlate with prudent or non-prudent use practices or the levels of antimicrobials used. Instead, we find that patterns of antimicrobial use are linked to how much farmers invest in biosecurity (e.g., footbaths) and the following vaccination protocols. Our results emphasize that more research is required to understand the interactions between animal health service providers and farmers regarding antimicrobial use and antimicrobial resistance. Addressing these gaps will be crucial to inform antimicrobial stewardship training, curriculums and, guidelines whose ultimate purpose is to limit the selection and transmission of antimicrobial resistance.

The Global Program for the Elimination of Lymphatic Filariasis (GPELF) started operation in 2000 and aimed at eliminating the disease by the year 2020, following 5–6 rounds of effective annual Mass Drug Administration (MDA). The MDA programme took off in Ghana in 2001 and has interrupted transmission in many areas while it has persisted in some areas after 10 or more rounds of MDA. This study was to appreciate community members’ perspectives on MDA after over 15 years of implementation. Findings will inform strategies to mobilise community members to participate fully in MDA to enhance the disease elimination process. This was a qualitative study, employing key-informant in-depth-interviews. Respondents were selected based on their recognition by community members as opinion leaders and persons who were knowledgeable about the topic of interest in the community. A snowball sampling technique was used to select respondents. Respondents were well informed about the MDA with most of them saying, it has been implemented for over 12 years. They were aware that the MDA was for the treatment/control of LF (elephantiasis). It came to light that MDA compliance was affected by five related barriers. These are; Medication, Personal, Health system, Disease and Social structure related barriers. Adverse effects of the drugs and the fact that many people perceived that they were not susceptibility to the infection have grossly affected the ingestion of the drugs. There is a need for community mobilization and promotional activities to explain the expected adverse reactions associated with the drugs to the people. Also the importance of why every qualified person in the community must comply with MDA must be emphasized.

To assess the feasibility of the Farmer Field School approach to address the complex problem of antimicrobial resistance in agriculture, specifically within small-to-medium-scale layer poultry systems in Ghana and Kenya. Impact was assessed across three domains relevant to the emergence and selection of antimicrobial resistance, including infection, prevention, and control practices, engagement with animal health professionals, and knowledge, attitudes, and practices on antimicrobial use and antimicrobial resistance. Farmer Field Schools were held in Ghana (N = 2) and Kenya (N = 3) across an eight-month period with an average of 18 participants in each school. After completion, a quantitative evaluation survey was administered to participants and a sample of non-participants (Ghana; N = 97) (Kenya; N = 103). Logistic and ordinary least squares regression were used to assess differences between participants and non-participants on the three domains. Participation in a layer poultry Farmer Field School in Ghana and Kenya is associated with self-reported reductions in antibiotic use, particularly for prevention, an increased investment in farm infection, prevention, and control practices, including the use of footbaths and personal protective equipment, and enhanced engagement with animal health professionals. Antimicrobial resistance is a complex problem driven by a wide range of practices and multiple stakeholders. To holistically address these factors requires the use of complex intervention approaches. The Farmer Field School approach offers a complex intervention methodology that can reduce the emergence and spread of antimicrobial resistance in agricultural systems through targeting the variety of on-farm and off-farm factors that drive resistance.

The lockdown measures in response to the coronavirus disease (COVID-19) have led to a wide range of unintended consequences for women and children. Until the outbreak of COVID-19, attention was on reducing maternal and infant mortality due to pregnancy and delivery complications. The aim of this study was to interrogate the impact of lockdown measures on women and children in two contrasting districts in Ghana – Krobo Odumase and Ayawaso West Wuogon. This study adopted the mixed-method approach using both qualitative and quantitative data. The qualitative study relied on two data collection methods to explore the impacts of COVID-19 control measures on women and children in Ghana. These were: Focus Group Discussions (FGDs; n = 12) and Key Informant Interviews (KIIs; n = 18). The study complemented the qualitative data with survey data - household surveys (n = 78) which were used to support the nutrition and school closure data; and policy data gathered from government websites consisting of government responses to COVID-19. The qualitative data was analysed using the thematic approach with codes generated apriori with the NVIVO software. The quantitative data used percentages and frequencies. Engagements with participants in the study revealed that the lockdown measures implemented in Ghana had consequences on child and maternal health, and the health care system as a whole. Our study revealed, for example, that there was a decrease in antenatal and postnatal attendance in hospitals. Childhood vaccinations also came to a halt. Obesity and malnutrition were found to be common among children depending on the location of our study participants (urban and rural areas respectively). Our study also revealed that TB, Malaria and HIV treatment seeking reduced due to the fear of going to health facilities since those ailments manifest similar symptoms as COVID 19. Government responded to COVID-19 using different strategies however the policy response resulted in both intended and unintended consequences especially for women and children in Ghana. It is recommended that national policy directions should ensure the continuous provision of child and maternal healthcare services which are essential health services during lockdowns.

Background: Leprosy and other skin neglected tropical diseases, including Buruli ulcer and yaws, remain significant public health challenges in Ghana. Despite control efforts, these conditions continue to cause disability, stigma, and social exclusion, particularly in rural and underserved communities. Misconceptions rooted in cultural and spiritual beliefs further delay care-seeking and reinforce discrimination. Objective: This study assessed community awareness, symptom recognition, and perceived causes of leprosy and other skin NTDs across four regions of Ghana, and examined how these varied by socio-demographic characteristics, to inform culturally appropriate interventions for early detection and stigma reduction. Methods: An analytical cross-sectional survey was conducted among 1,067 adults in Greater Accra, Eastern, Bono, and Savannah Regions of Ghana. Data were collected using structured questionnaires administered via Kobo Collect. Descriptive statistics summarized socio-demographic characteristics and outcome variables, including awareness, symptom recognition, and perceived causes of skin neglected tropical diseases. Associations between these outcomes and socio-demographic factors were assessed using chi-square tests, with statistical significance set at p ≤ 0.05. Results: Overall awareness of skin NTDs was high (75.6%) and was significantly associated with respondents’ educational level ( χ ² = 38.081, p < 0.001) and region of residence ( χ ² = 42.661, p < 0.001). Respondents with higher educational attainment and those from the Bono Region showed higher levels of awareness, whereas awareness was lowest among respondents from the Eastern Region. Symptom recognition was also assessed, with wounds (32.6%) and skin lesions (21.7%) being the most commonly identified manifestations. Perceived causes reflected a combination of biomedical and sociocultural explanations; bacterial infection and genetic factors were the most frequently reported causes, although supernatural beliefs remained prevalent, particularly among respondents with lower educational attainment. Conclusion: This study shows that community awareness, symptom recognition, and perceived causes of skin NTDs in Ghana differ across socio-demographic and regional contexts. Interventions should prioritize communities and population groups with lower awareness, strengthen education on early skin NTD symptoms and their biomedical causes, and engage local leaders to address misconceptions and stigma, thereby improving early detection and timely healthcare-seeking.