Pregnancy options counselling in Ghana: A case study of women with unintended pregnancies in Kumasi metropolis, Ghana

Abstract Background Unintended pregnancies have significantly contributed to maternal deaths and illnesses globally. Although good clinical practices show that options counselling enable clients to make informed decisions for healthy pregnancy outcomes, studies on this practice remain a grey area in Ghana. Aim of the study The study examines proportions of women exposed to pregnancy options counselling before decision-making, effects of counselling on pregnancy outcomes and associations between women characteristics and counselling. Methods Analytical cross-sectional study design was done in selected specialised public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April, 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analysed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study. Results Respondents had divergent reproductive and socio-demographic profiles. Majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counselling was observed to be significantly associated with parity (P= <0.001), gestational age (P= <0.001), previous induced abortions (P= <0.001), perception of pregnancy at conception (P= <0.001) and level of education (P= 0.002). The logistic regression analysis also shows that higher education has statistically significant effect on being exposed to options counselling (P= <0.001). Majority of respondents (95%) were not aware that giving a child up for adoption is an option to pregnancy crisis management. Conclusions Pregnancy options counselling remains a major challenge in some Ghanaian health facilities as evident by the study results. Multi-sectorial collaboration for education on pregnancy options counselling and further research to assess the type and depth of counselling services provided pregnant women in health facilities is recommended to inform reproductive health policy and program decisions.

Download Full-text

Pregnancy options counselling in Ghana: A case study of women with unintended pregnancies in Kumasi metropolis, Ghana

10.21203/rs.2.13062/v2 ◽

2019 ◽

Author(s):

Evans Kofi Agbeno ◽

Fred Yao Gbagbo ◽

ESK Morhe ◽

Soale Issah Maltima ◽

Kwadwo Sarbeng

Keyword(s):

Cross Sectional Study ◽

Induced Abortion ◽

Health Facilities ◽

Chi Square ◽

Cross Sectional ◽

Kwame Nkrumah ◽

Unintended Pregnancies ◽

Informed Decisions ◽

Study Results ◽

Methods Analytical

Abstract Background Pregnancy crisis mismanagement has contributed to maternal deaths and illnesses globally and in Ghana due to absence/inadequate pregnancy options counselling for clients to make informed decisions. Aim of the study This study examines options counselling for abortion seekers in health facilities in Ghana. Methods Analytical cross-sectional study design was done in selected specialised public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April, 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analysed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study. Results Respondents had divergent reproductive and socio-demographic profiles. Majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counselling was observed to be significantly associated with parity (P = <0.001), gestational age (P = <0.001), previous induced abortions (P = <0.001), perception of pregnancy at conception (P = <0.001) and level of education (P = 0.002). The logistic regression analysis also shows that higher education has statistically significant effect on being exposed to options counselling (P = <0.001). Majority of respondents (95%) were not aware that giving a child up for adoption is an option to abortion in Ghana. Conclusions Pregnancy options counselling remains a major challenge in comprehensive abortion care in Ghana. Although higher educational attainments significantly exposes women to options counselling for informed decisions, the less educated are disadvantaged in this regard. Further research on type and depth of counselling services provided to pregnant women in health facilities is required to inform health policy and program decisions.

Download Full-text

Pregnancy options counselling in Ghana: A case study of women with unintended pregnancies in Kumasi metropolis, Ghana

10.21203/rs.2.13062/v3 ◽

2019 ◽

Author(s):

Evans Kofi Agbeno ◽

Fred Yao Gbagbo ◽

ESK Morhe ◽

Soale Issah Maltima ◽

Kwadwo Sarbeng

Keyword(s):

