Predictors of burnout: the role of agency among obstetric providers in Kumasi, Ghana.

Burnout rates among sub-Saharan African healthcare providers are high. In particular, obstetric providers experience unique stressors surrounding poor neonatal and maternal outcomes. This study explores predictors of burnout among obstetric providers at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana.

The prevalence of self-reported medical comorbidities in patients with vulvar lichen sclerosus: A single-center retrospective study.

Objective: To compare the demographics and self-reported medical comorbidities of patients with vulvar lichen sclerosus (VLS) with those of women with other vulvar conditions.

Methods: Intake questionnaires for patients presenting to the University of Michigan Center for Vulvar Diseases between 1996 and 2019 were entered into a de-identified database (n = 1983). Responses to questions about thyroid disease, urinary symptoms and signs, gastrointestinal conditions, and pain conditions were collected.

Maternity waiting homes in Liberia: Results of a countrywide multi-sector scale-up.

Objective: Descriptions of maternity waiting homes (MWHs) as an intervention to increase facility delivery for women living in remote geographic areas dates back to the 1950s, yet there is limited information on the scale-up and sustainability of MWHs. The objective of this study was to describe the evolutionary scale-up of MWHs as a component of health system strengthening efforts and document the successes, challenges, and barriers to sustainability in Liberia.

Methods: Data were collected from a national sample of 119 MWHs in Liberia established between 2010-2018.

Is abortion justified to save the life or health of a woman? Evidence of public opinion from Accra, Ghana.

Objective: In this study, we sought to determine to what extent the abortion law in Ghana is reflective of public opinion.

Methods: In a cross-sectional, community-based survey, individuals in two fishing communities in Accra were interviewed about their beliefs on abortion between May and July 2016, and sociodemographic, attitudinal, and experience data were collected. Factors associated with the outcome variable (abortion is justified to save the life/health of the woman: Yes/No) were entered into a multivariate logistic regression.

Adapting a Sexual Violence Primary Prevention Program to Ghana Utilizing the ADAPT-ITT Framework.

Prevention of sexual violence among young people has become a priority area in Ghana, although few initiatives have focused on this topic. The ADAPT-ITT (ssessment, ecisions, dministration, roduction, opical experts, ntegration, raining staff, and esting) framework was used to systematically adapt an evidence-based sexual violence prevention program developed in the United States to a university in Ghana. Results from cognitive interviews, focus groups, beta testing, and topical experts indicate the adapted primary prevention program is promising for use in Ghanaian universities.

Toward a New Definition of Unmet Need for Contraception.

The current definition of unmet need for contraception assumes that all women who are using a method have a met need. We argue that without taking into account the level of satisfaction with a method, many women are classified as having a met need, when in fact they have an unmet need. They are using a method that does not meet their preferences, either because it causes side effects they find untenable or has other characteristics they do not like.

Achieving universal coverage: Understanding barriers to rural placement for final year midwifery students.

Objective: the objective of this study is to understand the barriers final year midwifery students face when deciding to practice in a rural, deprived area.

Design: a cross-sectional study design using a computer based structured survey.

Setting: 15 of the 16 publicly funded midwifery colleges across all ten regions in Ghana.

"My friend who bought it for me, she has had an abortion before." The influence of Ghanaian women's social networks in determining the pathway to induced abortion.

Background: Even given the liberal abortion law in Ghana, abortion complications are a large contributor to maternal morbidity and mortality. This study sought to understand why young women seeking an abortion in a legally enabling environment chose to do this outside the formal healthcare system.

Methods: Women being treated for complications arising from a self-induced abortion as well as for elective abortions at three hospitals in Ghana were interviewed.

When the baby remains there for a long time, it is going to die so you have to hit her small for the baby to come out": justification of disrespectful and abusive care during childbirth among midwifery students in Ghana.

Despite global attention, high levels of maternal mortality continue to plague many low- and middle-income settings. One important way to improve the care of women in labour is to increase the proportion of women who deliver in a health facility. However, due to poor quality of care, including being disrespected and abused, women are reluctant to come to facilities for delivery care.

Comparing Women's Contraceptive Preferences With Their Choices in 5 Urban Family Planning Clinics in Ghana.