Cross Sectional Study ◽

Induced Abortion ◽

Health Facilities ◽

Chi Square ◽

Cross Sectional ◽

Kwame Nkrumah ◽

Unintended Pregnancies ◽

Informed Decisions ◽

Study Results ◽

Methods Analytical

Abstract Background Pregnancy crisis mismanagement has contributed to maternal deaths and illnesses globally and in Ghana due to absence/inadequate pregnancy options counselling for clients to make informed decisions. This study examines options counselling for abortion seekers in health facilities in Ghana. Methods Analytical cross-sectional study design was done in selected specialised public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April, 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analysed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study. Results Respondents had divergent reproductive and socio-demographic profiles. Majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counselling was observed to be significantly associated with parity (P= <0.001), gestational age (P= <0.001), previous induced abortions (P= <0.001), perception of pregnancy at conception (P= <0.001) and level of education (P= 0.002). The logistic regression analysis also shows that higher education has statistically significant effect on being exposed to options counselling (P= <0.001). Majority of respondents (95%) were not aware that giving a child up for adoption is an option to abortion in Ghana. Conclusions Pregnancy options counselling remains a major challenge in comprehensive abortion care in Ghana. Although higher educational attainments significantly exposes women to options counselling for informed decisions, the less educated are disadvantaged in this regard. Further research on type and depth of counselling services provided to pregnant women in health facilities is required to inform health policy and program decisions.

Download Full-text

Pregnancy options counselling in Ghana: a case study of women with unintended pregnancies in Kumasi metropolis, Ghana

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2598-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Evans Kofi Agbeno ◽

Fred Yao Gbagbo ◽

E. S. K. Morhe ◽

Soale Issah Maltima ◽

Kwadwo Sarbeng

Keyword(s):

Cross Sectional Study ◽

Induced Abortion ◽

Health Facilities ◽

Chi Square ◽

Cross Sectional ◽

Kwame Nkrumah ◽

Unintended Pregnancies ◽

Informed Decisions ◽

Induced Abortions ◽

Comprehensive Abortion Care

Abstract Background Pregnancy crisis mismanagement has contributed to maternal deaths and illnesses globally and in Ghana due to absence/inadequate pregnancy options counselling for clients to make informed decisions. This study examines options counselling for abortion seekers in health facilities in Ghana. Methods Analytical cross-sectional study design was done in selected specialised public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April, 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analysed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study. Results Respondents had divergent reproductive and socio-demographic profiles. Majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counselling was observed to be significantly associated with parity (P = < 0.001), gestational age (P = < 0.001), previous induced abortions (P = < 0.001), perception of pregnancy at conception (P = < 0.001) and level of education (P = 0.002). The logistic regression analysis also shows that higher education has statistically significant effect on being exposed to options counselling (P = < 0.001). Majority of respondents (95%) were not aware that giving a child up for adoption is an option to abortion in Ghana. Conclusions Pregnancy options counselling remains a major challenge in comprehensive abortion care in Ghana. Although higher educational attainments significantly exposes women to options counselling for informed decisions, the less educated are disadvantaged in this regard. Further research on type and depth of counselling services provided to pregnant women in health facilities is required to inform health policy and program decisions.

Download Full-text

BARRIERS TO IMPLEMENTATION OF NURSING PROCESS AMONG NURSES WORKING IN NAROK COUNTY REFERRAL HOSPITAL

Journal of Health, Medicine and Nursing ◽

10.47604/jhmn.1145 ◽

2020 ◽

Vol 5 (4) ◽

pp. 15

Author(s):

Anna Saretin Lekenit ◽

Ruth G. Gatere ◽

Agnes K. Mutinda

Keyword(s):

Work Experience ◽

Statistical Significance ◽

Cross Sectional Study ◽

Referral Hospital ◽

Unique Contribution ◽

Nursing Process ◽

Chi Square ◽

Cross Sectional ◽

Process Implementation ◽

Study Results

Purpose of the study: This study therefore assessed barriers of nursing process implementation by Narok County Referral Hospital nurses. Methodology: A descriptive cross sectional study design was used to collect data from 102 randomly sampled nurses in NCRH. The study instruments used were self-administered questionnaires and key informant interview. SPSS version 20.0 was used to analyze quantitative data and sample characteristics were analyzed using mean and median. Themes were used to analyze qualitative data and narratively presented. Association between the study variables was calculated using chi square at 95% level of significance while statistical significance of results obtained was calculated using p values of 0.05. Data analysis was presented using tables and graphs. Approval was sought from relevant authorities. Results: The study results revealed that female participants were the majority at (70.6%). Most participants (71.6%) had attained diploma level of education and among them, 92.2% had received training in nursing process. Majority 95 (93.2%) were observed not to implement nursing process and of those who implemented, only 1 (1%) correctly outlined all the steps, a sign of poor nursing process implementation. NP implementation was of statistical significance with age of nurses as 18 out of 29 of younger nurses aged 21-30 years were found to actively practice it (p =0.001, work experience (p = 0.001), training (p > 0.05): institutional factors (p = 0.001). Unique contribution to theory, practice and policy: Nursing process mainstreaming interventions such as regular staff refresher courses and mentorship On NP in the hospitals, availability of relevant resources: human resource and supplies can highly mitigate these barriers.