Background: Concern about contraceptive side effects is a common reason reported by women for not using contraception or discontinuing use. We sought to characterize women's preferences related to method characteristics and side effects and to examine whether their adopted method was consistent with their stated preferences.

Methods: Between June 1, 2015, and August 31, 2015, we surveyed women attending 5 urban family planning clinics in Kumasi and Accra, Ghana, before and after their counseling sessions.

Quality of family planning counseling among women attending prenatal care at a hospital in Addis Ababa, Ethiopia.

Objective: To assess the quality of family planning counseling among women attending a prenatal clinic in Addis Ababa, Ethiopia.

Methods: In a descriptive cross-sectional study conducted between February and April, 2015, at the prenatal care clinic of Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, pregnant women in their third trimester were interviewed about their experience of family planning counseling. Data were collected via a questionnaire.

Attitudes toward abortion among students at the University of Cape Coast, Ghana.

Objectives: This study aimed to describe the attitudes toward abortion of Ghanaian University students and to determine factors which are associated with supporting a woman's right to an abortion.

Methods: This cross-sectional survey was administered to residential students at the University of Cape Coast. Participants were posed a series of 26 statements to determine to what extent they were supportive of abortion as a woman's right.

Exposure to disrespectful patient care during training: Data from midwifery students at 15 midwifery schools in Ghana.

Objective: to determine what midwifery students throughout Ghana were witnessing, perceiving, and learning with regard to respectful care during labour and childbirth.

Design: cross-sectional survey.

Setting: public midwifery schools in all 10 regions of Ghana.

The Relationship between Facility-Based Delivery and Infant Immunization in sub-Saharan Africa.

This study explored the relationship between facility-based delivery and infant immunizations in sub-Saharan Africa, controlling for economic development indicators. Publically available data were collected and imported into Stata 11.0 for descriptive, correlation, and regression analyses.

Barriers to Accessing Emergency Medical Services in Accra, Ghana: Development of a Survey Instrument and Initial Application in Ghana.

Background: Emergency medical services (EMS) systems provide professional prehospital emergency medical care and transportation to help improve outcomes from emergency conditions. Ghana's national ambulance service has relatively low public utilization in comparison with the large burden of acute disease.

Methods: A survey instrument was developed using Pechansky and Thomas's model of access covering 5 dimensions of availability, accessibility, accommodation, affordability, and acceptability.

What makes a likely abortion provider? Evidence from a nationwide survey of final-year students at Ghana's public midwifery training colleges.

Background: Even in countries where the abortion law is technically liberal, the full application of the law has been delayed due to resistance on the part of providers to offer services. Ghana has a liberal law, allowing abortions for a wide range of indications. The current study sought to investigate factors associated with midwifery students' reported likelihood to provide abortion services.

A case series study on the effect of Ebola on facility-based deliveries in rural Liberia.

Background: As communities' fears of Ebola virus disease (EVD) in West Africa exacerbate and their trust in healthcare providers diminishes, EVD has the potential to reverse the recent progress made in promoting facility-based delivery. Using retrospective data from a study focused on maternal and newborn health, this analysis examined the influence of EVD on the use of facility-based maternity care in Bong Country, Liberia, which shares a boarder with Sierra Leone - near the epicenter of the outbreak.

Methods: Using a case series design, retrospective data from logbooks were collected at 12 study sites in one county.

The role of short-term volunteers in a global health capacity building effort: the Project HOPE-GEMC experience.

Background: Increasingly, medical students and practicing clinicians are showing interest in traveling to low-income settings to conduct research and engage in clinical rotations. While global health activities have the potential to benefit both the individual and the host, there can be challenges. We describe one way to harmonize the desire of volunteers to have a meaningful impact on the health care delivery system in a developing country with the needs of that country.

Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana.

Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners.

Post-abortion contraception choices of women in Ghana: a one-year review.

Low rates of contraception in much of sub-Saharan Africa result in unplanned pregnancies, which in young, unmarried women often result in unsafe abortion. Increasing the use of highly effective forms of contraception has the potential to reduce the abortion-related mortality and morbidity. In this cross-sectional study, information collected by the post-abortion family planning counsellor was analysed.