Download Full-text

Physicians and communities knowledge and awareness about new vaccines in immunization program: A study to derive lesson for increasing uptake

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i1.3222 ◽

1970 ◽

Vol 8 (1) ◽

pp. 51-56 ◽

Cited By ~ 1

Author(s):

C Lahariya ◽

J Khandekar ◽

AS Vachher ◽

SK Pradhan

Keyword(s):

Hepatitis B ◽

Structured Interview ◽

Cross Sectional Study ◽

Health Facilities ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Knowledge And Attitude ◽

New Vaccines

Background: The knowledge, attitude of physicians about any interventions has effect on the practices while the perceptions about such intervention by caregivers have impact on the acceptance in community. Objectives: This study was conducted to assess the knowledge and attitude of physicians and perception of the caregivers about new vaccines, and to identify the solutions to address the knowledge gap, if any. Materials and methods: A cross sectional study was conducted a major city of India from Sept 2006-Jan 2007. 107 physicians and 298 caregivers were interviewed using a pre-tested semi structured interview schedule. The data so collected was analyzed using chi square test and proportions. P value of less than 0.05 was considered statistically significant. Results: It was found that only 3/5th physicians were aware that typhoid vaccination was part of the immunisation program. The knowledge about all the aspects of typhoid was poor amongst physicians in comparison of other vaccine (Hepatitis B) in the immunisation program. Physicians at private health facilities had poor knowledge than those working at government health facilities. However, majority of the physicians had positive attitude towards typhoid vaccination. All the caregivers had heard about typhoid disease and 39.8% about the vaccine also. Almost 80% of them were ready to pay for typhoid vaccination. Conclusions: The study underlines the need for special efforts to increase the awareness about typhoid vaccination amongst these groups to increase the uptake of the vaccine. Key words: Child Health; Hepatitis B, India; Newer vaccines; Typhoid DOI: 10.3126/kumj.v8i1.3222 Kathmandu University Medical Journal (2010), Vol. 8, No. 1, Issue 29, 51-56

Download Full-text

Assessment Of Knowledge Regarding The Dietary Practices Among Osteoarthritis Patients

Asian Journal of Allied Health Sciences (AJAHS) ◽

10.52229/ajahs.v6i1.793 ◽

2021 ◽

Author(s):

Maimoona Ashfaq ◽

Bahisht Rizwan ◽

Sana Farooq ◽

Anum Raheem ◽

Misbah Arshad

Keyword(s):

Sampling Technique ◽

Cross Sectional Study ◽

Public Health Issue ◽

Dietary Practices ◽

Chi Square ◽

Cross Sectional ◽

Level Of Education ◽

Study Results ◽

Progression Of Disease ◽

Chi Square Test

Osteoarthritis (OA) is a major public health issue, as it results in chronic pain, reduces physical function, and diminishes the quality of life. Awareness related to osteoarthritis is needed to improve the condition. Objective: To fnd out the knowledge regarding the dietary practices among osteoarthritis patients, visiting Sir Ganga Ram Hospital, Lahore. Methods: A cross-sectional study was conducted at Orthopedic and OPD Departments of the Sir Ganga Ram Hospital, Lahore, for 4 months. The data were collected through a pretested questionnaire from 100 osteoarthritis patients using the non-probability convenient sampling technique. Data were tabulated and analyzed with the help of SPSS version 24.0. Frequencies were calculated, and the Pearson chi-square test was applied. Results: The analysis revealed a significant association between level of education, knowledge regarding the dietary practices and progression of the disease. Conclusions: Based on the current study results, patient's level of education had significant association with knowledge, dietary practices, and joints pain and progression of disease among osteoarthritis patients. Majority of patients due to low knowledge about osteoarthritis have poor dietary practices.

Download Full-text

Why do married women procure abortion? Experiences from Ile-Ife, south western Nigeria

African Health Sciences ◽

10.4314/ahs.v21i1.42 ◽

2021 ◽

Vol 21 (1) ◽

pp. 327-37

Author(s):

Ibitola Eunice Ojo ◽

Temitope Olumuyiwa Ojo ◽

Ernest Okechukwu Orji

Keyword(s):

Focus Group ◽

Group Discussion ◽

Cross Sectional Study ◽

Induced Abortion ◽

Married Women ◽

Reproductive Age ◽

Group Discussions ◽

Cross Sectional ◽

Unintended Pregnancies ◽

Induced Abortions

Background: In Nigeria, about 1.25million induced abortions occur annually and the country accounts for one-fifth of abor- tion-related deaths globally. Objectives: The study aimed to assess the determinants of induced abortion among married women. Methods: A mixed methods study was conducted in Ile-Ife, Nigeria. The quantitative component employed a cross-sectional study design while the qualitative aspect comprised focus group discussions. Information on contraceptives use, unintended pregnancy and induced abortion were obtained from 402 married women (with at least one child) aged 18-49 years using a semi-structured questionnaire. Four focus group discussion sessions were conducted among women of reproductive age. Results: Majority (67.2%) of respondents had ever used a contraceptive method. However, 34.3% of the women have had un- intended pregnancies and 14.2% had induced abortion. FGD findings revealed that non-use of contraceptives and contraceptive failure were major reasons for unintended pregnancies and induced abortion. The significant predictors of induced abortion were non-use of contraceptives, age≥ 40 years and multiparity. Conclusion: Induced abortion still occur among married women particularly those not using contraceptives, aged ≥40 years and those with high parity. More emphasis should be placed on making contraceptives more accessible to married women. Keywords: Induced abortion; unwanted pregancies; married women; Nigeria.

Download Full-text

Disposal Practice of Unfit Medicines in Nongovernmental Hospitals and Private Medicine Outlets Located in Mwanza, Tanzania

Journal of Environmental and Public Health ◽

10.1155/2019/7074959 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Stanley Mwita ◽

Godfrey Ngonela ◽

Deogratias Katabalo

Keyword(s):

Social Sciences ◽

Management Practice ◽

Cross Sectional Study ◽

Storage Management ◽

Health Facilities ◽

Chi Square ◽

Cross Sectional ◽

Software Comparison ◽

Study Population ◽

Private Medicine

Introduction. For a medicine to qualify as safe and effective and to be of good quality, it should be properly labelled, stored, and transported. If a medicine is not handled properly, it ends up being unfit. Improper disposal of unfit medicines contributes to the appearance of their metabolites in the environment. Methods. A descriptive cross-sectional study was designed to capture quantitative data. The study was conducted in Mwanza region, Tanzania. The study population comprised nongovernmental hospitals and private medicines outlets in the region. The sample size was 111 facilities. This study was conducted between October 2013 and May 2014. The questionnaire was used to assess experience and challenges of dealing with unfit medicines. A review of waste management records was done to capture data of past disposal for unfit medicines. The coded data were analyzed using Statistical Package for Social Sciences (Version 20.0) computer analysis software. Comparison of proportions between groups was performed using Pearson’s chi square. Results. The majority of facilities (41.4%) used methods such as the pouring of unfit medicines into the sink and into the dustbin. About 60.4% of facilities were found with unfit medicines at the time of survey. Majority of unfit medicines found were antibiotics (64.1%). Almost 10% of health facilities maintained a register book for recording unfit medicines. Conclusion. There was improper disposal of unfit medicines in health facilities studied, whereby commonly reported methods of disposal were pouring into the sink and putting into the street dustbin. In private medicines outlets, there was poor storage management practice as some of the unfit medicines were left unpacked into boxes or separated from the usable medicines and not properly labelled.

Download Full-text

Determinants of EC Utilization among the Youth in the Tamale Municipality – A Cross-Sectional Study

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.09.01.art012 ◽

2021 ◽

Vol 9 (1) ◽

pp. 113-117

Author(s):

Abdul-Malik, Abdulai

Keyword(s):

Marital Status ◽

Unintended Pregnancy ◽

Sampling Technique ◽

Cross Sectional Study ◽

Northern Region ◽

Unprotected Sex ◽

Chi Square ◽

Cross Sectional ◽

Unintended Pregnancies ◽

Factors Influencing

Unintended pregnancy among the adolescent globally is very high. It poses serious health risk to them and must be addressed to save the young girls. The adolescent females are mostly in unstable relations and are most unlikely to be on regular contraceptives. Sex among them is sporadic and impromptu, hence they are unable to negotiate for safer sex, which sometimes results in unintended pregnancy. Emergency contraceptives remain the only option to prevent unintended pregnancies after unprotected sex. This study, therefore, sought to determine the factors that promote EC utilization among the Muslim youth in the Tamale metropolis of the Northern region of Ghana. A community-based cross-sectional design was adopted with a mixed method approach to collect both quantitative and qualitative data using a semi-structured questionnaire and FGD guide. A multi-staged sampling technique was used to select young Muslims, both males and females aged 15-24 years. Associated factors influencing EC use were determined using Chi-square (Chi2) and logistic regression at 95% CI and significant level set at p<0.05. Socio-demographics and socio-cultural factors influencing knowledge and utilization of EC among young Muslims were; age (OR = 22.28; 95% CI 2.97-171.85; p=0.001), marital status (OR = 0.56; 95% CI 0.34-0.93; p=0.030), education (OR = 0.19; 95% CI 0.05-0.66; p<0.001), and partner approval (OR=0.23; 95% CI 0.06-0.83; p = 0.020). Significant factors that determined EC utilization were age, educational level, marital status, and partner approval.

Download Full-text

Promoting evidence-based clinical practice for women in abortion situations after the implementation of a surveillance network: a situational analysis in a Brazilian university hospital

10.21203/rs.3.rs-967829/v1 ◽

2021 ◽

Author(s):

Nelio N. Veiga-Junior ◽

Caroline Eugeni ◽

Beatriz D. Kajiura ◽

Priscilla B. F. Dantas ◽

Caroline B. Trabach ◽

...

Keyword(s):

Medical Abortion ◽

Cross Sectional Study ◽

University Hospital ◽

Situational Analysis ◽

Evidence Based ◽

Clinical Practices ◽

Chi Square ◽

Surveillance Network ◽

Cross Sectional ◽

Vacuum Aspiration

Abstract Background Manual vacuum aspiration (MVA) and medical abortion (MA) can be used to treat women with abortion complications and the choice of the evacuation method is essential for the safe management of abortion. Objective to evaluate the frequency of use of MVA and MA and investigate the associated factors after the installation of a surveillance network of good practices (MUSA Network) in a university hospital in Brazil. Methods A cross-sectional study of women admitted for abortion at UNICAMP Women’s Hospital, Brazil, between July 2017 and November 2020. The dependent variables were the rates of MVA and MA. The independent variables were clinical and sociodemographic data. The Cochran-Armitage test, chi-square test, Mann–Whitney test and multiple logistic regression were used for statistical analysis. Results 474 women were included. Most women (91.35%) had undergone uterine evacuation: uterine curettage (78.75%), MVA (9.46%) and MA (11.54%). We observed a significant tendency toward an increase in the use of MVA (Z = 9.85; P <0.001). Factors independently associated with performance of MVA were admission in 2020 (OR 64.22; 95% CI 3.79–1086.69) and lower gestational age (OR 0.837; 95% CI 0.724–0.967). The only factor independently associated with MA was a higher level of education (OR 2.66; 95% CI 1.30-5.46). Conclusion the use of MVA increased after the installation of a surveillance network for good clinical practices. Being part of networks that encourage the use of evidence-based practices is an opportunity for health facilities to increase access to safe abortions.

Download Full-text